经肛门Ⅰ期巨结肠根治术治疗新生儿先天性巨结肠的临床研究

THE ONE-STAGE RADICAL CURE OF CONGENITAL MEGACOLON IN NEWBORNS

目的 探讨经肛门Ⅰ期巨结肠根治术治疗新生儿先天性巨结肠的方法和疗效。方法 采用单纯经肛门环形切开齿状线上方直肠粘膜、处理结肠系膜 ,拖出病变肠管并予以切除 ,经肛门Ⅰ期吻合的方法 ,治疗新生儿巨结肠 18例。并通过手术操作时间 ,术中出血量、术中盆腔污染、术后肠蠕动恢复时间、术后肛门狭窄率、粘连性肠梗阻发生率、病死率、肛门控便能力、病理符合率等 9项指标与采用传统手术治疗的对照组进行临床比较 ,测定、评估手术效果。结果 实验组手术时间短、术中出血少、术中盆腔无污染 ,术后肠蠕动恢复快 ,无术后并发症 ,与对照组相比较有显著性差异 (P <0 .0 1) ;实验组与对照组病理符合率基本相同 ,无统计学差异。结论 经肛门Ⅰ期巨结肠根治术是治疗新生儿先天性巨结肠一种全新术式 ;应用该术式治疗新生儿先天性巨结肠手术操作相对简捷 ,术后并发症少 ;术后患儿控便能力相对良好 。

Objective To explore the curative effects of one-stage radical cure of congenital megacolon.Methods The intestinal cavity was removed by incision in rectal mucosa and management of mesocolon and the one-stage anastomosis through anus was made in 18 cases of megacolon in newborns.The operative effects were compared between the treatment group and the contrast group in terms of the operation time,the amount of intraoperative bleeding,the intraoperative pollution in pelvic cavity,the postoperative recovery of peristalsis,the postoperative stricture rate of anus,the occurrence of intestinal obstruction,the death rate,the stool-control and the pathological coincidence.Results The operation time was shortened in the treatment group.There existed little intraoperative bleeding,no pollution in pelvic cavity,quick recovery of intestinal peristalsis and no postoperative complications in the treatment group pin contrast to the control group(P<0.01).The pathological coincidence in both groups was much the same,showing no statistical difference.Conclusion The one-stage radical cure of congenital megacolon in newborns has proven to be simple and effective and can greatly promote the quality of patients’ life.