腹腔镜手术在高中位肛门闭锁治疗中的应用效果

Application effect of laparoscopic surgery in the treatment of high-middle anal atresia

目的探讨腹腔镜手术在治疗高中位肛门闭锁中的应用效果。方法选取2016年11月至2018年11月我院收治的84例高中位肛门闭锁患儿作为研究对象,按照治疗方法的不同将其分为参照组和腹腔镜组,各42例。参照组给予传统后矢状入路肛门成形术,腹腔镜组给予腹腔镜辅助肛门成形术。比较两组治疗前及治疗1年后的肛门功能Kelly氏评分、治疗1年后的临床疗效及并发症发生情况。结果治疗前,两组的大便失禁、直肠积粪和括约肌收缩力评分比较,差异无统计学意义(P>0.05);治疗1年后,两组的大便失禁、直肠积粪和括约肌收缩力评分均升高,且腹腔镜组高于参照组,差异具有统计学意义(P<0.05)。治疗1年后,腹腔镜组的治疗总有效率高于参照组,并发症总发生率低于参照组,差异具有统计学意义(P<0.05)。结论腹腔镜手术在治疗高中位肛门闭锁中的应用价值显著,值得临床推广应用。

Objective To investigate the application effect of laparoscopic surgery in the treatment of high-middle anal atresia.Methods From November 2016 to November 2018,84 children with high-middle anal atresia admitted in our hospital were selected as the research objects,and they were divided into reference group and laparoscopic group according to the different treatment methods,with 42 cases in each group.The reference group was given traditional posterior sagittal anoplasty,and the laparoscopic group was given laparoscopic assisted anoplasty.The Kelly’s score of anal function before and after one year of treatment,clinical efficacy and complications after one year of treatment were compared between the two groups.Results Before treatment,there were no significant differences in the scores of fecal incontinence,rectal feces and sphincter contractility between the two groups(P>0.05);after one year of treatment,the scores of fecal incontinence,rectal feces and sphincter contractility of the two groups increased,and those in the laparoscopic group were higher than the reference group,and the differences were statistically significant(P<0.05).After one year of treatment,the total effective rate of treatment in the laparoscopic group was higher than that in the reference group,and the total incidence of complications was lower than that in the reference group,and the differences were statistically significant(P<0.05).Conclusion The laparoscopic surgery in the treatment of high-middle anal atresia has a significant application value,which is worthy of clinical promotion and application.