我们于1987年～1997年应用Ikeda术式对18例先天性巨结肠症患儿施行了手术,取得较为满意的疗效。报告如下。 1 临床资料 本组18例,男16例,女2例。年龄最大者为8岁,最小者15d,平均年龄2.6年。18例患儿出生后皆有胎粪排出延迟,并相继出现排便困难、腹胀及呕吐。体检可见:腹胀明显,肠型存在。肛检:直肠壶腹部空虚感,查毕皆可见明显喷射状气便排出。钡剂灌肠可见明显的狭窄段、移行段及扩张段。狭窄段及行段位于直肠上段及乙状结肠者14例,位于降结肠者4例。术前直肠粘膜肌层活检者15例,合并小肠结肠炎者3例。入院诊断均为“先天性巨结肠症”入院后皆行2～3周术前准备,特别是肠道准备。每日0.9％生理盐水清洁灌汤,并辅以口服石腊油,至腹胀明显减轻,肠型消失,然后行一期Ikeda手术。其中,环钳钳夹16例,kochers钳钳夹2例。术后环钳及kochers钳分别于6～9日自行脱落。术 In 1987 ~ 1997 Ikeda operation of 18 cases of Hirschsprung’s disease in children with surgery, and achieved satisfactory results. The report is as follows. 1 Clinical data The group of 18 patients, 16 males and 2 females. The oldest was 8 years old, the youngest was 15 days, with an average age of 2.6 years. Eighteen infants died of meconium after delivery, and had difficulty in defecation, bloating and vomiting. Physical examination shows: significant abdominal distension, intestinal type exists. Anal examination: emptiness of the ampulla of the abdomen, check all visible jet-like gas will be discharged. Barium enema showed obvious stenosis, migration and expansion of the segment. Fourteen cases were located in the upper rectum and sigmoid colon in the narrow segment and in the lower segment, and 4 in the descending colon. Preoperative rectal mucosa biopsy in 15 cases, 3 cases of enterocolitis. Admissions are diagnosed as "Hirschsprung ’disease admission after admission 2 to 3 weeks preoperative preparation, especially for intestinal preparation. 0.9% daily saline clean irrigation broth, supplemented with oral paraffin oil, significantly reduced abdominal distension, intestinal disappear, and then a Ikeda operation. Among them, the ring pliers clamp in 16 cases, kochers pliers clamp in 2 cases. Postoperative ring clamp and kochers pliers were 6 to 9 on their own off. Surgery