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目的探讨经会阴(大-W)手术方法治疗中、低位肛门直肠畸形(AA)的价值,对其长期疗效进行评价。方法对46例中、低位AA患儿进行经会阴(大-W)肛门成形术。包括充分保留直肠末端的瘘管结构,保证直肠末端从由耻骨直肠肌、肛门外括约肌组成的横纹肌复合体中心拖下,会阴倒V形皮瓣应用。术后随访时间平均7年2个月。按照修订的Wingspread Scoring肛门功能评分标准评估排便功能。结果除1例中位畸形伴其他畸形,肛门功能较差外,余患儿肛门功能均良好。结论经会阴(大-W)AA术治疗中、低位AA简便易行,因保留瘘管末端,且对控制排便的有关结构损伤少,长期随访效果满意。
Objective To investigate the value of perineal (large-W) surgery for the treatment of middle and low anorectal malformations (AA) and evaluate its long-term efficacy. Methods 46 cases of low AA children with perineal (large-W) anal angioplasty. Including adequate retention of the fistula of the distal rectum structure, to ensure that the rectum from the puborectalis, anal sphincter composed of striated muscle complex center drag down, perineal inverted V-flap application. The average follow-up time was 7 years and 2 months. Defecation was assessed according to the revised Wingspread Scoring anal function score. Results In addition to a case of malformations with other malformations, anal dysfunction, more than I anal function in children are good. Conclusions The treatment of middle and low AA by perineum (Da-W) AA is simple and easy. Because the distal end of the fistula is preserved and the structural damage to defecation control is less, the long-term follow-up effect is satisfactory.