出口梗阻型便秘的外科治疗

目的　探讨出口梗阻型便秘 (outlet obstruction constipation,OOC)的诊断方法、手术指征及术式选择。方法　本组65例均经肛门指诊、排粪造影和结肠传输试验检查 ,术前获得诊断 :直肠前膨出 40例 ,直肠粘膜内脱垂或内套叠 42例 ,肛门内括约肌失弛缓症 2 3例 ,耻骨直肠肌肥厚 2 1例 ,盆底痉挛综合征 9例 ,盆底下降 9例 ,骶直分离 1 3例 ;根据检查结果分别采用 :直肠前膨出修补术、直肠粘膜固定术、直肠粘膜部分切除加固定术、肛门内括约肌部分切除术、耻骨直肠肌部分全切、耻骨直肠肌部分全切加闭孔内肌自体移植术。结果　治愈 5 9例 (90 .8% ) ,好转 4例 (6.1 % ) ,无效 2例 (3 .1 % )。结论　对出口梗阻型便秘患者必须进行肛门指诊、排粪造影和结肠传输试验三项基本检查 ,根据这三项检查一般都能明确诊断。手术疗效确切 ,但术式选择应根据三项具体检查结果而定

Diagnosis and Surgical Treatment of Outlet Obstruction Constipation

Objective In order to investigate the diagnosis, surgical sign and surgical methods of the outlet obstruction constipation(OOC) Methods 65 cases with outlet obstruction constipation had ben examined with underwent digital examination, colonic transit test and defcography Based on these medical examinations, patients were categorized as choosing the suitable operative management Results 59 cases(about 90.8%)were cured, 4 cases(about 6.1%)improved, and 2 cases(about 3.1%)of no effect Conclusion It is suggested that all patients with outlet obstruction constipation should be examined with underwent digital examination, colonic transit test and defcography The diagnosis of outlet obstruction constipation can be definitive, and the curative effect of the operation is reliable The choice of operation pattern should depend on the result of the three exams