本文選題：先天性肛門(mén)直腸畸形　切入點(diǎn)：直腸黏膜脫垂　出處：《第三軍醫(yī)大學(xué)學(xué)報(bào)》2017年23期

【摘要】：目的分析并總結(jié)先天性肛門(mén)直腸畸形(anorectal malformations,ARMs)術(shù)后患兒直腸黏膜脫垂的發(fā)生情況及影響因素。方法回顧性分析我院2014-2016年收治的354例先天性肛門(mén)直腸畸形患兒的病歷資料,分析總結(jié)各種類型ARMs術(shù)后直腸黏膜脫垂的情況及影響因素。結(jié)果 (1)354例ARMs患兒行經(jīng)會(huì)陰或(腹)骶會(huì)陰肛門(mén)成形術(shù),術(shù)后15例(4.24%)出現(xiàn)直腸黏膜脫垂。(2)無(wú)肛伴直腸舟狀窩瘺、中位及高位ARMs術(shù)后直腸黏膜脫垂發(fā)生率經(jīng)χ2檢驗(yàn)差異有統(tǒng)計(jì)學(xué)意義(P0.05);122例經(jīng)(腹)骶會(huì)陰肛門(mén)成型術(shù)患兒,男性80例,女性42例,骶尾部畸形組23例,無(wú)畸形組99例,脊髓栓系組5例,無(wú)脊髓栓系組117例,3組分別經(jīng)χ2檢驗(yàn),直腸黏膜脫垂發(fā)生率差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);脫垂組骶尾比值為0.671±0.101,未脫垂組骶尾比值為0.678±0.085,兩者經(jīng)t檢驗(yàn)差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論先天性肛門(mén)直腸畸形術(shù)后直腸黏膜脫垂發(fā)生率不高,與直腸盲端的位置高低有關(guān),閉鎖盲端位置越高術(shù)后越容易出現(xiàn)直腸黏膜脫垂;與手術(shù)方式的選擇有關(guān),與性別、是否合并骶尾部畸形及脊髓栓系無(wú)關(guān),與骶尾比值的高低無(wú)關(guān)。
[Abstract]:Objective to analyze and summarize the incidence and influencing factors of rectal mucosal prolapse in children with congenital anorectal malformation (ARMs).Methods the medical records of 354 cases of congenital anorectal malformation treated in our hospital from 2014 to 2016 were analyzed retrospectively. The situation and influencing factors of rectal mucosal prolapse after various types of ARMs were analyzed and summarized.Results 354 cases of ARMs underwent perineum or (abdominal) sacroperineal anoplasty, 15 cases with rectal mucosal prolapse occurred after operation. (2) rectal scaphoid fossa fistula was not found.The incidence of rectal mucosal prolapse after middle and high ARMs was statistically significant (P 0.05). There were 80 males, 42 females, 23 patients with sacrococcygeal malformation and 99 patients without sacrococcygeal malformation.There were 5 cases in the tethered cord group and 117 cases in the no tethered group.There was no significant difference in the incidence of rectal mucosal prolapse (P 0.05), but the ratio of sacrococcyx was 0.671 鹵0.101 in prolapse group and 0.678 鹵0.085 in non-prolapse group. There was no significant difference between the two groups by t test.Conclusion the incidence of rectal mucosal prolapse is not high after operation of congenital anorectal malformation, which is related to the location of the blind end of the rectum, the higher the position of the atresia is, the more prone it is to the prolapse of the rectal mucosa after operation, and the choice of operation mode is related to the choice of operation mode and sex.There was no correlation between sacrococcygeal malformation and tethered spinal cord, and there was no relationship between sacrococcygeal ratio and sacrococcygeal ratio.
【作者單位】： 重慶醫(yī)科大學(xué)附屬兒童醫(yī)院胃腸新生兒外科兒童發(fā)育疾病研究省部共建教育部重點(diǎn)實(shí)驗(yàn)室重慶市兒童發(fā)育重大疾病診治與預(yù)防國(guó)際科技合作基地重慶市兒科學(xué)重點(diǎn)實(shí)驗(yàn)室;
【分類號(hào)】：R726.5

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