新生儿先天性巨结肠症38例报告

目的：探讨新生儿（日龄≤28d)先天性巨结肠症（Hirschsprung‘s Disease,HD)的诊断和处理。方法：回顾分析1985年1月至2001年12月收治的新生儿HD病历38份,复习病史、腹部平片、结肠造影、手术及尸检所见。结果：男35例,女3例。入院时日龄1－28d,出生体重＞2500g 31例,＜2500g 7例。胎便排出时间在出生＞24h 26例,＜24h 3例,未记录9例。全部病婴有腹胀。36例摄腹部平片,其中33例有肠胀气,3例腹腔内有游离气体。23例用12．5％泛影葡胺结肠造影,其中18例诊断HD。23例保守治疗,3例死亡（13％）,15例手术治疗,死亡9例（60％）。结论：我们的经验新生儿HD的诊断主要依据病史、结肠造影、肛门直肠测压,以及直肠粘膜活检和ACHE测定,大多数保守治疗,6个月后根治手术,保守治疗无效、并发肠穿孔或肠结肠炎者行结肠或小肠造瘘。

Hirchsprung''''s Disease in Neonates:A report of 38 cases

Objective:To study the diagnosis and management of Hirschsprung's disease(H.D)in neonates the age at administration was less than 28 days.Methods:Between April 1985 and December 2001 in our unite, 38 medical Charts of HD in neonates were reviewed with clinical feature?abdominal X-vays and Colongraphy. Results: There Were 35 Males and 13 femals, Their ages ranged from 1 day to 28 days. The birth Weight Was more than 2500g in 31 and less than 2500g in 7.Failure to pass meconium in first 24 hours of life was reported in 21. All patients Presented abdominal distation. Abdominal X-rays was Performed in 36 , 33 of them showed intestinal obstruction, other 3 patients showed free air in abdominal cavity. colongraphy using 12.5% urograffin was performed in 23, 1809 them showed a characterics for HD. 23 were received conservative, 3 of them died. 15 were performed procedure 9 of them died. Conclusions: Our date show that diagnosis of HD in neonates was based on clinical feature?colongraphy? anorectal manometry and ache test. majority can be conservetive treated, minority can be operated.