巨结肠根治术后小肠结肠炎──有关高危因素分析  

Enterocolitis Following the Definitive Surgery for Hirschsprung's Disease: the Potential Risky Factors

作　　者：施诚仁[1] 佘亚雄[1] 蔡威[1] 许德棣[1] 华剑虹 张忠德[1] 

机构地区：[1]上海第二医科大学附属新华医院小儿外科,上海第二医科大学附属新华医院病理科

出　　处：《中华小儿外科杂志》1994年第6期340-342,共3页Chinese Journal of Pediatric Surgery

摘　　要：１９８２～１９９２年采用根治术治疗先天性巨结肠１０３例，其中１６例（６．４３％）发生术后小肠结肠炎。分析有关因素，发现性别、手术时年龄、无神经节细胞肠段长度及根治术类型等对其发生影响不大，但与吻合口狭窄及术前小肠结肠炎的发生、肠炎发作与再根治术之间间隔的时间密切有关。观察术中拖出结肠段的病理组织学改变，提示拖出肠段明显炎性改变是发生术后小肠结肠炎的病理基础，并对有关因素进行了讨论。From 1982 to 1992. 103 children with Hirschsprung's disease underwent definitive surgery. Sixteen of them developed postoperative enterocolitis. The sexual difference, the age of operation, the length of aganglionic intestine or the type of operation played no important role in the development of the postoperative enterocolitis of H. D.. However, the anastomosis stenosis was found to be a potentially risky factor. Daily dilatation has been safe and effective in the treatment of anastomosis stenosis. The time between a previous enterocolitis and the definitive operation was considered as another risky factor, because inflammatory infiltration in proper layer and Peneth cell metaplasia were found in the pullthrough stump in about 50% cases of enterocolitis in H. D.. It could be the pathological basis of entrocolitis following the definitive surgery, which should be preferably performed not earlier than 6 months after the preoperative enterocolitis.

关 键 词：巨结肠 先天性 小肠结肠炎 

分 类 号：R726.569[医药卫生—儿科]