Teitelbaum D H, Drongowski R A, Chamberlain J N, Coran A G
University of Michigan Medical Center and the C.S. Mott Children's Hospital, Ann Arbor 48109, USA.
J Pediatr Surg. 1997 Jul;32(7):1049-52; discussion 1052-3. doi: 10.1016/s0022-3468(97)90397-3.
Primary endorectal pull-through (ERPT) has become an increasingly popular method of caring for neonates and young infants who have Hirschsprung's disease. This study evaluated the long-term stooling patterns and continence rates of patients who had a primary ERPT as a young infant. The records of 24 infants who underwent a primary ERPT for Hirschsprung's disease were reviewed. The patients' families (those patients over 3 years of age, n = 12) underwent a detailed interview that graded continence from 0 (poor) to 10 (normal). Mean age at ERPT was 15 +/- 17 days (range, 2 to 67). Mean follow-up was 1,036 +/- 614 days. Nine patients suffered from 20 episodes of enterocolitis. Stooling frequency declined rapidly in the first 6 months after the ERPT (r2 = 1.00) and more slowly after this time (r2 = 0.79). Continence was graded as normal (10) in one, good (6 to 9 points) in nine, and fair (1 to 5) in two patients, both of whom had total colonic disease. The authors conclude that a primary ERPT in the young infant who has Hirschsprung's disease can yield excellent results including normalization of stooling frequency and good to excellent levels of continence.
一期经直肠拖出术（ERPT）已成为治疗患有先天性巨结肠症的新生儿和幼儿越来越常用的方法。本研究评估了幼年时接受一期ERPT治疗的患者的长期排便模式和控便率。回顾了24例因先天性巨结肠症接受一期ERPT治疗的婴儿的记录。对患者家属（年龄超过3岁的患者，n = 12）进行了详细访谈，将控便情况从0（差）到10（正常）进行分级。ERPT时的平均年龄为15±17天（范围为2至67天）。平均随访时间为1036±614天。9例患者发生了20次小肠结肠炎。ERPT后的前6个月排便频率迅速下降（r2 = 1.00），此后下降速度较慢（r2 = 0.79）。1例患者控便分级为正常（10），9例为良好（6至9分），2例患者为一般（1至5分），这2例均患有全结肠疾病。作者得出结论，患有先天性巨结肠症的幼儿接受一期ERPT可以取得优异的效果，包括排便频率正常化以及控便水平达到良好至优异。
