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对 36例先天性巨结肠患儿行改良Duhamel式术根治术 ,随访 6个月～ 5年 ,总结其手术方法 ,并讨论疗效。本组病人共 36例 ,其中 3月龄 6例 ,4月～ 1岁 18例 ;男性 32例 ,女性 4例。普通型巨结肠 2 6例 ,短段型 3例 ,长段型 6例 ,全结肠型 1例。全部采用改良Duhamel术式 ,即直肠后结肠拖出 ,直肠结肠前壁环形钳夹吻合。 1例因小肠结肠炎至中毒性休克死亡 ,1例吻合口炎治愈 ,1例术后扩张吻合口致吻合口近端结肠后壁穿孔 ,结肠造瘘后愈。余 33例均顺利治愈 ,无污粪、大便失禁及盲袋闸门综合症 ,排便功能良好。提示 ,此术式不失为一种简单易操作 ,并发症少的根治方法 ,但要注意术前肠道准备 ,术中环钳与肠腔直径相符 ,术后 3月～ 6月扩张吻合口。
Thirty-six children with Hirschsprung’s disease were treated with modified Duhamel technique. The patients were followed up for 6 months to 5 years. The surgical methods were summarized and the therapeutic effects were discussed. A total of 36 patients in this group, of which 6 months at 3 months, April to 1 year 18 cases; 32 males and 4 females. 26 cases of common type megacolon, 3 cases of short segment, 6 segments of long segment and 1 case of colon-type. All modified Duhamel technique, that is, after the colon rectum traction, colorectal anastomosis ring anterior clamp. One case died of enterocolitis to toxic shock, one was cured by anastomotic stoma. One case was anastomosis after anastomosis, which resulted in perforation of posterior wall of colonic mucosa and colostomy. More than 33 cases were cured, no sewage, fecal incontinence and blindness gate syndrome, defecation function is good. Tip, this operation after all, is a simple and easy operation, less complications radical method, but should pay attention to preoperative bowel preparation, intraoperative ring clamp consistent with the lumen diameter, after 3 months to 6 months to expand anastomotic.