先天性巨结肠改良Duhamel术式术后远期排粪功能评价  

EVALUATION OF LONG-TERM ANORECTAL FUNCTION AFTER MODIFIED DUHAMEL OPERATION IN HIRSCHSPRUNG′S DISEASE

作　　者：温哲[1] 张道荣 牛爱国[1] 李振东[1] 

机构地区：[1]河北医科大学第二医院小儿外科,石家庄050000

出　　处：《河北医科大学学报》2001年第6期349-351,共3页Journal of Hebei Medical University

摘　　要：目的评估先天性巨结肠改良Duhamel术式术后远期排粪功能障碍的原因。方法对 4 2例先天性巨结肠术后 5年以上患儿进行排粪功能临床评价及直肠肛管测压、X线钡灌肠检查。结果大部分患儿排粪功能良好。排粪功能障碍主要表现为污粪和失禁。排粪功能评分优组 2 8例 ( 66.7% ) ,良组 10例 ( 2 3 .8% ) ,劣组 4例( 9.5 % )。静息压差、肛管高压区长度及钡灌肠肛管长度明显下降 (P <0 .0 5 ) ,自主收缩压优、良组明显高于对照组 ( P <0 .0 5 )。结论手术损伤造成的肛门内括约肌功能不全是污粪和粪失禁的主要原因 。﨩bjectiveTo evaluate the long term anor ectal function and reveal the cause of anorectal disfunction. MethodsThe clinical anorectal function were evaluated wit h anorectal manometry and x ray barium enema in 42 patients 5 or more than 5 y ears after modified Duhamel operation. HTH Results HTSS KG*2 The anorectal function of most of the patients are good. The anorectal disfunction is mainly soiling and fecal incontinence. The a norectal resting pressure difference, high pressure zone, and length of anus are decreased significantly (P< 0.05 ), while the voluntary sphincter pressur e is significantly increased (P< 0.05). ConclusionThe disfunction of internal anal sphincter resu lting from surgical injury is the main cause of soiling and fecal incontinence.

关 键 词：先天性巨结肠病 外科手术 手术方法 Duhamel术式 术后 排粪功能 评价 

分 类 号：R726.569[医药卫生—儿科] R656.9[医药卫生—临床医学]