先天性巨结肠及同源病患儿术后直肠肛管测压与分析  

Anorectal Manometry and Analysis of Patients after Surgery for Hirschsprung′s Disease and Hirschsprung′s Allied Disease

作　　者：吴晓娟[1] 魏明发[1] 郭先娥[1] 黎润光[1] 易斌[1] 冯杰雄[1] 覃宇冰[1] 宣晓琪[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院小儿外科,武汉430022

出　　处：《实用儿科临床杂志》2007年第23期1792-1793,1833,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的分析先天性巨结肠(HD)及同源病(HAD)术后患儿直肠肛管测压参数及其临床意义。方法对56例巨结肠术后患儿,包括32例HD和24例HAD,进行随访,并根据排便功能分为正常组、污粪组及便秘组。同时进行直肠肛管测压检查。根据不同病理分型,临床症状及随访时间比较分析测压结果。结果直肠肛管抑制反射(RAIR)重现率为55%,术后1a内RAIR重现率明显低于1a以上患儿(P<0.05)。HD术后患儿肛管直肠蠕动频率明显大于HAD(P<0.05)。按主观症状将患儿分为正常、污粪和便秘组,便秘组肛管/直肠静息压之比及高压带长度与前二组比较有显著差异(Pa<0.01)。结论部分患儿术后RAIR可恢复,并与术后时间有关,HD术后肛门功能改善优于HAD。影响术后测压结果的因素是多方面的。Objective To analyze the parameters of anorectal manometry of patients after surgical correction of Hirschspnmg＇s Disease （HD） and Hirschsprung＇s Allied Disease（HAD） associated with the clinical feature. Methods Fifty - six patients after operation,including 32 cases with HD and 24 cases with HAD,they were followed up. On the base of the function of defecation,patients were divided into normal, soiling and constipation groups. All of them were inspected by means of anoretal manometry and the findings were analyzed according to different pathological types and clinical groups. Results Fifty - five percent patients had rectoanal inhibitory reflex（fAIR） and the rate of fAIR recurrence within 1 year after surgery was significantly lower than that after 1 year and more （ P 〈 0.05 ）. There was significant difference between the children with HD and those with HAD concerning the frequency of anal peristaltic wave. The patients were subdivided into normal group, soiling group and constipation group according to symptoms. The anaL/rectal pressure ration and the length of anal high pressure region in constipation group was significantly higher than those in the other groups（Pa 〈 0.01 ）. Coadusions RAIR can reconstituted in some patients with HD or HAD with time after the operation. The anal function of patients with HD is better than that of patients with HAD. Multifactors can influence the result of anarectal manometry.

关 键 词：巨结肠 先天性 同源病 直肠肛管测压 直肠肛门抑制反射 肛管蠕动 肛管/直肠压力 

分 类 号：R726.5[医药卫生—儿科]