新生儿和婴儿直肠组织活检组织病理学和组织计量学变化的研究

Rusul A. Abdul Hussein, Sahar A. H. Al-Sharqi, A. Joda, Zaid Sharba
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摘要

赫氏肠病是最常见、最棘手的婴幼儿疾病之一。最可靠的诊断方法是对结肠直肠活检组织进行病理分析,而赫氏菌病的典型症状是缺乏神经节细胞。本研究涉及 36 例疑似赫氏菌病病例,其中 27 例为男性,9 例为女性,年龄介于(1 天 - 1 岁)之间。所有患者均接受了完整的病史采集、体格检查、放射学检查和直肠活检。组织标本取自新生儿和婴儿患者的直肠,保存在固定液(10% 福尔马林)中进行组织病理学分析,并根据组织学结果将患者分为两组(赫氏prung 病组和非赫氏prung 病组)。对表列数据采用卡方进行统计分析,并利用计算机采用的自动图像分析程序 Image J® 对直肠组织进行组织学检查。与女性相比,男性更容易患上赫氏肛门病。胎粪排出延迟是这些疾病最常见的症状。我们注意到,赫氏普隆病组和非赫氏普隆病组在临床症状、直肠空虚、直肠检查时肛门括约肌紧绷等方面存在显著差异。根据直肠活检组织病理学分析,在 36 例病例中,27 例(75%)被诊断为赫氏普隆病,9 例(25%)为赫氏普隆病阴性。直肠活检组织的组织计量学研究显示,赫氏普隆病患者与非赫氏普隆病患者的直肠黏膜、黏膜下层和外层肌肉存在显著差异。
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Investigation of The Histopathological and Histometric Changes in Rectum Tissue Biopsies of Hirschsprung and Non-Hirschsprung Disease in Neonate and Infant
Hirschsprung disease is one of the most common and problematic infancy and childhood maladies. The most reliable method for diagnosis is the histopathological analysis of colorectal biopsies and the typical finding of Hirschsprung disease is the absence of ganglion cells. The study involved 36 cases of suspected Hirschsprung disease, in which 27 cases were males and 9 cases were females with an age range between (1 day - 1 year). All patients undergo complete history taking, physical examination, radiological investigations, and rectal biopsy. The tissue specimens were obtained from the rectum of neonate and infant patients, maintained in the fixative solution (formalin 10%) for histopathological analysis, and patients were divided into two groups (Hirschsprung disease and non-Hirschsprung disease group) according to histological findings. Statistical analysis was performed on the tabulated data by chi-square, and the automated computer-adopted image analysis program Image J® was utilized for the histometrical examination of rectum tissue. The Hirschsprung disease is more common in males than females. The delayed passage of meconium is the most common symptom of these diseases. We notice that there is a significant difference between the Hirschsprung disease group and the non-Hirschsprung disease group in clinical signs, empty rectum, tight anal sphincter on per rectal examination. Based on histopathology analysis of the rectal biopsy, out of the 36 cases, 27(75%) cases were diagnosed as Hirschsprung disease, and 9 (25%) cases as negative for Hirschsprung disease. In Histometric study of rectal biopsies tissues showed a significant difference in the mucosa, Submucosa, and muscularis externa between Hirschsprung disease and non-Hirschsprung disease patients.
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