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1. 重庆医科大学附属第二医院胃肠外科,重庆,400010
2. 四川省德阳市人民医院普外科,德阳,618000
纸质出版日期:2014,
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孙家琛, 梁光熙, 官一平, 等. 改良Duhamel术治疗成人先天性巨结肠及其类缘病[J]. 重庆医科大学学报, 2014,38(1):94-97.
SUN Jiachen, Liang Guangxi, GUAN Yiping, et al. Modified Duhanmel procedure versus low anterior resection for Hirschsprung’s disease and its allied disorder in adults[J]. Journal of Chongqing Medical University, 2014,38(1):94-97.
孙家琛, 梁光熙, 官一平, 等. 改良Duhamel术治疗成人先天性巨结肠及其类缘病[J]. 重庆医科大学学报, 2014,38(1):94-97. DOI:
SUN Jiachen, Liang Guangxi, GUAN Yiping, et al. Modified Duhanmel procedure versus low anterior resection for Hirschsprung’s disease and its allied disorder in adults[J]. Journal of Chongqing Medical University, 2014,38(1):94-97. DOI:
目的:探讨改良Duhamel术治疗成人先天性巨结肠(Hirschsprung’s disease,HD)及先天性巨结肠类缘病(Hirschsprung’s allied disorder,HAD)的疗效与安全性。方法:回顾性分析2012年1月至2011年1月间在重庆医科大学附属第一、第二医院Ⅰ期接受改良Duhamel术(D组,n=16)或低位直肠前切除术(L组,n=13)治疗的29例成人HD及HAD患者的临床资料。结果:无术中死亡病例。D组在术前生活质量评分[(2.2±0.7)分;(15.1±1.0)分]、手术时间(160±21) min和术后并发症发生率上与L组差异均无统计学意义(P >0.05)。但D组术中出血量(54.4±23.7) ml少于L组(t=2.394,P=0.028),术后住院时间(12.6±4.1) d短于L组(t=2.381,P=0.025),术后生活质量评分(4.4±1.4;17.9±1.2)分高于L组(t=2.090,P=0.046;t=2.224,P=0.035)。有严重并发症未解决或接受再次手术的6例病例视为手术失败,其中D组2例,L组4例。结论:改良Duhamel术治疗HD及HAD疗效确切,安全性高。
Objective:To evaluate the clinical efficacy and safety of modified Duhamel procedure for Hirschsprung’s disease(HD) and Hirschsprung’s allied disorder(HAD) in adults. Methods:Clinical data of 29 adult patients with HD and HAD who underwent one-stage modified Duhamel procedure(D group,n=16) or low anterior resection(L group,n=13) between January 2001 and January 2012 were analyzed respectively. Results:All operations were one-stage procedure without death case. There was no significant difference in mean preoperative life quality score((2.2±0.7) or (15.1±1.0)),operation time((160±21) min) and incidences of postoperative complications between two groups(P >0.05). However,there were less mean intraoperative blood loss((54.4±23.7) ml,t=2.394,P=0.028),shorter mean postoperative hospital stay((12.6±4.1) d,t=2.381,P=0.025) and higher postoperative life quality score((4.4±1.4),t=2.090,P=0.046 and (17.9±1.2),t=2.224,P=0.035) in D group compared with those of L group. Of the six patients who were considered treatment failures with unsolved serious complications or reoperations,2 patients were from D group and 4 patients were from L group. Conclusions:Modified Duhamel procedure is safe and effective in the treatment of HD and HAD in adults.
成人先天性巨结肠成人先天性巨结肠类缘病改良Duhamel术术后肛门功能
adult Hirschsprung’s diseaseadult Hirschsprung’s allied diseasemodified Duhamel procedurepostoperative anal function
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