The results of 2389 patients exmained by colonofiverscope in past nine years are reported. Polyps were found in 561 cases, including 1256 polyps in the large intestine and 82 polyps in the terminal ileum. All 1299 polyps were removed with biopsy forceps. Pathology demonstrated that there were 406 adenomas, including 89 atypical hyperplasia and 23 cases with malignant change and 932 non-canerous polyps with 102 atypical hyperplasia. Since adenoma is seen to be a precancerous change, the polypectomy by colonofiberscope , ecpecially atypical hyperplastic polyps may decrease morbidity of large intestinal cancer. Cancer associated with adenoma may be as high as 51.28%, so the recrudescence of polyps may possibly be found even afer the cancer removal. These data showed that an early discovery of small malignant adenoma is key to improve efficiency.
目的 探讨结肠癌和直肠癌并发肠穿孔的外科诊治方法。方法 分析13例结直肠癌并发肠穿孔患者的临床资料。结果 13例患者中4例行肿瘤所在肠段一期切除吻合术; 4例行一期病灶切除吻合术,近端肠段行外置双管造瘘术; 2例切除肿瘤所在肠段,近端行端式结肠造瘘术,远端行封闭(Hartmann)术; 3例行单纯肠造瘘术。术后并发症发生率为46.15%(6/13),手术死亡率为15.38%(2/13)。结论 重视对结直肠癌并发肠穿孔的认识及选择合适的手术方式是减少并发症、提高疗效的重要措施。
ObjectiveTo improve the efficacy of colon doublecontrast barium enema examination by using digital gastrointestinal machine and modified enema techniques. MethodsSixtyfour patients were examined on digital remote controlled gyration table, with oral coloncleansing preparation and selfmade disposable plastic bag. Results In 64 patients, up to 93.8% were found with none or little fecal materials in the cecum and ascending colon. 80% of the results were scored excellent, and 95% were accurate for making diagnosis. All the patients underwent the examination successfully. ConclusionDigital gastrointestinal machine examination combined with modified hypotonic doublecontrast barium enema is a simple, convenient and efficient way to clearly demonstrate colonic mucosa, and help increase the detection and diagnosis rate.
目的 探讨双吻合器法回肠储袋肛管吻合治疗溃疡性结肠炎的临床疗效。方法 回顾性分析采用双吻合器法回肠储袋肛管吻合治疗11例溃疡性结肠炎患者的临床资料。 结果 手术时间(4.5±1.7)h(2.5~6.0h), 出血量(470±120)ml (200~800ml),住院时间(16±5.9) d (14~27d)。所有患者均获随访,随访时间为(31.3±5.7)个月(6~42个月)。 随访期内肛门功能恢复满意;主要并发症包括切口相关并发症5例,腹痛伴间断便血4例,储袋炎4例,肠梗阻3例,吻合口漏1例。 结论 双吻合法回肠储袋肛管吻合是治疗溃疡性结肠炎的有效手段,合理选择手术时机及方式可有效降低术后并发症的发生。