CAJ | 학술논문

目的：评价腹腔镜下金陵术治疗混合型顽固性便秘推广应用的有效性与安全性。方法回顾性分析2013年1月至2015年6月10例施行腹腔镜下金陵术治疗混合型顽固性便秘患者资料，采用胃肠生活质量评分、Wexner便秘评分和每日（周）完全自发排便（ SCBM ）所需时间来评估手术效果。所有数据分析应用SPSS 17．0统计软件完成。数据以x珋±s表示，手术前后各组均数比较采用One-Way ANOVA检验， P＜0．05有统计学意义。结果全组未出现手术相关性死亡。术后相关并发症4例，总并发症发生率40％。患者胃肠生活质量术前评分为（100．1±16．7）分，分别在术后3个月、6个月、12个月逐渐下降，24个月时为（19．6±4．8）分，与术前比较差异均有统计学意义（ P＜0．01）。 Wexner便秘评分由术前的（23．8±3．5）分降至术后3个月（7．7±2．1）分、6个月（5．3±1．9）分、12个月（5．0±1．7）分和24个月（4．8±1．8）分，与术前比较差异亦有统计学意义（P ＜0．01）；患者在术后早期均出现SCBM次数增多，多者可达10余次／d，随着时间的延长，排粪频次逐渐减少，6～12个月后大多减少至3～6次／d，但有2高龄患者排便在5～8次／d。结论腹腔镜下金陵术为混合型顽固性便秘的外科治疗提供了一种可推广的安全有效的术式选择。
목적：평개복강경하금릉술치료혼합형완고성편비추엄응용적유효성여안전성。방법회고성분석2013년1월지2015년6월10례시행복강경하금릉술치료혼합형완고성편비환자자료，채용위장생활질량평분、Wexner편비평분화매일（주）완전자발배편（ SCBM ）소수시간래평고수술효과。소유수거분석응용SPSS 17．0통계연건완성。수거이x류±s표시，수술전후각조균수비교채용One-Way ANOVA검험， P＜0．05유통계학의의。결과전조미출현수술상관성사망。술후상관병발증4례，총병발증발생솔40％。환자위장생활질량술전평분위（100．1±16．7）분，분별재술후3개월、6개월、12개월축점하강，24개월시위（19．6±4．8）분，여술전비교차이균유통계학의의（ P＜0．01）。 Wexner편비평분유술전적（23．8±3．5）분강지술후3개월（7．7±2．1）분、6개월（5．3±1．9）분、12개월（5．0±1．7）분화24개월（4．8±1．8）분，여술전비교차이역유통계학의의（P ＜0．01）；환자재술후조기균출현SCBM차수증다，다자가체10여차／d，수착시간적연장，배분빈차축점감소，6～12개월후대다감소지3～6차／d，단유2고령환자배편재5～8차／d。결론복강경하금릉술위혼합형완고성편비적외과치료제공료일충가추엄적안전유효적술식선택。
Objective To investigate the efficacy and safety of laparoscopic Jinling procedure in treating mixed refractory constipation . Methods The clinical data of 10 patients with mixed refractory constipation who underwent laparoscopic Jinling procedure from January 2013 to June 2015 were analyzed retrospectively .The clinical outcomes of the 10 patients were followed up , with regard to the gastrointestinal quality of life index ( GIQLI ) , Wexner constipation scale and spontaneous complete bowel movement (SCBM).Data analysis was performed by using SPSS 17.0 software.The data before and after surgery were shown as mean ± standard deviation, and were examined by one-way ANOVA.A P value <0.05 was considered statistically significant . Results There was no operation-associated death in these patients . Postoperative complications occurred in 4 patients, and the total incidence rate was 40%.GIQLI continued to decrease from (100.1 ±16.7 ) to (19.6 ±4.8 ) within 24 months after operation ( P<0.01).Wexner constipation scale decreased from (23.8 ±3.5 ) to (7.7 ±2.1 ) at 3 months, (5.3±1.9 ) at 6 months, (5.0 ±1.7 ) at 12 months, and (4.8 ±1.8) at 24 months during follow-up (P<0.01).Increased bowel movement frequency was observed postoperatively , and more than 10 times /d in some cases, the frequency of defecation was gradually decreased to 3-6 times /d at 6 to12 months after surgery.However, 2 of the elderly patients had 5-8 times/d of defecation at 12 months after surgery . Conclusion The laparoscopic Jinling procedure provides a safe and effective surgical treatment for mixed refractory constipation .