2020年10月26日星期一

lidocaine for hemorrhoids,Precautions for anorectal patients after surgery

    Many people think that in the treatment of anorectal diseases, simple surgery is done once and for all, but it is not. Later dressing changes, diet, living habits, etc. all determine the healing of anorectal diseases and whether they relapse again.

    For many years, I have summarized the situations and treatments that may be encountered after common anorectal surgery, and I will share them here with every patient who has undergone hemorrhoid surgery. I hope everyone has a healthy chrysanthemum!

    1. Postoperative pain

    Pain after hemorrhoid surgery is the most common phenomenon. After all, there are so many incisions in the area with very sensitive nerves. The pain is inevitable (individual patients with particularly high pain thresholds say otherwise, that is, the legendary nerves are thick and insensitive to pain. ).

    Generally, pain will appear 0-48 hours after surgery and 24 hours after stitch removal. The doctor will add analgesics to the infusion to help the patient get through the pain. The infusion of analgesics is as slow as possible, the analgesic time is longer, and there are fewer adverse reactions. When the pain is really unbearable, patients without stomach problems can take a diclofenac sodium capsule after eating to relieve the pain (take one capsule every 12 hours, it must be after eating, otherwise it will easily cause stomach bleeding and other adverse reactions ). Patients who suffer from stomach problems or who still cannot get relief after taking painkillers can tell our doctor on duty that they will inject a painkiller before going to bed.

    2. Urinary problems after surgery

    The most important problem in the first day after surgery is urination. The requirement here is the usual urination (4 hours after general anesthesia, patients with Yaoshu point anesthesia drink water 2 hours after surgery, and get out of bed after eating a liquid diet to relieve urine). Due to anesthesia, it may be difficult to urinate. You can drink more water, drink money grass powder, apply heat to your stomach, listen to the sound of water, etc. to help you urinate.

    If you still cannot urinate, do not hold back, as it will damage your bladder. See the doctor on duty to assess whether you need catheterization. After catheterization, the catheter will be kept for 2-3 days to allow the bladder sphincter to rest fully. If the catheter still cannot be removed, the catheter should be kept for 5-7 days after the catheterization.

    3. Stool problems after surgery

    Stool control is required within 2 days after surgery, and the dressing will be changed on the third day after surgery. Because there is a piece of hemostatic gauze in the anus, many patients will feel swelling, but this is not the meaning of stool, so do not loosen the gauze in advance to relieve the stool (this time there will be no stool, many patients take it I will just fart in the future) so as not to affect the hemostatic effect.

    Drink a packet of polyethylene glycol electrolyte powder (pink packaging) on ​​the second day after surgery, mix the A+B agents together, and add as much water as possible (over 500 ml) to soften the stool for the third day Smooth bowel movements.

    Eat as much food as possible on the second night after surgery, and stools will be produced on the third day.

    At the same time, you can rub the abdomen clockwise around the umbilicus to assist defecation.

    The number of bowel movements is 1-2 times a day. Soft stools are better. The time should be controlled within 5 minutes. If you can't solve it, don't shake it hard. It is easy to swell.

    If you have unresolved stool 4 days after the operation, you need to inform the doctor on duty and give an enema treatment.

    4. Postoperative diet problems

    During the 2 days after the operation, the main diet was liquid (sesame paste, corn paste, lotus root flour, porridge, steamed egg, etc.).

    On the second day after surgery, start a normal diet (rice, vegetables, lean meat, eggs, fruits, etc., preferably with high-quality protein to promote wound healing).

    Note: Remember to avoid all spicy foods (hot pot, tobacco and alcohol, chili, pepper, pepper, ginger, onion, garlic, seafood, etc.) before the cure is cured

    In addition, patients with perianal abscesses and anal fistulas should avoid all kinds of nourishing soups such as broth, fish soup, chicken soup, pigeon soup, etc., which are likely to cause the wound to grow granulation, leading to bridge healing and secondary surgery.

    5. Fumigation after toilet

    On the 3rd day after surgery, use a fumigant pack to fumigate and wash the perianal area. First, soak the fumigation pack in boiling water, steam perianal, and then add cold water to the basin to wash the perianal and incision. The time is controlled within 5-10 minutes.

    Some patients with perianal abscesses and anal fistulas need to take out the gauze strips and pull up the thin hanging thread (similar to the rubber band for tying hair). The doctor will explain specifically, do not pull other rubber strips at will.

    After the smoker is used up after discharge, you can continue to come to the hospital to buy smoker, or you can wash the anus with light salt water each time.

    Keep the anus and perineum clean and dry at ordinary times, and wash with light salt water after defecation and every night.

    6. Postoperative dressing change

    On the 3rd day after the operation, the dressing was changed, and medicines such as Fuzhiqing Ointment and Xiongzhen Suppository should be carried (some patients with perianal abscess and anal fistula do not need to carry it, and follow the doctor's instructions)

    The hemostatic thread needs to be removed after defecation. Pain will occur when the thread is removed, so you need to be psychologically prepared. (Some patients need 7-9 days to remove the thread, the doctor will explain specifically)

    Do not change the dressing more than 2 times a day. You can change the dressing once after one solution. You can change the dressing once in the morning and once again at 8 o'clock in the evening. Do not change the dressing repeatedly to stimulate the wound.

    The number of dressing changes for hemorrhoid patients is about 21 days (you can change the dressing at home later), and the number of dressing changes for perianal abscess, anal fissure, and anal fistula is about 1 month (special ones will last for 2-6 months, and it will be cured It is necessary to insist on going back to the hospital to change the dressing, and you cannot change the dressing by yourself), remember that insisting on changing the dressing is the guarantee for the recovery of anorectal diseases.

    7. Postoperative edema

    Excessive force of stool after surgery, slow blood return in some patients, and skin flaps left during the operation to protect the anal function will cause edema.

    Edema is a normal postoperative phenomenon. Don’t panic when there is edema. Ask the changing doctor to apply Huanglian ointment when changing the dressing. In severe cases, use Glauber's salt wet compress.

    Edema generally subsides slowly, and an epidermis will form after it subsides.

    8. Special attention for patients with hemorrhoids

    9. Precautions for postoperative life

    Avoid local irritation of the anus. Toilet paper should be soft, tights and hard, rough underwear, jeans should not be worn, and loose cotton underwear should be worn.

    Appropriate activities, but avoid strenuous exercise. Avoid increasing abdominal pressure, and avoid forced defecation, coughing, sitting, standing, squatting, etc. Do not bring your cell phone, books, newspapers, etc. when you are defecation, and the time for defecation is controlled within 5 minutes.

    10. Postoperative review time

    Patients with hemorrhoids were reviewed at 3 weeks after surgery, and patients with anal fistula, perianal abscess, and anal fissure were reviewed at 1 month after surgery.

    Follow-up observation at the outpatient clinic 3 and 6 months after operation. If you have any anal discomfort, contact Dr. Liu in time.

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