在被诊断患有赫施普朗格病的儿童进行拉透手术后,与肠道功能障碍相关的流行率和因素
Maliwan Surasen1, Palittiya Sintusek1,2, Nimmita Srisan2,3
1Department of Pediatrics, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Pediatric gastroenterology, hepatology & nutrition
|November 20, 2024
概括
肠道功能障碍在为希尔施普朗格病 (HD) 进行手术后很常见,影响近65%的患者. 术前肠球炎和早期手术与较差的结果有关.
科学领域:
- 儿科手术 儿科手术
- 胃肠病学 胃肠病学
- 临床研究 临床研究
背景情况:
- 赫施普朗格病 (Hirschsprung disease,简称HD) 是一种先天性疾病,需要通过拉透程序进行外科纠正.
- 手术后的肠功能障碍,包括肠球炎,便秘和失禁,对于患有HD的患者来说是一个重大问题.
- 了解肠道功能障碍的患病率和风险因素对于改善长期结果至关重要.
研究的目的:
- 为了确定患有赫施普朗格病的儿童在拉透手术后肠道功能障碍的患病率.
- 为了确定与术后肠道功能障碍发展相关的因素.
主要方法:
- 对于2004年至2022年期间被诊断患有HD的18岁以下儿童的医疗记录的回顾性审查.
- 肠道功能障碍的分类是与希尔施普朗相关的肠球炎 (HAEC),便秘和便失禁.
- 统计分析以确定与肠道功能障碍相关的因素,包括手术前条件和手术技术.
主要成果:
- 在平均8.33年的随访期间,肠道功能障碍的总体患病率为64.95%.
- 希尔施普朗相关肠道炎 (HAEC) 是最常见的问题 (46.39%),其次是非保持性失禁 (22.68%) 和便秘 (20.62%).
- 在6个月前进行手术前的HAEC,杜哈梅尔手术和拉透手术与肠道功能障碍的风险增加显著相关.
结论:
- 尽管成功进行了拉透手术,但肠道功能障碍仍然是赫施普朗格病儿童的普遍并发症.
- 手术前的HAEC,杜哈梅尔手术方法和早期的拉透手术 (6个月前) 是长期肠道功能障碍的独立风险因素.
- 需要进一步的研究和量身定制的管理策略来缓解这些术后并发症.
相关概念视频
01:21Inflammatory Bowel Disease V: Surgical Management
121
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
121
01:17Chronic Bowel Disorders: Introduction
388
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
388
01:30Inflammatory Bowel Disease II: Crohn's Disease
185
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
185
01:17Irritable Bowel Syndrome I: Introduction
247
Irritable Bowel Syndrome (IBS) is characterized by functional disturbances in the gastrointestinal system, presenting a cluster of symptoms without evident structural or biochemical abnormalities. It primarily affects the large intestine and may cause abdominal pain, bloating, excessive gas, diarrhea, constipation, or both.
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
Altered...
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
Altered...
247
01:25Assessment of the Rectum and Anus
157
Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
157
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
138
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
138