巨结肠患儿肠造口术后造口与肛门同时扩肛的临床意义

Simultaneously Implementing Ostomy Procteurysis and Anus One after Colostomy of Infantile Megacolon:Clinical Significance

为探讨巨结肠患儿肠造口术后造口与肛门同时扩肛的临床意义,回顾2017年2月至2018年6月我院收治的因先天性巨结肠而行肠造口的85例患儿资料,其中42例患儿术后第10天开始予以造口扩肛(对照组),43例患儿在造口扩肛的同时予以肛门扩肛(观察组),直至Ⅱ期造口还纳术前,大约扩肛3个月。比较2组患者扩肛前后肛门测压结果及Ⅱ期造口还纳术后并发症发生情况。结果显示,扩肛干预3个月后(Ⅱ期造口还纳术前),2组患儿肛门静息压、直肠静息压、肛门最大收缩压均明显高于干预前,肛门收缩持续时间明显长于干预前,P<0.05;2组扩肛干预后比较,观察组患儿肛门静息压、直肠静息压、肛门最大收缩压均明显高于对照组,肛门收缩持续时间明显长于对照组,P<0.05。Ⅱ期造口还纳术后,观察组小肠结肠炎及肠梗阻发生率均明显低于对照组,P<0.05。结果表明,巨结肠患儿肠造口术后造口与肛门同时扩肛,不仅有利于促进肛门功能恢复,而且可降低Ⅱ期还纳术后并发症的发生率,具有临床推广价值。

In order to explore the clinical significance of simultaneously implementing ostomy procteurysis and anus one after colostomy of infantile megacolon(IMC),authors review the data of 85 cases met above condition who had been treated with colostomy due to IMC in author’s hospital(2017-02-2018-06),including 42 cases received ostomy procteurysis on the 10 th day after surgery,as control group;another 43 cases simultaneously received ostomy and anus one,both procteurysis lasted for 3 months about,untilⅡstage of ostomy returned to preoperative situation;then,compared anal pressure before and after procteurysis,as well postoperative complication of ostomy returned back.As results,after procteurysis(3 months about)compared with that before procteurysis,anal resting pressure,rectal resting pressure,and anal max.diastolic pressure of both groups,as well their anal contraction lasting time was significantly higher,as well longer,observation group in above items was significantly more higher,as well more longer than control group(P<0.05);afterⅡstage of ostomy returned back in observation group the incidence of enterocolitis and intestinal obstruction was all lower than that in control group(P<0.05).Results show that both procteurysis implemented simultaneouly is not only beneficial to promoting anal function recovered,but can reduce complications afterⅡstage of ostomy returned back occured,thus worth to be populalized clinically.