NADPH-d染色法术中快速诊断先天性巨结肠  

Research on the intraoperative rapid diagnosis of Hirschprung's disease using NADPH-d technique

作　　者：朱利斌[1] 张普[2] 黄婷[1] 王永彪[1] 

机构地区：[1]温州医学院附属育英儿童医院儿外科,浙江温州325027 [2]温州医学院附属育英儿童医院病理科,浙江温州325027

出　　处：《温州医学院学报》2012年第2期120-123,共4页Journal of Wenzhou Medical College

基　　金：浙江省卫生厅科研基金资助项目(2009A149);温州市科技局科研基金资助项目(Y20070064)

摘　　要：目的:评价NADPH-d的快速染色法在术中诊断先天性巨结肠(Hirschprung’s disease,HD)及确定病变段肠管范围的优越性。方法:标本采自确诊HD患儿术中切除的结肠37例,其中男27例,女10例,平均年龄11.6个月。标本分狭窄段、移行段、扩张段,分别用NADPH-d的快速染色法与冰冻切片HE快速染色法进行配对比较研究。结果:NADPH-d染色法操作简单,易掌握,切片不需事先固定,无需水化、脱水等繁琐流程。冰冻切片HE染色法30 min出结果,NADPH-d法能在10 min内出结果,两者阳性率差异无统计学意义(P>0.05)。结论:NADPH-d染色法能在术中快速诊断HD并确定手术中切缘是否已达到正常肠管,且操作流程简单,阳性神经节细胞识别容易,较冰冻切片HE染色法有一定优越性。Objective： To evaluate the superiority of NADPH-diaphorase（NADPH-d） tech-nique for intraoperative rapid diagnosis of HD（Hirschprung＇s disease）.Methods： Thirty-seven children with HD underwent intraoperative full-thickness intestinal biopsies,of whom 27 cases were male,10 cases female,with average age 11.6 months.Biopsies at three levels（narrow segments,transi-tional region and dilated segments） were taken and investigated to determine the extent of aganglionosis by NADPH-d technique and traditional rapid HE technique,respectively.Results： NADPH-d technique was simple;section needn＇t fixation,hydration,dehydration,and so on.Traditional rapid HE technique was done in 30 min,while NADPH-d technique was done in 10 min.There is no significant difference between the two techniques of identification of ganglion cells（P 0.05）.Conclusion： The NADPH-d technique can be used as rapid intraoperative technique to determine the extent of aganglionosis and the cutting edge of colon.It is more superior than traditional rapid HE technique in brief procedures and easy identification of positive ganglion cells.

关 键 词：先天性巨结肠 诊断 病理 外科手术 儿童 

分 类 号：R726.1[医药卫生—儿科]