CAJ | 학술논문

目的：探讨腹腔镜辅助结肠次全切除、经肛门取出标本治疗慢传输型便秘的临床应用价值。方法回顾性分析2013年2-11月间行腹腔镜辅助结肠次全切除、经肛门取出标本并进行升结肠直肠吻合术的8例慢传输型便秘患者的临床资料。采用Wexner便秘与失禁评分来评估术后便秘情况，采用胃肠生活质量评分来评估术后生活质量。结果全组患者手术完成顺利，无肠瘘、盆腔感染、吻合口狭窄、术后肠梗阻和肛门失禁等并发症发生。手术时间（287．6±21．5） min，术中出血量（109．7±41．1） ml，术后肛门排气时间（2．5±0．9） d。患者术后便秘症状评分为4.7±1.9，较术前的15.1±2.8明显降低（P＜0．05）。术后胃肠生活质量评分为97．3±15．7，较术前的71．5±14．7明显提高（P＜0．05）；术后Wexner便秘与失禁评分为8．8±3．7，较术前20．4±5．7明显降低（P＜0．05）。结论腹腔镜辅助结肠次全切除、经肛门取出标本并进行升结肠直肠吻合术治疗慢传输型便秘，近期疗效满意，生活质量改善明显。
목적：탐토복강경보조결장차전절제、경항문취출표본치료만전수형편비적림상응용개치。방법회고성분석2013년2-11월간행복강경보조결장차전절제、경항문취출표본병진행승결장직장문합술적8례만전수형편비환자적림상자료。채용Wexner편비여실금평분래평고술후편비정황，채용위장생활질량평분래평고술후생활질량。결과전조환자수술완성순리，무장루、분강감염、문합구협착、술후장경조화항문실금등병발증발생。수술시간（287．6±21．5） min，술중출혈량（109．7±41．1） ml，술후항문배기시간（2．5±0．9） d。환자술후편비증상평분위4.7±1.9，교술전적15.1±2.8명현강저（P＜0．05）。술후위장생활질량평분위97．3±15．7，교술전적71．5±14．7명현제고（P＜0．05）；술후Wexner편비여실금평분위8．8±3．7，교술전20．4±5．7명현강저（P＜0．05）。결론복강경보조결장차전절제、경항문취출표본병진행승결장직장문합술치료만전수형편비，근기료효만의，생활질량개선명현。
Objective To investigate the clinical application of laparoscopy-assisted subtotal colectomy with transanal specimen extraction for slow transit constipation(STC). Methods Retrospective analysis was performed on the clinical data of 8 cases with STC undergoing the procedure mentioned above from February to November 2013. Pre-and post-opertive constipation was assessed using Wexner Constipation and Incontinence Scales, and quality of life was assessed using Gastrointestinal Quality of Life Index. Results All the operations were completely successful without postoperative complications , such as intestinal fistula, pelvic infection, anastomotic stricture, intestinal obstruction. The Operative time was (287.6±21.5) min, blood loss was (109.7±41.1) ml, time to first flatus was (2.5±0.9) d. The proportion of postoperative constipation symptom index improvement was (77.6 ±8.3)%. Postoperative quality of life score was 97.3 ±15.7, significantly higher than that before operation (P <0.05). Postoperative Wexner constipation score was 8.8 ±3.7, significantly lower than that before operation. Conclusion Laparoscopy-assisted subtotal colectomy with transanal specimen extraction in the treatment of STC has good short-term efficacy with obvious improvement in quality of life.