经肛穴肛门直肠成形术治疗女婴先天性肛门闭锁并直肠前庭瘘的疗效分析  

Analysis of the efficacy of anal dimple anorectoplasty on female infants with congenital anal atresia combined rectal vestibular fistula

作　　者：袁宇航 张翔宇 杨合英[1] 刘晓铭 苏璠 岳铭[1] 丁道奎[1] 李延安[1] 孙贝贝[1] 金亚丽[1] Yuan Yuhang;Zhang Xiangyu;Yang Heying;Liu Xiaoming;Su Fan;Yue Ming;Ding Daokui;Li Yan′an;Sun Beibei;Jin Yali(Department of Pediatric Surgery,the First Affiliated Hospital of Zhengzhou University,Key Disciplines Laboratory for Cli-nical Medicine of Henan Province,Zhengzhou 450001,China)

机构地区：[1]郑州大学第一附属医院小儿外科,河南省高等学校临床医学重点学科开放实验室,郑州450001

出　　处：《中华实用儿科临床杂志》2023年第9期698-701,共4页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的探讨经肛穴肛门直肠成形术在女婴先天性肛门闭锁并直肠前庭瘘中的临床疗效。方法回顾性分析2012年7月至2022年7月郑州大学第一附属医院小儿外科收治的69例肛门闭锁并直肠前庭瘘女婴的临床资料,根据手术方式将患儿分为2组:行经肛穴肛门直肠成形术者34例(A组);行前矢状入路肛门直肠成形术者35例(B组)。比较2组手术时间、住院时间及近期并发症、远期并发症和排便功能(术后6个月Rintala评分)情况。术后并发症发生率采用χ2检验比较;手术时间、术后住院时间及术后6个月Rintala评分采用配对t检验比较。结果A组手术时间[(80.18±9.29)min]及术后住院时间[(6.10±1.52)d]均短于B组[(103.85±8.26)min、(7.63±2.40)d],差异均有统计学意义(t=11.40、2.62,均P<0.05);术后6个月排便功能Rintala评分总分A组[(19.36±0.93)分]较B组[(18.76±0.44)分]高,差异有统计学意义(t=3.20,P<0.05)。近期并发症:A组4/34例(11.8%),B组7/35例(20.0%);远期并发症:A组2/34例(5.9%),B组4/35例(11.4%),2组近期、远期并发症发生率比较,差异均无统计学意义(χ^(2)=0.75、0.75,均P>0.05)。结论经肛穴肛门直肠成形术治疗女婴肛门闭锁并直肠前庭瘘安全有效。Objective To investigate the clinical efficacy of anal dimple anorectoplasty on female infants with congenital anal atresia combined rectal vestibular fistula.Methods Clinical data of 69 female infants with congenital anal atresia combined rectal vestibular fistula admitted to Department of Pediatric Surgery,the First Affiliated Hospital of Zhengzhou University from July 2012 to July 2022 were retrospectively analyzed.They were divided into 2 groups according to the surgical methods:34 cases of anal dimple anorectoplasty(group A)and 35 cases of anterior sagittal anorectoplasty(group B).The operation time,length of stay,short-term complications,long-term complications and bowel function(determined by the Rintala score at 6 months postoperatively)of the two groups were compared.The difference in the incidence of postoperative complications between groups was compared by Chi-square test,and the remaining differences between groups were compared by the paired t-test.Results The operative time[(80.18±9.29)min vs.(103.85±8.26)min]and postoperative hospital stay[(6.10±1.52)d vs.(7.63±2.40)d]in group A were significantly shorter than those of group B(t=11.40,2.62;all P<0.05).The Rintala total score at 6 months postoperatively in group A was significantly higher than that of group B[(19.36±0.93)points vs.(18.76±0.44)points](t=3.20,P<0.05).There were no significant differences in the incidences of short-term[(4/34,11.8%)vs.(7/35,20.0%)]and long-term complications[(2/34,5.9%)vs.(4/35,11.4%)]between group A and group B(χ^(2)=0.75,0.75;all P>0.05).Conclusions Anal dimple anorectoplasty for female infants with congenital anal atresia combined rectal vestibular fistula is safe and effective.

关 键 词：肛门闭锁 经肛穴肛门直肠成形术 直肠前庭瘘 并发症 

分 类 号：R726.5[医药卫生—儿科]