先天性肛门直肠畸形耻骨直肠肌、括约肌形态发育的探讨

Morphological Study of Puborectalis and Anal Sphincter in Anorectal Anomaly with Computerized Tomography

目的利用ＣＴ了解术前患儿的耻骨直肠肌、括约肌的形态变化，并寻找评价该肌肉的发育指标及其价值。方法对２９例患儿进行ＣＴ扫描检查，测量括约肌的宽度与坐骨支间距的比值，并根据肌肉形态制定发育标准与直肠盲端位置进行比较。结果得出肌肉发育程度与直肠盲端位置的高低不成比例；当括约肌的宽度与坐骨支间距的比值＜０．１３时表明括约肌发育差。结论从直肠盲端位置的高低判断盆底肌的发育不准确，ＣＴ可以直接从形态上了解括约肌为代表的盆底肌的发育，并从影像中定性定量地分析括约肌形态的变化与排便功能的关系。

Objective This study aims to correlate the morphological changes of puborectalis and anal sphincter with the level of rectal blind end in patients with anorectal anomalies.Methods Twenty nine patients underwent computerized tomography (CT) morphological study preoperatively. The ratios of sphincter width to the distance between ischial tuberosities were measured. A ratio less than 0.13 signified poor muscle development. The distance of blind end of rectum was also measured.Results The muscle development did not correlate with the level of rectal blind end.Conclusions The position of rectal blind end is not predictive of pelvic muscle development. Pelvic CT provides better visualization of pelvic muscle and correlates more to the functional outcome.