不同术式治疗先天性巨结肠症患儿临床研究

摘要

目的 探讨不同术式治疗先天性巨结肠症患儿的临床疗效及安全性. 方法 对行改良Soave术(A组,30例)、改良Swenson术(B组,30例)的60例先天性巨结肠症患儿的临床资料进行回顾性分析,比较两组各项手术指标、术后并发症、术后6个月排便功能恢复状况及手术前后生活质量.结果 A组手术时间显著长于B组(P<0.01),术中出血量显著多于B组(P<0.01),两组术后进食时间、住院时间、术后并发症发生率、排便功能恢复状况比较差异无统计学意义(P>0.05).术后6个月两组生活质量评分均较术前显著升高(P<0.01),同期两组比较差异无统计学意义(P>0.05).结论 改良Soave术与改良Swenson术治疗先天性巨结肠症均能有效改善患儿排便功能及生活质量,疗效显著且相当,并发症较少,与前者相比,后者手术时间较短、术中出血量较少.%Objective To explore the efficacy and safety of different operative treatments for children with Hirschsprung disease (HD).Methods The clinical data of 60 HD children undergoing modified Soave operation (group A, n=30) and doing modified Swenson operation (group B, n=30) were retrospectively analyzed.Operative indexes, postoperative complications, recovery of postoperative 6 month defecation function as well as pre-and post-operative quality of life were compared between 2 groups.before and after operation (operation time, intraoperative blood loss, postoperative feeding time, length of hospital stay), were compared between the two groups.Results The operation time was significantly longer and intraoperative blood loss more in group A than in B (P<0.01) and there were no significant group differences in postoperative feeding time and length of stay (P>0.05).Group differences in the incidences of postoperative complications and in postoperative defecation function recovery had no statistical significance (P>0.05). Scores on quality of life of both groups heightened more significantly in postoperative 6 months (P<0.01) and group difference had no statistical significance (P>0.05).Conclusion Both modified Soave and Swenson operations could effectively improve defecation function and quality of life of HD children, they have equivalent efficacy and fewer postoperative complications, and the latter has shorter operation time and fewer intraoperative blood loss compared with the former.