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目的 探讨经肛门Ⅰ期巨结肠根治术治疗新生儿先天性巨结肠的方法和疗效。方法 采用单纯经肛门环形切开齿状线上方直肠粘膜、处理结肠系膜 ,拖出病变肠管并予以切除 ,经肛门Ⅰ期吻合的方法 ,治疗新生儿巨结肠 18例。并通过手术操作时间 ,术中出血量、术中盆腔污染、术后肠蠕动恢复时间、术后肛门狭窄率、粘连性肠梗阻发生率、病死率、肛门控便能力、病理符合率等 9项指标与采用传统手术治疗的对照组进行临床比较 ,测定、评估手术效果。结果 实验组手术时间短、术中出血少、术中盆腔无污染 ,术后肠蠕动恢复快 ,无术后并发症 ,与对照组相比较有显著性差异 (P <0 .0 1) ;实验组与对照组病理符合率基本相同 ,无统计学差异。结论 经肛门Ⅰ期巨结肠根治术是治疗新生儿先天性巨结肠一种全新术式 ;应用该术式治疗新生儿先天性巨结肠手术操作相对简捷 ,术后并发症少 ;术后患儿控便能力相对良好 ,患儿生活质量提高
Objective To investigate the method and effect of transanal stage Hirschsprung’s disease in treatment of neonatal Hirschsprung’s disease. Methods The upper rectal mucosa of the dentate line was cut through the anus ring only. The mesangial membrane was treated, and the diseased bowel was excised and resected. 18 cases of neonatal megacolon were treated by anal anastomosis. And through the operation time, intraoperative blood loss, intraoperative pelvic pollution, postoperative bowel recovery time, postoperative anal stenosis rate, the incidence of adhesive intestinal obstruction, fatality rate, anus control ability, pathological compliance rate of 9 The indexes were compared with the control group with traditional surgical treatment, and the results were evaluated and evaluated. Results The experimental group had shorter operative time, less intraoperative bleeding, no intraoperative pelvic pollution, faster recovery of postoperative peristalsis, and no postoperative complications compared with the control group (P <0.01). The experiment The coincidence rates of pathology in the group and the control group were basically the same, with no significant difference. Conclusions Transanal Ⅰ-stage megacolon radical surgery is a new type of surgical treatment of neonatal Hirschsprung’s disease. The surgical treatment of neonatal Hirschsprung’s disease is relatively simple and has few postoperative complications. Will be relatively good, improve the quality of life of children