结直肠和肛门异物取出术的应用与方法分析

Application and Method Analysis of Removal of Foreign Body in Colorectal and Anus

摘要:

〔摘 要〕 目的：分享结直肠肛门异物取出术中的临床应用经验。方法：回顾性分析 2020 年 7 月至 2022 年 3 月深 圳市第二人民医院肛肠外科收治的 6 例因自身原因或误吞不能消化的异物需要经腹手术或经肛门取出的患者的临床资 料，总结结直肠肛门异物取出的临床应用经验。结果：6 例患者中，1 例在腰麻下经肛门取出异物，1 例在无麻醉下 通便灌肠经肛门排出异物，1 例在局部麻醉下经肛门取出异物，3 例在无麻醉下经肛门取出异物，所有手术均顺利完成， 手术时间 10 ~ 60 min，均未发生肛门括约肌损伤、直肠肛管黏膜皮肤损伤、腹盆腔感染等并发症。术后随访 1 月未 见便血及肛周感染等，恢复良好。结论：对于结直肠肛门异物取出技术成熟的手术团队，在严格把握手术指征、选择 合适方法的前提下，将不同方法应用于异物取出术中，可取得较为理想的临床效果。

Abstract:

〔Abstract〕 Objective To share the clinical experience in the removal of colorectal and anal foreign bodies. Methods The clinical data of 6 patients who needed transabdominal surgery or transanal removal for indigestion or indigestion of foreign bodies for their own reasons or ingestion admitted to the anorectal surgery department of Shenzhen Second People's Hospital from July 2020 to March 2022 were retrospectively analyzed, and the clinical application experience of colorectal and anal foreign bodies removal was summarized. Results Among the 6 patients, 1 case was removed via anus under lumbar anesthesia, 1 case was removed via anus by defecation enema without anesthesia, 1 case was removed via anus under local anesthesia, and 3 cases were removed via anus without anesthesia. All operations were successfully completed, and the operation time was 10-60 min, there were no anal sphincter injury, anorectal mucosa and skin injury, abdominal and pelvic infection and other complications. There was no hematochezia and perianal infection during 1 month follow-up, and the patients recovered well. Conclusion For the surgical team with mature technology of removing colorectal and anal foreign bodies, under the premise of strictly grasping the surgical indications and selecting the appropriate methods, different methods can be applied in the removal of foreign bodies, which can achieve more ideal clinical results.