16例肛门直肠损伤临床分析

Clinical analysis of anorectal injury in 16 cases

目的探讨肛门直肠损伤（ARI）的类型、临床特点及有效的诊断和治疗方法。方法回顾性分析16例ARI的致伤原因、损伤类型、临床表现及诊治过程。结果非手术治疗2例，14例根据病人的损伤情况选择相应的手术治疗。临床治愈14例，死亡2例。结论提高认识，详尽询问病史，及时行肛门直肠指检、肛门镜检查是早期诊断ARI的重要措施；早期冲洗清创、修补破损、充分引流及粪便转流是处理ARI的基本原则；充分引流及粪便转流是治疗ARI的关键。术后要重视直肠周围间隙感染。

Objective To study the type, clinical characteristics and the valid method of the diagnosis and treatment to the anorectal injury （ARI）. Methods The causes and classification of trauma, clinical findings performance and the process of the diagnosis and treatment were analysed retrospectively. Results Two pa- tients were treated conservatively, the other fourteen cases underwent surgical operation according to the patient harm circumstance. Fourteen cases were cured, two cases died. Conclusion The important measure in the early diagnosis of anorectal injury are to improve understanding, inquiry the disease history detailedly and completely and do digital examination of anorectum and proctoscopy in time. The basic standard principles in the treatment of severe anorectal injury are wound rinse in the early, wound clean and repair, wound drainage plenty as well as fecal diversion;wound drainage plenty and fecal diversion are the key that cures the anorectal injury. We should value the rectum surroundings cleft infection after operation.