fa بررسی علل بی اختیاری مدفوعی متعاقب عمل آنورکتوپلاستی در بیماران آنوس بسته و ارزیابی نتایج درمان در بیمارستان مریم کرج؛ بین سالهای 1394 تا 1399 تخصصي Special پژوهشي Research <span style="font-size:9pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">زمینه و هدف:</span></span></b><span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:"> بی اختیاری</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">مدفوعی</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">یکی</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">از</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">عوارض</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">وخیم</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">عمل آنورکتوپلاستی</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">در</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">کودکان</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">دچار</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">مقعد</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">بسته</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">به</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">شمار می&shy;&shy;آید. جابجایی</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">کامل</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">رکتوم و</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">نقص</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">موضعی</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">حلقوی عضله</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">اسفنکتر دو</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">دلیل اصلی در</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">پیدایش</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">بی</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">اختیاری</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">مدفوع</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">در</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">افرادی که تحت عمل جراحی آنورکتوپلاستی قرار گرفته&shy;اند می&shy;&shy;باشد. </span></span></span></span></span></span><br> <span style="font-size:9pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">مواد و روش&shy;ها:</span></span></b><span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:"> این مطالعه توصیفی گزارش موارد (</span></span>Case-Series<span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">) بین سالهای1394 تا 1399 در بیمارستان مریم کرج انجام شد. اطلاعات مورد نیاز مطالعه به وسیله چک لیستی که توسط محقق طراحی شده بود جمع&shy;&shy;آوری شد. داده&shy;ها توسط نرم افزار </span></span>SPSS<span style="font-size:10.0pt"><span b="" lotus="" style="font-family:"> نسخه 23 آنالیز شد. از تحلیل توصیفی برای آنالیز متغیرهای کیفی و برای متغیرهای کمی از شاخص میانگین و انحراف معیار استفاده شد.</span></span></span></span></span></span><br> <span style="font-size:9pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">یافته&shy;ها:</span></span></b><span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:"> میانگین سن بیماران 65/9 سال با انحراف معیار 45/7 (33-2 سال) بود. شایعترین عارضه جانبی بعد از عمل اسفنکتروپلاستی برای درمان بی اختیاری مدفوع متعاقب عمل آنورکتوپلاستی در بیماران آنوس بسته، تنگی آنوس می&shy;باشد. میزان موفقیت جراحی در بهبود بیماران دچار بی&shy;اختیاری مدفوعی پس از 6 ماه، 74% و پس از 2 سال به &shy;طور متوسط 89% می‌باشد.</span></span></span></span></span></span><br> <span style="font-size:9pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">نتیجه&shy;گیری:</span></span></b><span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:"> بیشترین علت بی&shy;اختیاری مدفوعی متعاقب عمل آنورکتوپلاستی، جابجایی عضلات رکتوم و قرار نگرفتن آنورکتوم در میان عضله اسفنکتر و همچنین نقص حلقوی اسفنکتر مقعد می&shy;باشد.</span></span>&nbsp;<span lang="FA" style="font-size:10.0pt"><span b="" lotus="" style="font-family:">در بیمارانی که قبلاً تحت عمل آنورکتوپلاستی برای مقعد بسته قرار گرفته بودند، اکثراً نقص حلقوی اسفنکتر در ساعت ۱۲ و ۶ بوده است (قسمت قدامی و خلفی اسفنکتر) که لازم است جراحان در ترمیم این نقاط بهنگام انجام عمل آنورکتوپلاستی دقت بیشتری اعمال نمایند</span></span>.<span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Lotus""></span></span></span></span></span></span><br> <span style="font-size:9pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Lotus""></span></span></span></span></span></span><br> &nbsp; <span style="font-size:10pt"><span style="line-height:12pt"><span new="" roman="" style="font-family:" times=""><b>Background:</b><b> </b>Fecal incontinence is one of the secondary and serious complications following anorectoplasty operation in the children with Imperforated Anus. Complete rectal dislocation and local spinal defect of the sphincter muscle are the main causes of fecal incontinence in people undergoing surgery for Imperforated Anus. <b><span style="font-size:14.0pt"></span></b></span></span></span><br> <span style="font-size:10pt"><span style="line-height:12pt"><span new="" roman="" style="font-family:" times=""><b>Methods:</b><b> </b>This retrospective descriptive Case-Series study was performed during 2015 to 2020 at Maryam hospital. Data were collected by a checklist that was designed by the research. The collected data were analyzed by SPSS software version 23. Descriptive analysis was used to analyze the qualitative variables while quantitative variables were summarized using mean and&thinsp;Standard Deviation (&plusmn;SD).</span></span></span><br> <span style="font-size:10pt"><span style="line-height:12pt"><span new="" roman="" style="font-family:" times="">&nbsp;<b>Results:</b><b> </b>The mean age of patients was 9.65 years and the standard deviation (&plusmn;SD) was 7.45 (2-33 years). Fecal incontinence is the most common side effect after Sphincteroplasty for treatment of &quot;Imperforated Anus&quot; following anorectoplasty. The success rate of surgery in this study in the recovery of patients with fecal incontinence after anorectoplasty for patients with imperforated anus is 74% after 6 months and 89% after 2 years.<span style="font-size:14.0pt"></span></span></span></span><br> <span style="font-size:10pt"><span style="line-height:12pt"><span new="" roman="" style="font-family:" times=""><b>Conclusion:</b><b> </b>The most common causes of fecal incontinence following anorectoplasty were rectal displacement as well as ano-rectum misplacement between the sphincter muscle and annular sphincter defect. In patients with history of anorectoplasty, annular sphincter defects were most often seen at rejoins 12 and 6 o&#39;clock (Superior and Inferior). It is necessary that surgeons pay more attention to repairing these points in order to prevent the incidence and recurrence of fecal incontinence.<b> </b><b><span dir="RTL" lang="FA" style="font-size:14.0pt"><span style="font-family:"B Lotus""></span></span></b></span></span></span><br> <span style="font-size:10pt"><span style="line-height:12pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:14.0pt"></span></b></span></span></span><br> &nbsp; اسفنکتروپلاستی, ناهنجاری آنوس بسته, تنگی آنوس Sphincteroplasty, Imperforated Anus, Anus Stenosis 153 160 http://aums.abzums.ac.ir/browse.php?a_code=A-10-1-351&slc_lang=fa&sid=1 Salahedin Delshad صلاح الدین دلشاد 10031947532846009419 10031947532846009419 Yes Department of Pediatric Surgery, Maryam Hospital, Karaj, Iran دپارتمان جراحی اطفال، بیمارستان مریم، کرج، ایران Naser Piri ناصر پیری 10031947532846009420 10031947532846009420 No Clinical research and Technology, Maryam Hospital, Karaj, Iran واحد تحقیقات بالینی و فناوری بیمارستان مریم، کرج، ایران