改良Altemeier手术联合括约肌成形术治疗重度直肠脱垂的临床效果  

Clinical Curative Effect of Improved Altemeier Operation Combined with Sphincteroplasty to Treat Severe Rectal Prolapse

作　　者：王大路[1] 任笑云 孟琦 殷红专[1] 苏琪[1] WANG Dalu;REN Xiaoyun;MENG Qi;YIN Hongzhuan;SU Qi(Department of General Surgery,Shengjing Hospital,China Medical University, Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院普外科,沈阳110004

出　　处：《中国医科大学学报》2018年第6期532-536,共5页Journal of China Medical University

基　　金：辽宁省自然科学基金(201602869)

摘　　要：目的探讨改良Altemeier手术联合括约肌成形术治疗重度直肠脱垂的临床疗效。方法采用回顾性分析,选择2014年10月至2016年1月我科室结直肠肛门病病房18例直肠脱垂患者(男8例,女10例),实施改良Altemeier手术联合括约肌成形术。采用肛门形态、肛门测压以及Wexner问卷评分指标评价术前、术后1个月、3个月、6个月、12个月患者的肛门功能。结果患者术后肛门形态明显好转、患者主观满意,随访期间无直肠脱垂复发;患者术后肛管静息压和肛管最大收缩压均高于术前(P<0.01);患者术后便秘和肛门失禁评分均较术前改善(P<0.01)。结论改良Altemeier手术联合括约肌成形术治疗重度直肠脱垂术后肛门直肠功能改善显著。Objective Evaluation of treatment for severe rectal prolapse by improved Altemeier operation combined with sphincteroplasty. Methods We performed a retrospective evaluation of 18 patients（8 men and 10 women） with rectal prolapse in the anorectal department of Shengjing Hospital of China Medical University from October 2014 to January 2016. The patients were compared in terms of anal shape,pressure,and Wexner value before and after the Altemeier operation combined with sphincteroplasty at 1 month,3 months,6 months,and 12 months. Results After operation,the patients＇ anal shape improved,and the patients were satisfied with the results. No rectal prolapse recurrence occurred during follow-up. Anal resting pressure and anal maximum contraction pressure increased after surgery（P 〈0.01）. Constipation and incontinence values improved after the Altemeier operation（P〈 0.01）. Conclusion The Altemeier operation combined with sphincteroplasty could improve the anorectal function of the patients with severe rectal prolapse.

关 键 词：重度直肠脱垂 Altemeier手术 括约肌成形术 肛门功能 

分 类 号：R657.1[医药卫生—外科学]