改良Altemeier术治疗成人直肠脱垂18例疗效观察  

Modified Altemeier Procedure in the Treatment of Adult Rectal Prolapse:Effect Observation on 18 Cases

作　　者：张文俊[1] 殷克[1] 王楠[1] 支宇[1] 刘莹 孙昱[1] 孙哲[1] ZHANG Wen-jun;YIN Ke;WANG Nan;ZHI Yu;LIU Ying;SUN Yu;SUN Zhe(Dept.of Coloproctological Surgery,Xinhua Hospital Affiliated to Dalian University,Dalian,Liaoning 116021)

机构地区：[1]大连大学附属新华医院肛肠外科,辽宁大连116021

出　　处：《中国肛肠病杂志》2023年第6期31-33,共3页Chinese Journal of Coloproctology

基　　金：大连市医学科学研究计划项目(编号:1911125)。

摘　　要：目的:观察改良经会阴直肠乙状结肠切除术(Altemeier)治疗成人完全性直肠脱垂的临床疗效。方法:收集2019年1月至2021年8月,本院18例应用Altemeier术联合肛门环缩术治疗的成人完全性直肠脱垂患者临床资料。观察手术时间、术中出血量、住院时间、并发症情况、便秘和肛门失禁评分等。结果:患者平均手术时间为1.3 h(1.1~2.1 h),术中平均出血量为80 mL(20~200 mL),平均住院时间为7.2 d(5~12 d)。术后Wexner便秘评分及肛门失禁评分均较术前明显降低(P<0.05)。肛管静息压和肛管最大收缩压均较术前明显升高(P<0.05)。随访12~43个月无复发。结论:应用改良Altemeier术治疗成人完全性直肠脱垂,方法安全,术后并发症少,疗效满意。Objective To investigate the clinical effect of modified Altemeier procedure for adult complete rectal prolapse(RP).Methods Reviewed the clinical data of 18 RP patients underwent Altemeier procedure combined with Thiersch procedure in authors hospital(2019-01-2021-08),analysed their operat-ing time,intraoperative bleeding volume,hospitalization stay,complications,the ratings on constipation and anal incontenence.Results The average operating time was 1.3(1.1-2.1)h;average intraioperative bleeding volume,80(20-200)mL,average hospitalization time,7.2(5-12)days.After surgery the Wexner ratings and the ratings on anal incontenence were significantly declined than before surgery(P<0.05),also,anal resting pressure and anal Max.contraction pressure were all up than before surgery(P<0.05).The follow-up of 12-43 months had found no recurrence cases.Conclusion The modified Altemeier procedure for adult complete RP has satisfactory effect,less postoperative complications,and it could be operated safely.

关 键 词：直肠脱垂 经会阴直肠乙状结肠切除术 肛门环缩术 疗效 

分 类 号：R657.19[医药卫生—外科学]