2020年10月29日星期四

are hemorrhoids dangerous,Postoperative complications and countermeasures for anorectal diseases-(postoperative bleeding)

    Postoperative bleeding is divided into primary (bleeding within 24h after operation) and secondary bleeding (bleeding after 24h after operation).

    Cause:

    ①Unskilled operation; incomplete anesthesia, poor anus relaxation; inadequate exposure of the operation area, improper handling of bleeding areas, and incomplete ligation of active bleeding points, which may easily cause bleeding in the wound; ②The surgical wound is large and the dressing is not compressed Prison, causing bleeding from the wound after surgery;

    ③ After the operation, due to vigorous activity or defecation on the same day, it is easy to cause wound bleeding;

    ④The internal hemorrhoids are not tightly ligated or the ligation thread falls off or the internal hemorrhoids necrosis falls off, which can easily cause wound bleeding;

    ⑤Improper injection of internal hemorrhoids sclerosing agent, excessive concentration, excessive puncture, and deep injection site, which damages the blood vessels of the muscle layer;

    ⑥The patient suffers from hypertension, arteriosclerosis, cirrhosis of the liver and blood diseases, and coagulation mechanism disorders are all likely to cause postoperative bleeding.

    Top defense:

    ① Sufficient preoperative preparation. Ask about the medical history and perform a comprehensive physical examination. Do a good job of psychological care to relieve the tension of the patient. If coagulation dysfunction and bleeding tendency are found, non-surgical treatment should be used first, and surgery should be performed after the coagulation function is restored.

    ② Correct surgical operation. During the operation, clear anatomy and careful operation are required, and should not be rough.

    ③Perfect postoperative care. The patient should not relieve the stool within 24h after operation, and keep the stool unobstructed after 24h. Strictly prohibit all kinds of breath holding and increase abdominal pressure, avoid strenuous activities, eat light and easy to digest products, and do not drink alcohol.

    ④Intramuscular injection of carbachol (Anluoxue) or intravenous drip of phenolsulfonic acid (hemostatic sensitivity) or aminomethylbenzoic acid (hemostatic acid) and other hemostatic drugs.

    ⑤After the operation, take some drugs that moisturize the intestines and relieve the bowels to prevent induration of stool and bleeding from the surgical wound.

    treatment:

    ① After the operation, the bleeding of the wound can be suppressed with gelatin sponge, epinephrine cotton block or Yunnan Baiyao;

    ②For patients with primary hemorrhage, blurred wounds, unclear vision, and difficult to suture, give the bleeding wound injection 1:1 Xiaozhiling injection to stop bleeding;

    ③If the internal hemorrhoids are not tightly ligated or the ligation thread falls off, the ligation should be reinforced again. For postoperative bleeding caused by necrosis and shedding of internal hemorrhoids, the bleeding point should be found under anoscope, and then compression or ligation should be used to stop the bleeding.

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