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本文报告7例先天性巨结肠症(HD)再次手术处理的原因及对策。7例中2例为便秘复发而再行Duhmel术;1例因盲袋闸门综合征而再次手术上钳,后因并发小肠结肠炎而死亡;1例首次手术为急诊盲肠造瘘,10月后再行Duhamel根治术;1例为新生儿HD,首次手术时未能明确病因行剖腹探查,后行Soave术;还有两例因粘连性肠梗阻和臀部脓肿而再次手术。作者通过近年文献回顾,结合7例HD再次手术治疗的临床体会,对先天性巨结肠的病因学、诊断、术式选择、便秘复发的原因及处理、肠造瘘问题等诸方面进行讨论。
This article reports seven cases of Hirschsprung ’s disease (HD) reoperation reasons and countermeasures. Duhmel surgery was performed in 2 of 7 patients with recurrence of constipation. One patient was again surgically impaled by blind-bag gate syndrome and then died of concurrent enterocolitis. One patient underwent first-time emergency cecal fistula. After 10 months Followed by Duhamel radical mastectomy; 1 case of neonatal HD, laparotomy at the time of first surgery, and Soave surgery at the time of first operation; and two cases of reoperation due to adhesive intestinal obstruction and buttock abscess. Through reviewing the literature in recent years and combining with the clinical experience of 7 cases of reoperation after HD surgery, the author discusses the etiology, diagnosis, operation selection, reasons and treatment of recurrent constipation, intestinal fistula problems and other aspects of congenital megacolon.