肛管直肠损伤的诊断和治疗

目的：探讨肛管直肠损伤的诊断和治疗。方法：回顾性分析近10年来收治的48例肛管直肠损伤患者的病历资料。直肠损伤41例,肛管损伤7例。合并伤33例(68．8％)。结果：全组均行手术治疗,单纯修补加局部引流14例,修补加结肠造口28例,单纯粪便转流加引流6例。45例治愈,3例(6．3％)死亡。16例(33．3％)术后发生并发症。结论：早期诊断,合理应用转流、引流、冲洗三项措施,控制感染和积极处理合并伤是提高治愈率、降低病死率的关键。

Diagnosis and treatment of anorectal injuries

Objective To investigate the diagnosis and treatment of anorectal injurjies(ARI). Methods The clinical data of 48 patients with anorectal injuries in the recent 10 years were analyzed retrospectively. Of all the patients,41 cases were rectal injuries,7 cases were anal injuries and 33 cases(68.8%) were associated injuries. Results All of the 48 patients underwent surgical treatment. Simple anorectal repair plus drainage was performed in 14 cases,and anorectal repair plus sigmoid colostomy in 28 cases,and the colostomy for fecal diversion and drainage in 6 cases. 45 of the 48 cases were cured,but 3 patients(6.3%) eventually died. The complications occurredin 16 cases (33.3%). Conclusion The early diagnosis,the proper application of fecal diversion,drainage,lavage,control infection,and the positive treatment of associated injuries are the key to improve the cure rate and reduce the mortality of ARI.