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Abstract：
BACKGROUND: Neurogenic bowel dysfunction is a frequent consequence of spinal cord injury/disease (SCI/D). A colostomy is considered when conservative treatments fail [1, 2]. In the last year we observed several SCI/D persons with colostomy, admitted to our institution with multiple complications.
METHODS: We present four cases of SCI/D persons treated with Hartmann\'s procedure and admitted to our institution for pressure ulcer (PU) treatment. All patients underwent PU surgery with good results. All patients reported a subjective good evacuation setting. No one assumed laxative therapies at home. At admission, all patients underwent abdominal radiography that showed an important constipation, with cases of sub-occlusion or complete occlusion with gastroparesis. One person presented a parastomal, strangulated hernia and underwent hernia reduction and patch positioning around the stoma. During hospital stay, bowel management required an important administration of laxatives and frequent, almost daily, stoma washes.
CONCLUSIONS: Some considerations must be made regarding the use of traditional techniques in SCI/D people, such as Hartmann\'s, leaving a large part of the colon and the anatomical position of the stoma itself represent limitations to fecal progression and may cause constipation. A specific approach, tailored on the SCI/D patients\' characteristics, such as the one described by our group, should be considered. Even if colostomy has been performed, appropriate therapies and health education on how to manage the stoma are fundamental to prevent complications.
METHODS: We present four cases of SCI/D persons treated with Hartmann\'s procedure and admitted to our institution for pressure ulcer (PU) treatment. All patients underwent PU surgery with good results. All patients reported a subjective good evacuation setting. No one assumed laxative therapies at home. At admission, all patients underwent abdominal radiography that showed an important constipation, with cases of sub-occlusion or complete occlusion with gastroparesis. One person presented a parastomal, strangulated hernia and underwent hernia reduction and patch positioning around the stoma. During hospital stay, bowel management required an important administration of laxatives and frequent, almost daily, stoma washes.
CONCLUSIONS: Some considerations must be made regarding the use of traditional techniques in SCI/D people, such as Hartmann\'s, leaving a large part of the colon and the anatomical position of the stoma itself represent limitations to fecal progression and may cause constipation. A specific approach, tailored on the SCI/D patients\' characteristics, such as the one described by our group, should be considered. Even if colostomy has been performed, appropriate therapies and health education on how to manage the stoma are fundamental to prevent complications.
摘要：
背景：神经源性肠功能障碍是脊髓损伤/疾病（SCI/D）的常见后果。当保守治疗失败时考虑结肠造口术[1,2]。在过去的一年中，我们观察到一些SCI/D患者的结肠造口术，因多种并发症入院.
方法：我们介绍了4例接受Hartmann手术治疗的SCI/D患者，并进入我们的机构接受压力性溃疡（PU）治疗。所有患者均行PU手术，效果良好。所有患者都报告了主观良好的疏散设置。没有人在家里接受泻药治疗。入院时,所有患者都接受了腹部X线照相，显示出重要的便秘，伴有胃轻瘫的亚闭塞或完全闭塞的病例。一个人展示了一个准动物，绞窄疝，并在造口周围进行疝复位和补片定位。住院期间,肠道管理需要重要的泻药和频繁的管理，几乎每天,造口洗。
结论：必须考虑在SCI/D人群中使用传统技术，比如哈特曼，离开结肠的大部分和造口本身的解剖位置代表了对粪便进展的限制，并可能导致便秘。一个具体的方法，根据SCI/D患者的特征量身定制，比如我们小组描述的，应该考虑。即使做了结肠造口术,关于如何管理造口的适当治疗和健康教育是预防并发症的基础。
方法：我们介绍了4例接受Hartmann手术治疗的SCI/D患者，并进入我们的机构接受压力性溃疡（PU）治疗。所有患者均行PU手术，效果良好。所有患者都报告了主观良好的疏散设置。没有人在家里接受泻药治疗。入院时,所有患者都接受了腹部X线照相，显示出重要的便秘，伴有胃轻瘫的亚闭塞或完全闭塞的病例。一个人展示了一个准动物，绞窄疝，并在造口周围进行疝复位和补片定位。住院期间,肠道管理需要重要的泻药和频繁的管理，几乎每天,造口洗。
结论：必须考虑在SCI/D人群中使用传统技术，比如哈特曼，离开结肠的大部分和造口本身的解剖位置代表了对粪便进展的限制，并可能导致便秘。一个具体的方法，根据SCI/D患者的特征量身定制，比如我们小组描述的，应该考虑。即使做了结肠造口术,关于如何管理造口的适当治疗和健康教育是预防并发症的基础。
