先天性巨结肠改良Duhamel术式治疗后远期生活质量评估及其对策  

Long term quality of life after modified Duhamel procedure for 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骨科,石家庄050000

出　　处：《中华小儿外科杂志》2001年第5期271-273,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的　评估改良Duhamel术式治疗术后远期生活质量 ,分析造成排便功能障碍的原因 ,并提出改善措施。方法　对 42例术后 5年以上患儿进行了远期生活质量评估、排便功能临床评价及直肠肛管测压、X线钡灌肠检查。结果　大部分患儿身体、心理发育及社会适应性正常。临床排便功能评分优良率达 90 .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　术后肛门内括约肌功能不全是污粪的主要原因 ,术后外括约肌功能代偿性增强。提出术中应减少对内括约肌的破坏 ,术后进行肛门功能锻炼。Objective To evaluate the long-term quality of life in patients who underwent Duhamel's procedure and assess the possible cause of anorectal dysfunction.Methods The quality of life evaluation,ano-rectal function assessment, anorectal manometry, barium enema were performed on 42 post-operative patients.Results The majority of the patients experienced normal physical development and psycho-social adjustment. The main anorectal dysfunction was soiling and fecal incontinence. The resting pressure difference,high pressure zone, and length of anus were significantly decreased (P< 0.05); The voluntary sphincter pressure increased significantly (P< 0.05).Conclusions The dysfunction of internal anal sphincter is the main cause of soiling and fecal incontinence. Minimizing damage to anal sphincter and post-operative anal sphincter training are recommended.

关 键 词：先天性巨结肠 生活质量 测压法 灌肠 改良Duhamel术式 

分 类 号：R726.5[医药卫生—儿科]