【摘要】 目的探讨Altemeier手术治疗嵌顿性直肠脱垂的临床疗效。方法直肠脱垂并嵌顿患者8例,均接受急诊Altemeier手术,其中4例附加回肠预防性造口手术。随访并观察8例患者的排便功能(每天排便次数、肛门失禁评分)和胃肠生活质量评分。结果术后吻合口出血1例,保守治疗成功。术后住院6~9天,平均住院时间为7天。远期并发吻合口狭窄1例,给予多次扩肛后完全缓解。随访2~58个月,无1例患者出现直肠脱垂复发,每天排便次数1~3次,肛门失禁评分由术前的6.3分降低至3.1分,胃肠生活质量评分由术前的103分上升至118.3分。结论Altemeier手术并发症少,疗效可靠,可作为治疗嵌顿性直肠脱垂的首选术式。更多还原

【Abstract】 Objective To evaluate the effectiveness of the Altemeier’s procedure in the management of acute incarcerated rectal prolapse.Methods A total of 8 patients with incarcerated rectal prolapse received emergent Altemeier’s procedure and 4 of them received additional ileum colostomy.The follow-up data included defecation function(defecation times,Wexner incontinence score)and gastrointestinal quality of life index.Results One case of anastomotic bleeding happened as early postoperative complication,which was cured with conservative treatment.The average postoperative hospital stay was 7(6~9)days.Long-term complications included one case of anastomotic stenosis and it was complete relieved after several anal dilation.After a follow-up of 2~58 months,no patient had recurrent prolapse.The frequency of defecation was 1~3 times a day.Wexner incontinence score decreased from 6.3 to 3.1 and the gastrointestinal quality of life index increased from 103 to 118.3.Conclusion Altemeier’s procedure is characterized with fewer complications and reliable curative effects,which could be the first choice in the emergent treatment.更多还原