成年人先天性巨结肠的诊治体会

The diagnosis and treatment of adult Hirschsprung's disease

目的探讨成年人先天性巨结肠的诊断及治疗方法。方法回顾性分析我院于1998年10月～2006年10月收治的成年人先天性巨结肠10例的临床资料。结果全组除1例由于多次腹部及肛门直肠手术史选用了保守治疗,效果理想外,其余均采用手术治愈。结论成年人先天性巨结肠误诊率高。诊断依据主要是追溯自幼便秘史,钡灌肠、全消化道钡餐X线透视及24、48h,甚至72h钡滞留X线摄片。诊断不能确定时加直肠黏膜活检及肛门直肠测压。有过多次手术史者,再手术时应视病情而定,并尽可能多地收集既往手术资料。强调治疗及手术方式应个体化。

Objective To investigate the diagnosis and treatment of adolescent and adult Hit schsprung＇s disease（HD）. Methods The clinical data of 10 patients with HD from October 1998 to October 2006 were retrospectively analyzed. Results All these cases were treated with surgical opera- tion and cured,except for one special case who had suffered repeated abdominal and anorectal opera tions. Conclusion The rate of misdiagnosis was high. The diagnosis of HD mainly depends on the his tory of constipation, the barium enema, and the entire gastrointestinal barium radiograph in 24 h or 48 h,even 72 h. If not determined,the diagnosis of HD was confirmed by obtaining a rectal biopsy or anorectal manometry. The individualized surgical operation and treatment should be performed.