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目的 总结肛门失禁( 主要为儿童)行括约肌重建的临床经验并针对性提出括约肌重建的方法。方法 回顾1992~1997 年对31 例完全性肛门失禁的治疗,其中25 例为先天性肛门闭锁术后,2 例为会阴损伤术后,4 例为盆腔和会阴术后。对此组病例采取不同的括约肌重建术,包括神经压榨股薄肌转移肛门外括约肌重建25 次,臀大肌转移5 次,PuriNixon 提肛肌成形术1 次,肛门内括约肌成形6 次。结果 对25 例进行平均25 个月的随访,按李正评分法,临床评分达优良22 例,占88.0 % ,客观评价8 例,5 例达优良。结论 对括约肌肌源性损害致肛门失禁的患者,正确地选择不同的括约肌成形术都可能达到满意的效果
Objective To summarize the clinical experience of sphincter reconstruction in anal incontinence (mainly in children) and to propose a method for targeted sphincter reconstruction. Methods From 1992 to 1997, 31 cases of complete anus incontinence were treated, of which 25 cases were congenital anal atresia, 2 cases were perineal injuries and 4 cases were pelvic and perineal postoperatively. Different sphincter reconstruction was performed in this group of patients, including 25 cases of anal sphincter reconstruction after gravitation of nerve grafts, 5 cases of transfer of gluteus maximus, Puri-Nixon levator ani angioplasty and 6 cases of anal sphincter. Results 25 cases were followed up for an average of 25 months. According to the Li Zheng score method, the clinical score reached 22 excellent, accounting for 88.0%, objective evaluation of 8 cases and 5 cases of excellent. Conclusion In patients with anal incontinence caused by sphincter myogenic damage, the correct choice of different sphincteroplasty may achieve satisfactory results