【摘要】 目的　探讨骶中动脉的解剖变异与先天性巨结肠Rehbein改良根治术中直肠分离异常出血的关系。方法　对我院收治的 49例先天性巨结肠Rehbein改良根治术中观察的骶中动脉解剖资料及异常出血的情况进行回顾性分析。结果　 49例病例中骶中动脉解剖变异 10例 ,其中血管外径达到 1 8mm 9例 ,占 18 3 7% ;缺如 1例 ,占 2 0 4%。异常出血 5例 ,占 8 16% ,其中 2例伴骶中动脉解剖变异 ,需作骶中动静脉结扎方可止血 ;骶中动脉无解剖变异的 3例中 ,2例作间接电凝止血 ,1例作纱布压迫即可止血。结论　解剖变异的骶中动脉的损伤是先天性巨结肠Rehbein改良根治术中直肠分离异常出血止血困难的重要原因 ,该动脉损伤引起的出血 ,应作骶中动静脉结扎更多还原

【Abstract】 Objective To investigate the relationship of anatomical variation in median sacral artery with the abnormal bleeding when separating rectum during modified Rehbein radical operation for the treatment of congenital megacolon. Methods Data of anatomical variation in median sacral artery and abnormal bleeding in 49 cases of congenital megacolon undergoing modified Rehbein radical operation from December 1993 to December 2003 were analyzed retrospectively. Results Anatomical variation in median sacral artery was found in 10 cases. The diameter larger than 1.8 mm was found in 9 cases (18.37%), congenital absence in 1 case (2.04%), and abnormal bleeding in 5 cases (8.16%) in which anatomical variation in median sacral artery was found in 2 cases. Ligation of the median sacral artery and vein could result in hemostasis. In 3 cases without anatomical variation in median sacral artery, indirect electric coagulation was performed in 1 case and compression using gauze in 1 case for hemostasis. Conclusion Anatomical variation and damnification in median sacral artery is the main cause for abnormal bleeding when separating the rectum during modified Rehbein radical operation for the treatment of megacolon. Ligation of the median sacral artery and vein should be conducted for the hemostasis of the abnormal bleeding during operation.更多还原