The day before yesterday
Surgery is the main method in the treatment of anorectal disease. However, any operation will bring certain damage to the patient. And due to the difference of the patient’s physique, the severity of the disease, the severity of the disease, and the priority, there are also differences in the size of the operation. Therefore, some patients often have certain These reactions and complications.
There are two types of pain after anal surgery, reflex pain and inflammatory pain. Because the anal region of the human body is rich in nerves and is innervated by spinal nerves, it is very sensitive to pain. Therefore, surgical trauma and inflammation can cause pain. The pain has the following reasons:
1. The patient is extremely sensitive to pain due to fear, and the anal sphincter is in a state of tension, and a little stimulation can cause pain. This kind of pain mainly occurs during surgery and after dressing changes.
2. Postoperative infection, wound edema, constipation, foreign body stimulation can also cause pain.
3. The anus is narrow, tearing the skin of the anal canal forcefully during defecation can cause pain.
4. The wound is large, the scar is too heavy after healing, and the scar contracture compresses the nerve endings and causes pain.
Treatment: There is no need to deal with mild pain, and those with severe pain are treated separately according to the situation. Analgesics such as oral or injection of strong pain medicine. Those who have difficulty in defecation take lactulose. Cicatricial pain, mild cases do not need to be treated, severe cases with Chinese medicine bath fumigation. Inflammatory pain should be treated with anti-inflammatory treatment. If the inflammation has been purulent, it should be cut in time.
2. Anal edema
Anal marginal edema is also a common reaction after anorectal surgery. After edema, it will aggravate anal pain. There are many reasons for the occurrence of edema.
1. Excessive resection or ligation of anal marginal tissue during surgery, too many incisions and unreasonable incision selection, etc., cause local blood and lymphatic drainage obstacles, increased vascular permeability, and water retention in the interstitial spaces.
2. Insufficient peeling of the anal vein cluster.
3. After the operation, the dressing is not evenly filled, it is difficult to urinate and urinate, and squat for too long.
Treatment: Mild edema can be absorbed slowly by itself, without repeated trimming. Maizhiling can be taken orally, washed externally with Qudu Decoction, wet compress with 40% hypertonic saline during local dressing change, or applied externally with golden ointment. For severe edema, surgical decompression incisions can be made.
The main causes of abdominal distension after anorectal surgery are:
1. Anesthesia, especially spinal anesthesia and sacral anesthesia, appears on the day after surgery.
2. The dressing used to wrap the wound is too tight, making the anus unable to exhaust.
3. Postoperative bed rest, poor bowel motility.
4. Food such as milk and sugar.
Treatment: First apply a hot compress on the abdomen, and after consulting the doctor's consent, appropriately loosen the bandage of the wound. You can also ask the doctor to give the anal canal exhaustion. If necessary, take the Qi-regulating and digestive medicine, Muxiang Shunqi Pill, Si Mo Tang, etc.
Fourth, blood in the stool
Anorectal surgery is mostly open wounds, mainly using local compression to stop bleeding, a few days after the operation, a small amount of bleeding during each defecation, after the defecation, it is normal. If the bleeding does not stop, seek medical attention immediately. Blood in the stool after anorectal surgery has the following reasons:
1. The small arteries are forgotten during the operation without ligation or the ligation thread falls off after the operation.
2. The wound is not compressed when bandaging.
3. Defecation on the same day after surgery.
4. Adrenaline is used during the operation, and the small arteries are bleeding after the operation.
5. After injection of sclerosing necrosis agent, hemorrhoid necrosis infection and hemorrhage.
Treatment: First, find out the cause of bleeding and the bleeding site, and locally apply gelatin sponge, Yunnan Baiyao and compress or ligate the bleeding point. Use hemostatic drugs throughout the body, such as reptilase, vitamin K, hemostatic sensitivity, etc., and use antibiotics in appropriate amounts. Those with more blood loss should also receive fluids, blood transfusions, and correct the acid-base balance of water and electrolyte. Instruct patients to control their bowel movements and stay in bed as much as possible.
Five, stool difficulties
1. The patient is afraid of anal pain caused by defecation, and deliberately prolongs the defecation time, so that the water in the feces is excessively absorbed and dried up, resulting in difficulty in passing out.
2. Excessive tension during the operation, sympathetic nerve excitement, inhibit bowel movement.
3. Bed rest and reduced activity after surgery slow down bowel movements
4. Less fiber in the diet
Treatment: The first bowel movement after anorectal surgery can be assisted by Kaisailu, and some intestinal moisturizers can be taken for prevention in the future, such as honey, Qirong Runchang oral liquid, etc., and Dumic and lactulose can also be taken to soften the stool.