髂腰肌加强盆底肌治疗小儿神经源性大便失禁

Strengthened pelvic floor by iliopsoas muscles in the treatment of neurogenic fecal incontinence

目的 :探讨小儿腰骶部脊髓脊膜彭出术后及隐性脊柱裂所致的神经源性大便失禁的手术治疗方法。方法 :4～ 1 4岁患儿 1 5 6例均表现为排便异常。病理改变为盆底肌肉瘫痪 ,肌层薄弱 ,盆底下垂 ,肛门松弛。均采用改良的髂腰肌加强盆底、直肠悬吊术进行治疗。结果 :随访 0 5～ 6a ,1 5 4例没有污粪 ,2例无效。结论 :髂腰肌加强盆底肌。

Aim:To study the operative method of neurogenic fecal incontinence in children with meningomyelocele and occulta spina bifida.Methods:156 cases aged 4～14 years were treated with modified rectal suspension and strengthening pelvic floor precedure.All of them presented disturbance of defecation.The pathological changes were paralysis of pelvic floor muscles,ptosis of pelvic floor and anus laxation.Results:Of 156,154 were satisfactory,2 were ineffective.Conclusion:The strengthened pelvic floor muscles by iliopsoas muscles and rectal suspension is a good method for neurogenic fecal incontinence.