王练英 李正 王伟 110003 沈阳， 中国医科大学第二临床学院小儿外科 中华小儿外科杂志 1998 0 19 6


    关键词：肛门闭锁；肛门内括约肌 期刊 zhxrwkzz 0 临床研究 fur -->


    

摘要 目的：观察保留内括约肌的肛门成形术后排便功能。方法： 无肛畸形患儿26例，高位15例， 中位11例， 全部行保留内括约肌的肛门成形术，随访平均6.28年。通过临床评分、 肛管直肠测压、 肌电图、钡灌肠等客观评分标准进行综合评定肛门排便功能。结果：术后肛门功能临床和综合评定优者分别由过去的23.1%、 26.9%提高到73.3%和66.7%(P<0.01和P<0.05)，而术后肛门功能差者由过去的23.1%、 23.1%分别下降到6.7%和0。结论：多数无肛畸形包括有直肠泌尿生殖道瘘的无肛畸形，在直肠远端有内括约肌， 手术尽量保留和利用，以便获较好的排便功能。

    Long Term Follow-up of High and Intermediate Imperforate Anus withPreservation of Internal Anal Sphincter Wang Lianying, Li Zheng, Wang Wei.Department of Pediatric Surgery, The 2nd Affiliated Hospital, China Medical University, Shenyang, 110003

    Abstract Objective: To assess anal continence after anoplastywith preservation of internal sphincter. Methods: Twenty-six patients with imperforateanus, 15 high types and 11 intermediate types, were followed-up for a mean duration of6.28 years. Defecation and sphincter function were graded in a combination with clinicalscores, anorectal manometry, electromyography and barium enema. Results: In patients withhigh imperforate anus, the percentages of the satisfactory and overall scores increasedfrom 23.1% and 26.9% to 73.3% and 66.7% respectively (P<0.01 and P<0.05). Thepercentages of the lowest scores decreased from 23.1% and 23.1% to 6.7% and 0%respectively. Conclusions: Most of the distal pouches of rectum, especially thoseassociated with urogenital fistulae, contain functional internal sphincter. Thesesphincters should be kept to achieve better function.

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