【摘要】目的探討急危重膽總管囊腫的治療。方法對我院1984~2001年收治的41例急危重膽總管囊腫患者的臨床資料進行回顧性分析。結果41例患者均行囊腫切除、膽道重建術，其中3例患者分兩期完成，全部病例均獲治愈，隨訪9例近、遠期效果均較好。結論囊腫切除、膽道重建術已成為根治膽總管囊腫的首選術式，但必須做好高危因素的處理，以提高手術安全性及療效，只要度過圍手術期，其預后較好。
OBJECTIVE To sum up the experience of diagnosis and treatment of intrinsic upper gastro-intestinal membrane, 13 cases in children were studied retrospectively. METHODS There were 10 boys and 3 girls, the major symptoms were vomiting and epigastric distension. Eleven cases were treated by membranectomy with intestinal plasty, and 2 cases were treated by retrocolic side to end duodenojejunostomy. RESULTS All cases had good results without severe complications. CONCLUSION The children who have typical symptom of upper digestive tract should be considered duodental and upper jejunal membrane, and should be proved by contrast radiology. The membranectomy with intestinal plasty is the better operative method.
Objective To investigate the application of gluteus maximus transplantation for fecal incontinence after surgery of high anal atresia. Methods Between December 2002 and November 2010, 25 patients with fecal incontinence were treated with gluteus maximus transplantation, which was caused by surgery of high anal atresia. There were 11 malesand 14 females with an average age of 10.2 years (range, 3-22 years). Preoperative radiography, anorectal manometer, and electromyogram showed abnormality or deficiency of anal sphincter function. Wexner score, Fecal Incontinence Quality of Life (FIQL) questionnaire, and Self-rated Health Measurement Scale Version 1.0 (SRHMS) score were used to evaluate l ife qual ity of the patients. The anorectal manometer, intra-rectal ultrasound examination, and defecation radiography were performed. Results Healing of incision by first intention was achieved in 23 cases and rectal-wound fistula occurred in 2 cases. The follow-up time was 1 to 9 years (mean, 6.3 years). Defecation frequency was decreased from more than 10 times to 4-6 times every day. Wexner score and SRHMS were significantly improved at 1 or 2 years after surgery when compared with preoperative socres (P lt; 0.05). FIQL was also significantly improved after 2 years (P lt; 0.05). At 2 years after surgery, the anal maximum systol ic pressure, contraction duration, and maximum systol ic volume were improved, showing significant differences when compared with those at preoperation and 1 year after surgery (P lt; 0.05). Conclusion Gluteus maximus transplantation can improve defecation controls in the patients with fecal incontinence after surgery of high anal atresia.