小肠短路术治疗病态肥胖症

Treatment of Morbid Obesity with Small Intestine Shunt Operation

过于肥胖是一种病态 ,它可以增加心、肺负担 ,引起心、肺疾病 ,高血压 ,下肢淋巴水肿 ,静脉淤滞 ,淤滞性皮炎等 ;还常伴有糖尿病、关节炎、痛风、月经紊乱和不育症。因而导致不同程度的劳力丧失和短寿。对病态肥胖症的治疗 ,一般先采取内科治疗法 ,包括用药 ,调节饮食和精神、心理方面的治疗。如果疗效不佳 ,才可考虑外科疗法。本文重点介绍了外科治疗中与小肠短路手术有关的一些问题。对于空肠 ,结肠端侧短路术、空肠 ,回肠端侧短路术、空肠 ,回肠端端短路术加回肠 ,结肠端侧吻合术 ,3种术式的优缺点作了详尽的比较。认为空肠 ,回肠端端短路术加回肠 ,结肠端侧吻合术是目前比较理想的术式。本文同时也对手术原理 ,手术适应证 ,禁忌证 ,围手术期准备 ,术后并发症以及疗效判定标准作出了详细的讨论。

Overweight is a kind of morbid that could heart,lung,hypertension lymphatic edema of lower extremity and venous stasis by inceasing heart and lung burden.It also combines with diabetes,arthritis,gout,disorder of menses and infertility and miht cause varied disability and short life-span.Its treatments are usually internal medicine combined with drugs,diet,spirit and psycology therapy otherwise surgical method is instead if its effect unsatisfied.The problems of small intestine shunts in surgical operation were mainly discussed in three methods in this paper and shortages and advantages of them also were discssed.The ideal operative method inight be end-end shunt of jejunum and ileum combined with end-side shunt of ileum and colon.The theory of operation,indication,contradiction,perioperative preparation,complication curative assessment were studied in detail.