急诊Altemeier手术治疗嵌顿性直肠脱垂(附四例临床分析)  

Emergency Altemeier operation for incarcerated rectal prolapse:a clinical analysis of 4 cases

作　　者：周小兵[1] 李冰心[1] 陈爱军[1] 周欣[1] 王广胜[1] Zhou Xiaobing;Li Bingxin;Chen Aijun;Zhou Xin;Wang Guangsheng(Department of Gastrointestinal Surgery,The First College of Clinical Medical Science,Three Gorges University,Hubei Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院胃肠外科,湖北宜昌443003

出　　处：《腹部外科》2020年第6期450-453,共4页Journal of Abdominal Surgery

摘　　要：目的探讨急诊Altemeier手术治疗嵌顿性直肠脱垂的临床效果。方法回顾性分析2015年12月至2019年11月三峡大学第一临床医学院胃肠外科收治的4例嵌顿性直肠脱垂病人临床资料,均接受急诊Altemeier手术,观察病人围手术期并发症发生情况及近期随访情况。结果4例病人均顺利完成急诊Altemeier手术+肛门环缩手术,未附加回肠预造口。术后肠道功能恢复时间为3~5 d,术后出现盆腔出血1例,肛周红肿1例,均经保守治疗好转。随访2~36个月,无1例病人出现直肠脱垂复发,Wexner肛门失禁评分3~4分,胃肠道生活质量指数评分110~123分。结论急诊Altemeier手术并发症少,复发率低,疗效可靠,是治疗嵌顿性直肠脱垂的首选术式。Objective To investigate the clinical effect of Altemeier emergency surgery for incarcerated rectal prolapse management.Methods A total of 4 cases of incarcerated rectal prolapse were treated with Altemeier emergency surgery from December 2015 to November 2019.The incidence of perioperative complications and recent follow-up were analyzed.Results All the 4 patients successfully received Altemeier emergency surgery and anal constriction operation without additional ileum colostomy.The postoperative intestinal function recovery time was 3-5 days.One case of pelvic hemorrhage occurred after operation,which was cured by conservative treatment.One case of perianal redness and swelling occurred after operation,which was cured by conservative treatment.After a follow-up of 2-36 months,no patient hadrecurrence of rectal prolapse.Wexner incontinence score ranged from 3 to 4.The gastrointestinal quality of life index ranged from 110 to 123.Conclusion Altemeier emergency surgery has the advantages of less complications,low recurrence rate and reliable efficacy.It is the first choice for the treatment of incarcerated rectal prolapse.

关 键 词：Altemeier手术 嵌顿性直肠脱垂 临床效果 

分 类 号：R657.3[医药卫生—外科学]