重庆医学Issue(3)：289-292,4.DOI:10.3969/j.issn.1671-8348.2016.03.001
192例0～3个月先天性肠无神经节细胞症婴儿临床分析
Clinical analysis on Hirschsprung′s disease in infants within 3 months:a 192 cases report
摘要
Abstract
Objective To research the calretinin for the clinical diagnosis of Hirschsprung′s disease within 3 months infant and follow up the patients which underwent trans‐anal rectum colon resection and oblique anastomosis within 3 months and evaluate the therapeutic efficiency .Methods We collected all the medical data of the 192 patients within 3 months which were diagnosed with Hirschsprung′s disease in our hospital from January of 2008 to October of 2014 .We followed up the intermediate patients who underwent trans‐anal rectum colon resection and oblique anastomosis to evaluate the anal rectum function and quality of life .Results There were 192 patients with Hirschsprung′s disease ,in which 139 patients underwent trans‐anal rectum colon resection and ob‐lique anastomosis ,53 patients underwent colonstomy surgery .The preoperative diagnosis was based on the typical medical history , physical examination ,and special auxiliary examinations .The special auxiliary examinations included barium enema ,anorectal mano‐metry and rectal suction biopsy ,the positive rate were 80 .1% ,92 .1% and 97 .9% respectively .Sixty‐six (60 .5% ) medium‐term patients were followed up successfully ,no stubborn constipation and incontinence occurred ,2 cases(3% ) had postoperative entero‐colitis ,2 cases(3% ) had defile feces .All male children had penile erectile phenomenon ,the growth and development level were ap‐propriate compared with normal infants and young children .Twenty‐five cases underwent stool routine ,blood routine ,liver and kid‐ney function tests ,which were in normal range .Barium enema showed 15 cases with intestinal morphological recovered well .Eleven patients underwent anorectal manometry ,10(90 .9% )of them had RAIR recovered ,one case had no RAIR .Conclusion Calretinin immunohistochemical staining could be used as a golden standard to diagnose Hirschsprung′s disease within 3 months before opera‐tion .Trans‐anal rectum colon resection and oblique anastomosis is appropriate to the patients within 3 month ,the design of which conforms to the physiological ,has low rate of postoperative complications and midterm satisfactory results .关键词
神经节/肠/婴儿 ,新生/先天性肠无神经节细胞症/钙视网膜蛋白/经肛门直肠结肠切除斜形吻合术/中期随访Key words
ganglia/intestines/infant ,newborn/Hirschsprung′s disease/calretinin/trans-anal rectum colon resection and ob-lique anastomosis/median follow-up分类
医药卫生引用本文复制引用
李洪,刘洪江,金先庆,李晓庆,向丽,刘伟,候金凤,金鑫,王海涛,童科融..192例0～3个月先天性肠无神经节细胞症婴儿临床分析[J].重庆医学,2016,(3):289-292,4.基金项目
国家自然科学基金项目（81370474）；国家临床重点专科建设项目资助（国卫办医函［2013］544）。 （）
