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目的 探讨直肠肛管测压检查在新生儿先天性巨结肠 (HD)早期诊断中的应用价值。方法 对 4 2例经手术病理或直肠粘膜活检确诊的新生儿HD患儿的术前直肠肛管压力监测结果进行评价分析 ,并与X线钡灌肠进行比较。结果 直肠肛管测压 18例未出现直肠肛管抑制反射(RAIR) ,12例RAIR反射异常 ,确诊HD30例 ,诊断符合率 71 4 3%。X线钡灌肠确诊HD 5例 ,可疑HD14例 ,诊断符合率 4 5 2 4 %。直肠肛管测压阳性而钡灌肠阴性者 16例 ,钡灌肠阳性而直肠肛管测压阴性者 5例。检查结果的不同部分进行统计学处理 χm2 =4 76 ,P <0 0 5 ,差异有显著意义。结论直肠肛管压力监测在新生儿HD诊断中优于X线钡灌肠。该检查方法简单、安全、有效、无创伤性 ,可作为新生儿期怀疑HD患儿的首选检查 ,但必须结合其他检查手段才能作出确切诊断
Objective To investigate the value of rectal anal tube manometry in the early diagnosis of neonatal Hirschsprung’s disease. Methods Preoperative anal canal pressure monitoring results of 42 cases of neonatal HD diagnosed by pathological or rectal mucosal biopsy were evaluated and compared with those of X-barium enema. Results Rectal anal canal manometry reflex in 18 cases did not appear rectal anal canal reflex (RAIR), 12 cases of RAIR reflex abnormalities, the diagnosis of HD30 cases, the diagnostic coincidence rate of 71.43%. X-ray barium enema confirmed HD 5 cases, suspicious HD 14 cases, diagnosis coincidence rate 4542%. Rectal anal canal manometry was negative and barium enema in 16 cases, barium enema positive and negative rectal anal canal in 5 cases. Different parts of the test results for statistical analysis χm2 = 4 76, P <0 0 5, the difference was significant. Conclusions Rectal anal canal pressure monitoring is superior to X-ray barium enema in neonatal HD diagnosis. The method is simple, safe, effective and noninvasive and can be used as the first choice of screening for suspected HD in neonatal period. However, it must be combined with other examination methods to make a definite diagnosis