腹腔镜下肛门直肠成形术治疗小儿高位直肠肛门畸形的疗效评价

目的：探究腹腔镜下肛门直肠成形术治疗小儿高位直肠肛门畸形的临床疗效。方法：研究对象选取为2013年7月至2015年4月我院收治的44例高位直肠肛门畸形患儿，在患儿监护人知情同意的情况下随机分组，分为观察组和对照组各22例，观察组患儿采用腹腔镜下肛门直肠成形术治疗，对照组患儿则采用后矢状入路肛门成形术治疗，对比两组患儿的肛门功能评分、直肠肛管测压结果以及出血量、住院时间等指标。结果：观察组患儿的肛门功能评分与对照组相比差异无统计学意义( P >0.05)；直肠肛管测压结果显示，观察组患儿的最大肛管静息压和静息非对称指数与对照组相比均差异具有统计学意义(P<0.05)；观察组患儿的手术出血量、住院时间均低于对照组，差异具有统计学意义(P <0.05)。结论：腹腔镜下肛门直肠成形术治疗小儿高位直肠肛门畸形的疗效确切，相较于后矢状入路肛门成形术的创伤更小，手术效果更好，具有更广阔的前景，值得在临床上推广和应用。

Laparoscopic Anorectal Plasty for Children with High Anorectal Malformation

Objective: To explore the clinical efficacy on treatment for children with high anorectal mal-formation using the laparoscopic anorectal plasty. Methods: 44 cases of children with high anorectal malforma-tion hospitalized were selected as objects from July 2013 to Aprile 2015, and divided randomly into two groups (control group and observation group, with 22 cases in each group) in the case of the infromed consent of the children’s guardian. Patients in the observation group were treated with laparoscopic anorectal plasty and the children in the control group using sagittal anoplasty treatment. The index such as the body’ s anal function score, anorectal manometry results and the amount of bleeding, hospital stay of the two groups were compared. Results:On the anal function score, there was no significant difference between the observation group and the control group (P>0.05); the anorectal manometry results showed that the the maximum anal resting pressure and resting asymmetric index of the two groups existed significant differences (P<0.05); the bleeding volume in surgery and length of hospital stay of the children in the observation group was significantly lower than those in control group, there were significant differences (P<0.05). Conclusion: Laparoscopic anorectal trauma an-gioplasty has a high efficacy to treat hign anorectal malformation in children. Compared to posterior sagittal an-oplasty, laparoscopic anorectal trauma angioplasty has less trauma and better curative effect. It is worthy of clinical promotion and application.