Gu Yichao,Chen Yongwei,Guo Weihong,et al.Efficacy of radical operations for megacolon in neonates and young infants under 3 months of age[J].Journal of Clinical Pediatric Surgery,2019,18(11):968-972.[doi:10.3969/j.issn.1671—6353.2019.11.014]
3月龄内新生儿及小婴儿先天性巨结肠根治术效果分析
- Title:
- Efficacy of radical operations for megacolon in neonates and young infants under 3 months of age
- Keywords:
- Hirschsprung Disease; Surgical Procedures; Operative; Defecation Function; Treatment Outcome; Infant Newborn
- 分类号:
- R722.1;R574
- 摘要:
- 目的 通过先天性巨结肠根治术后并发症及排便功能的初步评估，探讨3月龄内新生儿及小婴儿巨结肠根治术的疗效。方法 收集首都医科大学附属北京儿童医院2006年7月至2016年5月收治的先天性巨结肠（Hirschsprung’s disease，HD）患儿资料，选取其中3月龄内由同一术者行HD根治术的患儿共282例为研究对象。术后通过电话随访，按照随访资料的收集时段分为A组（资料收集时段为术后10个月至术后3年）、B组（资料收集时段为术后3~6年）、C组（资料收集时段为术后6~10年），对比不同随访时段下HD术后污粪、便秘、小肠结肠炎发生情况及排便功能，采用SPSS 19.0进行统计学分析。结果 282例中获访183例（获访率64.9%），污粪发生率为16.4%，无一例三级污粪，A、B、C三组污粪发生率分别为24.2%、14.9%、7.0%，发生率虽然逐渐降低但组间差异无统计学意义（P=0.154）。便秘总发生率为6.0%，无一例三级便秘，A、B、C三组间便秘发生率差异无统计学意义（P=0.725）。HD术后小肠结肠炎总发生率为11.8%，A、B、C三组间差异无统计学意义（P=0.868）。排便功能：A组优良率为84.4%，B组优良率为93.3%，C组优良率为93%，三组间差异有统计学意义（P=0.001）。结论 生后3个月内接受HD根治术总体安全可行，多数患儿术后排便功能良好，且术后污粪、便秘、小肠结肠炎发生率相对较低。
- Abstract:
- Objective To evaluate the efficacy of radical operations in newborns and young infants with Hirschsprung’s disease (HD) undergoing primary pull-through operation by analyzing postoperative complications and defecation functions. Methods From July 2006 to May 2016, 282 HD patients aged under 3 months were recruited to undergo primary pull-through operation by the same surgeon. The relevant data of postoperative complications and defecation functions were collected over telephone. They were divided into three groups of A (10 months-3 years), B (3-6 years) and C (6-10 years) according to the length of postoperative period. Statistical analysis was performed with SPSS 19.0. Results A total of 183 patients were obtained over telephone and the follow-up rate was 64.9%. The rate of soiling was 16.4% and there were no grade Ⅲ soling. Although no statistical difference existed among groups A(24.2%), B(14.9%) and C(7.0%), the rate of soiling gradually declined. The rate of constipation was 6.0% and there was no grade Ⅲ constipation. No statistical difference existed among three groups. The rate of enterocolitis was 11.8% and no statistical difference existed among groups A, B and C. The excellent/good rate of defecation function was 84.4% in group A, 93.3% in group B and 93% in group C and significant differences existed among three groups (P=0.001). Conclusion For HD neonates and young infants aged under 3 months undergoing primary pull-through operation, most cases achieve excellent defecation functions. Furthermore, the incidence of soiling constipation and HAEC is low.
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备注/Memo
收稿日期:2019-01-05。
通讯作者:陈永卫,Email:yongwei1964@126.com