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目的探讨先天性巨结肠经肛门Soave手术治疗后并发症的病因和诊治方法。方法对我院2001年至2007年收治的124例先天性巨结肠患儿的疗效及并发症情况进行回顾性分析。结果术后近期并发症(1个月内):结肠扭转2例,住院期间行二次手术复位后痊愈;小肠结肠炎11例,鞘内感染4例,鞘内结肠假性梗阻8例,均行保守治疗痊愈。远期并发症:便秘12例,其中4例于术后6个月再次行根治手术治疗后痊愈;另8例行长期排便训练后排便功能恢复正常。大便失禁14例,行三阶段排便训练及生物反馈治疗后,8例排便控制好,无污粪,余6例临床症状有好转。结论正确认识和防治经肛门Soave手术后并发症,可提高该手术的治疗效果。
Objective To investigate the etiology and diagnosis and treatment of congenital megacolon after anal Soave operation. Methods A retrospective analysis was performed on the efficacy and complications of 124 cases of Hirschsprung’s disease admitted to our hospital from 2001 to 2007. Results Postoperative complications (within 1 month): 2 cases of colonic torsion, 2 cases recovered during second hospitalization after hospitalization; 11 cases of enterocolitis, 4 cases of intrathecal infection and 8 cases of false intrathecal colon obstruction Line conservative treatment healed. Long-term complications: constipation in 12 cases, of which 4 cases after 6 months of radical surgery again cured; the other 8 cases of long-term defecation training bowel function returned to normal. Stool incontinence in 14 cases, three-stage defecation training and biofeedback treatment, 8 cases of defecation control, no sewage, more than 6 cases of clinical symptoms have improved. Conclusion Correct understanding and prevention of postoperative anal Soave complications can improve the therapeutic effect of the operation.