摘要
目的探讨长段型巨结肠及继发扩张肥厚段较长的普通型巨结肠的手术治疗方法及疗效。方法总结1990～2002年间58例结肠大部切除升结肠翻转Deloyers术治疗的先天性巨结肠的临床病历。年龄4个月～4.5岁。长段型32例,普通型26例。58例均行钡灌肠造影检查显示:结肠僵硬,结肠框呈“?”改变,痉挛段结肠有锯齿样改变。28例经肛门直肠测压检查,27例RAIR阴性(96%)。12例行直肠黏膜活检,10例未见神经节细胞,2例神经节细胞发育不良。结果全组无手术死亡。切除结肠40～86cm。术后随访1～10年,5年以上32例,肛门直肠功能异常7例(22%),均为长段型。结论升结肠翻转Deloyers术安全可靠,长段型巨结肠管神经发育不完善易导致术后功能异常。
Objective To discuss operative methods and treatment for long- segmental HD and secondary lengthen - enlarging - segmental common HD. Methods 58 cases, type long - segmental 32, type common 26, aged from 4 months to 4.5 years old, who were done large part of colon resection and ascending - colon reversing - Deloyers operation form 1990 - 2002 were collected. Barium enema showed rigid colon,＂ ？＂ -shaped colon -frame and sawtooth -like change in spastic colon segment. Among the 58 cases,anorectal menometry was done for 28 cases and 27 cases were RAIA negative（96% ）. Rectal mucosa biopsy were done for 12 cases, 10 cases no nerve note cells and 2 cases dysplasia. Results All cases survived after operation,lengths of colon resection were 40 - 86cm. Postoperative follow - ups were done 1 - 10years and 32 cases more than 5 years,7 long - segmental HD cases（22% ） were found anerectal functional abnormal. Conclusion Deloyers operation proved to be safe and postoperative abnormal function mainly caused by intestinal nerve dysplasia in long - segmental HD.
出处
《医药论坛杂志》
2005年第17期40-41,共2页
Journal of Medical Forum
关键词
巨结肠
先天性
吻合术
外科
Megacolon
Congenital
Anastemesis
Surgery
