Robert M, Lacombe A, Becmeur F
Chirurgie Pédiatrique Viscérale et Plastique, CHU Tours.
Chir Pediatr. 1988;29(2-3):142-6.
24 cases of disruption of the perineum from 8 Centres of Pediatric Surgery in France, were studied. The patients were aged between 4 months and 13 years, with an average age of 6.7 years, and 70% were boys. The cause of the injury was crushing in 13 cases. The associated were complex. Fractures of the pelvis (18) and associated multiple fractures (13), as were as profuse pelvi-peritoneal haemorrhages arising from fractures (3) or lower limb amputations (3) determined the care of associated soft-tissue injuries. Disruptions of the skin were almost constant and displayed a high rate of sepsis. There were noted lesions of the ureter (9), the vagina (5), the anus and rectum (17), the ano rectal sphincter (10) and the penis (1). The care of each of these lesions followed the usual practices of Reparative Surgery specific to each organ, but was also adapted to each case. In effect, disruptions of the perineum take place in a context of serious polytrauma, where the hierarchy of urgency determines the choice of therapeutic attitudes.
对法国8个小儿外科中心的24例会阴撕裂病例进行了研究。患者年龄在4个月至13岁之间，平均年龄为6.7岁，70%为男孩。损伤原因中13例为挤压伤。合并症复杂。骨盆骨折（18例）及合并多发骨折（13例），以及骨折引起的大量盆腔腹膜后出血（3例）或下肢截肢（3例）决定了相关软组织损伤的处理。皮肤撕裂几乎均有发生，且败血症发生率很高。发现有输尿管损伤（9例）、阴道损伤（5例）、肛门和直肠损伤（17例）、肛门直肠括约肌损伤（10例）及阴茎损伤（1例）。对这些损伤的处理均遵循各器官修复手术的常规做法，但也根据具体病例进行了调整。实际上，会阴撕裂发生在严重多发伤的情况下，紧急程度的先后顺序决定了治疗态度的选择。
