摘要
目的 :介绍经肛门结肠拖出术治疗新生儿及婴儿先天性巨结肠。方法 :回顾 4 3例采用经肛门结肠拖出术治疗的新生儿及婴儿先天性巨结肠。患儿年龄 14d至 12个月。方法为在肛门齿状线处切开直肠黏膜 ,向近端游离达盆底腹膜返折处。切除直肠肌鞘后壁约 1 0～ 1.5cm一条。游离乙状结肠达正常结肠后切断。拖出正常结肠与肛门吻合。结果 :4 3例经肛门直肠结肠拖出切除病变肠段顺利完成手术 ,术中出血少 ,术后 1～ 2d进食 ,5～ 7d出院 ,无术后尿潴留 ,无伤口感染及肛门回缩。全部患儿获随访 3～ 9个月 ,排便功能正常 ,无肛门狭窄发生。2例偶有污粪 ,为术后早期病例。结论 :经肛门结肠拖出术操作简便 ,创伤小 ,恢复快 ,术后护理负担轻 ,并发症少。此术式是新生儿和婴儿先天性巨结肠根治性治疗的理想方法。
Objective:To introduce the transanal pull through for congenital Hirschsprung's disease in new borns and infants. Methods: The 43 cases on whom were performed transanal pull through for Hirschsprung's disease were reviewed. The ages of the patients were 14 days 12 months.The technique included a rectal mucosectomy at the proximal to the dentate line, separating mucosas from rectal wall to the peritoneal reflection. The part of rectal muscularis below the peritoneal was resected posteriorly. An anastomosis was made between the pull through ganglionic colon and anus. Results:In the 43 cases the operations were easily accomplished by excising the injured intestine. The blood lost was small. The patients took food after 1-2 days of operation. discharged 5-7 days later. No retention of urine and no infection of incision wound were observed. Total follow up lasted 3-9 months. Defecation was normal,and there was no stricture of anus. Only 2 cases had soiling by chance. Conclusion: Simple transanal pull through is an ideal type of operation for congenital Hirschsprung's disease in new borns and infants. It is an easy operation,with less injury,quick recovery and rare complication.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2003年第2期200-201,共2页
Journal of Peking University:Health Sciences
