疑难病杂志2018，Vol.17Issue(6)：580-584,5.DOI:10.3969/j.issn.1671-6450.2018.06.010
不同术式治疗慢传输型便秘的效果及对术后腹泻影响的比较
Comparison the curative effect of two operation method on slow transit constipation and postoperative diarrhea
摘要
Abstract
Objective To investigate the effect of modified Duhamel procedure and ileal sigmoid anastomosis ( ISA) on slow transit constipation and the effect on postoperative diarrhea. Methods The subjects were from the clinical data of 35 cases of slow transit constipation ( STC) admitted to surgery department of the PLA 202 Hospital from January 2010 to Decem-ber 2015. According to the different surgical method,the patients were divided into two groups. Group modified Duhamel pro-cedure ( Duhamel group) was 21 cases and group ileal sigmoid anastomosis ( Anastomosis group) was 14 cases. The duration of operation, blood loss, postoperative intestinal fistula, postoperative intestinal obstruction, WCS score, GIQLI score and other data were analyzed. The duration of operation, blood loss, postoperative intestinal fistula, postoperative intestinal ob-struction, WCS score, GIQLI score and other data were analyzed. Repeated measurements of variance were used to analyze the frequency of defecation in 2 groups of patients at before, 3 months, 6 months, 1 year and 2 years after operation. Results There was no significant difference between 2 groups in gender, age, the duration of constipation, the time of resuming flow of fluid after operation, postoperative drainage tube time, length of stay after surgery, postoperative intestinal fistula, incisional infection and postoperative intestinal obstruction (P> 0. 05). The operation duration and intraoperative blood loss in Duhamel group were greater than those in Anastomosis group, the difference was statistically significant ( t=2. 221, t=2. 332,P=0. 033, P=0. 026). The 2 types of operation can obviously improve the constipation of patients. There was significant differ-ence between the 2 groups in WCS score and GIQLI score before and after operation( t=16. 861, t=7. 108;t=13. 432, t=7. 628,all P=0. 000). The number of defecation in Duhamel group was significantly less than that in Anastomosis group after opera-tion,the difference was statistically significant (t=2. 238, t=2. 620, t=2. 471,P=0. 033, P=0. 014、, P=0. 020). Con-clusion Both modified Duhamel procedure and ileal sigmoid anastomosis have a good therapeutic effect on slow transit con-stipation. Although the modified Duhamel procedure duration and intraoperative bleeding will increase. However, from the long term results, the modified Duhamel procedure can reduce the number of patients with postoperative diarrhea and surgical effects better than subtotal colon ileal sigmoid anastomosis.关键词
改良Duhamel术/结肠次全切除回肠乙状结肠吻合术/慢传输型便秘/排便次数Key words
Modified Duhamel procedure/Subtotal colectomy with Ileosigmoidal anastomosis/Slow transit constipa-tion/Defecation frequency引用本文复制引用
辛建,初侃,徐国帅,刘洪涛,蔡相军..不同术式治疗慢传输型便秘的效果及对术后腹泻影响的比较[J].疑难病杂志,2018,17(6):580-584,5.基金项目
辽宁省自然科学基金指导计划项目(201602751) （201602751）
