先天性肛门直肠畸形直肠前庭瘘患儿术后排便功能的随访和评估  

Follow-up and evaluation of anorectal malformation children with rectovestibular fistula after surgical treatment

作　　者：吴杨[1] 向波[1] 谢小龙 张一茂 蒋小平[1] WU Yang;XIANG Bo;XIE Xiaolong;ZHANG Yimao;JIANG Xiaoping(Department of Pediatric Surgery,West China Hospital of Sichuan University,Chengdu,Sichuan Province,610041,China)

机构地区：[1]四川大学华西医院小儿外科

出　　处：《第三军医大学学报》2018年第23期2142-2146,共5页Journal of Third Military Medical University

摘　　要：目的通过随访接受后矢状入路肛门直肠成形术的先天性肛门直肠畸形直肠前庭瘘患儿,分析其术后排便功能。方法回顾性纳入四川大学华西医院小儿外科2008年1月至2013年1月收治接受手术治疗的共计78例先天性无肛伴直肠前庭瘘患儿,其中60例获访,18例失访。规律随访此类患儿术后排便功能情况,同时进行评估和分析。结果 Krickenbeck分类的评分量表测量患儿排便功能显示:81. 7%的患儿术后达到主动随意控便。术后5~10年患儿主动随意控便率(78. 1%)高于5年以内患儿(64. 3%),但未显示统计学差异;便秘仍是术后主要并发症。便秘和粪污的情况以及排便评分随患儿年龄增长而有所改善。结论直肠前庭瘘患儿术后存在一定程度的排便功能障碍。随年龄增长,排便功能障碍有所改善。规律随访和治疗有助于改善该部分患儿的排便功能和生活质量。Objective To investigate the defecation function of the children who had received posterior sagittal anorectoplasty for rectovestibular fistula of anorectal malformation by following up in order to provide scientific references for evaluation of operative outcome and long-term prognosis.Methods A retrospective study was carried out on 78children with rectovestibular fistula and undergoing surgical treatment in our department from January 2008to January 2013.Among them,only 60children were regularly followed up postoperatively,and their defecation function was evaluated and analyzed after surgery.Results Krickenbeck classification revealed that 81.7%of the children obtained voluntary bowel controls immediately after surgery,and the rate of voluntary bowel control was higher in these children in 5to 10years later than within 5years.Constipation was the major complication.And constipation,fecal contamination and bowel movement scores improved with age.Conclusion Defecation dysfunction is quite common in the children after surgical treatment for rectovestibular fistula,and the dysfunction will be improved when they get older. So,regular follow-up and treatment can improve the defecation function and quality of life in some children.

关 键 词：先天性肛门直肠畸形 直肠前庭瘘 排便功能 随访 

分 类 号：R442.2[医药卫生—诊断学] R726.19[医药卫生—临床医学]