临床小儿外科杂志2024，Vol.23Issue(11)：1049-1053,5.DOI:10.3760/cma.j.cn101785-202307061-009
持续肛管排气排便在先天性巨结肠治疗中的应用
Clinical application of continuous rectal tube drainage in the treatment of Hirschsprung disease
摘要
Abstract
Objective To explore the application value of continuous defecation through indwelling anal canal in the conservative treatment period prior to surgery for Hirschsprung disease in infants.Methods This retrospective study included 80 infants with Hirschsprung disease treated at the Department of Neonatal Surger-y,Jiangxi Children's Hospital,from January 2019 to January 2023.Based on different methods of auxiliary defe-cation during the conservative treatment period,the infants were divided into a study group with long-term anal canal retention and a control group receiving enema and anal dilation.The study group was further divided into common type(Group A,n=21)and long segment type(Group C,n=11),while the control group was divided into common type(Group B,n=33)and long segment type(Group D,n=15).Compliance with tube place-ment was statistically analyzed.The four subgroups were paired for comparison(A&B/C&D)regarding gender,birth weight,age at first visit,age at definitive surgery,surgical method,incidence of small intestine-colonitis re-lated to Hirschsprung disease,rate of colostomy,weight at definitive surgery,duration of surgery,length of resec-ted bowel,maximum diameter of dilated segments in postoperative specimens,histological inflammation of bowel walls,postoperative complications,length of hospital stay,and hospitalization costs.Results There were no sta-tistically significant differences among groups in age at first visit,birth weight,age at definitive surgery,gender,or surgical method(P＞0.05).There were also no statistically significant differences in colostomy rates,weight at definitive surgery,duration of surgery,length of resected bowel,histological inflammation of bowel walls,postoper-ative complications,days in hospital,or hospitalization costs between Groups A and B(P＞0.05).For Groups C and D,there were no statistically significant differences in weight at definitive surgery,duration of surgery,or length of resected bowel(P＞0.05).In Group A,3 cases of small intestine-colonitis related to Hirschsprung dis-ease occurred,compared to 14 in Group B;the average maximum diameter of dilated segments in Group A was(3.00±0.59)cm,and(3.77±0.64)cm in Group B.In Group C,2 cases of small intestine-colonitis occurred,while Group D had 9 cases;no colostomy cases occurred in Group C,compared to 6 in Group D;the maximum diameter in Group C was(3.09±0.49)cm,and(3.9±0.55)cm in Group D;Group C had 1 case of histologi-cal inflammation,while Group D had 8 cases;Group C experienced 2 postoperative complications,while Group D had 10;Group C had an average hospital stay of(32.73±6.37)days,while Group D had(53.60±15.78)days;the average hospitalization costs for Group C was(53 891.29±10 317.25)yuan,and(81 400.33±27 393.87)yuan for Group D;all differences were statistically significant(P＜0.05).Conclusions Long-term placement of a rectal tube before definitive surgery can reudrce the incidence of small intestine-colonitis related to Hirschsprung disease in newborns and infants,prevent proximal bowel dilation and hypertrophy.In long segment types,it can significantly reduce the incidence of postoperative complications,decrease the rate of colostomy,alleviate suffering,promote surgical recovery,shorten hospital time,and reduce hospitalization costs.关键词
先天性巨结肠/外科手术/儿童Key words
Hirschsprung Disease/Surgical Procedures,Operative/Child引用本文复制引用
丁宁,成子衿,刘智文..持续肛管排气排便在先天性巨结肠治疗中的应用[J].临床小儿外科杂志,2024,23(11):1049-1053,5.基金项目
江西省卫生健康委科技计划项目(202310997) Science and Technology Plan Project of Jiangxi Provincial Health Commission(202310997) （202310997）
