先天性巨结肠及胆道.pptVIP

术后并发症 Postoperative complications 吻合口感染、泄漏 Anastomotic?infection and leakage 尿潴留 Retention of urine 小肠结肠炎 Enterocolitis 吻合口狭窄，便秘复发 Anastomotic stenosis and recurrent constipation 肛门内括约肌损伤 Internal anal?sphincter injury 远期生活质量下降 Declined quality of life in long-term 要点Key points 1、概念Concept of megacolon 2、分型Pathological type of megacolon 3、临床特征Clinical characteristics and?diagnosis of megacolon 4、治疗原则The surgical principles of megacolon 肛门直肠畸形的分类Classification?of anorectal malformation 没有X影像学资料前不要轻易手术We should?not do operation easily without X-ray MR 针形电刀 Needle?type electric?knife 电刺激仪 Electrical stimulation?instrument 先天性胆道闭锁Congenital biliary atresia Diagnosis and differential diagnosis MRCP,laparoscopic?exploration?and intraoperative cholangiography Cholestasis?syndrome Operation?treatment?of congenital biliary atresia 纤维三角板的切除 Excision of fibrous?triangle?plate 肝门部与肠吻合 Anastomosis of jejunum?and Hilar 胆道闭锁术后用药 Medication after?biliary atresia operation 激素应用 Hormone drugs 抗生素应用 Antibiotics 利胆药应用 Cholagogue 先天性胆总管囊肿Congenital?choledochal cyst MRCP 治疗:囊肿切除，Roux-en-Y吻合，抗反流瓣Treatment:?cyst excision,?Roux-en-Y anastomosis,?anti reflux?valve * * * * * * * * * * * * * * * * * * * * * 先天性巨结肠Congenital megacolon 定义 Defination 由于直肠或者结肠远端的肠管持续痉挛，粪便淤积在近端结肠，使该肠管肥厚、扩张 Rectal?or?colonic?intestinal has persistent?spasm and fecal?deposition in the ?proximal colon results in hypertrophy and?dilatation in proximal segment. Hirschsprung’s Disease,HD 赫什朋氏病Aganglionosis 先天性无神经节细胞症 英文名称 English name 概述 Summary 一种常见的消化道畸形 A common digestive?tract malformation 有遗传倾向， 约1.4-7.8% Genetic predisposition,?about 1.4-7.8% 发病率为1:2000-5000 Incidence rate of 1:2000-5000 男:女 = 4:1 Male:female=4:1 病 因Etiology 病变肠管肌间及粘膜下神经节细胞缺如，是一种发育停顿，停顿越早，无神经节细胞段越长. Absence of?ganglion cells in muscle?and?submucosa of lesion bowel. It is a development?pause.?The more early the pause occurs, the longer intestinal segment without ganglion cells is. 胚胎期第5周消化道神经母细胞从头端向