%0 Journal Article
%T 腹腔镜改良Soave术治疗小儿巨结肠的临床疗效观察<br>Cinical efficacy of laparoscope Soave operation in treatment of children with hirschsprung
%A 曹振杰
%A 杜俊鹏
%A 黄泓玮
%A 孙雪花
%A 陈
%A 玄
%A 陈
%A 琦
%J 郑州大学学报（医学版）
%D 2018
%R 10.13705/j.issn.1671-6825.2017.08.071
%X 目的:探讨腹腔镜改良Soave术治疗小儿巨结肠的临床疗效。方法:回顾性分析腹腔镜改良Soave术治疗的150例巨结肠患儿手术情况,术后均随访1 a,评估并比较患儿术后6、12个月排便功能,检测并比较手术前后直肠肛管压力变化,统计所有患儿术后相关并发症发生情况。结果:147例患儿手术顺利完成,手术成功率98.0%; 剩余3例因术中腹腔粘连严重转为开腹手术。术后6个月及12个月患儿排便功能优良率分别为72.8%及93.2%,且术后12个月较术后6个月升高(P<0.001); 与术前比较,术后6个月患儿直肠静息压力及肛管静息压力均降低(P<0.001),肛管高压区长度缩短(P<0.001); 患儿腹腔镜Soave术后小肠结肠炎、便秘、大便失禁及污粪等并发症的发生率分别为2.7%、3.4%、4.1%及3.4%,经对症治疗后均好转。结论:腹腔镜改良Soave术可有效改善巨结肠患儿术后排便功能,恢复其控便能力,并有效减少术后并发症的发生,具有较高的安全性。<br>Aim: To explore the clinical efficacy of laparoscope Soave operation in the treatment of children with hirschsprung.Methods: A total of 150 children with hirschsprung who accepted the laparoscope Soave operation in our hospital, and followed-up for 1 year post-operation were enrolled in the study. The defecation function 6 and 12 months post-operation, the change of rectal pressure pre-operation and post-operation, and the occurence of related complications post-operation were recorded or evaluated.Results: The operation of 147 children completed successfully, the achievement ratio of operation was 98.0%; the remaining 3 cases converted to open operation due to the serious intraoperative intraperitoneal adhesion. The distingushed achiever ratio of defecation function of the patients 6 and 12 months post-operation were 72.8% and 93.2%, respectively, and the ratio in the 12 months post-operation was higher than that in the 6 months post-operation(P<0.001); compared with pre-operation, the rectal resting pressure and anal resting pressure decreased significantly 6 months post-operation(P<0.001), the anal canal high length shortened significantly(P<0.001); the occurrence rates of enterocolitis, constipation, fecal incontinence and fouling dung of the patients after operation were 2.7%, 3.4%, 4.1% and 3.4%, which were improving after symptomatic treatment.Conclusion: Laparoscope Soave operation can improve the defecation function of children with hirschsprung effectively, restore the control ability and reduce the occurrence of related complications post-operation with high safety
%K 小儿巨结肠
%K 腹腔镜
%K Soave术
%K 疗效
%K 并发症&lt
%K br&gt
%K children with hirschsprung
%K laparoscope
%K Soave operation
%K efficacy
%K complication
%U http://jms.zzu.edu.cn/oa/darticle.aspx?type=view&id=201803031