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[新生儿先天性巨结肠症的外科治疗方法]

[Methods of surgical treatment of Hirschsprung's disease in newborns].

作者信息

Kotin A N, Arintsina I A, Bairov V G, Dreĭger K L, Karavaeva S A, Nemilova T K, Popov A A

出版信息

Khirurgiia (Mosk). 1993 Aug(8):44-9.

PMID:8264169
Abstract

Fifty-nine newborn infants with Hirschsprung's disease were treated at the Saint-Petersburg Center of Surgery of Developmental Anomalies from 1978 to 1991. The typical rectosigmoid form was found in 47.5% and a long zone of agangliosis in 35.6% of children. Mortality rate--16.7%. According to the development of enterocolitis, three variants of the course of the disease in the newborns were distinguished. It is shown that the informativeness of the diagnostic methods increases with the growth of the infants, and the final diagnosis of Hirschsprung's disease is best established at the age of over two weeks on the basis of repeated or initially postponed contrast study of the large intestine. Inefficacy of nonoperative treatment conducted for 2-3 days and recurrence of symptoms of intestinal obstruction are indications for operative decompression of the intestine. The performance of one-stage radical operation at the age of about one month is advisable in an uncomplicated course of the disease.

摘要

1978年至1991年期间,圣彼得堡发育异常外科中心对59例患有先天性巨结肠症的新生儿进行了治疗。47.5%的患儿表现为典型的直肠乙状结肠型,35.6%的患儿存在长段无神经节病变区。死亡率为16.7%。根据小肠结肠炎的发展情况,区分了新生儿疾病病程的三种变体。结果表明,随着婴儿的成长,诊断方法的信息量增加,先天性巨结肠症的最终诊断最好在两周以上时,根据重复或最初推迟的大肠造影检查来确定。进行2 - 3天的非手术治疗无效以及肠梗阻症状复发是肠道手术减压的指征。在疾病无并发症的病程中,建议在大约一个月大时进行一期根治手术。

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