后矢状入路经骶会阴肛门成形术对先天性中高位肛门闭锁患儿的临床疗效及术后排便功能的影响  

Effect of Sacral Perineal Anoplasty via Posterior Sagittal Approach on Clinical Efficacy and Postoperative Defecation Function in Children with Congenital Middle and High Anal Atresia

作　　者：苏嘉鸿 SU Jia-hong(Department of Pediatric Surgery,Boai Hospital of Zhongshan,Zhongshan 528403,Guangdong,China)

机构地区：[1]中山市博爱医院小儿外科,广东中山528403

出　　处：《医学信息》2023年第7期123-126,共4页Journal of Medical Information

基　　金：中山市卫生局医学科研基金项目(编号:2012A020029)。

摘　　要：目的研究后矢状入路经骶会阴肛门成形术对先天性中高位肛门闭锁患儿的临床疗效,以及术后排便功能的影响。方法选取2016年1月-2021年1月在我院诊治的64例行后矢状入路经骶会阴肛门成形术的先天性中高位肛门闭锁患儿为研究对象,采用随机数字表法分为对照组和观察组,各32例。对照组采用后矢状入路经骶会阴肛门成形Ⅰ期术治疗,观察组行伴有瘘管中高位肛门闭锁扩张瘘管后Ⅰ期术治疗。比较两组术后6个月临床手术指标、临床疗效、并发症发生率、排便功能评分。结果观察组手术时间、术中出血量与对照组比较,差异无统计学意义(P>0.05);观察组创口恢复时间、住院时间均小于对照组,差异有统计学意义(P<0.05);观察组治疗总有效率为96.88%,与对照组的93.75%比较,差异无统计学意义(P>0.05);观察组并发症发生率为6.25%,低于对照组的18.75%(P<0.05);观察组术后2个月大便失禁、污粪、括约肌收缩力评分与对照组比较,差异无统计学意义(P>0.05);观察组术后6个月大便失禁、污粪、括约肌收缩力评分均小于对照组(P<0.05)。结论后矢状入路经骶会阴肛门成形术治疗先天性中高位肛门闭锁具有较高中远期总有效率,采用伴有瘘管Ⅰ期术,可缩短创口恢复和住院时间,降低并发症发生率,改善排便功能评分,可实现较理想的中远期有效性和安全性,值得临床应用。Objective To study the clinical efficacy of sacral perineal anoplasty via posterior sagittal approach in children with congenital middle and high anal atresia and its effect on postoperative defecation function.Methods From January 2016 to January 2021,64 children with congenital middle and high anal atresia who underwent sacral perineal anoplasty via posterior sagittal approach in our hospital were selected as the research objects.They were divided into control group and observation group by random number table method,with 32 cases in each group.The control group was treated with one-stage operation of sacral perineal anal plasty through posterior sagittal approach,while the observation group was treated with one-stage operation after dilatation of fistula with middle and high anal atresia.The clinical operation indexes,clinical efficacy,incidence of complications and defecation function scores were compared between the two groups at 6 months after operation.Results There was no significant difference in operation time and intraoperative blood loss between the observation group and the control group(P>0.05).The wound recovery time and hospitalization time of the observation group were less than those of the control group,and the difference was statistically significant(P<0.05).The total effective rate of treatment in the observation group was 96.88%,which wa compared with 93.75%in the control group,the difference was not statistically significant(P>0.05).The incidence of complications in the observation group was 6.25%,which was lower than 18.75%in the control group(P<0.05).There was no significant difference in the scores of fecal incontinence,soil contraction score between the observation group and the control group at 2 months after operation(P>0.05).The scores of fecal incontinence,soiling and sphincter contractility in the observation group were lower than those in the control group at 6 months after operation(P<0.05).Conclusion Sacral perineal anoplasty via posterior sagittal approach for the treatment of

关 键 词：经骶会阴肛门成形术 先天性中高位肛门闭锁 排便功能 

分 类 号：R726.5[医药卫生—儿科]