2020年8月31日星期一

hemorrhoids treatment otc,Advantages of PPH

    Hemorrhoids are a common disease. The incidence rate of hemorrhoids in China is 46.3%. Patients with severe hemorrhoids have blood in the stool with prolapsed hemorrhoids, third-degree internal hemorrhoids can be inserted into the anus by hand, and fourth-degree internal hemorrhoids cannot be absorbed outside the anus. The traditional external stripping and internal ligation surgery is affirmative and effective, but theoretically, it cannot be completely cured, and it often has disadvantages such as heavier anal pain after surgery and a long course of disease. In 1998, Longo first reported the use of a stapler to simultaneously complete the circular resection and anastomosis of the part of the rectal mucosa above the dentinal line, and suspend the prolapsed internal hemorrhoid tissue to restore its normal anatomical position-PPH. PPH is to remove the prolapsed mucosa of the upper part of the hemorrhoids, move the "anal cushion" up, restore normal anatomy, and cut off the end branches that ligate the arteries and veins of the rectum. Although the hemorrhoids are not removed, the blood supply is reduced, generally 15- After 20 days, the hemorrhoids gradually shrink, so as to achieve the purpose of treating hemorrhoids. PPH differs from traditional surgery mainly in the following aspects: 1. The surgical site is in the anus, while the PPH surgical site is in the lower rectum. Traditional surgery will remove external hemorrhoids, ligate internal hemorrhoids, and have wounds in the anus, requiring a denucleation process, and daily replacement after surgery. Medicine, fumigation, dressing change. The wound is painful during defecation and can only heal gradually. The PPH operation site is in the lower rectum, and the resection and anastomosis immediately take only a few minutes. The anal cushion tissue is preserved, the anus is non-invasive, and there is no denucleation process. You can defecate normally on the first day after surgery, and you don’t need special dressing changes or fumigation. Traditional surgery needs to cut off the sphincter to prevent anal stenosis, while PPH surgery does not damage the sphincter, so anal stenosis or fecal incontinence will not occur. Traditional surgery is symptomatic treatment, while PPH surgery is to treat the cause. 2. Since PPH operation retains the anal cushion, does not damage the anal sphincter, there is no surgical incision in the anus, and retains the physiological function of the anal cushion to the greatest extent, so it has no pain after the operation, short time, small damage, fast recovery, and no damage Anal sphincter, no incontinence, narrow anus. The main advantages of PPH are: 1. Because the anal cushion is not removed, the postoperative fine defecation function is not affected; 2. Because the wound is above the dentate line, there is no spinal nerve sensory ending, and the postoperative pain is significantly reduced; 3. Because the wound is an anastomosis , No opening, extremely shortened healing time; 4. Because the size of the anastomosis is relatively fixed and located in the rectal mucosa, theoretically there will be no anal stenosis caused by skin scar contracture; 5. Because of the supporting equipment, the operation is simple and standardized. It is easy to promote and evaluate the prognosis. Practice has proved that the improved hemorrhoid circumcision and anastomosis for the treatment of acute annular incarcerated hemorrhoids has the same advantages as traditional external stripping and internal ligation, such as safety, effectiveness, and fewer complications, but in terms of operation time, hospitalization time, and healing time It is significantly shorter than the traditional external stripping and internal ligation, and has more advantages.

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