先天性肛门直肠畸形术后直肠黏膜脱垂的病因分析

发布时间：2018-04-01 01:39

本文选题：先天性肛门直肠畸形　切入点：直肠黏膜脱垂　出处：《第三军医大学学报》2017年23期

【摘要】：目的分析并总结先天性肛门直肠畸形(anorectal malformations,ARMs)术后患儿直肠黏膜脱垂的发生情况及影响因素。方法回顾性分析我院2014-2016年收治的354例先天性肛门直肠畸形患儿的病历资料,分析总结各种类型ARMs术后直肠黏膜脱垂的情况及影响因素。结果 (1)354例ARMs患儿行经会阴或(腹)骶会阴肛门成形术,术后15例(4.24%)出现直肠黏膜脱垂。(2)无肛伴直肠舟状窝瘘、中位及高位ARMs术后直肠黏膜脱垂发生率经χ2检验差异有统计学意义(P0.05);122例经(腹)骶会阴肛门成型术患儿,男性80例,女性42例,骶尾部畸形组23例,无畸形组99例,脊髓栓系组5例,无脊髓栓系组117例,3组分别经χ2检验,直肠黏膜脱垂发生率差异均无统计学意义(P0.05);脱垂组骶尾比值为0.671±0.101,未脱垂组骶尾比值为0.678±0.085,两者经t检验差异无统计学意义(P0.05)。结论先天性肛门直肠畸形术后直肠黏膜脱垂发生率不高,与直肠盲端的位置高低有关,闭锁盲端位置越高术后越容易出现直肠黏膜脱垂;与手术方式的选择有关,与性别、是否合并骶尾部畸形及脊髓栓系无关,与骶尾比值的高低无关。
[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 卤0.101 in prolapse group and 0.678 卤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.
【作者单位】：重庆医科大学附属儿童医院胃肠新生儿外科儿童发育疾病研究省部共建教育部重点实验室重庆市儿童发育重大疾病诊治与预防国际科技合作基地重庆市儿科学重点实验室;
【分类号】：R726.5

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