直肠脱垂的常见术式选择马树梅,王晓锋,李华山.doc

直肠脱垂的常见术式选择 马树梅, 王晓锋，李华山 马树梅, 王晓锋，李华山, 中国中医科学院广安门医院肛肠科 北京市 100053 马树梅, 女,1981-10-16生,河北丰宁人,满族.中国中医科学院广安门医院肛肠科在读硕士研究生, 主要从事中医肛肠专业,专于中医药治疗肛肠疾病的研究. 王晓锋，男，1974-06-03生,吉林省吉林市,汉族.中国中医科学院广安门医院肛肠科主治医师, 主要从事中医肛肠专业,专于中医药治疗肛肠疾病的研究. 通讯作者:李华山,100053,北京市,宣武区北线阁5号,中国中医科学院广安门医院肛肠科. lihuashan@263.net 电话: 010真:010收稿日期: 接受日期: Common surgical options for rectal prolapse Shu-Mei Ma, Xiao-Feng Wang,Hua-Shan Li Shu-Mei Ma, Xiao-Feng Wang, Hua-Shan Li, Department of Proctology, Guanganmen Hospital Affiliated to China Academy of Chinese Medical Sciences, Beijing 100053, China Correspondence to: Hua-Shan Li, Department of Proctology, Guanganmen Hospital Affiliated to China Academy of Chinese Medical Sciences, Beijing 100053, China. lihuashan@263.net Received: Accepted: Abstract Rectal prolapse is a kind of formidable disorder in anorectal department. There are a great deal of descriptions overseas of surgical treatment for this disease. Generally speaking, the surgical procedures contain transabdominal and perineal approaches. Laparoscopic repair represents the latest development. But each method has its merit or defect, a selective policy has greatly improved outcome compared with results of a single operation on the basis of individual difference. Commonly, injection treatment is fit for paediatric rectal prolapse. But some writer thought sclerotherapy like xiaozhiling injection can cure complete rectal prolapse in the way of double-layer four-step inject, which may be the preferential choice. Key Words: rectal prolapse surgical procedure/operation injection treatment/sclerotherapy 摘要： 直肠脱垂是肛肠科比较棘手的病症，国外对于该病的外科干预形式有诸多论述。手术总体上有经腹和经会阴两种，腹腔镜手术显示了必威体育精装版的进展，但是每一种术式都有其优缺点，根据病人个体差异，选择性的应用各种术式较之单一使用一种术式能大大的改善结果。一般认为注射疗法适用于儿童轻度直肠脱垂，但也有作者认为，对于成人完全性直肠脱垂，以硬化剂（如消痔灵注射液）采取直肠内外双层注射即可治愈，并可作为该病的优先选择。 关键词: 直肠脱垂 手术 注射疗法 0引言 直肠脱垂，多见于年轻人和老人，常引起诸如大便失禁等痛苦的症状。尽管大量的外科术式已经描述了如何纠正这种紊乱状态，但是还没有一致结论来证明有哪一种术式更为理想，目前还没有足够的证据来判断外科干预的形式中哪一种相较于其他的更有效、更安全，能够带来最好的结果和最小的死亡率。外科手术旨在通过纠正脱垂和恢复节制功能、解