【摘要】 目的　评估先天性巨结肠Swenson改良术后排便功能和生活质量。方法　随访常见型先天性巨结肠行Swenson改良术后患儿 4 5例 (男 37例 ,女 8例 ) ,手术年龄 2 .5个月～ 6岁 ,平均 1.6岁。术后随访 8～ 16年 ,平均 10 .9年。评估其排便功能和生活质量。结果　术后并发症有 :污粪和小肠结肠炎 17例 (37.8% ) ;便秘 3例 (6 .7% ) ;大便失禁 3例 (6 .7% ) ;小便失禁 4例 (8.9% ) ;吻合口狭窄 2例 (4.4 % )和粘连性肠梗阻 1例 (2 .2 % )。 2 3例 (5 1% )表现不同程度的排便障碍 ,但肛门功能优良率仍达到 84 .4 % (李正评分 )和 93.4 % (Rintala评分 )。生活质量评分显示 ,优者 18例 (40 % ) ,良者2 1例 (46 .7% ) ,差者 6例 (13.3% )。结论　先天性巨结肠Swenson改良术后 ,多数患儿远期肛门功能和生活质量优良 ,排便功能障碍是影响生活质量的主要因素。更多还原

【Abstract】 Objective To access long term results of anal function and quality of life (QOL) after modified Swenson’s procedure for Hirschsprung’s disease (HD). Methods Forty five cases (male 37, female 8) with common type HD were followed up from 8 to 16 years (mean 10.9 years) after modified Swenson’s operation. The timing at operation was 2.5 months and 6 years (wean 1.6 years). The diagnosis were confirmed by barium enema, anal rectal manometry and pathological examination. Results The postoperative complications were soiling and enterocolitis in 17 cases ( 37.8% ); constipation in 3 cases( 6.7% );fecal incontinence in 3( 6.7% );urinary incontinence in 4 ( 8.9% );anastomotic stricture in 2 ( 4.4% ); adhesive intestinal obstruction in 1 ( 2.2% ). Twenty three cases had different degrees of defective dysfunction (51%) postoperatively. According to Li and Rintala’s scores, the satisfactory rate was 84.4% and 93.3% respectively. The QOL investigation showed that 18 cases were satisfactory(40%),21 were fair ( 46.7% ),and 6 poor ( 13.3% ). Conclusions Most cases with HD can be expected to achieve a long term good or fair anal function and QOL after modified Swenson’s operation. Fecal dysfunction is the main factor influencing on long term QOL.更多还原