成人结肠冗长症的诊治(附42例分析)

目的：探讨成人结肠冗长症的诊断与围手术期处理经验，提高对该病的诊治水平。方法：回顾性分析42例成人结肠冗长症的临床资料，并作了随访观察。结果：32例患者（75．7％）有顽固性便秘，18例患者（42．9％）存在反复不完全肠梗阻，16例患者（38．1％）便秘与腹泻交替出现，以便秘为主。39例经X线钡剂灌肠透视确诊。急诊手术3例，择期手术39例。41例（97．6％）病理检查于镜下可见典型改变。42例均行不同长度的肠段切除，4例加行乙状结肠固定术。术后随访率为83．3％（35／42），28例症状消失，4例仍有症状，保守治疗有效果，3例再次手术，术后症状消失。结论：典型的病史和X线钡剂灌肠可确诊成人结肠冗长症，外科手术是治疗本病的最终有效措施。

Diagnosis and Surgical Treatment of Adult Dolichocolon Syndrome

Objective:To investigate and summarize the diagnostic and surgical experiences of 42 cases with adult dolichocolon. Methods:Clinical data of 42 cases with adult dolichocolon were retrospectively analysed.Results:The main manifestations were constipation(75.7%), obstruction(42.9%), contipation alternative with darrhea(38.1%).39 cases who were diagnosed by barium enema were given selective operation, and another 3 cases who got emergency operation. There were typical pathological changes under microscopy in the resected colon of 41 cases . Forty-two cases were all had single segment or 3-4 segments resection of dolichocolon. The follow-up rate was 83.3%(35/42). The syndrome disappeared in 28 cases, 4 cases had minor syndrome but effective with physical treatment, and 3 cases were given a second operation and recovered completely.Conclusion:Barium enema and history of disease are the main diagnostic methods, and operation is the last-effective treatment for dolichocolon.