先天性巨结肠诊疗规范化的再思考  

Some focal issues of standardizing the diagnosis and treatment of Hirschsprung's disease

作　　者：曾纪晓 徐晓钢 Zeng Jixiao;Xu Xiaogang(National Children Regional Medical Center,Guangzhou Women&Children's Medical Center,Guangzhou Medical University,Guangzhou 510120,China)

机构地区：[1]国家儿童区域医疗中心,广州医科大学附属广州市妇女儿童医疗中心,广东省广州市510120

出　　处：《临床小儿外科杂志》2021年第3期201-207,共7页Journal of Clinical Pediatric Surgery

基　　金：国家自然科学基金(编号:82070528);广东省自然科学基金(编号:2018A030313570);先天性巨结肠发病机制及转归预后前瞻性队列研究(编号:ChiCTR-eoc-17013386)。

摘　　要：先天性巨结肠(Hirschsprung's disease,HSCR)是小儿肛肠外科常见疾病,规范化的诊疗可以减少HSCR的误诊与误治,降低手术并发症的发生率和再次手术的概率。然而,我国大陆地区HSCR的诊疗策略经过数十年发展与演变仍未统一,一些诊疗的关键标准仍欠规范。近年来国内关于HSCR的临床研究和指南针对以上问题进行了深入探讨,但仍有部分患者未能从中获益。HSCR的规范化治疗对于患者实现个体化诊疗意义重大,标准化、规范化的流程有助于HSCR的精准诊断与手术治疗。本文就HSCR的精准诊断、手术时机、手术方式选择以及新技术应用等方面进行阐述。Hirschsprung's disease(HSCR)is a common disease in pediatric anorectal surgery.Standardized diagnosis and therapy may reduce its misdiagnostic and therapeutic errors,lower its incidence of complications and minimize redo pull-through procedure.However,its strategies of diagnosis and treatment in China's Mainland has not been unified after decades of development and evolution and some focal issues requires standardization.Recently domestic clinical studies and guidelines on HSCR have extensively discussed these issues.However,some patients have not benefited.Standardizing its diagnosis and treatment is essential for achieving individualized protocols for HSCR patients so as to ensure an accurate diagnosis and an optimal timing of operation.

关 键 词：先天性巨结肠/诊断 先天性巨结肠/外科学 手术后并发症 

分 类 号：R726.1[医药卫生—儿科] R574[医药卫生—临床医学]