前矢状入路直肠肛门成形术在肛门闭锁中的应用效果观察

何崇伟

[摘要] 目的 分析前矢状入路直肠肛门成形术在肛门闭锁中的应用效果。 方法 选取本院2010年10月~2013年10月诊治的肛门闭锁患者70例作为研究对象，将患者随机分为观察组与对照组，每组各35例。对照组采用常规结肠造瘘术，观察组采用前矢状入路直肠肛门成形术治疗。比较两组的术中出血量、住院时间、并发症发生率以及整体疗效。 结果 对照组中显效25例，有效9例，无效1例，总有效率为97.14%；观察组中显效22例，有效12例，无效1例，总有效率为97.14%。观察组的术中出血量明显少于对照组，住院时间明显短于对照组（P<0.05）。观察组中有1例发生切口感染，并发症发生率为2.86%，对照组中有6例（直肠回缩和肛门狭窄各1例，切口感染4例）发生并发症，并发症发生率为17.14%，观察组并发症发生率明显低于对照组（P<0.05）。 结论 前矢状入路直肠肛门成形术在肛门闭锁中具有良好的应用效果，值得临床推广应用。

[关键词] 前矢状入路直肠肛门成形术；结肠造瘘术；肛门闭锁；应用效果

[中图分类号] R574.8[文献标识码] A[文章编号] 1674-4721（2014）06（c）-0049-03

Application effect observation of anterior sagittal anorectoplasty in anal atresia

HE Chong-wei

Department of Surgery,Maternal and Child Health Hospital of Maoming City in Guangdong Province,Maoming 525000,China

[Abstract] Objective To analyze the application effect of anterior sagittal anorectoplasty in anal atresia. Methods 70 patients with anal atresia diagnosed and treated in our hospital from October 2010 to October 2013 were selected as the study objects,and they were randomly divided into the observation group and the control group,there were 35 cases in each group.The control group was given routine colostomy,and the observation group was given anterior sagittal anorectoplasty.Intraoperative amount of bleeding,hospital stay,incidence rate of complication and the total curative effect of the two groups were compared. Results 25 cases were markedly effective,9 cases were effective,1 was invalid，and the total effective rate was 97.14% in the control group, 22 cases were markedly effective,12 cases were effective,1 patient, was invalid and the total effective rate was 97.14%.Intraoperative amount of bleeding in the observation group was significantly fewer than that in the control group,hospital stay in the observation group was significantly shorter than that in the control group (P<0.05).There was 1 case of incision infection in the observation group,the incidence rate of complication was 2.86%,in control group,there were 6 cases (rectal retraction and anal stenosis in 1 case reapectively,incision infection in 4 cases) of complication,the incidence rate of complication was 17.14%,the incidence rate of complication in the observation group was significantly lower than that in the control group (P<0.05). Conclusion Anterior sagittal anorectoplasty has a good application in anal atresia,it is worthy of clinical promotion and application.

[Key words] Anterior sagittal anorectoplasty;Colostomy;Anal atresia;Application effect

先天性肛门闭锁属于小儿外科常见疾病，对患儿的正常排便造成了严重影响。随着医疗技术水平的发展、提高，各种治疗肛门闭锁的技术也不断增多，并各具优势[1]。比如前矢状入路直肠肛门成形术就是非常常见的一种类型，由于该手术方式创伤小、操作简单、并能够取得良好的治疗效果等而在临床上被广泛应用[2]。为了进一步分析前矢状入路直肠肛门成形术在肛门闭锁中的应用效果，本研究收集本院诊治的70例肛门闭锁患者进行分组试验，现报道如下。

1 资料与方法

1.1 一般资料

选取本院2010年10月~2013年10月诊治的70例肛门闭锁患者，所有患儿均因排便困难入诊，经会阴B超检查、X线倒立检查、经瘘管碘油造影检查确诊。将患者随机分为观察组和对照组，每组各35例。……