PDF(Pubmed)
Abstract：
Hirschsprung disease (HD) is characterized by the absence of ganglion cells in the myenteric and submucosal plexuses of the hindgut. Here, we report a case of an eight-year-old male child who had abdominal distension with a history of repetitive gas passage and a complaint of stool passage. In February 2023, the patient was diagnosed with Hirshsprung disease, for which a left-side colostomy was done. In November 2023, he underwent Hirshsprung stage 2 repair. He was operated on the 17th of December 2023 under general anaesthesia colostomy mobilization. Physiotherapy commencement and evaluation were started on the 18th of December 2023. After the colostomy procedure, the incision weakened the abdominal and lower limb muscles, while bowel obstruction and discomfort further impeded the patient\'s ability to perform daily activities. Physical examination revealed increased work of breathing, reduced range of motion of the bilateral hip joint, reduced muscle strength of lower limb musculature, reduced abdominal muscle strength, difficulty in walking and waddling type of gait. Physiotherapy goals were set based on the problem list. The patient showed improvement in the two weeks of physiotherapy commencement, followed by improvement in functional ability. The comprehensive care provided during the rehabilitation phase aimed at addressing the specific needs arising from the surgical intervention, promoting optimal bowel function, improving ranges and strength and ensuring overall well-being.
摘要：
Hirschsprung病（HD）的特征是后肠的肌间和粘膜下丛中不存在神经节细胞。这里,我们报告一例8岁男童腹胀,有反复气体通过史,并有大便通过主诉.2023年2月，该患者被诊断出患有Hirshsprung病，做了左侧结肠造口术。2023年11月，他接受了Hirshsprung第2阶段维修。他于2023年12月17日在全身麻醉结肠造口术动员下进行了手术。理疗开始和评估于2023年12月18日开始。结肠造口术后,切口削弱了腹部和下肢肌肉，而肠梗阻和不适进一步阻碍了患者进行日常活动的能力。体格检查显示呼吸工作增加，双侧髋关节的活动范围减小，下肢肌肉组织的肌肉力量降低，腹部肌肉力量降低，行走和蹒跚步态的困难。根据问题列表设置物理治疗目标。患者在两周的理疗开始中表现出改善，其次是功能能力的提高。康复阶段提供的全面护理旨在解决手术干预产生的具体需求，促进最佳肠道功能，提高范围和强度，确保整体健康。
