本文選題：腸無神經(jīng)節(jié)細胞癥 + 直腸結腸切除斜型吻合術�。� 參考：《重慶醫(yī)科大學》2012年碩士論文

【摘要】：目的：評價經(jīng)肛門直腸結腸切除斜型吻合術治療先天性腸無神經(jīng)節(jié)細胞癥的療效。 方法：2007年12月至2011年3月，我院普外科采用經(jīng)肛門直腸結腸切除斜型吻合術治療腸無神經(jīng)節(jié)細胞癥共105例，對該組觀察隨訪，并根據(jù)中華醫(yī)學會小兒外科分會肛腸外科學組制訂的最新便失禁程度判定標準進行便失禁臨床評分，評定手術療效。 結果：105例腸無神經(jīng)節(jié)細胞癥患兒行經(jīng)肛門直腸結腸切除斜型吻合術，其中60例經(jīng)6～40個月隨訪，結果如下： 1.一般情況：無吻合口瘺、吻合口裂開、傷口感染等近期并發(fā)癥； 2.中期隨訪：無死亡病例，無腹脹、便秘復發(fā)，無神經(jīng)性膀胱、肛門狹窄等并發(fā)癥，所有隨訪患兒大便均有便意，55例患兒大便基本正常，男性52例，均有陰莖勃起，28例行直腸肛管測壓檢查，4例存在RAIR反射，，1例存在接近于正常的RAIR反射，所有患兒營養(yǎng)發(fā)育均無明顯異常； 3.主要并發(fā)癥：輕度污便5例，術后小腸結腸炎4例； 4.肛門功能評價：便失禁臨床評分結果：優(yōu)（5～6分）：58例，良（3～4分）：2例，差（0～2分）：0例，優(yōu)良率100%。 結論：經(jīng)肛門直腸結腸切除斜型吻合術術后可獲得良好的排便功能，中期療效滿意，是治療先天性腸無神經(jīng)節(jié)細胞癥的理想手術，較目前國內外流行的Torre手術有明顯優(yōu)勢。
[Abstract]:Objective: to evaluate the effect of transrectal colonic resection and oblique anastomosis in the treatment of congenital apogoneurosis. Methods: from December 2007 to March 2011, 105 patients with intestinal apogoneurosis were treated by transrectal resection and oblique anastomosis in our hospital. According to the latest criteria for judging the degree of incontinence, the clinical score of fecal incontinence was evaluated according to the new standard of anorectal surgery of the Chinese Medical Association for pediatric surgery. Results one hundred and five children with intestinal apogoneurosis underwent anorectal resection and oblique anastomosis, and 60 of them were followed up for 6 to 40 months. The results were as follows: 1. General situation: no anastomotic leakage, anastomotic rupture, wound infection and other recent complications; 2. There were no death cases, no abdominal distension, no recurrence of constipation, no neurogenic bladder, anus stenosis and other complications. All 28 cases of penile erectile were examined by rectal anus manometry, 4 cases had air reflex and 1 case had rar reflex close to normal, all the children had no obvious abnormal nutrition development; 3. The main complications were mild stool in 5 cases, postoperative enterocolitis in 4 cases, and postoperative colitis in 4 cases. Anal function evaluation: clinical score of incontinence: 58 cases were excellent (5 ~ 6 points), 2 cases were good (3 ~ 4 points): 2 cases were good (0 ~ 2 points), 0 cases were poor (0 ~ 2 points), the excellent and good rate was 100%. Conclusion: transanorectal colonic resection and oblique anastomosis can obtain good defecation function and satisfactory intermediate curative effect. It is an ideal operation for the treatment of congenital intestinal apogoneurosis and has obvious advantages over Torre operation which is popular at home and abroad.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R726.5

【參考文獻】

相關期刊論文 前10條

1 杜鵬;金先慶;;兒童先天性巨結腸手術的治療進展[J];重慶醫(yī)學;2009年15期

2 朱進;金先慶;;Bcl-2、鈣視網(wǎng)膜蛋白在發(fā)育異常腸壁神經(jīng)節(jié)細胞中的表達[J];第三軍醫(yī)大學學報;2010年01期

3 翁正華;翁勛錦;林志勇;胡強;;改良經(jīng)肛門巨結腸根治術39例報告[J];廣西醫(yī)學;2009年03期

4 許芝林,李權,安群,王龍,邢軍,胡佐民;腹膜返折上方入路經(jīng)肛門巨結腸根治術[J];臨床小兒外科雜志;2002年03期

5 林忠亮;吳俊偉;黃理賢;;改良Swenson手術治療先天性巨結腸62例[J];臨床小兒外科雜志;2006年05期

6 馬能強;陳琦;李勇;;Calretinin在先天性巨結腸中的表達及其意義[J];現(xiàn)代實用醫(yī)學;2009年06期

7 易軍;劉大林;劉繼炎;李濤;姜斌;陸如鋼;孫斌;周勇;王浩;周建峰;杜寶峰;;經(jīng)肛門結腸套疊式切除術治療小兒先天性巨結腸[J];南京醫(yī)科大學學報(自然科學版);2009年01期

8 李建國;林志川;劉泉源;許篤行;郭鐘容;李輝;沈學藝;王淵全;;經(jīng)肛門拖\

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