Hill G L, Mair W S, Goligher J C
Br J Surg. 1975 Sep;62(9):720-6. doi: 10.1002/bjs.1800620912.
Ileostomy function was studied in 12 patients with an established ileostomy following proctocolectomy, in 6 of whom minimal amounts (less than 9 cm) and in 6 significant amounts (30-120 cm, mean 60 cm) of terminal ileum had been removed. Patients who had undergone significant ileal resection had daily faecal volumes considerably greater than those with minimal ileal resection (1202 +/- 284 ml versus 401 +/- 92 ml, P less than 0.001), and also greater daily outputs of sodium (146 +/- 53 mEq versus 43 +/- 12 mEq) and potassium (12.7 +/- 9.0 mEq versus 4.0 +/- 0.99 mEq). The percentage water content of the ileostomy fluid was greater in patients who had had the ileum resected (93.1 +/- 1.8% versus 89.8 +/- 2.5%). In addition, the sodium/potassium ratio in the urine in patients with a properly acting ileostomy after ileal resection was low. It is concluded that when recurrent inflammatory bowel disease, partial small bowel obstruction and intraperitoneal sepsis have been excluded there remains a number of patients whose high ileostomy output is due entirely to the amount of ileum resected. The management of patients with a high output ileostomy with codeine phosphate, Lomotil and oral administration of sodium chloride tablets is discussed.
对12例在直肠结肠切除术后已形成回肠造口术的患者的回肠造口功能进行了研究。其中6例切除了少量（小于9厘米）终末回肠，6例切除了大量（30 - 120厘米，平均60厘米）终末回肠。接受大量回肠切除的患者每日粪便量明显大于接受少量回肠切除的患者（1202±284毫升对401±92毫升，P＜0.001），每日钠（146±53毫当量对43±12毫当量）和钾（12.7±9.0毫当量对4.0±0.99毫当量）的排出量也更高。回肠切除患者的回肠造口液含水量百分比更高（93.1±1.8%对89.8±2.5%）。此外，回肠切除术后回肠造口功能正常的患者尿液中的钠/钾比值较低。得出的结论是，当排除复发性炎症性肠病、部分小肠梗阻和腹腔内感染后，仍有一些患者的高回肠造口排出量完全是由于回肠切除量所致。讨论了用磷酸可待因、洛哌丁胺和口服氯化钠片治疗高排出量回肠造口患者的方法。
