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原發性便秘的外科治療

Clinical Value of Health Education Applied to Unhealthy Lifestyle-caused Functional Constipation

ObjectiveTo explore the clinical effect of healthy education on functional constipation caused by unhealthy lifestyle, and to analyze the disadvantages affecting the curative effect. MethodsA total of 167 cases of functional constipation from February 2009 to February 2012 were included. All of the patients were followed up for one year. We collected clinical data of curative effect and influencing factors, determined the clinical value of healthy education, and analyzed the influence of different factors on the curative effect of healthy education. ResultsThe total curative effect after one-year follow-up was 84.4%. The curative effect in elderly patients was significantly higher than that in middle-aged ones (P<0.05). The curative effect in urban patients was remarkably higher than that in rural ones (P<0.05). And the curative effect of patients with college degree wass much higher than that in patients with education background of primary school or below (P<0.05). ConclusionHealthy education has important value on releasing and eliminating functional constipation caused by unhealthy lifestyle. And it needs individual education aimed at patients with different age, education degree, and domicile.

老年患者便秘的臨床護理

【摘要】 目的 總結老年患者便秘的臨床護理方法。 方法 將2007年5月-2009年5月收治的70歲以上老年患者62例隨機分為對照組30例和觀察組32例，所有患者按臨床常規護理、調節飲食、增加活動量、腹部按摩，在此基礎上對照組口服溫脾湯，觀察組采用便秘灸穴位敷貼，觀察兩組排便情況及不適癥狀。 結果 觀察組不適癥狀明顯少于對照組，兩組治療效果。 結論 便秘灸治療老年患者便秘痛苦小、副作用少、使用方便，近期效果滿意。

The Change of Electromyophysiology of the Rat with Cathartic Colon

ObjectiveTo explore etiopathogenesis of slow transit constipation(STC). MethodsThe model of rat with “cathartic colon” was established, and the changes of colonic electromyography of the rat was examined. ResultsThe frequency and amplitude of slow wave in vivo of rats with cathartic colon was decreased markedly. Postmeal spike potential and duration was decreased, showing that gastrocolonic reflex of rats colon was decreased.ConclusionLong term abuse of stimulant laxuatives could damage enteric nervous system and accelerate the pathological changes of STC.

Advances in Surgical Treatment for Colon Slow Transit Constipation

Study on the Clinical Effect of Biofeedback Therapy for Functional Constipation

摘要:目的: 隨機對照研究、評估生物反饋訓練治療慢性功能性便秘的療效。 方法 : 60例慢性功能性便秘患者,隨機分為治療組30例和對照組30例。治療組接受1個療程(5周)生物反饋訓練治療(10次為一個療程、一次30～45分鐘、每周2次)。對照組患者接受聚乙二醇4000 10g BID 口服,療程5周。治療前后作便秘癥狀評分、結腸通過試驗檢測、直腸肛門壓力檢測。 結果 : 生物反饋訓練和聚乙二醇4000均可使多數慢性功能性便秘患者的大便次數、大便性狀及伴隨癥狀恢復正常或緩解,總有效率分別為667%和80%(P ＞005)。生物反饋訓練和聚乙二醇4000口服治療后,結腸通過試驗72小時標志物排出率分別為75%及73%,均較治療前明顯增加。生物反饋訓練治療后力排時肛門壓明顯下降。 結論 : 生物反饋訓練對出口梗阻型、慢傳輸型便秘均有效,是一種有效的、新興的治療慢性功能性便秘的方法,可作為功能性便秘的一線治療方法。Abstract: Objective: To assess the clinic effect of biofeedback therapy for functional constipation. Methods : Sixty cases of chronic functional constipation were randomly divided into treatment group (30 cases) and control group (30 cases). Cases in the treatment group were exposed to biofeedback for a fiveweeklong treatment course—individual treatment lasted for 3045 minutes and twice per week. Patients in the control group received PEG 4000 10g BID for five weeks. Data from constipation symptom score, colonic transit test, and anorectal manometry were done and compared before and after two kinds of treatments. Results : Biofeedback training and PEG 4000 could restore the stoolfrequency, stool characteristics and accompanying symptoms to normal or mitigation of the majority of patients with chronic functional constipation, with the total effective rates being 667% and 80% (P gt;005), respectively. After biofeedback training and PGE 4000 treatment, the discharge rate of 72hour markers of colonic transit test significantly increased to 75% and 73%, respectively. Additionally, anorectal pressure decreased dramatically after biofeedback training. Conclusion : Biofeedback training would play a positive role in outlet obstruction and slow transit constipation. Thus, it could be an effective firstline treatment of chronic functional constipation.

