经肛门Soave根治术与开腹根治术治疗先天性巨结肠疗效比较  

Comparative study of effect between transanal soave endorectal pull-through procedure and trans-abdominal operation for hirsehsprung's disease

作　　者：李卫华[1,2] 丁娥[3] 牛军[3] 吕明[4] 

机构地区：[1]山东大学公共卫生学院,山东济南250014 [2]山东大学齐鲁医院手术室,山东济南250012 [3]山东大学齐鲁医院肝胆外科,山东济南250012 [4]山东大学齐鲁医院科研处,山东济南250012

出　　处：《中国现代普通外科进展》2014年第5期350-352,360,共4页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:对比经肛门Soave根治术与开腹巨结肠根治术对小儿先天性巨结肠的疗效。方法:回顾分析1991年1月—2011年12月252例先天性巨结肠患儿病历资料,其中开腹手术组121例,经肛门手术组131例。对比分析两组的手术时间、住院天数、术中出血、术后并发症、切口长度、肛门功能情况以及生活质量等。结果:与开腹手术相比,经肛门手术组手术时间短,术中出血量少,术后下床活动时间和进食时间短,术后切口感染、小肠结肠炎、腹腔感染等并发症发生率低,差异均有统计学意义(P<0.05)。2年随访,经肛门手术组的术后远期并发症如肠梗阻、排尿功能异常、术后复发等比开腹组少,远期恢复情况及生活质量比开腹组好,差异有统计学意义(P<0.05)。结论:与开腹手术相比较,经肛门Soave巨结肠根治术治疗小儿先天性巨结肠手术时间短、切口美观、住院时间短、术后并发症少、肛门功能恢复好、生活质量好。Objective： To comparatively study the clinical effect between transanal Soave endorectal pull-through procedure and laparotomy in the treatment of Hirsehsprung＇s disease（HD） of children. Methods：The clinical data of 252 patients suffered from HD from Jan. 1991 to Dec. 2011 were retrospectively analyzed. The 121 cases from Jan. 1991 to Dec. 2001 were assigned the laparotomy group and the 131 cases from Jan. 2002 to Dec. 2012 underwent transanal Soave endorectal pull-through procedure were assigned to the Soave group. The operative time, hospital stay, intraoperative blood loss, postoperative complications, the length of incision, function of the anas and the 2-year follow-up were comparatively investigated. Results. Compared to the laparotomy group, the operative time and blood loss were significantly less in the Soave group. Patients in the Soave group recovered faster for earlier off-bed activity and eating. The post-operative complications, such as incision infection, enterocolitis and peritoneal infection were less in the Soave group（P〈0.05）. During the 2-year follow-up, the long-term complications such as intestinal obstruction, voiding dysfunction, recurrence was significantly less in the Soave group. The long-term recovery and living quality in the Soave group were superior to that in the laparotomy group （P〈0.05） Conclution： Compared to the laparotomy, transanal Soave endorectal pull-through procedure in HD treatment has advantages of shorter operative time, better cosmetic results, less hospital stay,, better anal function and better living quality

关 键 词：先天性巨结肠 SOAVE根治术 开腹根治术 

分 类 号：R726.1[医药卫生—儿科] R657.1[医药卫生—临床医学]