保留直肠肛管移行上皮对预防感觉性大便失禁的意义  

The role of anorectal transitional zone in the prophylaxis against the sensory fecal incontinence.

作　　者：陈建发[1] 黄宗海[1] 肖建秋 

机构地区：[1]第一军医大学附属珠江医院普外科,广东广州510282 [2]解放军第422医院普外科,广东湛江524005

出　　处：《中国临床解剖学杂志》2003年第4期396-397,共2页Chinese Journal of Clinical Anatomy

摘　　要：目的 :观察保留直肠肛管移行上皮 (ATZ上皮 )对预防感觉性大便失禁的作用。方法 :对 12例切除ATZ上皮患者的排便功能进行随访 ,以同期行同种手术且保留ATZ上皮的患者为对照组。结果 :两组患者无一例发生完全性大便失禁。切除ATZ组发生排便感觉丧失和感觉性大便失禁的发生率明显高于ATZ保留组 (P <0 .0 5 )。但除 2例患者外 ,术后 3个月切除ATZ的 10例患者肛门自制自行恢复。结论 :ATZ上皮在肛门自制 ,特别是预防感觉性大便失禁有着重要作用 ,术中应尽可能保护 ,但如果为了避免直肠粘膜外翻 ,必要时也可以切除 ,不会引起完全性大便失禁和永久性感觉性大便失禁。Objective: To observe the role of anorectal transitional zone (ATZ)in prevention from the sensory fecal incontinence. Methods:12 patients without ATZ were followed up and other 12 patients whose ATZ were retained after the same operations were observed at the same time.Results:No complete fecal incontinence was found in both groups of patients.The incidence of sensory incontinence in the patients without ATZ was higher than those with ATZ,and more patients without ATZ were found to lose their defecatory sense too.To be interesting is that most of the patients suffering from the postoperational sensory fecal incontinence restored their fecal continence without any special treatments at 3 months or so after operation.Conclusions:On one hand,ATZ should be protected during the operations as much as possible for it is very important in the sustainment of defecatory continence,especially for the prophylaxis against the sensory fecal incontinence.On the other hand,ATZ may be resected so as to guard against the exstrophy of the rectal mucosa,which will not cause complete fecal incontinence and permanent sensory incontinence.

关 键 词：直肠 肛管 移行上皮 环状痔 感觉性大便失禁 

分 类 号：R657.18[医药卫生—外科学]