成人先天性巨结肠的诊断与外科治疗  

Diagnosis and surgical management for adult Hirschsprung’s disease

作　　者：楼征[1] 孟荣贵[1] 于恩达[1] 刘连杰[1] 郝立强[1] 王汉涛[1] 傅传刚[1] 

机构地区：[1]第二军医大学长海医院普通外二科,上海200433

出　　处：《中华胃肠外科杂志》2005年第4期304-305,共2页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的探讨成人先天性巨结肠的诊断与外科治疗。方法回顾性分析1992年6月至2004年6月间收治的15例成人先天性巨结肠患者的临床资料。结果15例患者年龄17～54岁。入院前有9.5个月至50.0年(平均21.4年)的长期便秘、腹胀史;6例患者有急性腹痛史;均无脱水或营养不良表现。钡剂灌肠可见肠管狭窄段和扩张段。予以Soave手术2例,次全结肠切除加结肛吻合术13例;术后所有患者排便功能优良。结论自幼长期慢性便秘史和钡灌肠检查是诊断的主要依据;结肠次全切除加结肛吻合术是安全有效的手术方式。Objective To investigate the diagnosis and surgical management of adult Hirschsprung’ s disease. Methods Clinical data of 15 patients with adult Hirschsprung’ s disease were reviewed retrospectively from July 1992 to July 2004. Results Patients age ranged from 17 to 54 years old. The main manifestations included long- term(ranged from 9.5 month to 50 years) constipation and abdominal distention. Acute abdominal pain occurred in six patients,but no sign of dehydration and malnutrition occurred in all patients. Bowel stenosis and dilation could be examined by barium enema. Soave procedure was performed in 3 patients, subtotal colectomy with coloanal anastomosis was performed in twelve patients. The function of defecation was improved in all patients after operation. Conclusions The diagnosis of adult Hirschsprung’ s disease mainly depends on the history of constipation from infant and barium enema. Subtotal colectomy with coloanal anastomosis is an effective and safe operative procedure.

关 键 词：成人先天性巨结肠 外科治疗 诊断 2004年6月 SOAVE手术 结肛吻合术 结肠次全切除 1992年 回顾性分析 全结肠切除 钡灌肠检查 临床资料 患者年龄 长期便秘 急性腹痛 不良表现 肠管狭窄 钡剂灌肠 排便功能 慢性便秘 手术方式 

分 类 号：R656.9[医药卫生—外科学]