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纤维结肠镜检查指导先天性巨结肠结肠灌洗的研究 |
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刘晓文 陈丽萍 韩秋梅 张丽君 丁凤鸣 齐超
摘要 为研究应用纤维结肠镜检查指导先天性巨结肠结肠灌洗的临床价值，将70例先天性巨结肠手术病例分为对照组35例，按常规灌洗；观察组35例，应用纤维结肠镜检指导灌洗。两组病例手术方式均为Swenson手术。结果：常规灌洗和纤维结肠镜指导下的灌洗效果、两组术后并发症发生率比较，经统计学处理，均有非常显著性差异(P<0.01)；两组术后住院天数比较，观察组比对照组平均缩短2.1 d。提示：纤维结肠镜检查指导结肠灌洗可减少肛管插入长度的随机性及清洁肠腔与炎症治疗的盲目性，提高灌洗质量；利于确定最佳手术时机，从而减少术后并发症，缩短住院天数。
关键词 结肠灌洗；纤维结肠镜；并发症；护理
Study of Coloclyster for Congenital Megacolon
under the Guidance of Fibro-colonoscope
Liu Xiaowen,Chen Liping,Han Qiumei,Zhang Lijun,Ding Fangming,Qi Chao
Wuhan Children Hospital,Wuhan 430016
Abstract In order to study the clinical value of fibro-colonoscopic examination for guiding coloclyster of congenital megacolon (CM),70 cases of CM were divided randomly into control group (n=35,without receiving the examination of fibro-colonoscope) and observed group (n=35,undergoing the examination of fibro-colonoscope). The procedure for the two groups was Swenson operation. The results showed that there was an apparently difference in coloclyster effects between routine coloclyster and coloclyster under the guidance of fibro-colonoscope and the postoperative complication occurrence between the two groups (P<0.01). The hospitalized days after operation were shortened by 2.1 days in the observed group as compared with control group. It was suggested that coloclyster under the guidance of fibro-colonoscope could reduce the randomness of the length of the canal into the nanus and the purposelessness of the clean intestine cavity and inflammation therapy,so as to increase the postoperative indications and shorten the hospitalized days.
Key words coloclyster; fibro-colonoscope; complications; nursing care
先天性巨结肠病是一种胃肠发育畸形性疾病。由于乙状结肠下段或直肠肠壁肌间神经节细胞发育不全或缺如，致使该段肠管处于痉挛收缩状态，失去蠕动能力，其近段肠管逐渐代偿性扩张、肥厚，临床表现腹胀、便秘［1］。为缓解患儿腹胀，消除肠腔内积粪，减轻肠道炎症，防止术后腹腔或盆腔发生感染，减少并发症的发生，术前做好结肠灌洗工作是至关重要的［2］。1986～1998年,我院对90例先天性巨结肠病例行手术治疗，笔者对其中70例术前结肠灌洗方法进行研究，报道如下。
1 临床资料
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