中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
20期
22-24
,共3页
便秘%结直肠外科手术%改良Duhamel术
便祕%結直腸外科手術%改良Duhamel術
편비%결직장외과수술%개량Duhamel술
Constipation%Colorectal surgery%Modified Duhamel procedure
目的 对比分析结肠次全切除术联合改良Duhamel术与单纯结肠次全切除术治疗重度功能性便秘(SFC)的疗效及并发症.方法 2006年1月至2010年6月收治40例经过严格内科治疗后效果欠佳的SFC患者,按随机数字表法分为对照组和联合组,每组20例,分别施行单纯结肠次全切除术和结肠次全切除术联合改良Duhamel术治疗.随访6个月至2年,对比两组术后近期疗效及随访结果.结果 两组手术均获成功,术后肛门排气时间、住院时间、术后早期并发症和大便失禁等比较差异无统计学意义(P>0.05).联合组GIQOL评分[(110.5±5.0)分]、便秘症状改善度[(79.0±6.5)%]、便秘复发率[10.0%(2/20)]、排便频率满意率[85.0%(17/20)]、生活质量满意率[90.0%(18/20)]明显优于对照组[分别为(90.5±3.5)分、(60.5±2.8)%、35.0%(7/20)、15.0%(3/20)、20.0%(4/20)](P<0.05).结论 结肠次全切除术联合改良Duhamel术治疗SFC较单纯结肠次全切除术对于胃肠功能改善更明显,是较为合理、疗效较好的手术方案.
目的 對比分析結腸次全切除術聯閤改良Duhamel術與單純結腸次全切除術治療重度功能性便祕(SFC)的療效及併髮癥.方法 2006年1月至2010年6月收治40例經過嚴格內科治療後效果欠佳的SFC患者,按隨機數字錶法分為對照組和聯閤組,每組20例,分彆施行單純結腸次全切除術和結腸次全切除術聯閤改良Duhamel術治療.隨訪6箇月至2年,對比兩組術後近期療效及隨訪結果.結果 兩組手術均穫成功,術後肛門排氣時間、住院時間、術後早期併髮癥和大便失禁等比較差異無統計學意義(P>0.05).聯閤組GIQOL評分[(110.5±5.0)分]、便祕癥狀改善度[(79.0±6.5)%]、便祕複髮率[10.0%(2/20)]、排便頻率滿意率[85.0%(17/20)]、生活質量滿意率[90.0%(18/20)]明顯優于對照組[分彆為(90.5±3.5)分、(60.5±2.8)%、35.0%(7/20)、15.0%(3/20)、20.0%(4/20)](P<0.05).結論 結腸次全切除術聯閤改良Duhamel術治療SFC較單純結腸次全切除術對于胃腸功能改善更明顯,是較為閤理、療效較好的手術方案.
목적 대비분석결장차전절제술연합개량Duhamel술여단순결장차전절제술치료중도공능성편비(SFC)적료효급병발증.방법 2006년1월지2010년6월수치40례경과엄격내과치료후효과흠가적SFC환자,안수궤수자표법분위대조조화연합조,매조20례,분별시행단순결장차전절제술화결장차전절제술연합개량Duhamel술치료.수방6개월지2년,대비량조술후근기료효급수방결과.결과 량조수술균획성공,술후항문배기시간、주원시간、술후조기병발증화대편실금등비교차이무통계학의의(P>0.05).연합조GIQOL평분[(110.5±5.0)분]、편비증상개선도[(79.0±6.5)%]、편비복발솔[10.0%(2/20)]、배편빈솔만의솔[85.0%(17/20)]、생활질량만의솔[90.0%(18/20)]명현우우대조조[분별위(90.5±3.5)분、(60.5±2.8)%、35.0%(7/20)、15.0%(3/20)、20.0%(4/20)](P<0.05).결론 결장차전절제술연합개량Duhamel술치료SFC교단순결장차전절제술대우위장공능개선경명현,시교위합리、료효교호적수술방안.
Objective To compare postoperative outcomes and complications between subtotal colectomy combined with modified Duhamel procedure and simple subtotal colectomy for severe functional constipation (SFC). Methods Between January 2006 and June 2010,40 SFC patients after strict but inefficient nonoperative treatments were randomized by number table method to control group (20 cases, receiving simple subtotal colectomy) and combined group (20 cases,receiving subtotal colectomy and modified Duhamel procedure). The selection criteria were normal colonoscopy,and abnormal dynamic proctography (DPG). The functional outcomes after surgery were assessed from 6 months to 2 years period. Results The preoperative clinical manifestations of the two groups were similar. No statistically significant difference was observed between the two groups for time for recovery of the bowel function,length of postoperative hospitalization.and the early postoperative complications (P > 0.05). Functional outcomes of combined group with CIQOL score [(110.5 ±5.0) scores],relieving of costive gastrointestinal symptoms [(79.0 ±6.5)%], recurrent constipation rate [10.0% (2/20)], satisfaction rate of defecation frequency [85.0%(17/20)], satisfaction rate of quality of life[90.0%(18/20)] were significantly better than those of control group[(90.5 ± 3.5) scores, (60.5 ± 2.8)% ,35.0%(7/20), 15.0%(3/20),20.0%(4/20)](P< 0.05). Conclusion Combined application of subtotal colectomy and modified Duhamel procedure for SFC has better outcomes.
