男性先天性中高位肛门直肠畸形的诊断及伴发畸形评估的临床研究.doc

男性先天性中高位肛门直肠畸形的诊断及伴发畸形评估的 临床研究 吴永隆 陈思远 陈秀兰 李晓庆 王佚 重庆医科大学附属儿童医院胃肠新生儿外科 基金项目：国家临床重点专科建设项目资助（项目号：国卫办医函[2013]544）， 重庆市卫计委医学科研重点项目资助（项目号。 作者简介：吴永隆，男，硕士。 通讯作者：王佚，E-mail：wy757311@ 常瘘管，为手术提供重要参考；伴发畸形需密切随访，部分畸形可自愈；骶尾部 MRI检查有助于发现骶尾部畸形，为术后患儿排便功能评估提供参考。 【关键词】 男性 肛门直肠畸形 诊断 Research on the diagnosis for male patients with high and intermediate imperforate anus and accompanied malformations Wu Yonglong ,Chen Siyuan ,Chen Xiulan ,Li Xiaoqing ,Wang Yi Department of Pediatric Surgery，Children’s Hospital of Chongqing MedicalUniversity Males；Anorectal malformations；Rectum abnormalities；diagnosis 【Abstract】 Objectiveo investigate and summarize the accurate diagnosis for the male patients with high and intermediate imperforate anus and accompanied malformations, and provide reference for the surgical method selection and prognosis. Methods The clinical symptoms, laboratory findings and accompanied malformations of the 29 boys with intermediate and high imperforate anus were retrospective analysed ,and the clinical characteristics as well as the supplementary examinations for accurate diagnosis for the distance between rectal blind end and anal fossa and associated congenital defects were summarized. Results (1) All cases were high and intermediate imperforate anus，including 12 cases with recto-urethral-bulbar fistula , 6 cases with recto-urethral-prostatic fistula , 2 cases with recto-bladder fistula, and 9 cases without fistula. (2) Abdominal distension and vomiting are common clinical performance, while, the meconium from the urethral discharge could be detected only in 6 cases with fistula at the first visit. (3)The distance between rectal blind end and anal fossa was 28.08 ± 16.03mm、14.29 ± 7.30mm、26.59 ± 14.45mm and 27.54±15.96mm respectively ,which measured by lateral upside-down plain film in abdomen,perineal high-resolution ultrasound, the colon distal colostography and operation. .The results measured by perineal ultrasound was significant difference