重视复杂肛门直肠畸形的综合治疗

Attaching a higher importance to a comprehensive management of children with complicated anorectal malformatons

肛门直肠畸形病理改变复杂,患儿手术后远期排便功能和生活质量与畸形复杂程度及伴发畸形密切相关。外科手术治疗仅仅是肛门直肠畸形治疗整体链中的重要一环,而不是治疗终点。复杂肛门直肠畸形手术后并发排便功能障碍者,需要对肛门功能进行客观评估,并积极采取有针对性的排便训练。对出现社会和心理问题的肛门直肠畸形患儿,需要取得家长、学校和社会的配合,及时进行必要的心理咨询及治疗,使患儿步入成年后能获得社会和家庭可接受的排便控制能力及生活质量。因此,复杂肛门直肠畸形外科解剖结构重建以后的肛门功能重建和远期生活质量提高,是一个由医生、家庭和社会参与的综合治疗,需要引起重视。

Anorectal malformations are manifested as significant pathological changes.The long-term defecation functions and quality-of-life are closely correlated with the complexity of anorectal malformations and other concurrent deformities.Surgery is vital in the whole chain of anorectal malformation s comprehensive treatment rather than an endpoint of treatment.It is necessary to evaluate anal functions objectively and conduct effective defecation training.For social and psychological problems,parents,schools and society should collaborate jointly and necessary psychological counseling and proper treatments should be performed to help children enter the adult stage with defecation control and quality-of-life acceptable to both society and family.Therefore reconstructing anal function and improving long-term quality-of-life after surgical anatomic reconstruction of complex anoretal malformations is a comprehensive endeavor of surgeons,families and society.