Nine out of ten people have hemorrhoids. Hemorrhoids are a common and frequently-occurring disease. There are significant differences in the prevalence of patients with different occupations. The prevalence of clinical officials, car drivers, salespersons, and teachers is significantly higher. It is also widespread in other populations, but the degree is different. Due to the large number of patients, some people think that hemorrhoids are not a serious disease, so there is no need to go to the hospital.
What is hemorrhoids?
At present, new breakthroughs have been made in the formation of hemorrhoids. It is believed that the masses formed by pathological hypertrophy and displacement of the anal cushion and blood stasis of the perianal subcutaneous blood vessels are called hemorrhoids. This view replaces the traditional "varicose veins" theory. Clinically, hemorrhoids are divided into three types: internal hemorrhoids, external hemorrhoids, and mixed hemorrhoids according to the location, course and pathology of hemorrhoids. Internal hemorrhoids are lumps of varicose veins of the superior rectal venous plexus, located above the dentate line and covered by the rectal mucosa. External hemorrhoids belong to the inferior rectal venous plexus, located below the dentate line, and the surface is covered by the skin of the anal canal. Often due to intravenous thrombosis and protruding from the anus or outside the anus. Mixed hemorrhoids are located on the dentate line and have the above two characteristics.
According to the symptoms of hemorrhoids and the degree of harm to human health, it can be divided into four degrees: Degree I: No pain, mainly for blood (blood, dripping), bleeding after stool can stop automatically; Degree II often has blood in the stool , Hemorrhoids prolapse with defecation, but can be absorbed on their own; Ⅲ degree may have blood in the stool, defecation or standing for a long time, cough, fatigue, weight bearing hemorrhoids prolapse outside the anus, must be returned by hand, Ⅳ degree often have blood in the stool, prolapse Things are not easy to take back.
Rectal cancer mistakenly believes that "hemorrhoids" are not small
Since hemorrhoids and rectal cancer are similar in their locations, the clinical diagnosis is often confused when the symptoms of the two overlap or are atypical. More than 90% of rectal cancer cases were misdiagnosed as hemorrhoids at the initial stage, delaying the treatment of rectal cancer. If the patient with the initial impression of hemorrhoids, careful history and examination can prevent many diagnostic errors. Hemorrhoids can occur in people of any age, and patients with rectal cancer are mostly middle-aged or elderly. Hemorrhoid patients have blood in their stools. This is because they scratch the affected area during defecation. Most of the blood drips with the stool, so it does not mix with the stool, and there is no mucus. The stool of patients with rectal cancer is often mixed with blood, mucus and pus, and the stool habits will change significantly. Increased stool frequency, accompanied by tenesmus. If the diarrhea cannot be relieved even after taking the medicine, you should pay special attention.
What kind of treatment is currently used?
Commonly used hemorrhoids treatment methods include: drug therapy, surgical treatment, other therapies (including drug injection therapy, copper ion electrochemical therapy, hemorrhoid therapy, infrared therapy, cryotherapy, laser therapy, etc.). A large number of clinical practices have proved that in general, conservative treatments such as drug therapy and other therapies have poor effects, and may have some short-term effects, but are prone to relapse. Therefore, surgical treatment is the only radical cure for patients with frequent or severe anorectal diseases. Ways, and need to cooperate with drug treatment to relieve pain and shorten the course of treatment.
Commonly used internal hemorrhoid surgery include internal hemorrhoid injection and internal hemorrhoid ligation. Injection therapy can be divided into sclerotherapy and necrosis exfoliation therapy. Traditional injection therapy is to achieve the purpose of treatment by necrosis and shedding of hemorrhoids. Due to the strong irritation of various necrotic agents, the dosage and concentration are difficult to grasp, so sclerotherapy is mostly advocated in China.
Ligation of internal hemorrhoids is a relatively thorough treatment. Clinically, it can be divided into simple ligation, continuous penetration ligation, and apron ligation.
External hemorrhoid surgery should be determined according to its nature. Commonly used are thrombus external hemorrhoid dissection, varicose thrombosis external hemorrhoid dissection, connective tissue external hemorrhoidectomy, and inflammatory external hemorrhoids (including anal edema) often use direct resection or decompression. formula.
The traditional classic surgical methods often used for mixed hemorrhoids include internal injection and external resection, internal ligation and external resection, and internal injection and external ablation. The respective indications are often determined according to the shape and extent of internal hemorrhoids and the nature of external hemorrhoids.
After a lot of clinical practice, we have made improvements to the above-mentioned surgical procedures, that is, internal ligation (internal injection) and external stripping (external resection) plastic suture, which can significantly shorten the treatment course, relieve pain, reduce or eliminate postoperative anal discomfort and anal discomfort. Complications such as stenosis. This method conforms to the minimally invasive concept of modern surgery, and at the same time greatly eliminates patients' fears of surgery for anorectal diseases, so it is worthy of popularization and application [This method has become a scientific and technological research project of Shaanxi Provincial Department of Science and Technology in 2011].
Talking about the new technique PPH surgery for the treatment of hemorrhoids
PPH operation is stapler hemorrhoidectomy, which is suitable for all kinds of hemorrhoids, especially patients with severe internal hemorrhoids and partial rectal mucosal prolapse. The principle is: with the aid of a stapler, the anal cushion is retained, and part of the internal hemorrhoids and the hemorrhoid mucosa and submucosal tissues are circularly removed, and an instant anastomosis is performed. That is, the blood supply of the hemorrhoids is blocked, and the slip tissue is suspended and fixed, and the pathological state of the anal canal is raised and restored to the normal anatomical state. The main advantages of PPH surgery are: less pain, less bleeding, faster recovery, and generally only need to be hospitalized for 1-3 days, which speeds up the recovery cycle and does not affect daily life. But the disadvantage is that the resection site is relatively high, easy to bleed, easy to relapse (low position of hemorrhoids), and expensive.
Precautions for hemorrhoids
A few days before hemorrhoid surgery, patients should make adequate preparations in terms of diet, work and rest, and exclude diseases that are not suitable for surgery, such as acute anal inflammation, hypertension, tuberculosis, severe anemia, nephritis, etc., and perform blood according to the doctor’s requirements. , Urine, feces, liver, kidney function and other routine examinations.
Regardless of whether it is an outpatient operation or inpatient treatment after hemorrhoids, self-adjustment should be paid to cooperate with the treatment.
1. Rest in bed for one day after treatment. It is forbidden to sit and stand for a long time to avoid bleeding. Avoid strenuous activities within 15 days, not to ride a bicycle, etc. Do not defecate on that day.
2. You can take a bath after the wound has healed. After taking a bath, apply Hemorrhoids Washing Ling or 1:1000PP powder (currently not recommended) to sit in the anus for 15-20 minutes. After drying, apply Jiuhua ointment or suppository for external use, once after going to bed and before going to bed.
3. The patient keeps defecation once a day after receiving treatment, and the stool should not be dry. Eat fiber foods, vegetables, vegetables, bananas, honey, pears, etc. every day. Do not eat hot foods such as peppers, white wine, beef, sheep, and dog meat. Listen to the doctor's guidance.
4. Routinely take anti-inflammatory drugs and hemostatic drugs after operation to prevent wound inflammation, erosion and infection.
5. If the stool is dry or the stool does not resolve within 3 days, please inform the doctor in time, and ask the doctor for further symptomatic treatment.