摘要
目的探讨不同改良直肠黏膜剥除鞘内结肠拖出术(Soave)根治术对先天性巨结肠(HD)长段型患儿肠道微生物定植抗力及肛门功能的影响。方法回顾性收集2018年1月至2020年11月期间于我院进行手术治疗的80例HD长段型患儿的临床病历资料,根据其手术方式不同分为改良组和腹腔镜组,每组40例。改良组患儿采取经肛门改良Soave根治术,腹腔镜组予以腹腔镜下Soave根治术。比较两组患儿手术时长、术中出血量、胃肠功能恢复时间、住院时间、手术前后肠道菌群情况以及肠道微生物定植抗力,比较术后6个月随访时两组肛门功能。结果腹腔镜组患者的手术时间、术中出血量、术后胃肠功能恢复时间以及住院时间均较改良组更短;两组患儿手术后大肠杆菌、双歧杆菌、乳酸杆菌以及粪球杆菌水平均明显高于手术前,且术后腹腔镜组双歧杆菌、粪球杆菌水平较改良组明显更高;腹腔镜组术后6个月随访时肛门功能优良率较改良组明显更高,差异经统计学分析有意义(P<0.05)。结论腹腔镜下Soave根治术可有效提升患儿肠道微生物定植抗力,促进患儿肛门功能恢复。
Objective To investigate the influence of different modified rectal mucosa stripping and endorectal pull-through(Soave)procedures on gut microbiota colonization resistance and anal function in children with long-segment Hirschsprung's disease(HD).Methods This study retrospectively collected the clinical data of 80 children with long-segment HD who underwent surgery in the hospital between January 2018 and November 2020.According to the surgical method,the children were divided into modified group and laparoscopic group with 40 children in each group.Children in the modified group were treated with modified radical Soave procedures,and children in the laparoscopic group were treated with laparoscopic radical Soave procedures.The operation time,intraoperative blood loss,gastrointestinal function recovery time,length of hospital stay,gut microbiota before and after surgery,gut microbiota colonization resistance and anal function were compared between the two groups.Results The operation time,intraoperative blood loss,postoperative gastrointestinal function recovery time and length of hospital stay of the laparoscopic group were shorter or less than those of the modified group.After operation,the levels of Escherichia coli,bifidobacteria,Lactobacilli and Coprococcus were significantly increased,and the levels of bifidobacteria and Coprococcus in the laparoscopic group were significantly higher than those in the modified group.The excellent and good rate of anal function in the laparoscopic group was significantly higher than that in the modified group during six-month follow-up(P<0.05).Conclusion Laparoscopic radical Soave procedures can effectively enhance gut microbiota colonization resistance in children with long-segment HD,and promote the recovery of anal function.
作者
徐丰
郭春娜
王瑾
XU Feng;GUO Chun-na;WANG Jin(Department of Surgery,Kaifeng Children's Hospital,Kaifeng 475000,Henan Province,China;Department of Pathology,Kaifeng Children's Hospital,Kaifeng 475000,Henan Province,China;Department of Clinical Laboratory,Kaifeng Children's Hospital,Kaifeng 475000,Henan Province,China)
出处
《罕少疾病杂志》
2022年第8期77-79,共3页
Journal of Rare and Uncommon Diseases
