Surgical treatment: Mainly applicable to patients with grade III and IV internal hemorrhoids, mixed hemorrhoids, and non-surgical effects including external hemorrhoid thrombosis.
Indications: Patients with larger thrombus and more severe pain.
The patient is placed in a lateral position, local routine disinfection, under local anesthesia, a small cut is made at the top of the thrombus, separated with mosquito forceps, the thrombus is removed, and pressure is applied to stop the bleeding. If the edema is severe and there are many epidermis, prismatic resection can be done, and one or two stitches can be sutured if necessary to prevent bleeding. After the operation, the tasha is compressed and fixed. Use appropriate antibiotics after surgery to prevent infection.
2. External hemorrhoidectomy:
Indications: Epidermal external hemorrhoids, inflammatory external hemorrhoids, thrombotic external hemorrhoids.
The patient exhausted urine and stool, took the lateral position, local anesthesia or Yaoshu acupoint anesthesia, routine disinfection of the anus, covered the sterile hole, according to the location and shape of the external hemorrhoids, select the appropriate incision to remove the excess epidermis and subcutaneous tissue , Can be sutured and fixed, reduce the wound surface, reduce bleeding, and facilitate wound healing. Surgery bitta yarn compression fixed. Use appropriate antibiotics after surgery to prevent infection.
3. Ligation of internal hemorrhoids: according to the size of internal hemorrhoids, two kinds of ligation can be used: simple ligation and segmental ligation.
(1) Simple ligation method:
Indications: Hemorrhoids in the second and third stage, more suitable for fibrous internal hemorrhoids.
Operation method: The patient is in the lateral position or the lithotomy position, under local anesthesia or Yaoshu acupoint anesthesia, routinely disinfect the anus and rectum, expand the anus, and make the internal hemorrhoids prolapse outside the anus. Then clamp the base of the internal hemorrhoids with hemostatic forceps and ligate under the vascular clamp with No. 7 silk thread. If the internal hemorrhoids are large, they can be sutured to cut off part of the ligated internal hemorrhoids to reduce postoperative anal bulging. To prevent edema of external hemorrhoids, decompression incisions can be made in the corresponding external hemorrhoids. 2-3 internal hemorrhoids can be ligated each time. After the operation, put oil gauze into the anus, and the tower gauze was compressed and fixed. After every defecation after the operation, the bath was changed and Xiongzhen ointment was injected into the anus until healed.
(2) Subsection ligation:
Indications: Ring internal hemorrhoids
The preparation is the same as before. Divide the circular internal hemorrhoids into several segments. At the division of the internal hemorrhoids, use two vascular clamps to clamp the mucosa, cut in the middle, up to the top of the hemorrhoid, and down to the tooth line, and treat other hemorrhoids in the same way. Then clamp the base of the internal hemorrhoids divided into segments, and the treatment is the same as simple ligation. To prevent edema of external hemorrhoids, radial decompression incisions can be made outside the anal margin of the mother hemorrhoids. After the operation, a gauze strip is placed in the anal canal, and the wide tape is pressed by the tower gauze to fix it. After the operation, he also took a bath and changed the dressing after every time he had a bowel movement.
Use appropriate antibiotics to prevent infection and promote wound healing.
4. External stripping (cutting) and internal ligation:
Indications: Hemorrhoids with external hemorrhoids, mixed hemorrhoids, circular mixed hemorrhoids, and incarcerated internal hemorrhoids in the second and third stage.
Preoperative preparation: skin preparation, enema, no fasting before operation.
Operation method: under Yaoshu acupoint anesthesia, cut the stone position, routinely disinfect the perineum, lay the aseptic hole, disinfect the lower end of the anorectal canal with 1‰ of Xinjieermei, expand the anus, and expose the internal hemorrhoids. Make a V-shaped incision in the external hemorrhoids, lift the flap with vascular forceps, and peel the venous plexus of the external hemorrhoids to the tooth line with scissors. Pay attention to protect the skin of the anal canal, remove the external hemorrhoid venous plexus as much as possible, and then use the middle-curved vascular clamp to clamp the stump of the external hemorrhoid and the base of the internal hemorrhoid. Use a round needle and 7-gauge silk thread to make a "8" stitch in the middle of the vascular clamp, and cut the ligation The stump makes a radial incision at the anal margin. Use the same method to treat other hemorrhoids. Check for bleeding after surgery. On the wound surface, put oil gauze and tower gauze pressure tape to fix.
Use appropriate antibiotics after surgery to prevent infection, take a bath and change the dressing after each defecation, until the wound heals.
Keep the stool unobstructed, especially in the shedding period to prevent hemorrhage.
5. High-tech therapy:
At present, many high-tech applications are used in the medical field, and they have achieved good results in the diagnosis and treatment of diseases. They also have certain effects in the treatment of anorectal diseases.
These high-tech, mostly high temperature, low voltage and low current, have a certain effect on internal hemorrhoids, but they have certain limitations for larger internal and external hemorrhoids. Sometimes they are not handled well, which can lead to hemorrhage, anorectal stenosis and other complications. Symptoms and sequelae, and the long-term effect is not good.
At present, there are laser, microwave, infrared, cryo, radio frequency electronic treatment devices for hemorrhoids, as well as TRM multi-source spectrometers and DTP for physical therapy.