小儿直肠尿道瘘的修补与肛门括约肌重建术  

Simultaneous fistulous repair and sphincteroplasty for children with refractory urethrorectal fistula

作　　者：林芃[1] 陈雨历[2] 谢义德[1] 

机构地区：[1]福建医科大学附属协和医院小儿外科,福州350001 [2]山东医科大学附属医院小儿外科

出　　处：《中华整形外科杂志》2001年第4期225-226,共2页Chinese Journal of Plastic Surgery

摘　　要：目的　提高经多次手术失败的直肠尿道瘘、大便失禁的手术成功率。方法　按Pick rell术式或Hartle改良方法 ,压榨股薄肌支配神经后移转到肛门周围固定 ,行肛门外括约肌成形术共18列。结果　 1989～ 1999年共治疗 3～ 15岁直肠尿道瘘伴大便失禁小儿 18例 ,结果 15例无漏尿 ,3例漏尿者也都在术后 5周内消失 ,大便失禁亦都有改善。 15例随访 7个月～ 6年 ,12例大便失禁明显改善。结论　用该法解决难以处理的直肠尿道瘘成功率高 。Objective In order to improve the surgical treatment of urethrorectal fistula and fecal incontinence. Methods Eighteen patients aged 3～15 years with urethrorectal fistula and fecal incontinence underwent sphincteroplasty using the neurotripsied gracilis muscle. Results\ 15 cases of urethral fistula were cured while discharged. Urine leakage in 3 cases stopped in 5 weeks postoperatively. Mean follow up for 2 years showed that the fecal incontinence improved obviously. 12cases got excellent or good results. Conclusions\ Simultaneous repair of urethrorectal fistula and fecal incontinence with neurotripsied gracilis muscle transplantation is a simple and effective method.

关 键 词：直肠尿道瘘 大便失禁 括约肌成形术 儿童 

分 类 号：R726.2[医药卫生—儿科]