CAJ | 학술논문

目的：探讨溃疡性结肠炎（ulcerative colitis，UC）的手术适应症和安全的手术方式。方法：回顾分析2008年1月—2013年1月在上海交通大学医学院附属仁济医院施行手术的36例 UC 患者的临床资料，对其手术方法及预后等进行分析。结果：36例中择期手术23例，急诊手术13例。23例择期手术均为一期全结直肠切除＋回肠贮袋肛管吻合术（ileal pouch-anal anas-tomosis，IPAA）；其中4例合并中毒性巨结肠患者通过急诊结肠镜下留置肠梗阻导管暂时缓解症状，再择期行 IPAA。13例急诊手术患者均一期行全结肠切除＋回肠造口术，二期行 IPAA。36例患者中除1例消化道穿孔、1例中毒性巨结肠及1例有腹部手术史的患者行开腹手术，其余33例患者均行腹腔镜手术。36例患者均无严重围手术期并发症发生。结论：对于 UC患者，应严格掌握手术适应证，合理选择安全有效的手术方式。UC 择期手术、急诊手术中行 IPAA，均安全有效。
목적：탐토궤양성결장염（ulcerative colitis，UC）적수술괄응증화안전적수술방식。방법：회고분석2008년1월—2013년1월재상해교통대학의학원부속인제의원시행수술적36례 UC 환자적림상자료，대기수술방법급예후등진행분석。결과：36례중택기수술23례，급진수술13례。23례택기수술균위일기전결직장절제＋회장저대항관문합술（ileal pouch-anal anas-tomosis，IPAA）；기중4례합병중독성거결장환자통과급진결장경하류치장경조도관잠시완해증상，재택기행 IPAA。13례급진수술환자균일기행전결장절제＋회장조구술，이기행 IPAA。36례환자중제1례소화도천공、1례중독성거결장급1례유복부수술사적환자행개복수술，기여33례환자균행복강경수술。36례환자균무엄중위수술기병발증발생。결론：대우 UC환자，응엄격장악수술괄응증，합리선택안전유효적수술방식。UC 택기수술、급진수술중행 IPAA，균안전유효。
Objective:To summarize the experience in surgical treatment for ulcerative colitis(UC).Methods:The clinical data of 36 patients with UC who underwent surgery in Renji Hospital,Shanghai Jiao Tong University School of Medicine from Jan 2008 to Jan 2013 were retrospectively analyzed.The surgical methods and prognosis were evaluated.Results:There were 23 ca-ses of selective operation which was total colectomy with ileal pouch-anal anastomosis(IPAA)in the first stage.Among the 23 cases,4 cases complicated with toxic megacolon were treated with intestinal obstruction catheter by endoscopy,and then under-went selective IPAA.There were 13 cases of emergency operation which was total colectomy with ileostomy in the first stage and IPAA in the second stage.Open surgery was done in 1 patient with perforation of digestive tract,1 patient with toxic mega-colon and 1 patient with history of abdominal operation,and laparoscopic surgery was done in the other 33 patients.None of the 36 cases had any severe perioperative complications.Conclusions:Indication of UC operation should be strictly controlled while safe operation method should be reasonably chosen.IPAA is a safe and effective method for selective operation and emergency surgery of UC.