CAJ | 학술논문

目的探讨Ⅰ期改良Pe(n)a术治疗新生儿中高位先天性肛门直肠畸形的临床可行性及有效性.方法对48例先天性肛门直肠畸形的新生儿行Ⅰ期Pe(n)a术,其中31例进行2个月至4年4个月随访,对临床及随访资料进行回顾性分析.结果术后1例因肺部感染加重出现呼吸循环衰竭死亡,2例切口部分裂开,余恢复良好.31例坚持随访2个月至4年4个月,3例便秘,3例稀便时污粪,1例用力时污粪,2例直肠黏膜脱垂,1例切口感染,1例肛门狭窄(未坚持扩肛所致).无完全大便失禁、瘘管复发、尿潴留等并发症出现.17例中高位肛门直肠畸形术后行肛门直肠测压检查,有3例存在RAIR.结论Ⅰ期Pe(n)a术治疗先天性肛门直肠畸形,术后肛门功能良好,早中期疗效满意,Ⅰ期Pe(n)a术是一种创伤小、花费少、美观、简洁的手术方式.
목적 탐토Ⅰ기개량Pe(n)a술치료신생인중고위선천성항문직장기형적림상가행성급유효성.방법대48례선천성항문직장기형적신생인행Ⅰ기Pe(n)a술,기중31례진행2개월지4년4개월수방,대림상급수방자료진행회고성분석.결과술후1례인폐부감염가중출현호흡순배쇠갈사망,2례절구부분렬개,여회복량호.31례견지수방2개월지4년4개월,3례편비,3례희편시오분,1례용력시오분,2례직장점막탈수,1례절구감염,1례항문협착(미견지확항소치).무완전대편실금、루관복발、뇨저류등병발증출현.17례중고위항문직장기형술후행항문직장측압검사,유3례존재RAIR.결론Ⅰ기Pe(n)a술치료선천성항문직장기형,술후항문공능량호,조중기료효만의,Ⅰ기Pe(n)a술시일충창상소、화비소、미관、간길적수술방식.
Objective The aim of this study was to examine the feasibility, safety, cost- effectiveness , and medium-term outcome of one-stage repair of intermediate and high imperforate anus in the newborn. Methods This is a retrospective review of forty eight consecutive newborns who underwent one-stage anorectoplasty during the newborn period at the children's hospital of Chongqing medical University between January 2006 and March 2010. Thirty one of 48 patients were followed-up for 2 months to 4 years 4 months, followed-up data on the retrospective analysis. Results Forty-five patients had excellent results. One case died of respiratory and circulatory failure, the other two suffered from part incision dehiscence. Twelve of Thirty-one of the 48 cases has been followed-up for 2 months to 4 years and 6 months. No fecal incontinence,fistula recurrence,urinary retention has been observed. 3 cases has had constipation, 4 patients has soiled his diapers between bowel movements, 2 cases has had rectal mucosa prolapse, 1 patient has had wound infection, 1 patient has had stricture of anus without dilating of the anus. 17 cases underwent Anorectal manometry,only 4 exist RAIR. Conclusions Complete 1-stage repair using the Pe(n)a to treat high-type and intermediate-type anorectal malformations can be offered the same results as the traditional Pe(n)a. Also.it is safe and feasible.