Gendre J P, Pornin B, Cosnes J, Le Quintrec Y
Gastroenterol Clin Biol. 1985 Aug-Sep;9(8-9):578-82.
Fecal losses of water, electrolytes, fat and nitrogen were studied retrospectively in 42 cases (40 patients). To assess the role of the terminal ileum, patients were classified into 2 groups according to the length of resected and/or excluded ileum before the ileocecal junction; group I (n = 17; length less than or equal to 15 cm) and group II (n = 25; length ranging from 15 to 50 cm). In group I, fecal weight and fecal output of sodium, fat and nitrogen were (mean for 24 h) 544 g, 63 mmol, 6.5 g (6.4 p. 100 of ingesta), 2.94 respectively. In group II, fecal outputs were higher; (mean for 24 h) 862 g, 112 mmol, 10.9 g (14.2 p. 100 of ingesta), 4.2 respectively. These differences were statistically significant for fecal weight and fecal output of sodium (p less than 0.001) and for fecal output of fat when expressed as percentage of ingesta (p less than 0.02). These results show that the length of terminal ileum is a major determinant in fecal losses after ileostomy; therefore, it appears to be of major importance to preserve this segment of ileum as much as possible during ileocolic surgery.
对42例患者（40名病人）的粪便中水、电解质、脂肪和氮的流失情况进行了回顾性研究。为评估回肠末端的作用，根据回盲瓣之前切除和/或排除的回肠长度，将患者分为两组：第一组（n = 17；长度小于或等于15厘米）和第二组（n = 25；长度在15至50厘米之间）。在第一组中，粪便重量以及粪便中钠、脂肪和氮的排出量（24小时平均值）分别为544克、63毫摩尔、6.5克（占摄入物的6.4%）、2.94克。在第二组中，粪便排出量更高；（24小时平均值）分别为862克、112毫摩尔、10.9克（占摄入物的14.2%）、4.2克。粪便重量、粪便中钠的排出量（p < 0.001）以及以摄入物百分比表示的粪便中脂肪排出量（p < 0.02），这些差异具有统计学意义。这些结果表明，回肠末端的长度是回肠造口术后粪便流失的主要决定因素；因此，在回结肠手术中尽可能保留这一段回肠似乎至关重要。
