以难治性便秘为主要表现的儿童结肠冗长症诊断及治疗进展

Recent advances in the diagnosis and treatment of intractable constipation due to redundant colon in children

难治性便秘是指经保守治疗3个月无效的胃肠运动障碍性疾病,患儿常并发结肠冗长症。结肠冗长症表现为长期便秘和大量粪便潴留,进而造成肠道蠕动障碍,严重影响患儿生长发育及生活质量。通过灌肠造影可判断结肠定位及形态是否异常,结肠传输试验、肛门直肠测压、结肠测压、组织病理学检查可辅助诊断难治性便秘。目前,以难治性便秘为主要表现的结肠冗长症如长期保守治疗无效,应采取顺行节制性灌肠、骶神经刺激以及手术治疗。本文对以难治性便秘为主要表现的儿童结肠冗长症的诊断与治疗进展进行综述。

Children of intractable constipation present frequently with dilated and redundant colon leading to long-term fecal impaction and not responding to conventional treatments for over 3 months.As a result,bowel loses normal function.Intractable constipation may adversely affect the growth,development and even quality-of-life.In conjunctions with contrast enema for determining whether or not colon location and morphological changes are abnormal,colonic transit time,anorectal manometry,colonic manometry and pathological findings aid in differentiating bowel movement disorders for individualized comprehensive managements.If medically unmanageable,antegrade continence enema(ACE),sacral nerve stimulation(SNS)and surgical interventions may be adopted.