临床普外科电子杂志
臨床普外科電子雜誌
림상보외과전자잡지
Journal of General Surgery for Clinicians (Electronic Version)
2013年
3期
41-43
,共3页
乙状结肠冗长%便秘%诊断%外科治疗
乙狀結腸冗長%便祕%診斷%外科治療
을상결장용장%편비%진단%외과치료
Redundant sigmoid colon%Constipation%Diagnosis%Surgical treatment
目的：总结成人乙状结肠冗长症的诊断与外科手术治疗经验。方法对21例成人乙状结肠冗长症的临床资料进行回顾性分析。21例患者的主要症状均为顽固性便秘，其中15例（71%）有反复发作的腹痛、腹胀及肛门停止排气、排便等急性肠梗阻表现。21例中14例（67%）经X线钡剂灌肠透视确诊，7例（33%）经急症剖腹探查证实为本病。14例择期手术患者行乙状结肠切除一期肠吻合；7例急症手术患者中5例行乙状结肠扭转复位、减压及固定术，2例因肠管绞窄坏死、穿孔行乙状结肠部分切除，远端封闭、近端造瘘术。结果围手术期死亡2例。19例术后随访3年，14例择期手术患者疗效满意，5例急症手术患者仍出现反复发作的顽固性便秘。结论成人乙状结肠冗长症主要表现为顽固性便秘和反复发作的急性肠梗阻；X线钡剂灌肠可确诊；外科手术是治疗本病的有效措施。
目的：總結成人乙狀結腸冗長癥的診斷與外科手術治療經驗。方法對21例成人乙狀結腸冗長癥的臨床資料進行迴顧性分析。21例患者的主要癥狀均為頑固性便祕，其中15例（71%）有反複髮作的腹痛、腹脹及肛門停止排氣、排便等急性腸梗阻錶現。21例中14例（67%）經X線鋇劑灌腸透視確診，7例（33%）經急癥剖腹探查證實為本病。14例擇期手術患者行乙狀結腸切除一期腸吻閤；7例急癥手術患者中5例行乙狀結腸扭轉複位、減壓及固定術，2例因腸管絞窄壞死、穿孔行乙狀結腸部分切除，遠耑封閉、近耑造瘺術。結果圍手術期死亡2例。19例術後隨訪3年，14例擇期手術患者療效滿意，5例急癥手術患者仍齣現反複髮作的頑固性便祕。結論成人乙狀結腸冗長癥主要錶現為頑固性便祕和反複髮作的急性腸梗阻；X線鋇劑灌腸可確診；外科手術是治療本病的有效措施。
목적：총결성인을상결장용장증적진단여외과수술치료경험。방법대21례성인을상결장용장증적림상자료진행회고성분석。21례환자적주요증상균위완고성편비，기중15례（71%）유반복발작적복통、복창급항문정지배기、배편등급성장경조표현。21례중14례（67%）경X선패제관장투시학진，7례（33%）경급증부복탐사증실위본병。14례택기수술환자행을상결장절제일기장문합；7례급증수술환자중5례행을상결장뉴전복위、감압급고정술，2례인장관교착배사、천공행을상결장부분절제，원단봉폐、근단조루술。결과위수술기사망2례。19례술후수방3년，14례택기수술환자료효만의，5례급증수술환자잉출현반복발작적완고성편비。결론성인을상결장용장증주요표현위완고성편비화반복발작적급성장경조；X선패제관장가학진；외과수술시치료본병적유효조시。
Objective To summarize and to analyse the experiences of the diagnosis and surgical treatment of 21 patients with redundant sigmoid colon in adults. Methods A retrospective analysis on 21 patients with redundant sigmoid colon in adults was performed for the patients with redundant sigmoid colon in adults. The main symptoms of these patients were constipation in all cases, abdominal pain and distention without passing flatus and cacation in 71%.Diagnosis was made in 14 cases(67%)by the examination of barium enema and in 7 cases (33%) by the emergency operation. 14 patients underwent sigmoidectomy,7 did emergency operation of which 5 did resetting,decompression and ifxation of volvulus of sigmoid,2 did partial sigmoidectomy due to strangulation and perforation of sigmoid. Results Two patients died during perioperative period.Of 19 following-up patients,14 have a satisfactory result and 5 underwent emergency operation have intractable constipation time and again for 3-year following-up.Conclusion Intractable constipation and acute repetitious intestinal obstruction are the main clinical symptoms of redundant sigmoid colon in adults.The examination of barium enema under X-ray could determine the disease.Surgical operation is an most effective modality for the treatment of the patients with redundant sigmoid colon in adults.
