论文部分内容阅读
目的评估肛门正常的直肠前庭瘘(RVFNA)的治疗方法,探讨RVFNA的发病原因。方法回顾性分析2006年1月-2012年1月收治的206例RVFNA患儿的临床资料。年龄3个月～15岁。其中23例患儿曾于外院接受手术治疗失败。181例患儿出生3个月内有明确会阴部感染史,之后在排气或排稀便时前庭部有气体或少量粪便漏出。77例患儿会阴部感染之前曾有腹泻。198例前庭有1个瘘口,8例具有2个瘘口,瘘口之间有皮桥相连。患儿内口均在齿状线以上。173例外口直径<5 mm。本组102例行经肛门直肠前庭瘘修补术,87例行经会阴直肠前庭瘘修补术,17例行会阴成形术,均未出现术后会阴体开裂。结果 29例术后4～10 d前庭瘘复发,其中12例通过每日3次硼酸溶液坐浴治疗自愈,另17例再次手术修补。电话或门诊随访2个月～3 a,患儿排便功能均正常。结论 RVFNA大多是因后天感染获得而不是先天性疾病。采用经肛门或经会阴前庭瘘修补术疗效较为满意。复杂的会阴修补术和肠造瘘术对多数RVFNA患儿是不必要的。
Objective To evaluate the treatment of anorectal rectal vestibular fistula (RVFNA) and to explore the etiology of RVFNA. Methods The clinical data of 206 children with RVFNA admitted from January 2006 to January 2012 were retrospectively analyzed. Aged 3 months to 15 years old. Of the 23 children who had surgery in the outpatient hospital, they failed. 181 cases of children with a clear history of perineal infection within 3 months after birth, then gas or a small amount of excrement leaked out of the vestibular department during excretion or excretion of stools. There were diarrhea in 77 children with perineal infection. 198 cases of vestibule has a fistula, 8 cases have 2 fistula, fissure bridge between the skin. Children in the mouth are above the dentate line. 173 cases outside diameter <5 mm. The group of 102 cases of anorectal fistula repair, 87 cases of perineal and retroperitoneal fistula repair, 17 cases of perineal angioplasty, no postoperative perineal body cracking. Results 29 cases of recurrent vestibular fistula 4 to 10 days after operation, of which 12 cases by three times a day boric acid bath treatment of self-healing, and the other 17 cases of reoperation. Telephone or out-patient follow-up of 2 months to 3 years, children with bowel function were normal. Conclusions RVFNA is mostly acquired by acquired infection rather than congenital disease. Using anal or perineal fistula repair effect is more satisfactory. Complex perineal repair and enterostomy are not necessary for most children with RVFNA.