一期与分期腹骶会阴肛门成形术治疗高位肛门直肠畸形的疗效比较

A comparison of One-stage and Three-stage operation for neonatal high imperforate anus following Sacral ventral perineal anoplasty

目的：比较腹骶会阴肛门成形一期手术与三期常规手术在治疗新生儿高位肛门直肠畸形中的疗效。方法回顾性分析本院收治的48例采用腹骶会阴肛门成形手术的新生儿先天性高位肛门直肠畸形患儿临床资料，分别采用一期手术（A组）和三期手术（B组）进行治疗，比较两组疗效。结果 A组21例均接受一期手术，2例失访，19例术后肛门功能优良率87．72％；B组27例中，肠造瘘后放弃后续手术或失访4例，23例全程完成三期手术，术后肛门功能优良率88．41％，两组疗效比较差异无统计学意义（P＞0.05）。结论选择性一期腹骶会阴肛门成形术治疗高位肛门直肠畸形同样可达到常规三期手术的效果，且有护理方便、病程短、费用低的优点。

Objetive To discuss the curative effects on Sacral ventral perineal anoplasty between one-stage and three-stage operation for neonatal high imperforate anus. Methods 48 neonatal patients with con-genital high imperforate anus who underwent sacral ventral perineal anoplasty were retrospectively analyzed, then,the effects of one-stage surgery（group A）and three-stagesurgery（group B）were compared. Results In group A,21cases accepted one-stage operation,2 cases among them missed,the postoperative anal function recovery good rate of other 19 patients was 87.72%;in group B,27 cases accepted three-stage operation,4 cases among them give up treatment or lost to follow-up after intestinal colostomy,23 patients underwent three-stage operation successfully,postoperative anal function recovery good rate was 88.41%.No statistical difference was found between two groups of curative effects（P〉0.05 ）. Conclusion The one-stage sacral ventral perineal anoplasty for high imperforate anus can achieve the alike effect of the three-stage operation,and also has the advantages of nursing convenient,short duration,and low cost.