Wu Xiaoxia,Sun Xiaobing,An Guoxian,et al.Evaluation of postoperative anal sphincter with endoanal ultrasound in children with anorectal malformation[J].Journal of Clinical Pediatric Surgery,2019,18(05):404-408.[doi:10.3969/j.issn.1671-6353.2019.05.013]
肛门直肠畸形患儿术后肛门括约肌肛管内超声评价及意义
- Title:
- Evaluation of postoperative anal sphincter with endoanal ultrasound in children with anorectal malformation
- Keywords:
- Anal Canal/AB; Rectum/AB; Colorectal Suegery; Anal Canal/IN; Ultrasonography/MT
- 分类号:
- R729;R445.1;R657.1
- 摘要:
- 目的 应用肛管内超声检查评价肛门直肠畸形术后患儿肛门内括约肌（internal anal sphincter，IAS）、肛门外括约肌（external anal sphincter，EAS）功能并与正常儿童进行比较，分析括约肌受损程度与肛门功能的相关性。方法 回顾性分析山西省儿童医院2014年8月至2016年10月50例正常儿童及122例肛门直肠畸形术后患儿的肛管内超声资料及临床资料，并进行括约肌受损程度评分；通过Spearman秩相关分析评价括约肌评分和肛门功能评分之间的相关性。结果 ①正常儿童IAS、EAS的厚度与性别、年龄无关； ②肛门直肠畸形术后患儿IAS、EAS最大厚度与正常儿童比较无明显差异（P>0.05）； ③不同类型肛门直肠畸形术后患儿IAS、EAS最大厚度无显著差异（P>0.05）；（4）肛门直肠畸形术后患儿括约肌受损程度与肛门功能评分呈明显负相关（r=-0.728，P<0.05）。结论 肛门直肠畸形术后患儿肛管内超声提示IAS、EAS最大厚度与正常儿童无明显差别，但存在局部缺损或变薄，其完整性或受损程度与肛门直肠畸形术后排便功能密切相关。
- Abstract:
- Objective To evaluate the postoperative internal anal sphincter (IAS) and external anal sphincter (EAS) in children with anorectal malformation.The correlation between the sphincter damage degree of and postoperative anal function was analyzed.Methods From August 2014 to October 2016,122 cases of children who had undergone surgeries for anorectal malformation and 50 normal children were received endoanal ultrasound in our hospital.Their endoanal ultrasound data and clinical data were analyzed retrospectively.Spearman analysis was performed to examine the correlation of anal sphincter damage with postoperative anal function score.Results The thickness of IAS and EAS in normal children is independent of sex and age.The maximum thickness of IAS and EAS in postoperative children is not significantly different from that of normal children (P>0.05).There was no significant difference in the maximum thickness of IAS or EAS in the postoperative children with different types of anorectal malformations(P>0.05).There is a significant negative correlation between the sphincter damage score and postoperative anal function score(r=-0.728,P<0.05).Conclusion The maximum thickness of IAS and EAS in postoperative children with anorectal malformation has no different from that of normal children,but the presence of a sphincter defect was prevalent,and the degree of anatomic integrity or damage of anal sphincter is closely related to the postoperative anal function.
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备注/Memo
收稿日期:2018-11-13。
基金项目:山西省儿童医院院内课题（编号：201512）
通讯作者:孙小兵,Email:sunxiaobing.phd@163.com