经肛门直肠内拖出术治疗婴幼儿常见型先天性巨结肠症临床研究

Treatment by Pulling Colon Out from Anus for Infants with Congenital Megacolon

目的:观察经肛门直肠内拖出术治疗婴幼儿常见型先天性巨结肠症的效果及并发症。方法:采用经肛门拖出病变肠管并予以切断,结肠、直肠一期吻合的方法,治疗先天性婴幼儿常见型巨结肠症患儿82例,观察术后并发症并于术后1、3、6、12个月观察并发症及例数。结果:全组患儿手术获得成功,24h内开始恢复肠功能,未出现早期并发症。1个月内随访62例患儿有腹泻(大于3次),3个月内仍有21例患儿排便次数较多;5例患儿1个月内出现污粪,3个月时随访1例仍有污粪;3例患儿1个月内出现吻合口狭窄,1例患儿3个月时仍有狭窄,6个月后均恢复正常;未发生小肠结肠炎、粘连性肠梗阻、便秘、失禁等并发症。结论:经肛门直肠内拖出巨结肠根治术手术创伤小,治疗效果良好,并发症少,适用于婴幼儿常见型先天性巨结肠症的治疗。

Objective：To investigate the effects and complications of operation of pulling colon out from anus for infants with Congenital Megacolon.Methods：82 cases with Congenital Megacolon were treated by the operation of pulling the disease colon out from anus,cutting and sewing up the colon and rectuming in stage I.To observe the postoperative complication after 1 month,3 months,6 months and 12 months.Results：All the operations were successful,intestinal function restored in 24 hours,and no recent complication was observed.62 infants had diarrhea within 1 month（more than 3 times）,there were 21 cases with diarrhea in 3 months.5 cases with fecal pollution within 1 month,there were still one case in 3 months.Three cases with anastomotic stenosis occurred within 1 month,and one children was still with anastomotic stenosis in 3 months.All the compications were restored in six months.There were no entercolitis,adhesive intesinal obstruction,constipation,incontinence and other complications occurred.Conclusion：The operation of pulling colon out from anus is safe,effective,little ingurious while having good effect.It is suitable for treating the Congenital Megacolon of the ordinary type for infant.