1、直肠肛管纵切心型吻合术治疗先天性巨结肠远期疗效观察2001?d7?d3?H255?6?O?8?C?f?e?H?%?8?6?O?8?C?,?5?4?f?e?68?V0?T?1992?1996?E?O?8?C?,?F?f?e?68?V0?S40?(?28?(?C?6?R?822?(32%),?A?H?w10?(15%),6?R?8?3?27?(40%),3?19?(28%);?K?46?(67%)?(?10?(15%),?12?(18%)V0?d?w?%?V0?P?c?:?V2?e?V2?9?,V2?V2?i?(?C?L?E?(?C?L?K?H?O?V0?(?K?V0c?:?g?V2?V0?0?K
2、?313?(19%)?(?O?B?P7?(10%)?(?A?C?)6?41?(1.4%),4-6?6?(8.8%),?2?(3%)?(?i?4?(6%);?g?:?68?E?K?1?(?W?l?7?(10%),24h?W?2?(3%)V0?:?T?7?p?e36?(52.94%)?(?B?K?1?bV0?6?O?8?C?0?E?7?7?(?H?(?(?F?(?a?P?H?%V0?s?f?e?O?8?C?H?f?e?E?6V2?O?8?C?O?8?(?O?8?e?(?C?)?%?(?e?(?(?i?a?y?h?k?V0?;?1992?19%?E?C?,?(?H?V0?y?O?H?,?F?(?C?
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4、2%)?(?A?H?w10?(15%?),6?R?8?3?27?(40%)a3?19?(28%)V0?A?K?46?(67%)?(?10?(15%)?12?(18%)V0?7?(5?9)?(?C?,?12?(17.6%)?(?3?V0?C?)?,?2?(2.9%)V0?e?O1?(?6?1?V01.2?O?:?(?e?(?9?,?(?V2?i?(?C?L?E?W?(?C?L?K?H?O?(?K?(?F?5?w?5?K?V2?i?V2?68?A?(?C?)?H?0?K?313?(19%)?(?O?7?(10%)?(?2?(3%)?(?i?4?(6%)?(?,?2?(2.9%)V0?7?A?(?C
5、?)6?4?31?(4?6?6?;?i?4?A?(2?C?6?R?8?(3?,1?B?V0?:68?w?E?K?1?V07?W?l?,2?24h?W?V0?T?7:68?A?E36?(?i32?V0?B?K?1?bV0?1?5?)?5?K?i?3?:47500(?(?2?2?0?w?O?K?12102001?d7?d3?H?2?O?)X?V2?5?(?)?v?(?)?W?l?(?)?(24h)?7?E?i?(kPa)?B?(mm)?K?i?5576?H10.22.0?0.3218t4.3482?H11.30.83?0.3110t4.8783?9.11.80?0.4117?4.0278?H10.
6、71.9?0.417.4?5.1?i?1V2?2?0?K?)?L?)?9?V0?C?)?0?K?3?V03?;?1992?f?e?E?6?O?8?C?H?21?C?,?K?g?7?C?,?o?(?7?C?,?6?)?,?(?5?)?A?6?40.5?1cm?(?3?5cm?(?6?(?%?6?(?e?(?(?a?V0?O?8?(?C?)?%?9?(?O?8?e?(?C?)?V0?19?3?H?1017?w?(?i?31.65%?(?e?)?l?b3?C?,?P?B?7?(10%),?l?s?(?7?,?V2?e?OV2?6?H?(?B?;?10?E?C?,?(?9?f?V2?C?A?C?)?H
7、?(?2?V0?d?C?)?5?4?68?A?(?0?K13?(19%)?(?A?P?(?3?i?(?5?)?(?3?C?)?0?K?3?V0?P?9?i?(?B?%?V0?C?)?F?(?a?P?H?%V0?(?K?V2?H?i?)?A?6?l?6?%?(?5?C?)?i?V0?2?)?C?A?c?6?%?H?(?g?C?)?9?V0?d?C?9?6?,?V0?6?O?8?C?9?(?;V2?;V2?H?o?(?(?V?H?V0?1?s?2?(?.?f?e?C?)?H?8?.?A?,?w?l?W?(1999,200):38?39?8?(?.?f?e?C?,?.?l?W?(1994,2(2):
8、34?35?(?(?6?O?8?C?F?C?F?A?,?w?l?W?(1991,12(6):345Long-termEffectofRectumandAnusCanalVerticalExcisionandHeart-shapedAnastomosisforHirschsprungsDiseaseTreatmentLiPing?(ShiSongnian.KaiFengChildrengksHospital.475000ChinaABSTRACTObjective:Toevaluateeffectof68caseswhomhavebeenperfomedrectumandanuscanalver
9、tialexcisionandheart-shapedanastomosisover5years.Methods:68caseswhomhavebeenperformedreturnandanuscanalverticalexcisionwerecollectedfrom1992to1996.A-mongthesepatients,40weremaleand28female,twenty-twocases(32%)werelessthansixmonthsoldincludingtennew-born(15%)?(twenty-sevencases(40%)rangefromsixmonths
10、to3yearsold,nineteencases(28%)weremorethanthreeyearsold.Typecommonwas46cases(67%)?(typelong-segmenttencases(15%)andshort-segmenttwelve(18%).Allthesepatientswererechecked.(1)fecaldischargeabilitywhichincludedsuchitemsas:timesperday.characterofstool,senseofdefecation,conspitation,incontinenceandcontam
11、inatedstool,ifusingpurgative,ifcommonlifeaffectedanddoingroutineanuscheck,(2)Objectivefecaldischargeabititywhichincludesuchitemsas:bariumenemaradiograph,pressureofrectumandanus.Results:Thirteenpatients(19%)wereabnormalinaurasfunction.Sevenpatients(10%)havecontaminatedstool,(Onepatient(1.4%)lastedsix
12、years,sixpatients(8.8%)lastedfourtosixyears),twopatients(3%)constipation,Fourpatients(6%)stoolin-continence.Theresultofbariumenemal:Allpatientswerenormalintheangleofanuscanalandrectum,sevenpatientsbariumleakage,twopatientsbariumretention.Theresultofrectumandamuspressure:Thirty-sixpatients(52.94%)wer
13、epositiveinrectalandanuscanalsuppressivereflex.Therangeofpressureofanuscanalandrectumandthehigh-pressuresectionofanuscanalarealllowerthannormal?Conclusion:RectumandanuscanalverticalexcisionadaptedtoallagesandallkindsofHirschsprungsdisease.Long-termeffectwasaffected?Bthelengthofintestinewithoutganglion.Thesymptomswillbereliefedwiththegrowingofchildenandcanbespeeded?Bbiologyfeed-backtraining.KeyWordsHirschsprungsdisease;Heart-shapedanastomosic;Long-termeffect(?T?w?H?2000-05-02;?T?H:2001-01-02)
