临床小儿外科杂志2024，Vol.23Issue(1)：56-60,5.DOI:10.3760/cma.j.cn101785-202208030-011
肛门直肠畸形合并先天性脊髓栓系综合征的发生情况及治疗探讨
Occurrences and treatments of tethered cord in children with anorectal malformations
摘要
Abstract
Objective To explore the occurrence of anorectal malformation(ARM)plus tethered cord syndrome(TCS)and examine the significance of related treatments.Methods Medical records and imaging data were retrospectively reviewed for 105 children hospitalized with ARM from February 2018 to February 2022.According to the Wingspread classification,they were assigned into middle/high and low positions.Based upon the Krickenbeck classification,they were divided into with fistula and non-fistula.According to the findings of magnetic resonance imaging(MRI),they were divided into two groups of TCS and non-TCS.Correlation of TCS with age,ARM-related classification and other malformations were analyzed.Results There were TCS(n=29,27.6％)and non-TCS(n=76,72.4％).Among 55 cases(52.4％)of other malformations,37 cases had another malformation and 18 cases two or more other malformations.Wingspread classification and concur-rent malformations were independent factors for TCS in ARM children.The probability of middle/high position plus TCS was 3.223 folds(OR=3.223,95％CI:1.128-9.210,P=0.029)higher than that in low position.Children with two or more other malformations were 10.120 folds(OR=10.120,95％CI:2.715-37.729,P=0.001)more prone to develop TCS than those with one other malformation.No significant difference existed in incision infection rate,length of hospitalization,effective rate,mortality rate or defecation functions between ARM children without TCS and those with TCS(P＞0.05).After treatment,there was no significant inter-group difference in the improvement of defecation function(P＞0.05).Conclusions The incidence of TCS is high-er in middle/high ARM children and those with multiple system malformations.Lumbosacral MRI is recommen-ded for detect the type and severity of TCS as early as possible in ARM children.It helps clinicians to optimize treatments for ARM children.If combined with TCS,tethered cord release is recommended for preventing further severe consequences of spinal cord injury.关键词
肛门直肠畸形/脊髓栓系/外科手术/儿童Key words
Anorectal Malformation/Spinal Tethered System/Surgical Procedures,Operative/Child引用本文复制引用
张桃桃,赵清爽,应建彬,陈帆,荆俊杰..肛门直肠畸形合并先天性脊髓栓系综合征的发生情况及治疗探讨[J].临床小儿外科杂志,2024,23(1):56-60,5.基金项目
福建省省级临床重点专科建设项目-福建省儿童医院小儿神经外科[闽卫医政(2023)1163 号]Fujian Provincial Clinical Key Specialty Construction Project-Fujian Children's Hospital Pediatric Neurosurgery(MWYZ-2023-1163) （2023）
