Altemeier手术治疗嵌顿性直肠脱垂八例临床分析

Altemeier's procedure for incarcerated rectal prolapse:an analysis of 8 cases

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。

Objective To evaluate the effectiveness of the Altemeier′s procedure in the manage-ment of acute incarcerated rectal prolapse. Methods A total of 8 patients with incarcerated rectal pro-lapse received emergent Altemeier′s procedure and 4 of them received additional ileum colostomy. The fol-low-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 compli-cation,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 gastro-intestinal quality of life index increased from 103 to 118. 3. Conclusion Altemeier′s procedure is charac-terized with fewer complications and reliable curative effects,which could be the first choice in the emer-gent treatment.