摘要
目的:探讨儿童肛门失禁及臀大肌瓣肛门括约肌成形术治疗肛门失禁的机制。方法:采用一种半导体力敏式测压仪对正常儿童、各种原因的肛门失禁及肛门失禁行臀大肌瓣肛门括约肌成形术后患儿进行静态、动态及模拟状态下的测压。结果:失禁者肛管最大拖出力明显降低(P<0.005);反映横纹肌功能的球海绵体肌反射、肛皮反射及主动收缩均明显降低或缺乏(P<0.05);最低感觉气量明显升高,尤其是在骶脊膜膨出失禁组(P<0.001);行臀大肌瓣肛门括约肌成形术后以上指标均有不同程度的改善。结论:提示不同原因所致的肛门失禁机制不完全相同,臀大肌瓣肛门括约肌成形术改善肛门控制在于增加肛管长度、恢复了肛管感觉、建立了主动意识控制。
Objective:To investigate the mechanical activity of anal incontinence and the effect of transplantated gluteus maximus anal sphincteroplasty.Methods:Manometric study was taken by mechanical sensitive semiconductor manometer on anal incontinence of patients underwent glu- teus maximus transplantation and normal controls in static,dynamic and/or simulate conditions. Results:The expulsive force of anus was very low in all incontinent children(P<0.005)。As showed in bulbocavernous and anal skin reflex,the strait muscle function was also reduced signifi- cantly(P<0.05).The feeling threshold of inflation was increased especially in sarcrospinal bifida group(P<0.001).The above parameters improved by different degree after the gluteus maximus transplantation.Conclusions:The anal incontinence of various causes have different mechanism. The gluteus maximus transplantation can increase the length of anal canal,restore the anal sensa- tion and establish the voluntary control.
出处
《中华小儿外科杂志》
CSCD
1997年第5期285-287,共3页
Chinese Journal of Pediatric Surgery