摘要
目的:为了解决肛门直肠畸形术后大便失禁的问题。方法:对7例患儿行两侧臀大肌瓣移植括约肌重建术,其中高位畸形4例,中位畸形3例,年龄6～14岁。入院时有肛门口哆开、粘膜外翻、肛门收缩无力。根据便意的有无和大便失禁程度进行肛门功能临床评定,1分者3例,2分者4例。结果:无术后并发症,术后肛门功能明显改善,肛门口闭合或明显缩小,粘膜外翻消失或缩小,肛门收缩力增强,便意恢复正常,干便能控制,肛门功能临床评定为4～5分。6例获随访、最短3个月,最长7年半。除2例肛门口轻度哆开,粘膜部分外翻外,其余肛门外观基本正常。3例偶有污粪或稀便时失禁,临床评分5分,另3例肛门功能正常(6分)。其中4例进行肛门功能综合评定,均为优。结论:本手术是一种较理想的肛门外括约肌重建方法。
Objective:Seven cases(aged 6-14yrs)of anal atresia(high 4,middle.3)with postoperative fecal incontinence are reported.On admission,patients had anal relaxation and mu- cosal prolapse.The anal function was scored as 1(3 cases)and 4(2 cases)according to bowel sensation and fecal incontinence.All patients underwent transplantation of muscle flaps by bilater- al gluteus maximum muscles without any complication.After operation,the anal contraction im- proved,mucosal prolapse disappeared and the bowel sensation recovered.The anal function was scored as 4-5.Six patients were followed-up for 3 months to 7.5yrs.of them,3 had normal anal function(score of 6),and 3 had occasional fecal soiling(score of 5).The authors consider this is a better and ideal technique of anal sphincter reconstruction.
出处
《中华小儿外科杂志》
CSCD
1997年第2期88-90,共3页
Chinese Journal of Pediatric Surgery
