Diagnostic scoring system of Hirschsprung's disease in the neonatal period

被引：10

作者：

Guo, Weihong ^{[1
]}

Zhang, Qinming ^{[1
]}

Chen, Yongwei ^{[1
]}

Hou, Dawei ^{[1
]}

机构：

[1] Capital Univ Med Sci, Beijing Childrens Hosp, Dept Surg, Beijing 100045, Peoples R China

来源：

ASIAN JOURNAL OF SURGERY | 2006年 / 29卷 / 03期

关键词：

Hirschsprung's disease; neonatal period;

D O I：

10.1016/S1015-9584(09)60082-8

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

OBJECTIVE: Eighty to ninety percent of Hirschsprung's disease (HD) patients present in newborns. However, the diagnosis of HD in the neonatal period remains difficult. Our present study aims to propose a diagnostic scoring system and hope this will increase early diagnosis of HD and avoid unnecessary rectal biopsy. METHODS: In the first study period, 57 suspected HD patients (0-3 months) completed our predetermined study protocol in which barium enema (BE), rectal manometry (RM) and full-thickness rectal biopsy were performed. Symptoms, signs and investigations were analysed for their correlation with HD diagnosis. A HD diagnostic scoring system was developed according to the statistical results and was assessed in 74 patients in the second study period. RESULTS: Forty-five patients were diagnosed with HD in the first study period. A HD scoring system was developed in which delayed meconium, tight anus, BE and RM were diagnostic factors. A cut-off point of 3 provided 84% of HD patients score > 3, whereas 75% non-HD patients score <= 3 (P < 0.05). In the second study group, patients with score <= 3 were selected for rectal biopsy. CONCLUSION: In the neonatal period, using a HD scoring system may help to select patients for further invasive investigation so that unnecessary biopsy can be avoided.

引用

页码：176 / 179

页数：4