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目的 评估先天性巨结肠Swenson改良术后排便功能和生活质量。方法 随访常见型先天性巨结肠行Swenson改良术后患儿 4 5例 (男 37例 ,女 8例 ) ,手术年龄 2 .5个月～ 6岁 ,平均 1.6岁。术后随访 8～ 16年 ,平均 10 .9年。评估其排便功能和生活质量。结果 术后并发症有 :污粪和小肠结肠炎 17例 (37.8% ) ;便秘 3例 (6 .7% ) ;大便失禁 3例 (6 .7% ) ;小便失禁 4例 (8.9% ) ;吻合口狭窄 2例 (4.4 % )和粘连性肠梗阻 1例 (2 .2 % )。 2 3例 (5 1% )表现不同程度的排便障碍 ,但肛门功能优良率仍达到 84 .4 % (李正评分 )和 93.4 % (Rintala评分 )。生活质量评分显示 ,优者 18例 (40 % ) ,良者2 1例 (46 .7% ) ,差者 6例 (13.3% )。结论 先天性巨结肠Swenson改良术后 ,多数患儿远期肛门功能和生活质量优良 ,排便功能障碍是影响生活质量的主要因素。
Objective To assess the postoperative defecation function and quality of life of patients with Hirschsprung’s disease. Methods Follow-up The common type of Hirschsprung disease was treated with Swenson modified 45 cases (37 males and 8 females). The operative age ranged from 2.5 months to 6 years (mean, 1.6 years). Follow-up 8 to 16 years, an average of 10.9 years. Assessment of bowel function and quality of life. Results Postoperative complications included: faecal and enterocolitis in 17 cases (37.8%), constipation in 3 cases (6.7%), fecal incontinence in 3 cases (6.7%), incontinence in 4 cases (8.9%), Anastomotic stricture in 2 cases (4.4%) and adhesive intestinal obstruction in 1 case (2.2%). Twenty-three (51%) patients showed varying degrees of defecation disorder, but the anal function rate still reached 84.4% (Lee positive score) and 93.4% (Rintala score). Quality of life scores showed excellent in 18 cases (40%), good in 21 cases (46.7%), poor in 6 cases (13.3%). Conclusions After the improvement of Hirschsprung’s disease, the majority of children with long-term anal function and quality of life, defecation dysfunction is the main factor affecting the quality of life.