【摘要】：目的比較經(jīng)肛門(mén)直腸內(nèi)拖出術(shù)和經(jīng)腹巨結(jié)腸根治術(shù)治療先天性巨結(jié)腸的長(zhǎng)期排便功能和生活質(zhì)量,以指導(dǎo)臨床治療方式的選擇。 方法回顧性研究自1998-2008年收治的90例先天性巨結(jié)腸患兒，其中50例采取經(jīng)肛門(mén)直腸內(nèi)拖出術(shù),40例經(jīng)腹手術(shù),對(duì)比分析兩組患兒術(shù)后晚期并發(fā)癥,遠(yuǎn)期排便功能和遠(yuǎn)期生活質(zhì)量。 結(jié)果兩組晚期并發(fā)癥發(fā)生率比較,經(jīng)肛門(mén)直腸內(nèi)拖出術(shù)低于經(jīng)腹手術(shù)(29%vs33%),其中發(fā)生兩種以上并發(fā)癥差異有統(tǒng)計(jì)學(xué)意義(5%vs20%,P.001)。兩組排便功能總評(píng)分相似,但是肛門(mén)直腸內(nèi)拖出術(shù)在排便控制(4.38±4.77vs8.00±6.06,P=.04)大便性狀方面(1.58±1.26vs2.71±2.24,P.05)評(píng)分優(yōu)于經(jīng)腹手術(shù),差異有統(tǒng)計(jì)學(xué)意義。生活質(zhì)量評(píng)分顯示,肛門(mén)直腸內(nèi)拖出術(shù)和經(jīng)腹手術(shù)無(wú)統(tǒng)計(jì)學(xué)差異(8.5±1.6vs6.8±1.2,P.05)；排便控制與生活質(zhì)量呈有意義的相關(guān)性(r=0.827,P.001),排便控制好,生活質(zhì)量高。 結(jié)論經(jīng)肛門(mén)直腸內(nèi)拖出術(shù)是治療先天性巨結(jié)腸的可行有效的方法,晚期并發(fā)癥少,長(zhǎng)期排便控制優(yōu)于經(jīng)腹手術(shù),生活質(zhì)量與經(jīng)腹手術(shù)相比無(wú)明顯差異。但經(jīng)肛門(mén)直腸內(nèi)拖出術(shù)的長(zhǎng)期療效評(píng)價(jià)仍需大量的病例和長(zhǎng)期密切隨訪研究來(lái)評(píng)估。
[Abstract]:Objective to compare the long-term defecation function and quality of life (QOL) of congenital Hirschsprung's disease with transrectal draining operation and transabdominal megacolon radical operation in order to guide the choice of clinical treatment. Methods A retrospective study of 90 children with Hirschsprung's disease from 1998 to 2008 was carried out. Among them, 50 cases were treated with transrectal internal draining and 40 cases underwent transabdominal surgery. The late postoperative complications of the two groups were compared and analyzed. Long-term defecation function and long-term quality of life. Results the incidence of late complications in the two groups was lower than that in the transabdominal operation (29% vs 33%), and there was a significant difference between the two groups (5vs20 / P.001). The total score of defecation function in the two groups was similar, but the score of defecation control (4.38 鹵4.77vs8.00 鹵6.06) was (1.58 鹵1.26vs2.71 鹵2.24) P.05 better than that of abdominal operation. The difference is statistically significant. The quality of life score showed that there was no significant difference between internal draining operation and transabdominal operation (8.5 鹵1.6vs6.8 鹵1.2 鹵P.05). There was a significant correlation between defecation control and quality of life (r = 0.827 P. 001). The defecation control was well controlled and the quality of life was high. Conclusion the transanal rectal draining is a feasible and effective method for the treatment of Hirschsprung's disease. The late stage complications are less, the long-term defecation control is better than the transabdominal operation, and the quality of life is not significantly different from that of the transabdominal operation. However, the long-term outcome evaluation of transanal-rectal draining still requires a large number of cases and long-term follow-up studies to evaluate.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類(lèi)號(hào)】：R726.5

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