先天性巨结肠经肛门一期拖出术的评估  

Evaluation of One-Stage Transanal Endorectal Pull-Through for Hischsprung's Disease

作　　者：余世耀[1] 施诚仁[1] 励楚刚[1] 王捍平[1] 葛莉[1] 许德棣[1] 张驰[1] 

机构地区：[1]上海第二医科大学新华医院上海儿童医学中心小儿外科,上海200092

出　　处：《上海第二医科大学学报》2005年第1期80-81,88,共3页Acta Universitatis Medicinalis Secondae Shanghai

摘　　要：目的观察经肛门一期拖出术(TAS)治疗先天性巨结肠的近、中期并发症,并探讨其防治方法。方法先天性巨结肠患儿63例行TAS治疗,随访51例(81%),随访时间3月-4年结果术后1周内有肛周炎38例,小肠结肠炎5例,肛门黏膜外翻2例,吻合口狭窄2例,排便失禁2例。术后6个月,大便次数>5次/d有45例,1-3次/d有6例,随术后时间推延,大便次数逐渐减少。结论TAS的优点虽多,但仍存在小肠结肠炎、肛周炎、吻合口狭窄等并发症,长期疗效还有待于进一步随访。Objective To observe the clinical course and follow-up of pediatric patients who underwent one-stage transanal endorectal pull-through (TAS) procedures for Hischsprung's disease (HD) in the past 4 years. We review early and late postoperative complications,and propose efficient ways to control the complications. Methods Sixty-three patients with HD who underwent TAS were analysed. Fifty-one patients were followed 3 months to 4 years after operation. Results A total of 88.2% patients had postoperative complications such as perianatitis ( n = 38) , en-terocolitis (n =5) , extroversion of anal mucosa (n =2) , anal stenosis ( n = 2) , and 2 cases suffered from discontinuance of defecation. After 6 months of operation, 45 patients had more than 5 bowel movements per day, while 6 patients had 1 to 3 times per day. The frequency of defecation gradually declined postoperatively. Conclusion Transanal surgery (TAS) as a new operative procedure for HD has many distinct advantages, although it may have some complications such as enterocolitis, perianatitis, anastomosis stenosis,etc. The long-term outcome requires further follow-up.

关 键 词：先天性巨结肠 肛门Ⅰ期拖出术 术后并发症 治疗 患儿 肛门黏膜外翻 小肠结肠炎 肛周炎 

分 类 号：R726.5[医药卫生—儿科]