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目的:探讨应用经肛门置回肠引流管在回肠末端闭锁手术中的价值及对患儿术后营养的影响。方法:回顾性分析2014年1月至2017年12月，就诊于河北省儿童医院的25例回肠末端5 cm以内肠闭锁患儿的临床资料。按照手术方式不同分为两组，对照组13例，采用切除回盲部，行近端回肠与远端结肠吻合；观察组12例，采用保留回盲部，并经肛门置管达吻合口近端10～20 cm，平均达近端15 cm。所有病例同时行腹腔引流。对比两组患儿的手术时间、效果、术后营养及胃肠功能。结果:观察组12例及对照组13例患儿恢复顺利，无吻合口漏、腹腔残余脓肿等并发症。观察组3例，对照组7例患儿术后因并发症再次入院，无再次手术患儿。观察组手术时间(115.2±18.1)min高于对照组(105.3±16.9)min，差异有统计学意义(n P0.05)；达全肠内营养时间比较观察组(12.6±2.4)d与对照组(14.8±2.8)d差异有统计学意义(n P<0.05)，住院天数观察组(16.1±2.4)d与对照组(18.7±3.6)d相比，差异具有统计学意义(n P<0.05)。术后15 d，前白蛋白、白蛋白水平观察组[(113.8±8.7)g/L，(31.8±4.3)g/L]，显著高于对照组[(107.5±5.1)g/L，(28.1±3.3)g/ L]，差异有统计学意义(n P<0.05)。术后30 d前白蛋白、白蛋白水平观察组[(117.5±7.4)g/L，(38.1±3.8)g/L]，显著高于对照组[(111.4±6.0) g/L，(34.1±3.4) g/L]，差异有统计学意义(n P<0.05)。n 结论:在距离回盲部不足5 cm的闭锁病例中，应用经肛门置管达吻合口近端减压并直接吻合可保留回盲部，减少患儿营养相关并发症，操作简单，效果肯定，值得在临床应用。“,”Objective:To explore the value of transanal ileal drainage tube for terminal ileal atresia and to examine its effect on postoperative nutrition.Methods:From January 2014 to December 2017, clinical data were retrospectively analyzed for 25 children with intestinal atresia within 5 cm of ileum at terminal ileum .According to different surgical approaches, they were divided into control (n n=13) and observation (n n=12) groups.In control group, ileocecal resection was performed.And proximal ileum and distal colon were anastomosed.In observation group, ileocecal plexus was preserved and anal canal created near anastomosis.The proximal end was 15(10-20) cm.All cases underwent simultaneous abdominal drainage.The operative duration, efficacy, postoperative nutrition and gastrointestinal function of two groups were compared.n Results:Twelve children in observation group and 13 in control group recovered successfully.There were no complications such as anastomotic leakage and residual abscess in abdominal cavity.Three cases in observation group and 7 in control group were hospitalized for postoperative complications and no reoperation was performed.The average operative duration of observation group was higher than that of control group [(115.2±18.1) vs (105.3±16.9) min, (n P0.05)]. No statistical significance existed.A statistically significant difference existed between observation group (12.6±2.4 days) and control group (14.8±2.8 days) (n P<0.05). The average hospital stay observation group (16.1±2.4 days) and control group (18.7±3.6 days). The difference was statistically significant(n P<0.05). At 15 days postoperatively, pre-albumin and albumin levels were observed (113.8±8.7, 31.8±4.3 g/L). Both were significantly higher than those of control group (107.5±5.1, 28.1±3.3 g/L) (n P<0.05). The difference was statistically significant; pre-albumin and albumin levels at Day 30 postoperatively (117.5±7.4 vs 38.1±3.8 g/L). Both were significantly higher than those of control group (111.4±6.0 vs 34.1±3.4). The difference was statistically significant(n P<0.05).n Conclusions:For atresia <5 cm away from ileocecal area, transanal catheter is utilized for reaching the proximal end of anastomosis and direct anastomosis may preserve ileocecal area and lower the nutrition-related complications.This simple procedure has a definite efficacy.It is worthy of wider clinical applications.