全结肠型巨结肠保留结肠根治术的研究

Investigation of reserving all colon in the radical cure performance of total Hirschsprung's disease

目的:探讨全结肠型巨结肠根治术中保留全部结肠,并行回肠、升结肠侧侧吻合的治疗效果。方法:将正常的回肠从直肠后间隙拖至肛门,然后用结肠直肠吻合钳夹除回肠前壁和直肠后壁,再行回肠、升结肠侧侧吻合。术后定期检查血K+、Na+、Cl-、CO2-CP,生长发育情况及排便情况。结果:13例患儿(包括3例升结肠闭锁患儿),1例死亡,12例存活,血K+、Na+、Cl-、CO2-CP逐渐趋于正常小儿,排便由每日10余次逐渐降至每日2～3次。结论:全结肠型巨结肠根治术中保留全部结肠,并行回肠、升结肠侧侧吻合保留了结肠的部分功能,在维持水电解质及酸碱平衡中起重要作用,有较显著疗效。

Objective： To investigate the effect in total Hirschsprung＇s disease radical cure performance of reserving all colon , and make ileum to ascending colon anastomosis. Methods： Draw the normal ileum to anus behind rectum , moved the septum （fore wall of ileum and back wall of rectum ） away by anastomoses damp, made ileum and ascending colon side to side anastomosis afterward. Examine K Na C1 and Co2 - CP in blood , as well as the condition of growth and nutrition. Results： 13 cases , include 3 cases who committed colonic atresia , 1 was dead , and 12 of them were alive. K Na C1 and Co2 - CP in blood , as well as the condition of growth and nutrition going to normal gradually , defecation was 10 times one day after operation , 2 to 3 times when they were 2 to 3 years old. Conclusion： The effect in total Hirschsprungg disease radical cure performance when reserving all colon , and making ileum to ascending colon anastomosis is remarkable , and has important use in maintaining water and electrolyte balance and acid to alkali balance.