先天性肛门直肠畸形相关排尿异常的尿动力学评估  

Urodynamic assessment of voiding dysfunction associated with anorectal malformation

作　　者：贾茹 胡绘杰 宋翠萍[1] 文建国[3] Jia Ru;Hu Huijie;Song Cuiping;Wen Jianguo(Department of Pediatric Surgery,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,China;Nursing College of Xinxiang Medical University,Xinxiang 453000,China;International Joint Laboratory of Urodynamics and Pelvic Floor in Children,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]新乡医学院第一附属医院小儿外科,新乡453100 [2]新乡医学院护理学院,新乡453000 [3]郑州大学第一附属医院河南省小儿尿动力和盆底国际联合实验室,郑州450052

出　　处：《中华实用儿科临床杂志》2022年第3期237-240,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：国家自然科学基金(81670689,U1904208);河南省医学科技攻关计划省部共建项目(SBGJ2018059)。

摘　　要：先天性肛门直肠畸形(ARM)占小儿消化道畸形的首位,发病率在新生儿中为1/5000-1/1500。该病常表现为肛门狭窄或肛门闭锁,伴或不伴瘘管和泄殖腔畸形。其中泌尿生殖系统伴发畸形最多见,发生率为26%-55%。35%-50%的儿童出现脊髓束末梢畸形或神经源性下尿路功能障碍,这也是ARM合并排尿异常症状的常见原因。尿动力学检查(UDS)是评估ARM合并下尿路功能变化最好的方法,可以对膀胱尿道功能进行客观分类指导并制定精准治疗方案和随访治疗效果。现就ARM合并排尿异常的原因及相关UDS评估的进展进行综述,为临床提供参考。Anorectal malformation(ARM)accounts for the first place of digestive tract malformations in children,with the incidence of 1/5000-1/1500 in newborns.ARM is typically manifested as anal stenosis or anal atresia with or without fistulas and persistent cloaca.Genitourinary malformation is the most common malformation associated with ARM,with the incidence ranging 26%-55%.There were 35%-50%of ARM children develop spinal cord peripheral abnormalities or neurogenic lower urinary tract dysfunction,which usually causes voiding dysfunction associated with ARM.Urodynamic study is the best method to analyze the changes of lower urinary tract function,which can provide an objective classification for bladder and urethral function and guide the formulation of precision treatment plan and therapeutic efficacy during the follow-up period.This study aims to review the cause of voiding dysfunction asso-ciated with ARM and its urodynamic changes.

关 键 词：先天性肛门直肠畸形 排尿异常 尿动力学 神经源性膀胱 脊髓发育不良 

分 类 号：R726.5[医药卫生—儿科]