Pea术式治疗中高位肛门直肠畸形的并发症及对策

目的探讨Pena术式治疗中高位肛门直肠畸形的并发症及预防治疗措施。方法回顾性分析行Pena肛门成形术的58例中高位肛门直肠畸形患儿的临床资料及肛门排便功能情况、并发症，采用肛门功能临床评分标准进行评价。结果58例中优良者45例（83．3％），差者9例（偶有污粪6例，大便失禁1例，便秘2例），有并发症者8例（14．8％），其中直肠黏膜脱垂3例，粪便潴留2例，大便失禁1例，尿漏1例，直肠回缩1例。结论真正理解Pena的“无血、解剖式”手术技术的精髓，提高手术技巧和精细操作，加强术后康复训练是减少并发症的关键。

Complications and countermeasures of Pe(n)a's procedure to treat meta-superior position anorectal malformation

Objective To investigate the complications and its prevention and treatment strategies of Pena＇s procedure to treat meta - superior position anorectal malformation. Methods The clinic data, anus defecating function and complications of 58 patients with meta- superior position anorectal malformation, which were treated by Pena＇s procedure, were reviewed and analyzed retrospectively. Anorectal function was evaluated by Li＇s score system. Results Of 58 cases, the results were good in 45 （83.3%） and poor in 9 including mild fecal contamination in 6 ,fecal incontinence in 1 and constipation in 2. Eight cases （ 14.8% ） had complications including rectal mucosa prolapse in 3 ,fecal retention in 2, fecal incontinence in 1, urine leak in 1 and rectal retraction in 1 case respectively. Conclusion Real apprehension to the essence of Pena＇s procedure,improvement of surgical skill and strengthening of operafive rehabilitation training are the keys to decrease the complications.