Ⅰ期经肛门改良Soave与经腹会阴根治术治疗小儿先天性巨结肠的对比研究  

A comparative study of one-stage transanal modified Soave pull-through procedure and radical operation via abdominal and perineal approach for Hirschsprung's disease in children

作　　者：吕良峰[1] 刘士会[1] 吴琦 胡成文 左芦根[2] LYU Liang-feng;LIU Shi-hui;WU Qi(Department of Pediatric Surgery, the First People＇s Hospital of Bengbu, Bengbu, Anhui 233000, Chin)

机构地区：[1]蚌埠市第一人民医院小儿外科,安徽蚌埠233000 [2]蚌埠医学院第一附属医院普外科,安徽蚌埠233004

出　　处：《中华全科医学》2018年第9期1459-1461,共3页Chinese Journal of General Practice

基　　金：国家自然科学基金青年科学基金项目(81700476)

摘　　要：目的探讨Ⅰ期经肛门改良Soave与经腹会阴根治术治疗小儿先天性巨结肠的临床效果与安全性。方法回顾性选取2014年10月—2017年8月收治的52例小儿先天性巨结肠患儿作为研究对象,根据手术方式分为观察组和对照组各26例,其中对照组患儿均进行传统经腹会阴根治术,观察组患儿均予以Ⅰ期经肛门改良Soave术。比较2组患儿手术一般情况如手术时间、术中出血量、胃肠功能恢复时间以及住院时间;比较2组患儿术后排便功能以及并发症情况;术后6个月对患儿进行随访以评价其生活质量和家长满意度。结果观察组患儿手术时间、术中出血量、胃肠功能恢复时间以及住院时间均明显短于对照组,差异均有统计学意义(P<0.05);观察组患儿术后排便功能以及并发症发生情况均显著优于对照组,差异均具有统计学意义(P<0.05);观察组患儿术后6个月的生活质量和家长满意度均显著优于对照组,差异具有统计学意义(P<0.05)。结论在治疗小儿先天性巨结肠的术式选择上,Ⅰ期经肛门改良Soave不仅较经腹会阴根治术临床效果更佳,患儿具有较好的术后恢复,生活质量也获得显著改善,家长满意度高,因此值得临床广泛推广与应用。Objective To investigate the clinical effect and safety of one-stage transanal Soave pull-through procedure （modified Soave procedure） and radical operation via abdominal and perineal approach in the treatment of congenital megacolon （Hirschsprung＇s disease）. Methods The clinical data of 52 children with Hirschsprung＇ s disease in our hospital from October, 2014 to August, 2017 were reviewed. The patients were randomly divided into observation group and control group with 26 cases in each group. The control group underwent the radical operation via abdominal and peri- heal approach, while the observation group received the modified Soave procedure. The operation time, the amount of bleeding in the operation, the recovery time of gastrointestinal function and the time of hospitalization were compared be- tween the two groups. The postoperative defecation and complications were compared between the two groups. The chil- dren were followed up 6 months after the operation to evaluate their quality of life and parents＇ satisfaction. Results The operative time, intraoperative blood loss, gastrointestinal function recovery time and hospitalization time in the obser- vation group were significantly shorter than those in the control group, the differences were statistically significant （ P 〈 0.05）. The postoperative defecation and complications of the children in the observation group were significantly better than those in the control group, and the difference was statistically significant （P 〈 0.05）. The quality of life and the sat- isfaction of the parents in the 6 months of the observation group were significantly better than those in the control group, and the difference was statistically significant （P 〈 0.05 ）. Conclusion For the treatment of congenital megacolon, the modified Soave procedure is our preferences. When compared with the radical operation via abdominal and perineal ap- proach, the children with modified Soave procedure will have good postoperative recovery, the improved

关 键 词：Ⅰ期经肛门改良Soave术 经腹会阴根治术 小儿先天性巨结肠 

分 类 号：R725.7[医药卫生—儿科] R726.1[医药卫生—临床医学]