探讨改良式肠造瘘术在先天性中高位肛门闭锁中的可行性  

Study on the Feasibility of Modified Enterostomy in Congenital Middle and High Anal Atresia

作　　者：王坤[1] 蔡晶 卢应酬[1] 李小卫[1] 翟国敏[1] 伍岗泉[1] WANG Kun;CAI Jing;LU Yingchou;LI Xiaowei;ZHAI Guomin;WU Gangquan(Department of Pediatric Surgery,Maternal and Child Health Hospital of Dongguan,Dongguan Guangdong 523000,China)

机构地区：[1]广东省东莞市妇幼保健院小儿外科,广东东莞523000

出　　处：《临床研究》2020年第5期24-26,共3页Clinical Research

基　　金：东莞市社会科技发展一般项目(2018507150071531)。

摘　　要：目的探讨改良式肠造瘘术在先天性中高位肛门闭锁患儿中的临床应用及其可行性。方法选取2016年1月-2019年10月在广东省东莞市妇幼保健院接受治疗的11例先天性中高位肛门闭锁的患儿,其中男8例,女3例。所有患儿经查体及辅助检查并根据Krinkenbeck分类确诊为中高位肛门闭锁,一期手术均行本院改良式肠造瘘术,术后监测指标包括术后肠功能恢复、营养以及是否出现肠造瘘并发症(造瘘口回缩、造瘘口突出、伤口感染以及切口疝)等情况。结果所有患儿均在急诊手术条件下顺利完成本院改良的肠造瘘术,所有患儿术后均未出现术后肠造瘘并发症,并分期实施肛门成型及肠关瘘手术,目前身高和体重均达到正常同龄儿水平。结论对于先天性中高位肛门闭锁的患儿,采用本院改良的肠造瘘术是安全可行的。Objective To investigate the clinical application and feasibility of modified enterostomy in children with congenital middle and high anus atresia.Methods 11 children with congenital middle and high anal atresia treated in the Maternal and Child Health Hospital of Dongguan affiliated to Southern Medical University from January 2016 to October 2019 were selected as research subjects(including 8 males and 3 females).All the children were diagnosed as middle and high anal atresia by physical examination and auxiliary examination according to Krinkenbeck classification.One stage of operation was performed with modified enterostomy in our department.Postoperative monitoring indexes were included postoperative intestinal function recovery,nutrition and complications of enterostomy(fistula retraction,fistula protruding,wound infection and incisional hernia).Results All the children successfully completed the improved enterostomy in our hospital under the condition of emergency surgery.All the children had no postoperative complications of enterostomy,and the anal shaping and enteroguan fistula surgeries were performed by stages.At present,the height and weight reached the normal level of children of the same age.At present,the height and weight of the children reached the normal level of the same age.Conclusion For children with congenital middle and high anal atresia,it is safe and feasible to use modified enterostomy drainage in our hospital.

关 键 词：肛门闭锁 新生儿肠造瘘 

分 类 号：R726.1[医药卫生—儿科]