结肠慢传输型便秘及其合并出口梗阻型便秘的诊治

Diagnosis and Treatment of Slow Transit Constipation Accompanied with Outlet Obstruction Constipation

目的：探讨结肠慢传输型便秘（STC）及合并出口梗阻型便秘（OOC）的诊断和外科治疗。方法：对顽固性便秘的病人根据临床表现结直肠及盆底动力学等检查的结果进行分析诊断。对48例确诊为STC的病人采用结肠切除术治疗，对其中27例伴有OOC的病人于结肠切除术同期或前期采用相应的手术治疗。结果：病理检查：结肠壁内神经丛均有变性。56.3％（27／48）STC患者伴有OOC。术后随访1～5年手术有效率为93．8％。结论：STC的外科治疗应根据结肠慢传输的病变程度、分布范围及是否合并OOC选择适合的手术方案。

Objective：To evaluate the diagnosis and treatment of slow transit constipation （STC） accompanied with outlet obstruction constipation （OOC）. Methods：Forty eight patients with colon STC, diagnosed by clinic manifestation and colorectal and pelvic floor dynamics, received colectomy. 56.3% （27/48） of patients accompanied with OOC received relevant operation at the same time or before colectomy. Results： Pathological finding suggested the nerve plexus in the intestinal wall of all the patients degenerated and decreased. Followed up for 1-5 years, satisfactory functional outcome was obtained in 93.8% of the patients received the operation. Conclusion：We should choose proper surgical procedure for the patients with STC based on severity, extension of STC and whether accompanied with OOC.