先天性巨结肠31例的诊治体会

Hirschsprung disease(HP) in children:31 cases report

目的探讨新生儿先天性巨结肠的诊断、合理的治疗方案，以提高治愈率。方法对３１例先天性巨结肠的患儿进行回顾性分析，本组有近半数在新生期误诊为胎粪堵塞综合征或其它疾病。结果１３例采用保守治疗，仅暂时缓解症状；５例行Ｓｗｅｎｓｏｎ术，２例复发，１例并发肠扭转，１例吻合口出血并发小肠结肠炎；３例行Ｒｅｈｂｅｉｎ术，１例复发，１例并发小肠结肠炎；１２例行Ｄｕｈａｍｅｌ术，仅１例出现不全性肠梗阻，余随访１～２年。结论传统的保守治疗仅作为术前准备阶段或暂时缓解症状，Ｄｕｈａｍｅｌ术与其它术式比较创伤小，操作简便，并发症少。

Objectives To put importance on the diagnosis of HD in infancy ,to explore the treatment of improving the cure-rate.Methods 31 cases of HD in children were retrospectively studied.There were 25 cases boys,6 cases girls,aged from 2 days to 13 years old,and about half cases were misdiagnosed in their infancy.Results Among 31 cases,13 cases used conservation treatment,the result was not satisfactory 5 cases used Swenson′s operation,2 cases with recurrence,1 cases with volvulus,3 cases with entercocolitis,3 cases used Rehbein′s operation,1 cases with recurrence,1 cases with entercocolitis.12 cases used Duhamel′s operation only 1 cases with incompletely obstructive.Conclusions Duhamel′s aperation is less complication,simpler operating and smaller tranme than other methods.