摘要
本文报告68例高位无肛术后肛门括约肌功能随访结果.随访时间1～24年.均系作腹会阴肛门成形术.排便功能优组29例,良组17例,差组22例.肛直肠测压证实所有失禁病例,其内括约肌均缺如,外括约肌电图及钡灌肠摄片说明其外括约肌及耻骨直肠肌功能均丧失.建议高位无肛者拟先作结肠造瘘,待1岁后再行骶腹会阴肛门成形术.判断术后最终能否控制排便,常须在青春期才能定论,故完全失禁者至少超过术后五年而症状毫无改善者,方可施行修补或替代控制肛门手术.
This paper reports 68 cases of postoperative anal sphincter function of high imperforate anus were studied with ano-rectal manometry, elec-tromyography and roentgenography. We followed up for 1-24 years. All patients were undergoing pull-through procedures by abdominoperineal approaches.In the incontinence group, ano-rectal manometry results all showed, length of the high preassure zone significantly noticeably shorter than normal group. Anorectal relaxation reflex were absence and anorectal resting pressure significantly lower than cured group. Electro-myography showed only a basic electrical rhythm without high frequency potentials.The anorectal angle was increased in barium enema.Therefore, to prevent postoperative fecal incontinence, the authors suggest that, in cases of high position, first performed colostomiesand, one year later, carried of sacro-abdomino -perineal anoplasty.In addition, any patients with a persistently incontinence for more than five years should be offered a secondary repair.
出处
《中华小儿外科杂志》
1987年第4期202-204,插1,共4页
Chinese Journal of Pediatric Surgery
