慢传输性便秘的外科治疗的疗效分析

Curative effect analysis of surgical treatment for slow transit constipation

目的 分析慢传输性便秘 (slowtransitconstipation ,STC)的临床特征、手术治疗效果及结肠的病理变化。方法 回顾性分析我院近 13年来手术治疗的 44例STC病例特点、手术方式及效果。结果 主要临床表现为排便间隔延长 ,平均为 1次 /4 .8～ 7.4d ,90 .9%的病人靠服用泻剂。本组病人结肠传输均明显减慢 ,72 .7%的病人伴有直肠内脱垂。大多数结肠存在肌间神经变性和黏膜炎症 ( 77.3 %、75 .0 %) ,44 .7%的结肠发生肌萎缩。所有病人术后恢复良好 ,83 .3 %( 2 5 /3 0 )病人在术后半年大便次数正常。

Objective To analyze the clinical characteristics, surgical outcomes, and pathological changes of patients with slow transit constipation (STC). Methods The characteristics, surgical approaches, and surgical outcomes of 44 STC cases undergoing colectomy in the past 13 years were analyzed retrospectively. Results The main clinical manifestation was infrequent defecation with a mean frequency of once per 4.8 to 7.4 d. About 90.9% patients depended on laxatives. Internal rectal prolapse was found in 72.7% patients. The major pathological changes included neural degeneration of myenteric plexus, chronic inflammation within mucosal layer, and atrophy of muscular layers. All patients recovered well, and 83.3% patients have a normal frequency of defecation 6 months after operation. Conclusion Total colectomy is an effective procedure for STC.