肛管内超声及肛直肠测压在肛门闭锁术后肛门功能评估的意义

发布时间：2018-07-03 00:49

本文选题：肛门闭锁 + 肛管内超声　；参考：《重庆医科大学》2014年硕士论文

【摘要】：目的通过肛管内超声（EUS）和肛直肠测压检查对肛门闭锁术后肛门功能做客观评价，并指导进一步治疗。方法对34例肛门闭锁术后患儿分别采用EUS、肛直肠测压测量肛管中位水平内外括约肌厚度、肛周肌肉血供及弹性、肛门括约肌松弛反射情况，并结合临床评分评价术后肛门功能。对Pe a术组、经会阴肛门成形术组及对照组肛管中位水平内外括约肌厚度行组间独立样本t检验。结果（1）EUS测得肛门闭锁术后患儿肛管中位水平肛门内外括约肌厚度优良率为100％，肛直肠测压括约肌松弛反射引出的优良率为91.2％，，均高于肛门功能临床评分优组70.6％，客观指标的恢复先于主观指标，可以通过参照客观指标，对主观指标恢复不满意的患儿有针对性的行个体化功能锻炼。（2）Pe a术组测得肛门闭锁术后患儿肛管中位水平内外括约肌厚度分别为：1.42±0.22mm及3.21±0.25mm，经会阴肛门成形术组为1.33±0.22mm及3.10±0.33mm，对照组肛管中位水平内外括约肌厚度分别为1.21±.017mm及3.00±0.18mm，组间两两比较差异均无统计学意义。（3）20例Pe a术后行EUS检查，6例检测到骶尾部肛周肌肉缺损。结论 EUS及肛直肠测压检查可客观评价先天性肛直肠畸形术后排便功能。
[Abstract]:Objective to evaluate the anal function after anal atresia by means of intraanal ultrasound (EUS) and anorectal manometry. Methods 34 children with anal atresia were treated with EUSand anorectal manometry to measure the internal and external sphincter thickness, the blood supply and elasticity of perianal muscle, and the relaxation reflex of anal sphincter. The anal function was evaluated with clinical score. The thickness of internal and external sphincter at the median level of anal canal in the perineum anoplasty group and the control group were examined by independent t-test. Results (1) the excellent and good rate of anal canal horizontal anal sphincter thickness was 100 in children after anal atresia, and the excellent and good rate of sphincter relaxation reflex in anorectal manometry was 91.2. The recovery of objective indexes was earlier than that of subjective indexes, and the objective indexes could be obtained by referring to objective indexes. (2) the median anal sphincter thickness of children after anal atresia was measured to be: 1. 42 卤0.22mm and 3. 21 卤0. 25 mm respectively, and the perineal anal thickness was 3. 21 卤0. 25 mm in the perineum anus group. (2) the median anal sphincter thickness of the children after anus atresia was 1. 42 卤0.22mm and 3. 21 卤0. 25 mm respectively. The thickness of internal and external sphincter in the control group was 1.21 卤.017mm and 3.00 卤0.18mm, respectively. There was no significant difference between the two groups. (3) there was no significant difference between the two groups. (3) the sacrococcygeal perianal muscle defect was detected in 6 cases after Pe a operation in 20 cases. Conclusion EUS and anorectal manometry can objectively evaluate postoperative defecation function of congenital anorectal malformation.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R726.5

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