张力－应力定律在肛门直肠狭窄治疗中的应用──一种非手术治疗的新方法

利用张力－应力原理，采用球囊持续扩张方法，治疗肛门直肠狭窄患儿１３例，其中先天性肛门狭窄２例，肛门成形术后肛门狭窄５例，先天性直肠狭窄１例，术后或外伤性直肠狭窄４例，先天性肛门直肠狭窄１例。狭窄段长度０．６～１．０ｃｍ４例，１．２～５．０ｃｍ９例。８例曾经扩肛器扩肛失败。持续球囊扩肛每天２０小时，扩张压力在狭窄部静息压力曲线的迅速上升期范围。１３例中１２例成功，即排便通畅，肛检及球囊造影示狭窄段消失。所需时间５～１５天，平均６．７天。１例无效。随访６～１８个月无复发者。球囊持续扩张为治疗小儿肛门直肠狭窄的可靠方法，特别适用于狭窄段长和常规扩肛器扩张治疗失败的患儿。

The Tension-Stress Effects on the Treatment of Anorectal Stenosis

To evaluate a continuous balloon distension on the treatment of anorectal stenosis.the study was carried out on 1 3 patients with anorectal stenosis. There were two congenital anal stenosis,five anal stenosis after anoplasty,one congenital rectal stenosis,four rectal stenosis from rectal operation or trauma and one congenital anorectal stenosis. The lengths of the stenotic segment varied from 0.6 to 1.0 cm in four cases and 1.2 to 5.0 cm in nine cases. Eight patients failed in bougie anal dilatation. In this series,the dilatation was performed by a distended ballon,which was inserted into and fixed in the stenotic segment.By injecting water into the ballon at 1 ml increament,the resting pressure on the stenotic segment(RPSS)was measured.Then the balloon was continuously distended at the pressure of mid-accelerating phase of the RPSS for 20 hours every day until the patient was able to pass stool without difficulty,and the stenotic segment disappeared in digital examination and balloonogram. Twelve of the 1 3 patients were successful in 5 to 15 days(average 6.7 days)and remained a normal defecation pattern in 6 to 18 months 'follow-up. The continuous balloon distension for anorectal stenosis is a preferable therapeutics,It is especially effective for cases failed by bougie anal dilatation.