1. Pain There is no anorectal surgery that can bypass the topic of pain. As long as it is painless after surgery, it is a lie. The anal area is rich in nerves and very sensitive to pain, so surgical trauma and inflammation can cause pain. The pain has the following causes:
(1) The patient is extremely sensitive to pain due to fear. This pain mainly occurs during defecation and after dressing change. (2) Postoperative infection, wound edema, constipation, and foreign body stimulation can also cause pain. (3) Dry stools, tearing the skin of the anal canal forcefully during stool causes pain.
(4) The wound surface 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 should be treated separately according to the situation. Analgesics such as oral or injection of strong pain medicine. In severe cases, use Chinese medicine to fumigate and wash. Inflammatory pain should be treated with anti-inflammatory treatment. If the inflammation has become purulent, it should be cut in time.
2. Anal edema
(1) After the operation, local blood and lymphatic drainage will be hindered, the permeability of blood vessels will increase, and water will be retained in the interstitial spaces. (2) Perianal sphincter spasm, and the reflux is not smooth. (3) Difficulty in urination and defecation after operation, squatting for too long, and excessive defecation.
Treatment: Mild edema can be absorbed slowly by itself, and related drugs can be taken orally or intravenously.
(1) Anesthesia, especially in spinal and sacral anesthesia, appears on the day after surgery. (2) Wrap the wound dressing so that the anus cannot be exhausted. (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 request the doctor to give the anal canal exhaustion. If necessary, take the Qi-regulating and digestive medicine, Muxiang Shunqi Pill, Si Mo Tang, etc.
(1) Intraoperative blood loss, sweating and fluid loss, decreased body resistance, leading to cold and fever. (2) Intraoperative drug reaction, postoperative low fever (3) Infusion reaction. (4) Local infection.
Treatment: It is indeed a local infection, and the infected site should be incised in time to prevent the whole body from being infected. If it is not a local infection, consider other reasons and give symptomatic treatment. If there are no other symptoms and signs, and the body temperature does not exceed 38°C, the drug should be considered to absorb heat without special treatment. Generally, it can relieve itself within 5 to 7 days.
5. Blood in the stool
Anorectal surgery is mostly open wounds. A few days after the operation, there is a small amount of bleeding during each defecation, which will stop after the defecation, which 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 ligature fell off during and after the operation. (2) The wound was not compressed when bandaging. (3) Defecation on the same day after surgery. Excessive bowel movements after surgery. (4) After injection of sclerosing necrosis agent, local tissues are fragile, eroded, hemorrhoids necrosis, infection and hemorrhage. (5) The sutures or staples fall off due to individual differences, and the blood vessels are not closed and bleeding. (6) Patients with internal medical diseases with bleeding tendency, such as leukemia, coagulation factor deficiency, liver cirrhosis, hypertension, etc.
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.
6. Difficulty in defecation
(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, resulting in difficulty in passing out.
(2) Excessive tension during the operation, sympathetic nerve excitement, and inhibition of bowel movement. (3) Postoperative bed rest and reduced activity make bowel movement slow (4) There is 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 stool.
7. Difficulty urinating
(1) Anesthesia factors. Anesthesia makes the bladder dilated or disappears, and the bladder is over dilated and loses its tension.
(2) Urethral sphincter spasm. Postoperative anal pain makes the anal sphincter spasm. Because the anal sphincter and urethral sphincter are innervated by the same nerve, the urethral sphincter also spasm. (3) Change urination habits after lying in bed. (4) Too much packing of the anal or intestinal cavity compresses the urethra.
Treatment: (1) Apply hot water bottle to lower abdomen and anus perineum. (2) Acoustic stimulation of artificial water droplets causes conditioned reflexes and enhances urination. (3) Loosen the bandage after consulting the doctor. (4) 0.5～1mg neostigmine is injected intramuscularly. Overfilling of the bladder, use catheterization.
8. Anal itching
(1) The normal reaction during wound healing. Generally, in the later stage of healing, the wound will crawl and the wound edge may be itchy, and it will disappear slowly without treatment. (2) One is allergic to postoperative topical ointment or lotion, which may cause perianal skin flushing and papules.
Treatment: (1) Stop the general topical ointment and keep the area dry. Avoid alcohol, chili and seafood (2) Chinese medicine salt water bath. (3) Apply ointment to the outside. (4) Partially closed