结肠次全切除术治疗结肠慢传输性便秘48例的效果观察

Subtotal resection for the treatment of colonic slow transit constipation: Report of 48 cases

目的观察结肠次全切除术治疗结肠慢传输性便秘的临床疗效。方法选取2011年3月至2014年7月结肠慢传输性便秘患者共48例,进行结肠次全切除术治疗。观察患者手术治疗情况,对比患者术前及术后3个月的情况,数据经SPSS18.0进行统计学分析,手术前后排便情况、直肠肛管压力数据和直肠肛管协调运动功能用(x珋±s)表示,采用t检验;P<0.05差异有统计学意义。结果所有患者均顺利进行手术,术后并发症发生率10.4%(5/48)。患者术后3个月的腹痛程度评分、腹胀频率、腹痛频率、每日排便次数和Wexner便秘评分均显著低于术前,(t=4.435,9.794,7.918,60.528,44.886),P<0.01;治疗3个月后的静息压、肛管高压带、最大收缩压和收缩持续时间均显著高于治疗前(t=14.005,8.054,13.462,26.736),P<0.01;术后3个月的肛管松弛压、直肠排便压和肛管松弛率显著高于治疗前(t=15.160,11.500,19.584),P<0.01。差异均有统计学意义。结论结肠次全切除术治疗结肠慢传输性便秘可显著改善患者的临床症状,同时促进结直肠收缩功能的改善,值得临床推广。

Objective To observe the clinical efficacy of subtotal resection for the treatment of colon slow transit constipation. Methods From March 2011 to July 2014, 48 patients with slow transit constipation underwent colonic subtotal resection. Pre-and post-operative conditions of patients were analyzed and compared within 3 months. Statistical analysis was performed using the SPSS18.0 software. Measurement data including perioperative defecation and the movement and pressure of rectum and anal canal were expressed as mean ：t： SD and examined using Student＇ s t test. P 〈 0.05 was considered statistically significant. Results The 48 patients were subjected to surgical treatment, with a postoperative complication rate of 10.4% （5/ 48）. Three months after surgery, the score of postoperative pain, the frequency of bloating, the frequency of abdominal pain, bowel movements per day, and the score of Wexner constipation were significantly lower than those before surgery （t =4. 435, 9. 794, 7. 918, 60. 528, 44. 886 respectively, P 〈0.01 ）. Three months after surgery, the values of HPZ, MSP and DSS were significantly higher than those before treatment （ t = 14.005, 8. 054, 13. 462, 26.736, respectively, P 〈 0.01 ）. Three months after surgery, the values of RAP, IRP and ARR were significantly higher than those before treatment （t = 15. 160, 11. 500, 19. 584, respectively, P 〈 0.01）. Conclusion Subtotal colon resection in treating colon slow transit constipation could significantly ameliorate the patient＇ s clinical symptoms,thus promoting the improvement of colorectal rectal motor function.