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结肠慢传输型便秘(STC)是临床上常见的、以腹胀及便意淡漠为主要症状的慢性顽固性便秘。近年来大量的临床和实验研究发现。(1)STC病人的结肠壁变薄、肌细胞空泡变性或脂肪变性、环肌萎缩,病变呈进行性过程。(2)肠壁问神经节细胞数量减少,排列紊乱,形态皱缩或轻度水肿,空泡变性;神经微丝和微管数量减少、排列紊乱。(3)肠壁内兴奋性神经递质(Ach、SP)减少,抑制性递质(VIP)含量有增高现象。(4)Cajal间质细胞(ICC)的分布和功能异常与肠动力障碍有密切关系,详细机理尚不清楚。根据研究资料,肠壁肌细胞和肌问神经丛的损害、神经递质的改变以及ICC的分布和功能异常是STC发病的关键环节,究竟什么原因引起这些病理改变,目前尚不清楚。因此,目的STC的预防尚无良策,治疗仍是一般性的保守治疗,包括:①粗纤维饮食;②在结肠高动力期(早晨起床后或早餐后)训练排便运动,改善排便体位(蹲位最佳);③加强腹肌和膈肌锻炼;①适当给予粪便软化剂和润肠剂;⑤上述治疗无效者给予低渗性药物、水灌肠或油剂保留灌肠。对保守治疗无效者给予手术治疗,目的理想的术式为全结肠切除,回一直肠吻合术和次伞结肠切除,盲一直肠吻合术。作者提出。在STC确诊后先用结肠壁活组织病理检查或电生理等检查。根据肠壁肌、肌间神经、ICC及神经递质的
Slow transit constipation (STC) is clinically common, with bloating and indifference as the main symptom of chronic refractory constipation. In recent years, a large number of clinical and experimental studies have found. (1) STC patients with thinning of the colon wall, myocytes vacuolar degeneration or steatosis, muscle atrophy, lesions were progressive process. (2) The numbers of ganglion cells in the intestine wall were decreased, disordered, morphologically contracted or slightly edematous, and vacuolar degeneration. The number of neurofilaments and microtubules was reduced and disordered. (3) The excitatory neurotransmitter (Ach, SP) in the intestinal wall decreased and the content of inhibitory transmitter (VIP) increased. (4) The distribution and dysfunction of Cajal interstitial cells (ICC) are closely related to intestinal motility disorders. The exact mechanism is not yet clear. According to research data, damage to the intestinal muscle cells and muscular plexus plexus, changes in neurotransmitter and the distribution and dysfunction of ICC are the key links in the pathogenesis of STC. It is not clear exactly what causes these pathological changes. Therefore, the purpose of the prevention of STC is no good policy, the treatment is still conservative treatment in general, including: ① crude fiber diet; ② in the colon during high motility (wake up in the morning or after breakfast) training defecation exercise to improve the defecation position Best); ③ strengthen the abdominal muscles and diaphragm exercises; ① appropriate to give stool softener and runchang agent; ⑤ ineffective treatment given to hypotonic drugs, water enema or oil retention enema. Surgical treatment of ineffective conservative treatment, the purpose of the ideal surgery for the whole colon resection, back to the total anastomosis and parachute resection, the total bowel anastomosis. The authors propose. After the diagnosis of STC with colon wall biopsy or electrophysiological examination. According to the intestinal wall muscle, myenteric nerve, ICC and neurotransmitter