还原型尼克酰胺腺嘌呤二核苷酸脱氢酶-d染色方案对小儿先天性巨结肠诊断的临床价值

Clinical value of NADPH-d staining in diagnosing Hirschsprung's disease in children

目的探讨还原型尼克酰胺腺嘌呤二核苷酸脱氢酶(NADPH-d)染色对小儿先天性巨结肠诊断的临床价值。方法收集青岛妇女儿童医院2017年5月至2019年5月收治的57例先天性巨结肠患儿术中切除的结肠,包括扩张段、移行段、狭窄段,行NADPH-d染色和苏木素-伊红(HE)染色,将NADPH-d染色结果与HE染色结果进行对比分析。结果HE染色阳性50例,阴性7例,阳性率为87.72%;NADPH-d染色阳性53例,阴性4例,阳性率为92.98%。NADPH-d染色与HE染色阳性率差异无统计学意义(P>0.05)。结论NADPH-d染色对小儿先天性巨结肠具有较高诊断价值,具有对肠壁神经节细胞识别性高、染色用时少、缩短手术时间、易于医生掌握、减少病理漏诊率、减少术后便秘复发的优点,适用于临床诊断小儿先天性巨结肠。

Objective To investigate the clinical value of nicotinamide-adenine dinucleotide phosphate diaphorase(NADPH-d)staining in diagnosing Hirschsprung′s disease in children.Methods Surgically resected colon segments were collected from 57 children with Hirschsprung’s disease in Qingdao Women and Children′s Hospital between May 2017 and May 2019,each including the dilated,transitional and narrow segments.All the selected segments were subject to NADPH-d and hematoxylin-eosin(HE)staining.The results of the staining two methods were compared.Results By HE staining,50 cases were positive and 7 negative(positivity rate:87.72%);by NADPH-d staining,53 cases were positive and 4 negative(positivity rate:92.98%).There was no statistical difference in positive findings between NADPH-d and HE staining(P>0.05).Conclusion NADPH-d staining offers high diagnostic value for Hirschsprung′s disease in children,in terms of effective identification of intestinal ganglion cells,quicker staining,shorter operation time,easier to use,less missed diagnosis by pathology,and reduced postoperative recurrence of constipation,and therefore is useful for diagnosing Hirschsprung’s disease in clinical settings.