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先天性巨结肠合并先天性心脏病患儿的治疗及患者报告结局

Treatment and Patient Reported Outcome in Children with Hirschsprung Disease and Concomitant Congenital Heart Disease.

作者信息

Hasserius Johan, Hedbys Josefine, Graneli Christina, Hagelsteen Kristine, Stenström Pernilla

机构信息

Faculty of Medicine, Lund University, Lund, Sweden.

Department of Clinical Sciences, Unit of Pediatric Surgery, Skane University Hospital, Lund University, 221 85 Lund, Sweden.

出版信息

Biomed Res Int. 2017;2017:1703483. doi: 10.1155/2017/1703483. Epub 2017 Mar 8.

DOI:10.1155/2017/1703483
PMID:28373976
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5360935/
Abstract

. Congenital heart disease (CHD) is reported to be associated with Hirschsprung disease (HD). The aim was to evaluate any differences between children with HD with and without CHD, respectively, with regard to patient characteristics, medical care, and patient reported bowel function. . This is a retrospective chart study and a cross-sectional long-term follow-up of patients older than 4 years old, including all children with HD operated on with transanal endorectal pull-through (TERPT) at a tertiary center of pediatric surgery. Information about patient characteristics, diagnostics, surgery, and medical care was compiled. At long-term follow-up, bowel function was assessed by Bowel Function Score. . Included were 53 HD-patients, 13 with CHD and 40 without CHD. Children with CHD more commonly presented with failure to thrive; 4 (23%) compared to those without CHD (0%) ( < 0.01). In the long-term follow-up, including 32 patients (6 with CHD), constipation was more commonly reported by children with CHD 5 (83%) than by children without CHD 4 (27%) ( = 0.01). No differences were shown in the other parameters such as fecal control and incontinence. . HD-patients with CHD more commonly presented with failure to thrive and more frequently reported constipation than HD-patients without CHD. The findings indicate that HD-patients with CHD might need special consideration in their initial care and long-term follow-up.

摘要

据报道,先天性心脏病(CHD)与先天性巨结肠病(HD)有关。本研究旨在评估患有和未患有CHD的HD患儿在患者特征、医疗护理以及患者报告的肠道功能方面是否存在差异。

这是一项回顾性图表研究,对4岁以上患者进行横断面长期随访,包括在一家三级小儿外科中心接受经肛门直肠内拖出术(TERPT)治疗的所有HD患儿。收集了有关患者特征、诊断、手术和医疗护理的信息。在长期随访中,通过肠道功能评分评估肠道功能。

纳入研究的有53例HD患者,其中13例患有CHD,40例未患有CHD。患有CHD的儿童更常出现生长发育迟缓;与未患有CHD的儿童(0%)相比,有4例(23%)(P<0.01)。在长期随访中,包括32例患者(6例患有CHD),患有CHD的儿童报告便秘的情况比未患有CHD的儿童更常见,分别为5例(83%)和4例(27%)(P = 0.01)。在其他参数如粪便控制和大便失禁方面未显示出差异。

与未患有CHD的HD患者相比,患有CHD的HD患者更常出现生长发育迟缓,且更频繁地报告便秘。研究结果表明,患有CHD的HD患者在初始护理和长期随访中可能需要特别关注。

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本文引用的文献

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Bowel Function and Quality of Life After Transanal Endorectal Pull-through for Hirschsprung Disease: Controlled Outcomes up to Adulthood.先天性巨结肠经肛门直肠内拖出术后的肠道功能与生活质量:直至成年期的对照结果
Ann Surg. 2017 Mar;265(3):622-629. doi: 10.1097/SLA.0000000000001695.
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Evaluation of nutritional status and support in children with congenital heart disease.先天性心脏病患儿营养状况评估与支持
Eur J Clin Nutr. 2016 Apr;70(4):528-31. doi: 10.1038/ejcn.2015.209. Epub 2015 Dec 23.
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Hirschsprung's Disease and Associated Congenital Heart Defects: A Prospective Observational Study from a Single Institution.
先天性巨结肠症与相关先天性心脏缺陷:单中心前瞻性观察研究。
Front Pediatr. 2014 Sep 17;2:99. doi: 10.3389/fped.2014.00099. eCollection 2014.
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Hirschsprung's disease in children: a five year experience at a university teaching hospital in northwestern Tanzania.儿童先天性巨结肠症:坦桑尼亚西北部一家大学教学医院的五年经验
BMC Res Notes. 2014 Jun 28;7:410. doi: 10.1186/1756-0500-7-410.
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Development of Frequency of Stools over Time in Children with Hirschsprung Disease Posttransanal Endorectal One-Stage Pull-through.先天性巨结肠经肛门直肠内一期拖出术后患儿排便频率随时间的变化情况
Eur J Pediatr Surg. 2015 Aug;25(4):359-64. doi: 10.1055/s-0034-1376396. Epub 2014 May 28.
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Quality of life and congenital heart disease in childhood and adolescence.儿童及青少年时期的生活质量与先天性心脏病
Arq Bras Cardiol. 2014 Feb;102(2):192-8. doi: 10.5935/abc.20130244. Epub 2013 Dec 21.
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A prospective observational study of associated anomalies in Hirschsprung's disease.先天性巨结肠症相关畸形的前瞻性观察研究。
Orphanet J Rare Dis. 2013 Nov 23;8:184. doi: 10.1186/1750-1172-8-184.
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Hirschsprung disease and use of calretinin in inadequate rectal suction biopsies.先天性巨结肠病和钙视网膜蛋白在直肠吸引活检不足中的应用。
Arch Pathol Lab Med. 2013 Aug;137(8):1099-102. doi: 10.5858/arpa.2012-0220-OA.
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Visualisation of the rectoanal inhibitory reflex with a modified contrast enema in children with suspected Hirschsprung disease.改良对比灌肠法对疑似先天性巨结肠患儿肛直肠抑制反射的可视化。
Pediatr Radiol. 2013 Aug;43(8):950-7. doi: 10.1007/s00247-013-2622-4. Epub 2013 Mar 6.
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