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结肠测压是排便障碍患儿盲肠造瘘术成功的预测因子 被引量:1
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作者 van den berg m.m. Hogan M. +2 位作者 Caniano D.A. H.M. Mousa 刘凯 《世界核心医学期刊文摘(儿科学分册)》 2006年第9期41-42,共2页
Purpose:The aim of this study was to define the predictive value of colonic manometry and contrast enema before cecostomy placement in children with defecation disorders. Methods:Medical records,contrast enema,and col... Purpose:The aim of this study was to define the predictive value of colonic manometry and contrast enema before cecostomy placement in children with defecation disorders. Methods:Medical records,contrast enema,and colonic manometry studies were reviewed for 32 children with defecation disorders who underwent cecostomy placement between 1999 and 2004. Diagnoses included idiopathic constipation (n=13),Hirschsprung’s disease (n=2),cerebral palsy (n=1),imperforate anus (n=6),spinal abnormality (n=6),and anal with spinal abnormality (n =4). Contrast enemas were evaluated for the presence of anatomic abnormalities and the degree of colonic dilatation. Colonic manometry was considered normal when high-amplitude propagating contractions (HAPC) occurred from proximal to distal colon. Clinical success was defined as normal defecation frequency with no or occasional fecal incontinence. Results:Colonic manometry was done on 32 and contrast enema on 24 patients before cecostomy. At follow-up,25 patients (78% ) fulfilled the success criteria. Absence of HAPC throughout the colon was related to unsuccessful outcome (P=0.03). Colonic response with normal HAPC after bisacodyl administration was predictive of success (P=0.03). Presence of colonic dilatation was not associated with colonic dysmotility. Conclusion:Colonic manometry is helpful in predicting the outcome after cecostomy. Patients with generalized colonic dysmotility are less likely to benefit from use of antegrade enemas via cecostomy. Normal colonic response to bisacodyl predicts favorable outcome. 展开更多
关键词 排便障碍 造瘘术 盲肠造瘘 结肠运动 肛门闭锁 医疗记录 大便失禁 造影术 预测价值 肠造瘘口
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排便障碍患儿的盲肠造口术
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作者 Mousa H.M. van den berg m.m. +1 位作者 Caniano D.A. 成虹 《世界核心医学期刊文摘(胃肠病学分册)》 2006年第5期15-15,共1页
Administration of antegrade enemas through a cecostomy is a therapeutic option for children with severe defecation disorders. The purpose of this study is to report our 4 year experience with the cecostomy procedure i... Administration of antegrade enemas through a cecostomy is a therapeutic option for children with severe defecation disorders. The purpose of this study is to report our 4 year experience with the cecostomy procedure in 31 children with functional constipation (n = 9), Hirschsprung’ s disease (n = 2), imperforate anus (n = 5), spinal abnormalities (n = 8), and imperforate anus in combination with tethered spinal cord (n = 7). Data regarding complications, antegrade enemas used, symptoms, and quality of life were retrospectively obtained. Placement of cecostomy tubes was successful in 30 of 31 patients. Soiling episodes decreased significantly in children with functional constipation (P = 0.01), imperforate anus (P < 0.01), and spinal abnormalities (P = 0.04). Quality of life improved in patients with functional constipation and imperforate anus. No difference in complications was found between percutaneous and surgical placement. Use of antegrade enemas via cecostomy improved symptoms and quality of life in children with a variety of defecation disorders. 展开更多
关键词 盲肠造口 排便障碍 肠造口术 患儿 HIRSCHSPRUNG病 顺行性结肠灌洗术 功能性便秘 脊髓栓系综合征 肛门闭锁 生活质量
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