脊髓损伤患者孤立性直肠溃疡综合症28例报道

Solitary Rectal Ulcer Syndrome in Patients with Spinal Cord Injury:28 Cases Report

目的探讨脊髓损伤（SCI）患者孤立性直肠溃疡综合症（SRUS）的病因与诊疗方法。方法对本院2008年8月1日~2011年8月30日收治的260例SCI患者使用肛门指检和肛门直肠镜检查进行肛肠疾病调查,发现溃疡取活组织送病理检查,对明确诊断为SRUS患者使用国际SCI肠功能基础及扩展数据集部分指标进行排便状况调查,并进行非手术及手术治疗,定期复查肛门直肠镜评价疗效。结果和结论排便障碍、便秘、肛门直肠脱垂、开塞露不当使用是导致SCI患者SRUS的重要病因,非手术治疗同时加强排便管理可以有效治疗SCI患者SRUS。

Objective To explore the diagnosis,treatment and pathogenesis of solitary rectal ulcer syndrome（SRUS） in patients with spinal cord injury（SCI）.Methods 260 patients with SCI accepted rectal diseases survey,anal examination and anus straight endoscopic.Those who had rectal ulcer also performed biopsy,and patients who had been diagnosed as SRUS were evaluated by the index of International bowel function basic SCI data set,then further accepted non-operative or surgical treatment,and regular reexamination with anal straight colonoscopy for clinical evaluation after discharge.Results and Conclusion Bowel dysfunction,constipation,and anal rectum prolapsed,improper uses of glycerine enema were important causes of SRUS after SCI.Non-operative therapy as well as strengthening defecate management could be an effective treatment for SRUS after SCI.