经肛门直肠内拖出术和经腹巨结肠根治术治疗先天性巨结肠长期排便功能和生活质量对比研究
发布时间：2019-02-13 11:57
【摘要】：目的比较经肛门直肠内拖出术和经腹巨结肠根治术治疗先天性巨结肠的长期排便功能和生活质量,以指导临床治疗方式的选择。 方法回顾性研究自1998-2008年收治的90例先天性巨结肠患儿，其中50例采取经肛门直肠内拖出术,40例经腹手术,对比分析两组患儿术后晚期并发症,远期排便功能和远期生活质量。 结果两组晚期并发症发生率比较,经肛门直肠内拖出术低于经腹手术(29%vs33%),其中发生两种以上并发症差异有统计学意义(5%vs20%,P.001)。两组排便功能总评分相似,但是肛门直肠内拖出术在排便控制(4.38±4.77vs8.00±6.06,P=.04)大便性状方面(1.58±1.26vs2.71±2.24,P.05)评分优于经腹手术,差异有统计学意义。生活质量评分显示,肛门直肠内拖出术和经腹手术无统计学差异(8.5±1.6vs6.8±1.2,P.05)；排便控制与生活质量呈有意义的相关性(r=0.827,P.001),排便控制好,生活质量高。 结论经肛门直肠内拖出术是治疗先天性巨结肠的可行有效的方法,晚期并发症少,长期排便控制优于经腹手术,生活质量与经腹手术相比无明显差异。但经肛门直肠内拖出术的长期疗效评价仍需大量的病例和长期密切随访研究来评估。
[Abstract]:Objective to compare the long-term defecation function and quality of life (QOL) of congenital Hirschsprung's disease with transrectal draining operation and transabdominal megacolon radical operation in order to guide the choice of clinical treatment. Methods A retrospective study of 90 children with Hirschsprung's disease from 1998 to 2008 was carried out. Among them, 50 cases were treated with transrectal internal draining and 40 cases underwent transabdominal surgery. The late postoperative complications of the two groups were compared and analyzed. Long-term defecation function and long-term quality of life. Results the incidence of late complications in the two groups was lower than that in the transabdominal operation (29% vs 33%), and there was a significant difference between the two groups (5vs20 / P.001). The total score of defecation function in the two groups was similar, but the score of defecation control (4.38 卤4.77vs8.00 卤6.06) was (1.58 卤1.26vs2.71 卤2.24) P.05 better than that of abdominal operation. The difference is statistically significant. The quality of life score showed that there was no significant difference between internal draining operation and transabdominal operation (8.5 卤1.6vs6.8 卤1.2 卤P.05). There was a significant correlation between defecation control and quality of life (r = 0.827 P. 001). The defecation control was well controlled and the quality of life was high. Conclusion the transanal rectal draining is a feasible and effective method for the treatment of Hirschsprung's disease. The late stage complications are less, the long-term defecation control is better than the transabdominal operation, and the quality of life is not significantly different from that of the transabdominal operation. However, the long-term outcome evaluation of transanal-rectal draining still requires a large number of cases and long-term follow-up studies to evaluate.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R726.5
本文编号：2421527
[Abstract]:Objective to compare the long-term defecation function and quality of life (QOL) of congenital Hirschsprung's disease with transrectal draining operation and transabdominal megacolon radical operation in order to guide the choice of clinical treatment. Methods A retrospective study of 90 children with Hirschsprung's disease from 1998 to 2008 was carried out. Among them, 50 cases were treated with transrectal internal draining and 40 cases underwent transabdominal surgery. The late postoperative complications of the two groups were compared and analyzed. Long-term defecation function and long-term quality of life. Results the incidence of late complications in the two groups was lower than that in the transabdominal operation (29% vs 33%), and there was a significant difference between the two groups (5vs20 / P.001). The total score of defecation function in the two groups was similar, but the score of defecation control (4.38 卤4.77vs8.00 卤6.06) was (1.58 卤1.26vs2.71 卤2.24) P.05 better than that of abdominal operation. The difference is statistically significant. The quality of life score showed that there was no significant difference between internal draining operation and transabdominal operation (8.5 卤1.6vs6.8 卤1.2 卤P.05). There was a significant correlation between defecation control and quality of life (r = 0.827 P. 001). The defecation control was well controlled and the quality of life was high. Conclusion the transanal rectal draining is a feasible and effective method for the treatment of Hirschsprung's disease. The late stage complications are less, the long-term defecation control is better than the transabdominal operation, and the quality of life is not significantly different from that of the transabdominal operation. However, the long-term outcome evaluation of transanal-rectal draining still requires a large number of cases and long-term follow-up studies to evaluate.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R726.5
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