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患几年龄为1个月至3岁,男20例,女1例,临床表现为便秘、排便困难,每次排便哭闹,部分患儿大便带血,排便时肛门后位膨隆,均有不同程度的肛门前移,肛门呈瘘口状,其中15例为遮盖性肛门,肛门后方有明显凹陷处,排便时凹陷处皮肤隆起,检查有冲击感,从肛门瘘口插入探针向后检查能在此触及探针。手术方法:术前清洁灌肠并禁食5h,皮肤常规消毒,全部用1%利多卡因局麻,或点状麻醉,取截石位,从瘘口向后插入蚊式血管钳稍张开作引导,在瘘口后方纵形向后切开皮肤至直肠后壁处,将后壁无张力情况下拉下,与切开口皮肤呈横形间断缝合4~6针,术后检查伤口有无出血,正常包扎,冲洗,术后不控制排便,每日便后用我诊所配制“消毒液”冲洗肛门会阴创面,换敷料,术后7~8d拆线,拆线后20~30d给患儿扩肛,每天一次,以后隔日一次,一般扩肛1~2个月左右。结果:6个月后21例患儿均能正常排便,无1例伤门感染,指诊肛门括约肌紧张度及功能均正常,全部治愈。
Suffering from a few months of age from 1 month to 3 years old, 20 males and 1 females, clinical manifestations of constipation, defecation difficulty, every defecation crying, some children with stool bloody defecation anus posterior bulging, are different Degree anus forward, anus was fistula, of which 15 cases were obscure anus, anal obvious recess, defecation depression at the skin uplift, check the impact of a sense, from the anal fistula into the probe back to check Touch the probe here. Surgical methods: preoperative clean enema and fasting 5h, routine disinfection of the skin, all with 1% lidocaine local anesthesia, or punctate anesthesia, take lithotomy position, backward from the fistula of mosquito vascular forceps slightly open for Guide, in the back of the fistula longitudinal incision of the skin to the posterior wall of the rectum, the posterior wall without tension down, and the opening of the skin was transverse suture interrupted 4 to 6-pin, postoperative wounds with or without bleeding, Normal dressing, rinse, postoperative do not control defecation, daily after I use the clinic preparation “disinfectant” rinse anus perineal wound dressing for dressings, 7 ~ 8d after stitches, stitches after 20 ~ 30d to children with anal extension anal , Once a day, every other day after the general anal about 1 to 2 months or so. Results: After 6 months, all the 21 children were able to defecate normally without any wound infection. The anal sphincter tension and function were normal and all were cured.