先天性巨结肠拖出术丨医学英语视听学习

Pull Through Procedure for Hirschsprung Disease

先天性巨结肠拖出术 

During a normal pregnancy, nerve cells travel down the developing nervous system to the growing digestive system, including the large intestine. 

正常妊娠期间，神经细胞沿发育中的神经系统下行到消化系统，如大肠。

These nerve cells develop into ganglion cells between the muscle layers of the large intestine. The ganglion cells send nerve signals to the muscle layers to contract and relax. These contractions are part of a series of wave-like motions that push waste along the length of the large intestine.

这些神经细胞在大肠肌间发育为神经节细胞。神经节细胞将神经信号传递给肌肉层，使其收缩和舒张。肌肉收缩是一系列推动废物沿大肠移动的波浪式运动。

In a newborn baby, this movement pushes waste along the length of the large intestine toward the rectum and anus. 

对于新生儿，肌肉运动推动废物沿大肠，向直肠和肛门移动。

If the developing baby has hirschsprung disease, these cells either don't reach this area or don't become functioning ganglion cells when they get there. When this baby is born, a section of large intestine does not have ganglion cells. It can also extend for a short segment or a longer segment, involving the colon or rarely the entire colon.

如果发育中的胎儿患有先天性巨结肠症，神经细胞无法到达大肠区域，或者即便到达该区域也不能发育为功能性神经节细胞。胎儿出生时，部分大肠缺少神经节细胞。它也会延伸一小段或较长一段，累及结肠，或者，罕见情况下累及整个结肠。

Without ganglion cells to signal the intestinal wall to relax, this area of the large intestine stays contracted and narrow, blocking the passage of waste and gas. 

没有神经节细胞传递肠壁松弛信号，这段大肠将保持收缩，变得狭窄，阻碍废物和气体通过。

As waste and gas buildup behind the blockage, the large intestine and abdomen begin to swell. The baby may develop an intestinal infection, called enterocolitis, then the intestine may stretch further and cause vomiting and nutrition problems.

随着废物和气体堆积，大肠和腹部开始膨胀。新生儿可能发生肠道感染（小肠结肠炎），随后大肠进一步伸展，导致患儿呕吐和营养不良。

A baby with hirschsprung disease will need a surgical procedure to remove the diseased section of his or her large intestine. 

先天性巨结肠患儿需要手术切除发生病变的大肠。

Until the baby is ready to have this procedure, he or she will need rectal irrigations. This procedure will help remove gas and waste several times a day, which helps prevent infection. 

术前，患儿需要直肠冲洗。该手术帮助患儿每天多次清除气体和废物，有助于预防感染。

The most common surgical procedure for hirschsprung disease is called a laparoscopically assisted transanal pull-through. 

先天性巨结肠症最常见的手术是腹腔镜辅助经肛门拖出术。

During the procedure, the surgeon will make three or four tiny incisions in the baby's abdomen and insert a thin lighted camera and special instruments. The surgeon will use these instruments to loosen and remove the diseased intestines attachments to the body. 

术中，医生在新生儿腹部做3或4个小切口，插入微小带灯摄像机的特殊仪器。医生将使用这些器械疏通并切除病变肠道。

To remove the diseased intestine, the surgeon will make a circular incision in the baby's rectum inside of the anus, then the surgeon will pull the diseased intestine out through the baby's anus and remove it. The remaining healthy intestine will be sutured to the baby's anus. 

为切除病变肠道，医生将在患儿肛门内的直肠处做环形切口，然后经肛门拖出病变肠道并切除；将剩余的健康肠道与患儿的肛门缝合。

This new connection will form a tube that can properly move waste out of the body. 

这种新形成的管道能够使废物正常排出体外。

At the end of the procedure, the surgeon will remove the instruments and close the abdominal incisions with sutures or skin closure tape. Since most of the procedure will be done through the anus, there will be no incisions to close outside the anus.

手术结束时，医生将取出器械，使用缝线或皮肤封闭带闭合腹部切口。大部分操作均经由肛门完成，因此肛门外并不存在任何切口。