复合肌肉移植治疗小儿大便失禁

Composite Muscle Graft to Treat Fecal Incontinence in Children

目的 探讨小儿大便失禁的治疗方法。方法 本组１２ 例， 男１０ 例， 女２ 例。年龄６～１２ 岁。均采用双侧髂腰肌加强盆底肌、股薄肌肛门成形术治疗。术后禁食４～５ 天， 切口暴露， 随时清除创口和肛门分泌物， 保持肛门处清洁。术后３ 周开始肛门功能训练。结果 术后随访６ 个月～４ 年，９ 例无污粪，３ 例稀便时有污粪。临床评分５ ～６ 分， 客观评分４～５ 分。结论 复合肌肉移植是治疗小儿大便失禁的较好方法。

Objective To evaluate combined muscle graft in management of fecal incontinence in children. Methods Twelve children, 10 boys and 2 girls (age range: 6 12 years) underwent iliopsoas and gracilis composite muscle graft to strengthen the muscles of pelvic floor and anal sphincter. The children were fasted for 4 to 5 days postoperatively. The wounds were left open for clearance of mucus secretion. Training of anal sphincter started 3 weeks postoperatively. The children were followed up for 4 months to 4 years. Results Nine children were continent. Three children were soiling while lossened stool. The clinical continence scores were 5 6 and objective continence scores were 4 5. Conclusion Combined gracilis and ilio psoas graft is a feasible treatment for fecal incontinence in children.