腹腔镜下改良Soave术对先天性巨结肠患儿肛门功能、肠道菌群及生活质量的影响

摘要 目的：探讨腹腔镜下改良Soave术对先天性巨结肠患儿肛门功能、肠道菌群及生活质量的影响。方法：选取2019年5月~2022年3月期间本院接收的先天性巨结肠患儿68例，根据手术方案的不同将患儿分为常规组（常规经腹腔镜辅助下Soave术，32例）和改良组（腹腔镜下改良Soave术，36例），比较两组临床指标、肛门功能、肠道菌群、生活质量的变化及并发症发生情况。结果：与常规组比较，改良组手术时间、术后肠蠕动时间、住院时间较短，术中出血量较少（P<0.05）。改良组的优良率高于常规组（P<0.05）。改良组术后3个月健康生活量表简表（SF-36）各维度评分高于常规组（P<0.05）。改良组术后3个月双歧杆菌、乳酸杆菌、粪肠球菌高于常规组（P<0.05），大肠杆菌低于常规组（P<0.05）。改良组的中期并发症发生率、短期并发症发生率低于常规组（P<0.05）。结论：与常规经腹腔镜辅助下Soave术相比，先天性巨结肠患儿采用腹腔镜下改良Soave术治疗，在改善肛门功能、肠道菌群、生活质量、临床指标、降低并发症发生率等方面效果显著，临床应用价值较高。

Effects of Laparoscopic Modified Soave Operation on Anal Function,Intestinal Flora and Quality of Life in Children with Hirschsprung's Disease

ABSTRACT Objective: To investigate the effect of laparoscopic modified Soave operation on anal function, intestinal flora and quality of life in children with Hirschsprung''s disease. Methods: 68 children with Hirschsprung''s disease who were admitted to our hospital from May 2019 to March 2022 were selected, and they were divided into conventional group (conventional laparoscopic-assisted Soave operation, 32 cases) and modified group (laparoscopic modified Soave operation, 36 cases) according to different surgical plans. The changes of clinical indicators, anal function, intestinal microbiota, quality of life and complications were compared between the two groups. Results: Compared with the conventional group, the operation time, postoperative intestinal peristalsis time and hospital stay in the modified group were shorter, and the amount of intraoperative blood loss was less (P<0.05). The excellent and good rate in the modified group was higher than that in the conventional group(P<0.05). The scores of all dimensions of the Short-Form-36 Health Survey (SF-36) in the modified group at 3 months after operation was higher than that in the conventional group(P<0.05). The bifidobacterium, Lactobacillus and Enterococcus faecalis in the modified group at 3 months after operation were higher than those in the conventional group(P<0.05), the Escherichia coli was lower than that in the conventional group(P<0.05). The incidence of mid-term complications and short-term complications in the modified group were shorter than those in the conventional group(P<0.05). Conclusion: Compared with conventional laparoscopic-assisted Soave operation, children with Hirschcongenital''s disease are treated by laparoscopic modified Soave operation, which has significant effects in improving anal function, intestinal flora, quality of life, clinical indicators, and reducing the incidence of complications, and which has high clinical application value.