什么是结肠造口术?

A colostomy is surgery to create an opening for the colon (large intestine) through the belly (abdomen). 结肠造口术可以是短期的(临时的)也可以是长期的(永久性的)。. 通常在肠道手术或受伤后进行. 大多数永久性结肠造口术是末端结肠造口术. Many temporary colostomies bring the side of the colon up to an opening in the abdomen.

During an end colostomy, the end of the colon is brought through the abdominal wall. 然后它可以像袖口一样转到下面. The edges of the colon are then stitched to the skin of the abdominal wall to form an opening called a stoma. 便便(粪便)从气孔流入附着在腹部的袋子或小袋. 在暂时性的环形结肠造口术中, a hole is cut in the side of the colon and stitched to a matching hole in the abdominal wall. 这在以后可以更容易地逆转. 这是通过从腹壁上切除结肠来完成的. 然后这些孔被关闭，这样大便就可以再次流过结肠.

为什么我可能需要结肠造口术?

结肠造口术 surgery may be needed to treat several different diseases and conditions. 这些包括:

• Birth defect, such as a blocked or missing anal opening, called an imperforate anus

• 憩室并发症. 这些是结肠上的小的鼓鼓囊囊. 它们在60岁以上的人群中很常见. 它们会被感染(憩室炎). 或者它们会导致严重出血，需要进行肠道手术.

• 炎症性肠病

• 结肠或直肠的损伤

• 部分或完全的肠或肠阻塞

• 直肠癌或结肠癌

• 会阴处的伤口或瘘管. 瘘管是身体内部部位之间的异常连接. 或者在内脏和皮肤之间. 女性的会阴是肛门和外阴之间的区域. 男性则在肛门和阴囊之间.

如果外科医生可以选择做临时结肠造口术，他们通常会这么做. Talk with your healthcare provider before surgery to see if your colostomy will be permanent or temporary. Some infections or injuries require giving the downstream bowel a rest with a colostomy so that it can heal. 然后再重新连接.

在某些情况下，外科医生可能需要做永久性结肠造口术. For instance, this may be advised if 癌症 is the cause and the rectum must be removed. 或者控制排便的直肠肌肉失灵.

From there, it travels to your small intestine and then to your large intestine, or colon. 几小时或几天后, the indigestible residue leaves the storage area of your rectum through your anus, 随着粪便. Poop typically stays loose and liquid during its passage through the upper colon. 在那里，水被吸收. 所以粪便在接近直肠时变得更坚固.

升结肠在你身体的右侧. 这里的粪便是液体，有点酸性，它含有消化酶. 横结肠穿过你的上腹部. And the 下行 and sigmoid colon go down the left side of your body to your rectum. 在左冒号中, 大便的液体会逐渐减少, 减少酸性, 含有更少的酶.

Where your colon is interrupted by the colostomy determines how irritating to the skin your poop output will be. 大便液体越多，酸性越强. And the more important it will be to protect your abdominal skin after a colostomy.

手术的风险是什么?

Getting a colostomy marks a big change in your life, but the surgery itself is not complex. It will be done under general anesthesia, so you will be asleep and feel no pain. 结肠造口术可以作为开放手术进行，只有一个主要切口. 也可以在腹腔镜下进行，有几个小切口.

和任何手术一样, the main risks for anesthesia are breathing problems and poor reactions to medicines. 结肠造口术还有其他手术风险:

• 出血

• 对附近器官的损害

• 感染

手术后的风险包括:

• 结肠造口口狭窄

• 引起肠道阻塞的疤痕组织

• 皮肤过敏

• 伤口开放

• 在切口处出现疝气

我该如何为结肠造口术做准备?

手术前, discuss your surgical and postsurgical choices with a healthcare provider and an ostomy nurse. 这是一位受过专门训练来帮助结肠造口推荐十大正规网赌平台的护士. 与造口推荐十大正规网赌平台见面也会有所帮助. This is a volunteer who has had a colostomy and can help you understand how to live with one. And, before or after your surgery, you may want to join an ostomy support group. You can find out more about such groups from the United Ostomy Associations of America or the American Cancer Society.

如果结肠造口术不是紧急手术, your healthcare team will give you specific presurgery instructions about diet and medicines. Follow all presurgery directions and contact your healthcare provider if you have questions.

在结肠造口术中会发生什么?

这取决于你为什么需要结肠造口术, 它将在结肠的四个部分之一产生:升结肠, 横向, 下行, 或乙状结肠.

• 横向结肠造口术. 这是在结肠的中间部分进行的. 这个口在上腹部的某处. 这种手术通常是暂时的. 这通常用于憩室炎, 炎症性肠病, 癌症, 堵塞, 受伤, 或者是先天缺陷. 在横向结肠造口术中, the poop leaves the colon through the stoma before reaching the 下行 colon. 你的造口可能有一个或两个开口. 一个开口是用来排泄的. The second possible stoma is for the mucus that the resting part of your colon normally keeps producing. 如果你只有一个造口，这种粘液会通过你的直肠和肛门.

