经肛门Ⅰ期巨结肠根治术预后因素的探讨

目的对经肛门Ⅰ期巨结肠根治术预后因素进行探讨,以期为临床治疗提供依据。方法对经肛门Ⅰ期巨结肠根治术治疗的患儿177例,将其原始资料按统一标准列表、赋值,以其根治术后便秘、术后小肠结肠炎作为自变量,将其他因素作为应变量,采用多元回归法分析其根治术预后与其他因素之间的关系。结果先天性巨结肠经肛门Ⅰ期根治术便秘可能与后鞘切除范围、黏膜剥离位置、吻合口狭窄及手术年龄有关;术后小肠结肠炎可能与后鞘切除范围、黏膜剥离位置、吻合口狭窄及术前是否存在小肠结肠炎有关。结论经肛门Ⅰ期巨结肠根治术手术后主要与术中病变肠管及后鞘切除范围、黏膜残留、手术年龄,以及正确术前诊断有关,选择合适手术时机,正确处理后鞘及黏膜是提高治愈率的关键。

Study on the prognosis of One-stage transanal endorectal pull-through for Hirschsprung disease

Objective To investigate the prognosis of one-stage transanal endorectal pull-through for Hirschsprung's disease,in order to provide the basis for the clinical treatment.Methods177 children with Hirschsprung's disease underwent one-stage transanal pull-through operation in the depertment of pediatric surgery of affiliated hospital of Ningxia medical university.Using the multiple regression analysis to analyze the interrelated prognosis factor of the one-stage transanal pull-through for Hirschsprung's disease.ResultsThe constipation after one-stage transanal pull-through procedure were possible related to the range of muscular cuff incised,the position of mucosa be stripped,stoma stenosis and if the children having the per-operation enterocolitis.ConclusionThe prognosis of one-stage transanal pull-through for Hirschsprung's disease are mainly related with the incised range of pathological bowel segment and muscular cuff;the position mucosa residual,the age of patients and the correct pre-operative diagonsis.The key points of improving cure rate are the proper operative time and correctly incised range of muscular cuff and mucosa.