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1、改良Perm术一期治疗高屮位肛门闭锁临床探讨【摘要】目的探讨改良Pea术治疗屮高位先天性肛门闭锁。方法采用改良Pea术一期治疗中高位先天性肛门闭锁53例,回顾53例临床资料进行分析。结果53例存活,无死亡病例。手术时间110~160min,术中出血为15〜35ml。术后2周开始扩肛6个月~1年。其中切口I期愈合50例,3例切口感染。随访53例,随访时间为6个月~2年。术后肛门排便功能优49例,占92.4%;良好3例,占5.6%;差1例,占1.8%。无肛门失禁、肛门狭窄。1例真肠黏膜轻度外翻,肛门松弛,大便次数增多,后经二期手术治愈。
2、结论先天性真肠肛门畸形是指胚胎期示肠末端发冇异常的一类疾病,是小儿最常见的消化道畸形,经典的Pea术分三期,结肠造痿-肛门形成-造痿口关闭,疗稈长,住院费用高。通过改良Pea术治疗一•期中高位先天性肛门闭锁,术中暴嘉好,术后肛门失禁、肛门狭窄发生率低,是一种疗程短、费用低、创伤少,且可靠的手术方法。【关键词】改良Pea术;肛门成形术;先天性肛门闭锁;治疗AmodifiedPeaclinicalstudyontreatmentofhighanalatresiaZHENGuo-zhi,LTLiang-bo.TheProvincehosp
3、itaiforsurgeryShundedistrict,FoshanCity,Guangdong528300,china【Abstract]ObjectiveTodiscussimprovingPeahighinthetreatmentofcongenitalanalatresia・Review53casesclinicalanalysis・MethodsUsingamodifiedPeahighs53casesofcongenitalanalatresiaintreatment.Results53casesofsurvivalw
4、ithoutcleaths.Durationofoperation110T60min,intraoperativebleeding15-35ml.Started2weeksafteranaloperationfrom6monthstoayear.Healingofincisionsstage50cases,3casesofwoundinfection.Follow-upin53cases,follow-uptimeof6monthsto2years・Foranusafterdefecationfor49cases,92.4%,goo
5、d3cases,5・6%,1shortexample,1.8%,freeanalincontincnce,analstenosis・1mildcasesofRectalMucosavalgus,analrelaxation,increasedstoolfrequency,afterthesecondstageoperationcure>ConclusionReferstocongenitalanorectalmalformationafterfetalendintestinaldysplasiatypeofdiseasearemos
6、tcommondigestivetract,malformationinchilclren,classicalPeathreephases,colonicstoma-formation-analfistulaclosedcourseslonger,hospitalcosts・ThroughimprovedPenahighinthefirststageoftreatmentofcongenitalanalatresia,exposedinthewel],lowincideneeofpostoperativeanalincontinen
7、ce,analstenosis,isashortcourse,lowcost,lesstraumatic,andreliableoperation.[Keywords]ModifiedPeaoperation;Anoplasty;Congenitalimperforateanus;Treatment先天性肛门闭锁是较常见的消化道畸形,表现为頁肠与肛管发育异常,可分为高位、屮位、低位三种类型。高屮位肛门闭锁常合并有泌尿道畸形,占60%[1],其治疗比较复杂,死亡率校高。笔者于2007年3月~2011年3月对53例诊断为屮高位先天性肛门
8、闭锁患儿采用改良Pe&术一期肛门成形术治疗,效果满意,现报告如下。1资料与方法1.1一般资料自2007年3月'2011年3月本院收治高中位先天性肛门闭锁53例,男39例,女14例,年龄广20d,出生体重2.8^3.8kg,均以先天性无