家族性结肠息肉病两种术式的比较(1)
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【摘要】目的:比较两种术式(结肠直肠全切除永久性回肠造口术和离断肠系膜上动静脉全直肠肌鞘内回肠袋-肛管吻合术)治疗家族性结肠息肉病的疗效。方法:将60只SD大鼠随即分为两组,第一组采用结肠直肠全切除永久性回肠造口术治疗;第二组采用离断肠系膜上动静脉全直肠肌鞘内回肠袋-肛管吻合术治疗,观察两组大鼠术后7天及3个月的生存率。结果:两组大鼠术后7天生存率差异无统计学意义(χ2=0.12,P>0.05),术后3个月第二组大鼠生存率明显高于第一组(χ2=5.71,P<0.05)。结论:采用离断肠系膜上动静脉全直肠肌鞘内回肠袋-肛管吻合术治疗家族性结肠息肉病较结肠直肠全切除永久性回肠造口术疗效更好,且并发症较少,值得临床推广应用。
【关键词】家族性结肠息肉病;术式;回肠N形袋
doi:10.3969/j.issn.1006-1959.2010.09.121文章编号:1006-1959(2010)-09-2406-02
Comparison of 2 surgical approaches on treatment of familial polyposis coliHE Jie,HE Min
【Abstract】Objective:To compare curative effect of 2 surgical approaches which were 'total resection of colorectum with Permanent ileostomy' and 'cutting the superior mesenteric artery and vein and then making anastomosis of the ileum pouch and the anal canal within the muscular sheath of the rectum' on treatment of familial polyposis coli.Methods:60 rats were randomly divided into 2 groups with 30 rats in each group:'total resection of colorectum with Permanent ileostomy' treatment group and 'cutting the superior mesenteric artery and vein and then making anastomosis of the ileum pouch and the anal canal within the muscular sheath of the rectum' treatment group.Then to observe these rats survival rates on postoperative 7 days and 3 months.Results:The difference of 2 groups rats survival rates was not statistically significant onpostoperative 7 days (χ2=0.12,P>0.05);To compare secend group with first group,the secend group rats survival rate was higher(χ2=5.71,P<0.05).Conclusion:'Cutting the superior mesenteric artery and vein and then making anastomosis of the ileum pouch and the anal canal within the muscular sheath of the rectum' was a better surgical approach to familial polyposis coli.And it had less complication.The new surgical approach had an important application value in clinical practice.
【Key words】Familial polyposis coli (FPC);Surgical approach;N-shaped pouch in the ileum
家族性结肠息肉病(familial polyposis coli,FPC)属于腺瘤性息肉综合征,是一种常染色体显性遗传性疾病[1],全结肠与直肠均可有多发性腺瘤生长,多数腺瘤有蒂,乳头状较少见,息肉数从一百到数千个不等,直径0.3～5厘米大小不一,常密集排列,有时成串,其组织结构与一般腺瘤相似 ......
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