结肠慢传输型便秘42例分析

Colonic Slow Transit Constipation：Analysis of 42 Cases

为提高结肠慢传输型便秘的诊疗水平，对42例顽固性便秘患者的临床症状、纤维结肠镜检查、结肠传输试验和排粪造影等检查结果进行回顾分析。其中全结肠切除、回肠与直肠吻合术11例，次全结肠切除、盲肠与直肠吻合术29例，左半结肠切除2例。结肠慢传输型便秘的病理检查见肠壁神经丛有变性、减少。回直肠吻合术后患者大便次数偏多，多数〉3次／d，个别患者难以控制；行左半结肠切除术后的仍有排便困难；而盲直肠吻合术效果较好，多数患者大便1～3次／d。结果表明，结肠慢传输型便秘的患者行次全结肠切除，盲直肠吻合术效果较好。

The clinical data including symptoms, fibro colonoscopy, colonic transit text, defecography, etc. from 42 patients with intractable constipation were analized retrospectively in an attempt to improve the diagnosis ＆ treatment of colonic slow transit constipation. Of the 42 cases, 11 underwent total colectomy and ileorectal anastomosis,29 underwent subtotal colectomy and cecorectal anastomosis,and 2 cases underwent left hemicolectomy. Pathological examination showed degeneration ＆ reduction of nervous plexus of intestinal wall. In the patients undergoing ileorectal anastomosis, the frequency of defecation was more,more than 3 times per day in most of the cases,defecation incontinence were noticed in few cases. In the patients undergoing left hemicolectomy, dysporia was found. Generally, the therapeutic effect of cecorectal anastomosis was better,most of the 29 cases had defecation frequency of 1-3 times per day. It is suggested that subtotal colectomy plus cecorectal anastomosis is of better therapeutic effect.