Dolichocolon with Colorectal Cancer: Report of 17 Cases and Review of The Literatures

目的總結結腸冗長癥合并結直腸癌的臨床病理特征，并文獻復習結腸冗長癥與結直腸癌的關系。 方法回顧性分析蘭州大學第一醫院普外一科2011年1月至2012年12月期間收治的17例結腸冗長癥合并結直腸癌患者的臨床資料。 結果184例結直腸癌患者中合并結腸冗長癥17例（9.24%），合并家族性息肉病惡變2例（1.09%），合并遺傳性非息肉病性結直腸癌1例（0.54%），合并炎癥性腸病1例（0.54%）。合并結腸冗長癥的比例較高（P＜0.05）。其中術前經結腸氣鋇灌腸檢查診斷為結腸冗長癥5例，術中診斷為結腸冗長癥12例。所有患者均行手術治療，切除結腸13～80 cm，平均33.8 cm。術后發生肺部感染、切口液化1例，腹水1例，腸瘺1例，骶前感染1例。術后17例患者均獲隨訪，隨訪時間6～12個月，中位數為10個月。隨訪期間，1例患者于術后1年出現卵巢轉移。 結論結腸冗長癥合并頑固性便秘可能是結直腸癌發病的高危因素。

乙狀結腸造瘺術后腸瘺手術的護理體會一例

Analysis of constipation status and influencing factors in patients with lung cancer during postoperative hospitalization

Objective To investigate the current status of constipation during postoperative hospitalization and the factors associated with moderate to severe constipation at discharge in lung cancer patients. Methods Lung cancer patients who underwent surgery in 6 tertiary hospitals in Sichuan Province from November 2017 to January 2020 were enrolled. The MD Anderson Symptom Scale-Lung Cancer Module was used to collect postoperative constipation scores. Unconditional logistic stepwise regression was used to analyze the related influencing factors for moderate to severe constipation on the day of discharge. Results Finally 337 patients were collected. There were 171 males and 166 females, with an average age of 55.0±10.3 years. Constipation scores of lung cancer patients increased from postoperative day 1 to day 3, and showed a decreasing trend from day 3 to day 7. Moderate to severe constipation was present in 68 (20.2%) patients at discharge. The postoperative hospital stay (OR=0.743, P<0.001) and the dose of morphine used during postoperative hospitalization (OR=1.002, P=0.015) were influencing factors for moderate to severe constipation at discharge in lung cancer patients. ConclusionLung cancer patients have the most severe constipation on postoperative day 3. Moderate to severe constipation at discharge is associated with the postoperative hospital stay and the dose of morphine used during postoperative hospitalization.

結腸透析治療慢性重癥乙型肝炎患者便秘及腹脹的護理

目的　總結結腸透析治療慢性重癥乙型肝炎患者便秘及腹脹的護理方法及療效。 方法　對2010年7月－2011年7月45例慢性重癥乙型肝炎合并便秘及腹脹患者結腸透析治療中，所采用的護理措施及效果進行回顧性分析。 結果　45例患者一個療程結束后，其中10例便秘及8例腹脹癥狀緩解顯著，13例便秘及10例腹脹癥狀有所緩解，2例便秘及2例腹脹患者癥狀無改善。 結論　結腸透析對治療慢性重癥乙型肝炎患者便秘及腹脹一定療效，是一條新的治療途徑。