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目的根据先天性巨结肠(HD)及其同源病(HAD)根治术治疗前后的小肠结肠炎(HAEC)发病情况,探讨导致术后小肠结肠炎发生的原因。方法 55例HD和40例HAD患者病例,均行根治术。将HD患者分为A1组和A2组,分别为行左半结肠切除术和行结肠次全切除术;同样相对应将HAD患者分为B1组和B2组。分析比较这四个小组术前、术后的小肠结肠炎发病情况,探讨引发术后HAEC的相关因素。结果 HD组术前发生HAEC 7例(12.7%),HAD组术前发生HAEC 8例(20.0%);四组术后共发生HAEC 28例,其中10例是术前发生HAEC的患者。55例HD患者术后发生HAEC 11例(20.0%),40例HAD患者术后发生HAEC 13例(32.5%),两组比较差异有统计学意义(P<0.05)。A2组术后HAEC发生率30.0%明显高于A1组14.2%;B1的术后HAEC发病率33.3%高于B2组31.6%,两组数据比较差异均无统计学意义(P>0.05)。结论先天性巨结肠及其同源病和治疗前的小肠结肠炎都是导致行根治术后发生小肠结肠炎并发症的重要原因。
Objective To investigate the pathogenesis of enterocolitis according to the incidence of enterocolitis (HAEC) before and after the treatment of Hirschsprung’s disease and Hirschsprung’s disease. Methods 55 cases of HD and 40 cases of HAD patients were treated with radical mastectomy. Patients with HD were divided into groups A1 and A2, respectively, for the left hemilaminectomy and subtotal colon resection; the same corresponding HAD patients were divided into B1 and B2 groups. Analysis and comparison of these four groups preoperative and postoperative incidence of enterocolitis, to explore the postoperative HAEC related factors. Results There were 7 cases (12.7%) of HAEC preoperatively in HD group and 8 cases (20.0%) of HAEC preoperatively in HA group. 28 cases of HAEC occurred in 4 cases, of which 10 cases were preoperative HAEC. There were 11 cases (20.0%) of HAEC occurred in 55 cases of HD patients, and 13 cases (32.5%) of HAEC occurred in 40 cases of HAD patients. The difference between the two groups was statistically significant (P <0.05). The incidence of postoperative HAEC in group A2 was significantly higher than that in group A1 (30.0% vs 14.2%). The incidence of postoperative HAEC in group B1 was 33.3% higher than that in group B2 (31.6%). There was no significant difference between the two groups (P> 0.05). Conclusions Hirschsprung’s disease and homologous disease and pre-treatment enterocolitis are all the major causes of complications of enterocolitis after radical operation.