CAJ | 학술논문

目的：探讨先天性肛门闭锁在基层医院的诊断和治疗，分析和评估其诊断分型及治疗手段的可行性，规范基层医院在其治疗进程中的作用和定位。方法回顾性分析1993年5月至2013年3月收治的21例先天性肛门闭锁患儿的临床资料。结果21例患儿中15例行手术治疗：12例直肠盲端与肛穴隐窝皮肤间的距离（P-P 间距）1．5 cm 以下患儿行会阴肛门成形术，3例 P-P 间距1．5～1．8 cm 的患儿行骶会阴肛门成形术；术后随访6个月至1年，15例患儿肛门功能及排便功能正常。另6例患儿因高位畸形，瘘管开口部位高，合并其他畸形而转诊专科医院。结论基层医院具备对肛门闭锁的诊断分类及手术治疗中低位肛门闭锁的能力，但对高位畸形及合并其他畸形的治疗手段较弱。
목적：탐토선천성항문폐쇄재기층의원적진단화치료，분석화평고기진단분형급치료수단적가행성，규범기층의원재기치료진정중적작용화정위。방법회고성분석1993년5월지2013년3월수치적21례선천성항문폐쇄환인적림상자료。결과21례환인중15례행수술치료：12례직장맹단여항혈은와피부간적거리（P-P 간거）1．5 cm 이하환인행회음항문성형술，3례 P-P 간거1．5～1．8 cm 적환인행저회음항문성형술；술후수방6개월지1년，15례환인항문공능급배편공능정상。령6례환인인고위기형，루관개구부위고，합병기타기형이전진전과의원。결론기층의원구비대항문폐쇄적진단분류급수술치료중저위항문폐쇄적능력，단대고위기형급합병기타기형적치료수단교약。
Objective To explore the diagnosis and treatment of congenital anal atresia in basic-level hospitals for analyzing and evaluating the feasibility of diagnostic classification and treat-ment and standardizing the function and position of basic-level hospitals in the treatment of con-genital anal atresia.Methods Clinical data of 21 children who were treated between May 1993 and March 2013 for congenital anal atresia were analyzed retrospectively.Results Among the 21 children,6 patients were transferred to special hospital due to high deformity,high fistula opening position and other complicated malformations.Among the 15 children who received surgical treat-ment,perineal anoplasty was performed in 12 children with a distance below 1.5 cm between the blind end of rectum and the lowest tangent of steel ball the distance between the distal rectal pouch and the anal skin pouch(P-P spacing),and sacroperineal anoplasty in 3 children with P-P spacing of 1.5-1.8 cm.After 6-12 months of follow-up,all the 15 children had normal function of anus and defecation.Conclusion Basic-level hospitals have the ability for diagnostic classification of anal atresia and surgical treatment of middle and low anal atresia,but are incapable of treating high deformity and other complicated malformations.