Soyer M T, Aldrete J S
Am J Surg. 1980 Sep;140(3):421-5. doi: 10.1016/0002-9610(80)90182-8.
Experience with 12 patients with toxic megacolon that required surgical intervention is described and analyzed. Ten patients had ulcerative colitis and 2 had Crohn's colitis; 9 were treated with corticosteroids before operation. The diagnosis was established by radiologic studies, operative findings and examination of the surgical specimens. The operations performed in these patients were proctocolectomy and ileostomy in five, abdominal colectomy and ileostomy with preservation of the rectum in five, and loop ileostomy and colonic venting in two. All patients had prolonged and complicated recovery periods; 1 died in the postoperative period and 10 reassumed their pre-illness activities. A highly specific therapy program is proposed for managing patients with toxic megacolon.
本文描述并分析了12例需要手术干预的中毒性巨结肠患者的治疗经验。其中10例为溃疡性结肠炎患者，2例为克罗恩氏结肠炎患者；9例患者在手术前接受了皮质类固醇治疗。通过放射学检查、手术所见及手术标本检查确诊。这些患者接受的手术包括：5例行直肠结肠切除术及回肠造口术，5例行保留直肠的结肠切除术及回肠造口术，2例行袢式回肠造口术及结肠造瘘术。所有患者的恢复期均延长且病情复杂；1例患者在术后死亡，10例患者恢复了病前的活动能力。本文提出了一个针对中毒性巨结肠患者的高度特异性治疗方案。