• 提升结肠造口术. 这个在你的右侧腹部. 它只留下一小部分结肠活跃. It's generally done only when 堵塞 or severe disease prevents a colostomy further along the colon.

• 下行结肠造口术. 这是在腹部的左下方.

• 行乙状结肠. 这是最常见的类型. 它比下行结肠造口术低几英寸.

结肠造口术后会发生什么?

你可以在手术当天吃冰块. 你可能会在第二天得到清澈的液体. 有些人在结肠造口术后2天内进食正常.

正常的气孔湿润，呈粉红色或红色. When you first see your colostomy, it may look dark red and swollen, with bruises. 别担心. 几周后，颜色会变浅，瘀伤也会消失.

The bandage or clear pouch covering your colostomy right after surgery likely won't be the same type that you'll use at home. 你的结肠造口术会将结肠中的粪便排出到这个结肠造口袋或袋子中. 你的大便可能会比手术前更稀. Your poop consistency will also depend on what type of colostomy you have and how much of your colon is still active.

在医院里

结肠造口术需要住院约3天至一周. 如果结肠造口术是紧急情况，你的住院时间可能会更长. You'll learn to care for your colostomy and the appliance or pouch that collects your poop during your hospital stay.

你的护士会告诉你如何清洁你的口. 每天回家后用温水轻轻地洗一下. 然后轻轻地拍干或让该区域风干. 如果你看到一点血也不用担心.

利用你在医院的时间来学习如何照顾你的结肠造口术. 你需要穿紧身裤, 轻量级, 如果你做的是升结肠造口术或横结肠造口术，要随时保持引流袋. 有许多不同类型的袋子. 它们的价格各不相同，都是由防臭材料制成的.

Some people with a 下行 或乙状结肠 colostomy can learn over time to predict when their bowels will move and wear a pouch only when they expect a movement. They may also be able to master a process called irrigation to stimulate regular, 控制排便.

回家前, talk with an ostomy nurse or other expert who can help you try out the equipment you'll need. 什么效果最好取决于你做的是什么类型的结肠造口术, 你的口的长度, 你的腹部形状和结实度, 口附近有没有疤痕或褶皱, 还有你的身高和体重.

Sometimes the rectum and anus must be surgically removed, leaving what's called a posterior wound. 在医院里，你会用敷料和垫子盖住这个伤口. 你也可以洗坐浴. 这些都是浅层的温水浸泡. Ask your healthcare provider and nurse how to care for your posterior wound until it heals. 如果出现问题，请联系您的提供商.

在家里

The skin around your (pink) stoma should look like the skin on the rest of your belly. 但由于暴露在粪便中，尤其是松散的粪便，皮肤会受到刺激. 以下是一些保护皮肤的建议:

1. 确保你的眼袋和皮肤屏障开口的大小合适.

2. Change the pouch when it is about 1/3 full to prevent leakage and skin irritation. 不要等到你的皮肤开始发痒和灼烧.

3. 轻轻地移除眼袋系统，将皮肤推开而不是拉.

4. Barrier creams may be used if the skin becomes irritated despite these measures.

如果你有以下任何一种情况，告诉你的医疗保健提供者:

• 持续2小时以上的严重痉挛

• 造口阻塞或塌陷

• Excessive bleeding from the stoma or a moderate amount of blood in the pouch (Note: eating beets will lead to some red discoloration in the poop)

• 严重损伤或切到口

• 持续的皮肤刺激

• 持续的恶心或呕吐

• 难闻或不寻常的气味持续超过一周

• 改变你的口的大小或颜色

• 阻塞或鼓胀的气孔

• 水样便便超过5小时

• 无法戴袋2至3天没有泄漏

• 任何与你有关的异常情况

一个好的规则是当你的袋子有1/3到1/2满的时候清空. 在袋子漏出来之前把它换掉. 不同的袋装系统可以维持不同的时间长度. 这可以是每天到每周的任何时间. Ask your healthcare team about what financial resources may be available if you need help paying for colostomy supplies.

结肠造口术是一个很大的改变. 这需要一些调整. 即使你能感觉到你的眼袋贴着你的身体，其他人也看不见它. 不要觉得有必要向每个人解释你的结肠造口术. 你想分享多少就分享多少.

对一些人和他们的直系亲属来说, 结肠造口术会导致抑郁症, 焦虑, 或者自尊问题. Ask for mental health resources if you or your immediate family is having a hard time adjusting to the surgery. 简单的解释就是你做了腹部手术. 考虑加入一个支持小组来帮助适应结肠造口术. 你的造口护士或医疗团队可以提供支持小组资源.