【摘要】 目的　总结我院 1985～ 2 0 0 1年实施Rehbein手术治疗先天性巨结肠症的经验。方法　全组 2 99例 ,男 2 6 6例 ,女 33例。年龄 15d～ 18岁。Ⅰ期根治手术 2 77例 ,结肠造瘘后Ⅱ期根治手术 2 2例。结果　本组病例无围手术期死亡。吻合口瘘 3例发生于婴儿 ,均经结肠造瘘而愈合 ,再关瘘治愈。有 2 2例术后早期出现内括约肌症状 ,坚持扩肛 3～ 6个月后 ,便秘消失。污粪 6例 ,其中有 4例直肠指诊为吻合口狭窄 ,扩肛后 ,症状均消除。术后获得随访者 16 4例 ,随访内容包括生长发育、排便、直肠检查等。随访时间最长者 16年 ,最短者 8个月。随访中发现 :有便秘症状 6例 ,其中 2例为粘连性肠梗阻 ,经再次手术治愈 ;4例为吻合口狭窄 ,乃出院后未按医嘱行扩肛治疗所致 ,复诊经扩肛后狭窄消除 ,无一例需行内括约肌切开术者 ;有 5例曾出现肠炎、腹泻症状 ,经保守治疗痊愈 ;本组病例中未发现有肛门失禁及长期污粪者。其他病例生长发育与同龄儿相当 ,能自行排便 ,每日大便 1～3次 ,无腹胀。远期并发症有 11例 ,占 6 .7% (11/ 16 4 )。结论　Rehbein手术操作简单 ,创伤小 ,并发症低 ,易于推广。更多还原

【Abstract】 Objective The purpose of this study is to review the experience of Rehbiein’s operation on Hirschsprung’s disease(HD). Methods A total of 299 patients (male 266, female 33) of HD admitted between 1985 and 2001 were reviewed. The age ranged from 15d to 18 years. There were short segment in 18, common type 248, long segment 24 and total colonic type 2 and uncertain type 7. One stage procedure was carried out in 277 cases, Two stage procedures with colostomy followed by Rehbein’s operation were performed on 22 patients. Results There were no postoperative deaths. The early complication consisted of constipations or fecal soiling (22), anastomotic leaks (3), adhesive intestinal obstruction (2) abdominal incision infection (3) and wound dehiscence (2). The followed up results of 164 cases from 8 months to 16 years showed that most patients had bowel movements 1～3 times per day except 6 cases had constipation and 5 enterocolitis ( 6.7% ). Conclusion The Rehbein’s method in the treatment for children with Hirschsprung’s disease is easy to perform with less complications.更多还原