Uncle Li is 62 years old. He has been tortured by hemorrhoids for more than 30 years. He has tried various treatments (including surgery), but his symptoms continue to come and go. In recent years, due to frequent bleeding, severe anemia, pale face, even dizziness, deeply troubled.
1. What is hemorrhoids?
Hemorrhoids are the most common anorectal disease, with an incidence rate of 87.5%, which is close to the Chinese folk saying that "nine hemorrhoids in ten people". And with the increase of age, the incidence rate continues to increase, and the incidence rate of women is slightly higher than that of men. People's knowledge of hemorrhoids can be traced back to 4000 years ago, but theories related to hemorrhoids are constantly enriched, and there are two main types.
(1) Varicose Vein Theory
The main structure of the anal cushion is the venous plexus. The formation of hemorrhoids is mainly related to the congestion and expansion of the venous plexus under the rectal mucosa and under the skin of the anal canal.
(2) Theory of anal cushion downward movement
The function of the anal cushion is to close the anal canal and control defecation. Under normal circumstances, the anal cushion is loosely attached to the muscle wall of the anal canal. It is pushed down due to downward pressure during defecation, and can retract into the anal canal with its own contraction after defecation. However, after the elasticity of the recoil is weakened, the anal cushion becomes congested and moves downward to form hemorrhoids.
There are many predisposing factors for hemorrhoids, among which constipation, long-term drinking, eating a lot of irritating food and sitting for a long time are the main factors.
Medically, hemorrhoids are classified into internal hemorrhoids, external hemorrhoids and mixed hemorrhoids according to the relationship between the growth site of hemorrhoids and the dentate line (a normal structure in the anus).
2. What are the symptoms and harms of hemorrhoids?
(1) Internal hemorrhoids are mainly manifested as bleeding and prolapse, and external hemorrhoids are mainly manifested as anal discomfort, itching and lumps. After internal hemorrhoids progress to a certain degree, mixed hemorrhoids will form.
(2) The bleeding symptoms of hemorrhoids cause bacteria, toxins, and pus plugs to invade the blood. Extremely severe symptoms can cause sepsis, toxemia, and hypertoxemia.
(3) Long-term hemorrhoids with blood in the stool will directly lead to severe anemia as blood loss increases. The patient will have symptoms such as pale, fatigue, dizziness, weakness, and memory loss.
(4) The prolapse of hemorrhoids causes the sphincter to relax, the mucus flowing out of the anus irritates the surrounding skin, and anal eczema and anal itching occur from time to time.
3. How to treat hemorrhoids?
There are many traditional treatment methods for hemorrhoids, the common ones are injection therapy, electronic laser therapy, cryotherapy, surgical resection and PPH, etc., each of which has corresponding indications and advantages and disadvantages, but for a long time, there has not been a single recognized clinically good one. treatment method. So far, the surgical "external peeling and internal ligation" method is mainly adopted for patients with severe hemorrhoids, which is a rubber band ligation therapy and surgical therapy for fleshy (hemorrhoids). The patient suffers a lot and takes a long time to recover.
Adhesive band ligation is to apply appropriate instruments to ligate a certain amount of mucosa and submucosa tissue above the hemorrhoid at an appropriate position above the dentate line; or directly at the base of the hemorrhoid. The anal pad is lifted up and the backflow of the hemorrhoidal vein is blocked at the same time, the effect is definite. However, if it is not handled properly (inaccurate positioning and poor suction pressure control, etc.), complications such as hemorrhage and rectal perforation will result.
Hemorrhoidectomy includes a variety of surgical methods, such as submucosal hemorrhoidectomy, closed hemorrhoidectomy, and PPH. Each of these techniques has advantages and disadvantages. PPH has a definite curative effect, but there is a risk of serious complications, such as bleeding, rectal stenosis, acute rectal anal dysfunction, etc. It is currently restricted to be used for grade III and IV internal hemorrhoids and mixed hemorrhoids mainly internal hemorrhoids.
Relatively speaking, the ultrasound-guided hemorrhoid artery ligation + suspension used in developed countries such as Europe and the United States brings a new treatment method for patients with hemorrhoids. It is a minimally invasive treatment for hemorrhoids, integrating ultrasonic exploration and suture + Suspension and surgery are a new diagnosis and treatment technology. It cuts off the blood supply of the hemorrhoids at a high position, reduces and eliminates swelling and bleeding, and protects the physiological function of the anus to the greatest extent. At the same time, it can lift the prolapsed hemorrhoids and fix them on the rectal wall. , So as to solve the problem of prolapse as much as possible. Its main advantages are: the operation is quick and easy, and it takes about 20 minutes to complete one operation; minimally invasive, no open wound, less bleeding during the operation, no serious complications and sequelae, high safety, and a low-invasive operation; Less moderate pain, mild postoperative pain, and small response after treatment; short treatment cycle, quick recovery, short hospital stay, saving other related medical expenses, so the total cost is lower than conventional surgery. It provides a better treatment option for the majority of hemorrhoid patients. In particular, it greatly reduces the recurrence rate after surgical treatment of hemorrhoids, which is in line with the development direction of minimally invasive surgery. In 2005, the team of Professor Huang Dongping from Putuo People’s Hospital affiliated to Tongji University introduced and carried out more than 1,000 cases. The cure rate for stage I-IV hemorrhoids is as high as 90%. The technology has been radiated to ten provinces and cities such as Zhejiang, Jiangsu, Fujian and Wuhan. Several hospitals have trained more than 50 professional physicians both inside and outside the city, and performed nearly 100 cases of surgery. They went to Jiangsu, Zhejiang and other places, so that many patients who could not be treated well in the past can now receive effective treatment, which to a certain extent solves the problem of "seeing a doctor". The current situation of “expensive and difficult to see a doctor” has obvious social benefits. And there are good economic benefits.