新生儿巨结肠4种治疗方法探讨

Four Methods of Treatment for Neonate Hirschsprung Disease

1991～1995年收治新生儿巨结肠(HD)50例,非手术治疗19例(38％),手术治疗31例,其中肠造瘘5例(10％),直肠内括约肌切除11例(22％),根治术15例(30％)。术后随访2月～5年,平均2.5年,非手术治疗有效率(良好、好转)为52.6％,其中短段型HD有效率达76.9％(10/13),内括约肌切除术达81.8％,根治术达73.3％,根据不同病情选择适当的疗法,可达到较好的效果。

Fifty cases with neonate Hirschsprung disease (HD) who were hospitalized and treated in the past 5 years were reviewed. Among these cases, 19 (38 %) were given non-surgical treatment and 31 (62 %) received different surgical operations. The surgical operations involved enterostomy (n=5, 10%); rec-tal internus sphincterotomy (n=11, 22%); and radical operation (n=15, 30%). Follow-up periods lasted from 2 months to 5 years, with an average of 2. 5 years. The effective rates were 52. 6 % in the group with non-surgical treatment, of which the effective rate in cases with short HD was 76. 9 %(10/13); 81. 8 % in patients with rectal internus sphincterotomy; and 73. 3 % in patients with radical operation. It is concluded that good effects can be reached by selecting optimal therapy based on the condition of individual case.