新生儿骶尾部畸胎瘤手术后肛门直肠功能的相关因素分析

目的评估新生儿骶尾部畸胎瘤手术后远期肛门直肠功能,并探讨其影响因素。方法选取2013年8月至2018年2月天津市儿童医院新生儿外科收治的97例新生儿骶尾部畸胎瘤患者,记录患者临床特征及肛门直肠功能障碍发生情况,对患者肛门直肠功能障碍的发生率及其危险因素进行分析。结果新生儿骶尾部畸胎瘤的Altman分型、肿瘤体积和术中残余肿瘤体积与术后肛门直肠功能的恢复相关(P<0.05),而性别、血清AFP水平、肿瘤性状和病理类型与肛门直肠功能障碍不相关(P>0.05);在Altman分型Ⅱ型和Ⅲ型的新生儿中,术后出现肛门直肠功能障碍和未发现肛门直肠功能障碍者比较,畸胎瘤大小差异具有统计学意义(P<0.05),而Ⅰ型新生儿中上述指标差异没有统计学意义(P>0.05)。结论肛门直肠功能的恢复与多种因素有关,术前对Altman分类、肿瘤体积和肿瘤位置关系的准确预判,可有效避免肿瘤生长、瘤体对盆底、肛门直肠周围组织及神经的压迫和侵犯,也可避免术中对重要组织脏器的损伤,并预防终末器官损害,改善患者的远期预后。

Influencing factors of anorectal complications of sacrococcygeal teratoma in neonates

Objective To explore the effects of risk factors on anorectal complications of sacrococcygeal teratoma(SCT).Methods From August 2013 to February 2018,a total of 97 SCT neonates were recruited.Their clinical characteristics and occurrences of anorectal complications were recorded.Results Clinical classification of sacrococcygeal teratoma and size of surgical residue were correlated with the recovery of postoperative anorectal functions.And other factors,including gender,serum level of alpha-fetoprotein(AFP),tumor size,tumor properties and pathological types were not significant risk factors of anorectal dysfunctions(P>0.05).In Altman typesⅡ&Ⅲ,statistically significant difference in tumor size between those with anorectal dysfunctions and those without(P<0.05)whereas typeⅠshowed no statistical difference(P>0.05).Conclusion The anorectal function is associated with a variety of factors,preoperative to Altman accurate classification,tumor size and location of tumor,which can effectively avoid tumors growth,tumors of pelvic floor,around the anus rectum tissue and nerve oppression and aggression,also can avoid intraoperative to important organs of tissue damage,and prevent end-organ damage,improve the long-term prognosis of patients.