小儿先天性巨结肠手术临床治疗效果分析

Clinical efficacy of surgery on pediatric Hirschsprung’s disease

目的：分析不同手术方式治疗小儿先天性巨结肠的临床疗效。方法回顾性分析2008年1月至2014年1月收治的60例小儿先天性巨结肠患者的临床资料，其中行开腹巨结肠根治术的30例患儿为对照组，行经肛门 Soave 根治术的30例患儿为观察组，比较两组患儿的手术情况和术后并发症发生情况。术后对患儿进行为期2年的随访，比较两组预后。结果观察组手术时间、术中出血量、术后下床活动时间和进食时间、住院时间等手术情况以及术后并发症发生率均优于对照组，差异有统计学意义（P 〈0.05）。术后随访中两组均无失访者，随访成功率均为100%。根据随访统计数据，观察组饮食受限、交往障碍、影响学习等情况的发生率均低于对照组。结论与传统开腹根治术相比，经肛门 Soave 根治术缩短了手术时间、患者术后下床活动时间和进食时间、住院时间，减少了术中出血量，且降低术后并发症发生率，改善了预后，临床应用效果更好。

Objective To analyze the clinical efficacy of different surgical treatment on pediatric Hirschsprung’s disease. Methods The clinical data of 60 cases of pediatric patients with Hirschs-prung’s disease between January 2008 and January 2014 were retrospectively analyzed. Thirty patients with laparotomic pull-through as the control group,30 patients through the anus Soave radical as observa-tion group. The surgery condition and postoperative complications were compared between the two groups. All of the patients with two-year following-up and postoperative prognosis were compared between the two groups. Results The operation time,intraoperative blood loss,postoperative bed activity time and feeding time,hospitalization time and operation situation and the incidence of postoperative complica-tions of the observation group were better than those of control group,the differences were significant （P 〈 0. 05）. Both groups had no visitors,the success rate of following-up was 100% . According to sta-tistics of the following-up,the rates of limited diet,the incidence of communication disorders,affect learning in observation group were lower than those in the control group. Conclusions Compared with the traditional open radical prostatectomy,through the anus Soave radical can shorten the operation time, postoperative bed activity time,eating time and length of hospital stay,reduce the intraoperative blood loss,and reduce the incidence of postoperative complications and improve the prognosis and clinical ap-plication effect is better.