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先天性巨结肠症行斯文森手术后13至25年的随访

13--25 Years follow-up after Swenson's operation for Hirschsprung's Disease.

作者信息

Nielsen O H, Madsen C M

出版信息

Prog Pediatr Surg. 1977;10:97-102.

PMID:866692
Abstract

77 patients with Hirschsprung's disease, operated according to the Swenson procedure in the period from 1949--1960 have been followed up in 1961 and 1975. 6 were dead, all from operative complications (a mortality of 8%). The results in the survivors were assessessed with regard to their bowel function and genito-urinary symptoms. The results in 1961 were 37 good (48%), 25 satisfactory (32%) and 9 poor (11%). In 1975, 8 patients were untraceable (10%), of the remainder 34 were good (44%), 22 satisfactory (29%) and 4 poor (5%), while 3 had been reoperated (4%). Two of the patients in the "poor" group had permanent enterostomy. The detailed assessment seems to indicate that diarrhoea and especially soiling in the first postoperative years are symptoms with a tendency to subside spontaneously. A residual constipation did subside in a few cases, but on a whole was much less likely to do so. In some instances, patients who for a long period had had normal stool passage again developed slight constipation, but only in one case a real recurrence with severe constipation was seen. tthere were no sexual complaints among the patients, and their fertility seemed normal. Only 5 patients had very moderate urinary symptoms, although a somewhat larger proportion of urinary anomalies might have been expected. (At the time of admission, a complete urological survey was not routine in these patients).

摘要

1949年至1960年间,按照斯文森手术方法接受手术的77例先天性巨结肠患者在1961年和1975年接受了随访。6例死亡,均死于手术并发症(死亡率8%)。对存活患者的肠道功能和泌尿生殖系统症状进行了评估。1961年的结果为,良好37例(48%),满意25例(32%),差9例(11%)。1975年,8例患者失访(10%),其余患者中,良好34例(44%),满意22例(29%),差4例(5%),3例再次手术(4%)。“差”组中有2例患者有永久性肠造口。详细评估似乎表明,术后最初几年的腹泻,尤其是便污,有自发缓解的趋势。少数病例中残留的便秘确实有所缓解,但总体而言缓解的可能性要小得多。在某些情况下,长期排便正常的患者再次出现轻度便秘,但只有1例出现了严重便秘的真正复发。患者中没有性方面的主诉,其生育能力似乎正常。只有5例患者有非常轻微的泌尿系统症状,尽管预计泌尿系统异常的比例会略高一些。(入院时,对这些患者进行全面的泌尿系统检查并非常规操作)

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