CAJ | 학술논문

目的了解以充盈性大便失禁为主要症状的患儿的诊断及手术治疗后的近期疗效.方法回顾性分析14例充盈性大便失禁患儿在我科手术治疗的临床资料,术后对所有患儿进行随访,随访内容包括患儿每日大便次数、大便性质和排便的控制能力.结果 14例充盈性大便失禁患儿均有便秘史,结合患儿病史、体格检查以及术前钡剂灌肠、直肠肛管测压和直肠黏膜乙酰胆碱酯酶(AChE)组织化学检查结果明确术前诊断,所有患儿均接受巨结肠根治手术治疗,术后病理证实2例为先天性巨结肠(HD),12例为巨结肠同源病(HAD).所有患儿术后随访6～12个月,“大便失禁”症状均消失,排便前有感觉,大便控制能力好.结论患儿大便失禁的病因繁多,便秘导致的充盈性大便失禁的患儿,需对其进行详细的病史采集、体格检查及影像学检查,如确诊HD或HAD为病因,采用先天性巨结肠根治的不同术式完整切除病变肠管,效果满意.
목적 료해이충영성대편실금위주요증상적환인적진단급수술치료후적근기료효.방법 회고성분석14례충영성대편실금환인재아과수술치료적림상자료,술후대소유환인진행수방,수방내용포괄환인매일대편차수、대편성질화배편적공제능력.결과 14례충영성대편실금환인균유편비사,결합환인병사、체격검사이급술전패제관장、직장항관측압화직장점막을선담감지매(AChE)조직화학검사결과명학술전진단,소유환인균접수거결장근치수술치료,술후병리증실2례위선천성거결장(HD),12례위거결장동원병(HAD).소유환인술후수방6～12개월,“대편실금”증상균소실,배편전유감각,대편공제능력호.결론 환인대편실금적병인번다,편비도치적충영성대편실금적환인,수대기진행상세적병사채집、체격검사급영상학검사,여학진HD혹HAD위병인,채용선천성거결장근치적불동술식완정절제병변장관,효과만의.
Objective To explore the diagnosis and surgical efficacy of children with overflow fecal incontinence.Methods The clinical data of 14 surgical cases of overflow fecal incontinence were retrospectively analyzed.And their defecation frequency,stool character and self-controlled ability in defecation were evaluated during follow-ups.Results All cases had a history of constipation.On the basis of disease history,physical examination,barium enema,anorectal manometry and AchE histochemical staining of rectal mucosal biopsy,the preoperative diagnosis was established.Radical operations were performed.And the postoperative pathological diagnoses were Hirschsprung's disease (HD,n=2) and Hirschsprung's allied disease (HAD,n =12).During a follow-up period of 6-12 months,satisfactory self-control was achieved in defecation and fecal incontinence disappeared.Conclusions The causes of fecal incontinence vary in children.If either HD or HAD is confirmed,radical operation may be performed with satisfactory outcomes.