乙状结肠膀胱扩大术后脊髓损伤患者的排便状况变化

Comparison of bowel function pre and post-sigmoid augmentation cystoplasty in spinal cord injury patients

目的了解乙状结肠膀胱扩大术前后脊髓损伤患者排便情况的变化。方法收集2005年9月至2011年1月在北京博爱医院和南通大学附属医院进行乙状结肠膀胱扩大术的脊髓损伤患者的资料进行分析。结果30例患者入选本项研究，其中18例（60．0％）大便较术前变软，18例（60．0％）排便耗时较前减少。手术后患者大便性状、排便耗时有明显变短[由术前的（20．5±20．7）min下降为术后的（13．7±9．7）min]（P〈0．05），而且外伤性脊髓损伤同先天性脊髓栓系综合征患者相比排便耗时有明显减少[外伤性脊髓损伤患者由术前（38．7±20．6）min降为术后的（19．1±9．5）min，脊髓栓系综合征患者则由术前（10．3±6．4）min降为术后的（8．3±6．7）min，P〈0．05]。结论乙状结肠大部切除可改善脊髓损伤患者尤其是外伤性脊髓损伤患者的排便状况；对需进行膀胱扩大伴严重便秘的脊髓损伤患者建议行乙状结肠膀胱扩大术。

Objective To explore the changes of bowel function in spinal cord injury （SCI） patients undergoing sigmoid augmentation cystoplasty. Methods From September 2005 to January 2011, 30 SCI patients undergoing sigmoid augmentation cystoplasty were surveyed by follow-up questionnaires at Beijing Charity hospital and Affiliated Hospital of Nantong University. Results Among them, 18 cases （60. 0% ）believed their defecation became softer and 18 cases （60.0%）thought their defecation time became shorter. The postoperative profiles of patient defecation traits and defecation time were better （P 〈 0. 05）, especially traumatic SCI patients （ P 〈 0. 05 ）. Conclusions The subtotal resection of sigmoid colon improves the defecation of spinal cord injury patients. The SCI patients undergoing sigmoid augmentation cystoplasy may avoid urinary tract dysfunctions and improve bowel dysfunction.