改良Swenson术治疗先天性巨结肠

Chinical outcome evaluation of modified pull-through Swenson to treat Hirschsprung’s disease

目的 探讨改良Swenson手术治疗先天性巨结肠的有效性、安全性。方法 对我院自1995年10月-2004年6月采用改良Swenson术治疗的52例（男50例，女2例，48例为常见型，4例为短段型）先天性巨结肠患儿进行回顾性分析。所有患儿均经病理明确诊断，术后常规肛门指检。随访40例、时间1～6年。对顽固性便秘、营养状况、吻合口狭窄、污裤及失禁等情况进行评价。结果 52例患儿顽固性便秘消失，营养改善。近期无吻合口漏，无腹腔及伤口感染，远期随访无便秘复发及直肠回缩，无吻合口狭窄、污裤及失禁。52例中仅2例有小肠结肠炎，占3．8％。结论改良Swenson术适用于常见型、短段型及长段型先天性巨结肠并且疗效满意，具有较高的实用性和安全性。

Objective To investigate the outcome of pull-through Swenson to treat Hirschsprung＇s disease. Methods Reviewing analysis was usad in 52 cases of children, with Hirschsprung＇s disease （aganglionic megacolon）, who underwent pull-through Swenson. Results 52 children with, pertinacious constipation recovered and their nutritional condition was improved, No anastomosis leakage and infection of abdominal cavity and incision were found in the short period follow-up, No anastomosis stenosis and incontinence were found in the long-period follow-up, while 2 children remains with enterocolitis. Conclusions The modified pull-through Swenson is indicated to treat congenital megacolon of common, short or long-segment type.