两种结肠造瘘术式对先天性高位肛门直肠畸形患儿的治疗效果分析  

Effects of two colostomy methods on children with congenital high anorectal malformations

作　　者：赵景全[1] 张正茂[1] 周鹏 ZHAO Jingquan;ZHANG Zhengmao;ZHOU Peng(Department of Pediatric Surgery,Zibo Maternal and Child Health Hospital,Shandong,Zibo 255000,China)

机构地区：[1]山东省淄博市妇幼保健院小儿外科,山东淄博255000

出　　处：《中国医药科学》2020年第8期87-90,共4页China Medicine And Pharmacy

摘　　要：目的探讨横结肠(乙状结肠)袢式造瘘术与改良Pena术对先天性高位肛门直肠畸形患儿的治疗效果。方法选择2015年3月~2019年8月本院收治的先天性肛门直肠畸形新生儿80例为研究对象,按照随机数字表法分为两组,各40例。对照组实施横结肠(乙状结肠)袢式造瘘术,观察组行改良Pena术,比较两组手术相关指标;比较两组干预前后自主排便能力;比较两组发生的相关并发症;比较两组更换造口袋耗时及造口袋平均使用时间。结果观察组手术时间短于对照组(P<0.05),术中出血少于对照组(P<0.05),术后住院时间短于对照组(P<0.05),干预后两组自主排便能力均显著高于干预前(P<0.05),同时干预后观察组自主排便能力评分显著高于干预后对照组(P<0.05),观察组发生肠管扩张、切口感染及造瘘口脱垂的比例显著低于对照组(P<0.05),观察组更换造口袋平均耗时短于对照组(P<0.05),造口袋平均使用时间显著长于对照组(P<0.05)。结论针对先天性肛门直肠畸形患儿,实施改良Pena术,能有效的缩短手术时间,减少手术创伤,促进患儿术后肛门排便能力恢复,提高术后舒适度,且并发症少,安全性高。Objective To investigate the treatment effect of transverse colon loop ostomy(sigmoid)and modified Pena on children with congenital high anorectal malformations.Methods 80 neonatals with congenital high anorectal malformations admitted to our hospital from March 2015 to August 2019 were selected as the study subjects.They were divided into two groups according to the random number table method,with 40 cases in each group.The control group was given transverse colon loop ostomy(sigmoid),while the observation group was given modified Pena surgery.The surgical-related indicators,ability of autonomic defecation before and after the intervention,complications,time consumption for changing ostomy bag and average usage time of ostomy bag were compared between the two groups.Results The operation time of the observation group was shorter than that of the control group(P<0.05),the intraoperative bleeding was less than that of the control group(P<0.05),and the postoperative hospital stay was shorter than that of the control group(P<0.05);The autonomic defecation score in both groups after intervention was significantly higher than that before intervention(P<0.05),meanwhile,the autonomic defecation score in the observation group was significantly higher than that in the control group after intervention(P<0.05);The proportion of intestinal dilatation,incision infection and prolapse of stoma in the observation group was significantly lower than those in the control group(P<0.05);The average time for changing the ostomy bag in the observation group was shorter than that in the control group(P<0.05),and the average usage time of the ostomy bag was significantly longer than that in the control group(P<0.05).Conclusion For children with congenital anorectal malformations,the implementation of modified Pena surgery can effectively shorten the operation time,reduce surgical trauma,promote the recovery of postoperative anal defecation ability,improve postoperative comfort,and have fewer complications and higher safety.

关 键 词：横结肠(乙状结肠)袢式造瘘术 改良Pena术 先天性 高位肛门直肠畸形 

分 类 号：R722.1[医药卫生—儿科] R726.1[医药卫生—临床医学]