Perry-Woodford Zarah L, McLaughlin Simon D
St Mark's Hospital, Harrow.
Br J Community Nurs. 2009 Nov;14(11):502-6. doi: 10.12968/bjcn.2009.14.11.45037.
With the advent of new surgical techniques to manage colorectal disease, the number of ileoanal pouch operations has amplified and therefore increased numbers of pouch patients are being discharged into the community setting. Community nurses will now encounter the ileoanal pouch patient and may be required to manage related complications. Restorative proctocolectomy with ileoanal pouch anastomosis (RPC) has become established as the gold standard operation for patients with ulcerative colitis (UC) and selected patients with familial adenomatous polyposis (FAP). Using a reservoir constructed from small bowel as a substitute rectum is a medical triumph which in the majority of cases improves the quality of life for patients, not only by eradicating disease and preserving anal sphincter function but also by avoiding a permanent ileostomy. Recent investigation into the use of Medena catheterization for pouch dysfunction has found that it is tolerated in the long-term and is associated with satisfactory quality of life in pouch patients with outflow obstruction.
随着治疗结直肠疾病的新手术技术的出现,回肠肛管储袋手术的数量有所增加,因此越来越多的储袋患者出院后回归社区。社区护士现在会接触到回肠肛管储袋患者,可能需要处理相关并发症。保留肛门的直肠结肠切除术加回肠肛管吻合术(RPC)已成为溃疡性结肠炎(UC)患者和部分家族性腺瘤性息肉病(FAP)患者的金标准手术。使用小肠构建储袋作为替代直肠是一项医学成就,在大多数情况下,这不仅通过根除疾病和保留肛门括约肌功能,还通过避免永久性回肠造口术来提高患者的生活质量。最近对Medena导管插入术用于储袋功能障碍的研究发现,该方法在长期使用中耐受性良好,并且与有流出道梗阻的储袋患者令人满意的生活质量相关。