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目的 了解Ｐｅ～ｎａ 手术及盆底肌折叠术治疗无肛术后大便失禁的效果。方法 采用再次Ｐｅ～ｎａ 手术和盆底肌折叠术治疗高中位无肛畸形术后大便失禁患儿９ 例（ 平均年龄６ ．３ 岁）。术中见９ 例患儿肛门和直肠均未穿过横纹肌复合体的中心，其中４ 例新生儿期行腹会阴肛门成形术的患儿，直肠偏于复合体的左侧或右侧，另外５ 例直肠偏于复合体的前方。术中将直肠重新固定在横纹肌复合体之中心。结果 术后随访半年到两年，显示患儿的排便控制功能均有改善，３ 例术前临床评分为０ 者，术后增加到４ ～５ 分，２ 例术前１ 分者，术后增加到５ 分和６ 分，３ 例２ 分者增加到５ ～６ 分，另１ 例３ 分者增加到６ 分。肛门直肠测压显示：术前和术后肛管的静息压力变化不明显，而收缩压力增加显著，由术前的（３０ ．８±１６ ．４）ｍ ｍ Ｈｇ 增加到（５２ ．７ ±１１ ．１）ｍ ｍ Ｈｇ。结论 直肠错过横纹肌复合体中心是高中位肛门畸形患儿术后大便失禁的病因之一。再次行Ｐｅ～ｎａ 手术和盆底肌折叠术可以改善患儿的排便控制功能
Objective To understand the effect of Pe na operation and pelvic floor fold surgery in the treatment of fecal incontinence without anus. Methods Nine patients (mean age 6.3 years) with fecal incontinence were treated with Pe na procedure and pelvic floor fold surgery. In operation, 9 cases of children with anus and rectum did not pass through the center of striated muscle complex, including 4 cases of neonatal abdominal perineal anoplasty in children, the rectum partial to the left or right side of the complex, the other 5 Cases of rectum partial complex in front of. Rectal surgery will be re-fixed in the center of striated muscle complex. Results The follow-up of 6 months to 2 years showed that the defecation control function of the children was improved. Three patients had a preoperative clinical score of 0, increased to 4 to 5 after operation, 2 patients had a preoperative score of 1, and postoperatively increased To 5 points and 6 points, 3 cases 2 points increased to 5 to 6 points, another 1 cases 3 points increased to 6 points. Anorectal manometry showed that there was no significant difference in resting pressure before and after operation but systolic pressure increased significantly from (30.8 ± 16.4) m m Hg to (52.7 ± 11 .1) m m Hg. Conclusion Rectal miss striated muscle complex center is one of the causes of postoperative fecal incontinence in high school anus malformation. Again Pe ~ na surgery and pelvic floor fold surgery can improve children’s defecation control function