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目的探讨矩形带蒂皮瓣推移肛门成形术治疗小儿先天性肛门狭窄和肛门直肠畸形术后肛门狭窄的应用。方法对2002年5月-2009年9月本院收治的10例先天性肛门狭窄和肛门直肠畸形术后肛门狭窄患儿的临床资料进行回顾性分析。其中先天肛门狭窄6例,男4例,女2例;平均年龄9个月(6～13个月);肛门直肠畸形术后肛门狭窄4例,男2例,女2例;平均年龄14个月(10～18个月)。患儿均以排便困难就诊。4例肛门直肠畸形术后肛门狭窄患儿均诊断为先天性肛门闭锁,均于出生1个月后拟行肛门成形术,术后未正规扩肛。10例均采用矩形带蒂皮瓣推移肛门成形术治疗,并采用肛门功能临床评分标准评估其排便功能。患儿术后3、6个月常规来院复诊,随访2个月～7 a。结果10例患儿肛门切口Ⅰ期愈合,肛门外观良好,术后能完全解除狭窄,明显改善排便困难症状。患儿排便功能均良好,总评分5～6分。结论矩形带蒂皮瓣推移肛门成形术对先天肛门狭窄的局部解剖学狭窄及排便困难症状有良好的治疗效果。
Objective To investigate the application of rectangular pedicle flap anoplasty for the treatment of anal stenosis in children with congenital anal stenosis and anorectal malformation. Methods The clinical data of 10 children with anal stenosis and anorectal malformation after anal stenosis admitted to our hospital from May 2002 to September 2009 were analyzed retrospectively. Including congenital anal stenosis in 6 cases, 4 males and 2 females; average age of 9 months (6 to 13 months); anorectal malformation anal stenosis in 4 cases, 2 males and 2 females; mean age 14 Month (10 ~ 18 months). Children are defecating treatment. Four cases of anorectal malformations in children with anal stenosis were diagnosed as congenital anal atresia, are to be performed 1 month after birth anal angioplasty, postoperative informal expansion of the anus. Ten cases were treated with rectangular pedicled flap anoplasty, and their defecation function was evaluated by anal function score. Children 3,6 months after routine hospital referral, follow-up 2 months to 7 a. Results The anus incision healed in 10 cases, the appearance of the anus was good, the stenosis was completely relieved after operation, and the symptoms of defecation were significantly improved. Children defecation function are good, the total score of 5 to 6 points. Conclusion Rectangular pedicle flap anoplasty has a good therapeutic effect on the local anatomical stenosis and defecation symptoms of congenital anal stenosis.