External treatment is an important treatment method in surgery, divided into drug therapy, surgical therapy and other therapies. The main external dosage forms of drugs commonly used in anorectal department are as follows:
1. Fumigation and sitz bathing method: It uses steam fumigation and hot water to soak the affected area to treat diseases. It has the function of cleaning the local area, can promote local blood circulation, accelerate the absorption and dissipation of inflammation. Commonly used Chinese medicines include Qudu Decoction, Kushen Decoction, and Chinese herbal medicines such as heat-clearing and detoxifying. It is mainly used for anal postoperative care, hemorrhoid swelling and pain, anal fissure and unexplained anal pain, anal eczema and other skin diseases.
How to use: Decoction of Chinese medicine into 2000~3000ml soup, put it in a bathtub, fumigate the anus first, when the liquid is not hot, soak the anus in the liquid for about 15-20 minutes, usually after stool Or take a bath at night before going to bed, 1-2 times a day.
2. Retention enema: It is a treatment method in which a small amount of liquid medicine is poured into the rectum and absorbed through the intestinal mucosa. The drug directly acts on the lesion and can avoid the influence of various digestive enzymes. It can directly reduce inflammation and stop bleeding, repair ulcers, and relieve intestinal spasm. It is suitable for ulcerative rectal inflammation and other intestinal inflammatory diseases and intestinal polyposis. , Anal sinusitis, etc. Commonly used drugs include Baitouweng soup, enema prescription, and clinical formulas.
How to use: Decoct Chinese medicine into about 150ml liquid medicine, filter out the medicine residue with gauze, after emptying the urine, wait for the liquid medicine temperature to drop to the same body temperature, pour the medicine liquid slowly into the rectum, raise the buttocks, reduce turning, let The liquid medicine remains in the intestinal cavity for more than two hours.
Note: 1) Do not have too much liquid medicine. Too much liquid medicine enters the intestinal cavity, which can easily stimulate the bowel defecation reflex, and cannot keep the medicine liquid. Or the coverage is less, thus affecting the efficacy. 2) The temperature of the liquid medicine is very important. Too high will easily burn the intestinal mucosa, while too low will easily stimulate bowel movements and defecate earlier. 3) The drug residue must be filtered clean, otherwise it will stimulate the intestines, cause discomfort, and defecate in advance.
3. Rectal plug method: refers to the ointment or suppository stuffing into the anus, dissolving in the intestine, and being absorbed through the mucous membrane to play the therapeutic effect of clearing away heat and detoxification, relieving pain and stopping bleeding, and promoting muscle and sore. Used for various anal diseases and their operations, proctitis, anal sinusitis, etc. Currently commonly used clinically there are Mayinglong Musk Hemorrhoids Ointment, Longchang Kangtai Hemorrhoids Ointment (Suppository), Jiuhua Ointment, Taining Cream, Musk Hemorrhoids Suppository, Taining Suppository, Ximitai Hemorrhoid Suppository and so on.
How to use: Put the hemorrhoid ointment (suppository) into the anal canal after an anal sitz bath. When the suppository is inserted, there is a feeling of hollowing out, which means that the medicine has entered the anal canal to the rectum. 1-2 times a day, one suppository each time, and an appropriate amount of ointment.
4. Ointment coating method: It is a method of treating the affected area or wound by applying the prepared medicinal ointment. According to different diseases, there are different formulas: hemorrhoids swelling and pain, use Xiaozhi ointment, hemorrhoid pain relief ointment (in-hospital preparation) to reduce swelling and pain; for paraanal abscess, use detoxification bite ointment to hold the poison through the pus; anal itching, chronic anus eczema It is advisable to use damp toxin ointment to reduce dampness and relieve itching for chapped; Jiuhua ointment and hemorrhoid ointment should be used for dressing after anal surgery to remove decay and grow muscle and promote wound healing; in the later stage of anal fistula surgery, if the wound does not heal for a long time, use Shengji cream and pearl The cream produces muscles and sores.
How to use: After anal sitz bath, apply ointment to the affected area or wound and apply gauze to fix it once a day.
5. Powder external application method: It is a method of grinding the medicine into powder and sprinkling it on the affected part or sore surface for treatment. Different formulas have different effects: Liuyisan and Qingdaisan are used to dry dampness and relieve itching for anal eczema; after anal fistula or abscess excision, if there is more fluid from the wound, use Yuebaisan, Jiuyidan, and Wu The dressing of Wudan has the effect of lifting pus and removing rot; after anal surgery, especially after anal fistula or abscess, the sepsis is exhausted and the wound does not heal for a long time, and the growth of granulation is not good. You should use Shengji powder and Zhenzhu powder to change the dressing to promote The wound grows; if there is more bleeding on the wound, Taohuasan and Yunnan Baiyao are used for dressing.
How to use: Anal eczema: After taking anal bath, spread the medicine powder on the anus, and put a sanitary napkin on the underwear to avoid contaminating the underwear and bedding. Once every night before going to bed. Wound dressing change: After the anus sits in a bath, sprinkle the powder on the gauze strip, fill it on the wound, and then apply gauze tape to fix it. Once a day.