發(fā)布時(shí)間：2018-07-05 05:09

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

【摘要】：目的：評(píng)價(jià)經(jīng)肛門(mén)直腸結(jié)腸切除斜型吻合術(shù)治療先天性腸無(wú)神經(jīng)節(jié)細(xì)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(mén)直腸結(jié)腸切除斜型吻合術(shù)治療腸無(wú)神經(jīng)節(jié)細(xì)胞癥共105例，對(duì)該組觀察隨訪，并根據(jù)中華醫(yī)學(xué)會(huì)小兒外科分會(huì)肛腸外科學(xué)組制訂的最新便失禁程度判定標(biāo)準(zhǔn)進(jìn)行便失禁臨床評(píng)分，評(píng)定手術(shù)療效。 結(jié)果：105例腸無(wú)神經(jīng)節(jié)細(xì)胞癥患兒行經(jīng)肛門(mén)直腸結(jié)腸切除斜型吻合術(shù)，其中60例經(jīng)6～40個(gè)月隨訪，結(jié)果如下： 1.一般情況：無(wú)吻合口瘺、吻合口裂開(kāi)、傷口感染等近期并發(fā)癥； 2.中期隨訪：無(wú)死亡病例，無(wú)腹脹、便秘復(fù)發(fā)，無(wú)神經(jīng)性膀胱、肛門(mén)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(cè)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(yíng)養(yǎng)發(fā)育均無(wú)明顯異常； 3.主要并發(fā)癥：輕度污便5例，術(shù)后小腸結(jié)腸炎4例； 4.肛門(mén)功能評(píng)價(jià)：便失禁臨床評(píng)分結(jié)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(jié)論：經(jīng)肛門(mén)直腸結(jié)腸切除斜型吻合術(shù)術(shù)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(wú)神經(jīng)節(jié)細(xì)胞癥的理想手術(shù)，較目前國(guó)內(nèi)外流行的Torre手術(shù)有明顯優(yōu)勢(shì)。
[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(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R726.5

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本文編號(hào)：2099050