后矢状入路经骶会阴肛门成形术治疗不同年龄先天性中高位肛门闭锁的疗效比较  

Clinical efficacies of posterior sagittal sacroperineal anoplasty( Pena surgery) on children of different ages with intermediate and high-order position congenital anal atresia

作　　者：莫优炼 胡小华[1] 杨六成[2] 钟陈[1] 冯大军[1] 张平锋[1] 苏嘉鸿 张家德[1] Mo Youlian;Hu Xiaohua;Yang Liucheng;Zhong Chen;Feng Dajun;Zhang Pingfeng;Su Jiahong;Zhang Jiade(Department of Pediatric Surgery,Affiliated BoAi Hospital,Southern Medical University,Zhongshan 528400,China;Department ofPediatric Surgery Affiliated Pearl River Hospital Southern Medical University Guangzhou 510280 China)

机构地区：[1]南方医科大学附属中山市博爱医院小儿外科,广东省中山市528400 [2]南方医科大学附属珠江医院小儿外科,广东省广州市510280

出　　处：《临床小儿外科杂志》2018年第8期600-606,共7页Journal of Clinical Pediatric Surgery

摘　　要：目的比较后矢状入路经骶会阴肛门成形术(Pena术)治疗不同年龄段中高位先天性肛门闭锁患儿的临床疗效。方法回顾性分析2012年1月至2016年12月本院收治的46例先天性中高位肛门闭锁患儿临床资料,分为新生儿一期手术组(A组)、三期手术组(B组)、有体表瘘管的中高位肛门闭锁扩张瘘管后一期手术组(C组)。比较三组患儿一般资料、手术并发症以及远期排便功能。结果 46例均行后矢状入路经骶会阴肛门成形术(Pena术)。三组一般资料、平均术中出血量、手术并发症及远期排便功能比较,差异无统计学意义(P> 0. 05);手术时间比较,差异有统计学意义(P=0. 004)。结论先天性肛门闭锁患儿在不同年龄段行后矢状入路经骶会阴肛门成形术(Pena术)的近期并发症及远期肛门功能无明显差异,可根据患儿病情、家属需求及手术医生的技术水平,灵活选择合适年龄段进行手术。Objective To evaluate the clinical efficacies of posterior sagittal sacroperineal anoplasty（Pena surgery） on children of different ages with intermediate and highorder position congenital anal atresia.Methods Retrospective analyses were performed for the clinical data of 46 children undergoing posterior sagittalsacroperineal anoplasty （Pena surgery） from January 2012 to December 2016. They were divided into 3 groups：group A （onestage pullthrough）,group B （threestage pullthrough） and group C （onestage pullthrough afterdilating fistula for high position anus atresia with a body surface fistula）. General profiles,surgical complicationsand longterm defecation were compared among three groups. Results All of them underwent posterior sagittalsacroperineal anoplasty （Pena surgery）. No significant statistical differences existed in general data,intraoperativeblood loss,surgical complications and longterm defecation function among three groups （P 〉 0. 0 5）. However,thedifference of operative duration was statistically significant among three groups （P = 0. 004）. Conclusion Nosignificant differences exist in complications or anal functions for patients with congenital anal atresia undergoingposterior sagittal sacroperineal anoplasty （Pena surgery） at different ages. An appropriate age may be selected foroperative flexibility by disease condition,family needs and technical level of a surgeon.

关 键 词：肛门闭锁 外科手术 治疗结果 

分 类 号：R726.5[医药卫生—儿科]