Xie Chuanping,Yan Jiayu,Chen Yajun,et al.Risk factors for long-term bowel function outcomes after Soave procedure for Hirschsprung’s disease[J].Journal of Clinical Pediatric Surgery,2024,(05):426-429.[doi:10.3760/cma.j.cn101785-202304013-005]
先天性巨结肠Soave术后远期排便功能不良的危险因素分析
- Title:
- Risk factors for long-term bowel function outcomes after Soave procedure for Hirschsprung’s disease
- Keywords:
- Hirschsprung’s Disease; Bowel Function; Risk Factors; Surgical Procedures; Operative; Child
- 摘要:
- 目的 探讨先天性巨结肠(Hirschsprung’s disease,HD)患儿接受Soave术后的远期排便功能情况,为HD的临床诊疗提供依据。 方法 本研究为回顾性研究,收集2011年1月至2020年12月首都医科大学附属北京儿童医院普外科收治的280例HD患儿临床资料,并进行电话随访,随访时间7.2(5.4,9.7)年;随访内容依据Rintala量表确定,包括排便控制能力、排便感觉、排便频率、污粪、便秘等。根据Rintala评分结果,将HD患者分为排便功能不良组(Rintala评分＜12分)和排便功能一般或良好组(Rintala评分≥12分),分析远期排便功能不良的危险因素。 结果 280例HD患儿Rintala评分为18 (15,20)分,其中189例(189/280,67.5%)排便功能评分等级为良好(Rintala评分≥17分),65例(65/280,23.2%)排便功能评分等级为一般(Rintala评分12~16分),26例(26/280,9.3%)排便能评分等级为较差(Rintala评分＜12分);90.0%(252/280)的患儿有相对正常的感知大便的能力;污粪频率大于1次/周者占35.0%(98/280);仅5.7%(16/280)的患儿出现便秘,术后需要泻药(如开塞露)辅助排便;4.3%(12/280)的患儿存在社交活动受限/障碍。单因素分析发现,巨结肠类型为短段型和再手术是Soave术后远期排便功能不良的危险因素(P＜0.05)。 结论 污粪是Soave术后远期排便功能损害的主要表现;短段型巨结肠和再手术与Soave术后远期排便功能有关。
- Abstract:
- Objective To explore the long-term status of bowel function recovery for children with Hirschsprung’s disease (HD) after Soave procedure.Methods A total of 280 HD children (age≥4 years) were followed up by telephone.Based on Rintala questionnaire outcomes,they were divided into two groups of poor bowel function outcomes (Rintala score<12) and average or good bowel function outcomes (Rintala score ≥12).The risk factors of long-term bowel function outcomes were examined.Results During follow-ups,median score of Rintala questionnaire was 18(15,20).Among them,189 cases (189/280,67.5%) had normal bowel function outcomes,65 cases (65/280,23.2%) mild bowel dysfunction and 26 cases (26/280,9.3%) severe bowel dysfunction.Constipation was relatively rare after Soave,with only 5.71% (16/280) requiring a laxative to assist defecation.4.3% (12/280) of the patients had impaired social activities.Univariate analysis found that the type of HD and reoperation were risk factors for long-term poor bowel function after Soave with a statistically significant difference.Conclusions Soling is a major manifestation for long-term bowel function impairment.Short-segment HD and reoperation are the risk factors for poor bowel function outcomes after the Soave procedure.
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备注/Memo
收稿日期:2023-04-04。
通讯作者:陈亚军,Email:chenyajunmd@aliyun.com