2020年12月21日星期一

hemorrhoids bleeding treatment,Common inspection methods in anorectal department

    1. Position: According to the patient's physical condition and specific requirements.

    Knee-thoracic position: This position causes the anal canal to droop, the anal area is clearly exposed, the internal organs are moved up, and the pelvic cavity is empty. The inspection is convenient and easy to succeed. It is the most commonly used position;

    Left prone position: This position is suitable for those who are weak or who are doing simple treatment at the same time;

    Lithotomy position: Clearly exposed and can be used for double diagnosis at the same time. This position is also a common position for rectal anal surgery; squatting position: It is suitable for checking internal hemorrhoids, prolapsed anus or rectal polyps, etc. This position has the greatest pressure on the rectum and anal canal and internal hemorrhoids can be seen And the most serious cases of prolapse;

    Bending arm chair position: poor exposure, but convenient and time-saving, suitable for population health survey;

    2. Inspection: presence or absence of blood, pus, feces, mucus, fistula, lumps, eczema, ulcers, scars, anal tightening or relaxation, external hemorrhoids, prolapsed internal hemorrhoids or rectal mucosa, pinworms, anus Sentinel hemorrhoids, sentinel hemorrhoids, let the patient apply force toward the anus to observe for internal hemorrhoids, polyps or anorectal prolapse, etc.;

    3. Digital rectal examination: simple but extremely important;

    4. Anoscopy: first enter the anus completely, then exit slowly, observe, record according to the clock, and do not miss the comprehensive observation;

    Check the contraindications: anal stenosis, women's menstrual period, anal fissure or local inflammation and pain;

    5. Sigmoidoscopy: It is an important examination method for the diagnosis of upper rectum and lower sigmoid colon lesions. For: unexplained blood in the stool, mucus stool, chronic diarrhea, tenesmus, thin stools and other clinical manifestations, sigmoidoscopy should be considered;

    Methods: The day before the examination, give a no-dregs diet and laxatives, and enema before the operation. The first digital anus examination, the lens is about 15 cm, the intestinal cavity becomes smaller and there are spiral mucosal folds, which is the sigmoid colon. Biopsy can be taken at the same time, but do not take the center of the ulcer or the ulcerated part of the tumor to avoid perforation.

    Complications: bleeding, perforation;

    6. X-ray barium enema examination: filling defect or mucosal destruction;

    7. Defecation examination: suitable for long-term constipation, a method to determine the morphology, function and dynamics of the anal sphincter and anorectal;

    8. CT examination: understand the location and size of the tumor, provide the relationship between the tumor and the surrounding pelvic organs and the scope of tumor invasion, and perform the staging of rectal cancer;

    9. MRI: Perform rectal examination before or after surgery;

    10. Intrarectal ultrasound scan, lipiodol contrast, electromyography, colonic transmission test, etc.

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