2021年11月2日星期二

Postoperative medication and precautions for hemorrhoids

Hemorrhoids are the most common anorectal diseases. In recent years, the incidence rate of hemorrhoids is 50.28%, of which the highest prevalence is 35~59 years old. It is divided into internal hemorrhoids, external hemorrhoids and mixed hemorrhoids. Clinically, it is diagnosed through anal digital diagnosis and anoscopy.

The treatment of hemorrhoids is divided into conservative treatment, instrument treatment and surgical treatment. Generally, conservative treatment is mainly used to alleviate symptoms and prevent prolapse, including anal lifting training, dietary changes (especially high fiber intake) and local treatment. After conservative treatment fails, surgical treatment can be carried out. After surgical treatment, how should patients use drugs to improve symptoms and improve quality of life? Listen to the pharmacist:

1. Intravenous active drugs

It can improve venous tension, stabilize capillary permeability and increase lymphatic drainage

① Melissa flow extract tablet (xiaotuozhi): it is recommended to take it orally 30 minutes before meals.

② Maizhiling tablets: take orally after meals.

③ Diosmin tablets: take it at lunch and dinner.

2. Laxative

Relieve hemorrhoid symptoms and reduce bleeding

① Wheat cellulose granules (non specific bran): non specific bran can be added to food or beverages, such as soup, porridge, milk, fruit juice, etc. the best effect can be achieved by taking about 200 ml of liquid each time.

② Milk analgesics: non steroidal anti-inflammatory drugs (NSAIDs) and non opioid analgesics: quick onset, no anesthetic, no drug dependence. During medication, we need to pay attention to serious gastrointestinal, renal and cardiovascular adverse events.

3. Topical drugs

Direct administration, disinfection and cleaning of wound surface

① Compound Cortex Phellodendri liquid coating: usage and dosage: soak gauze strips and apply externally to infected wounds or broken abscesses. If the ulcer is deep, use a sterile hose with a diameter of 0.5 ~ 1.0 cm to insert it into the deep part of the ulcer, and use a syringe to extract the product for flushing. The dosage is generally 10 ~ 20 ml, once a day.

② Benzalkonium chloride solution: 0.1% solution for skin disinfection, 0.05% solution for mucosal disinfection and 0.01% solution for wound disinfection. Dilution method: 0.05% solution, take 1 part of the product, add sterile water for injection or fresh sterile distilled water to 2 parts. 0.01% solution, take 1 part of this product and add sterile water for injection or fresh sterile distilled water to 10 parts.

③ Jinxuan Zhike fumigation and washing powder: one bag at a time, add 1000 ml of boiling water for flushing, fumigate before washing the affected area while it is hot, 30 minutes at a time, twice a day.

④ Potassium permanganate tablets for external use: prepare a 1:1000 solution (take one tablet and add 100ml of water), dip it with sterile cotton wool or cotton swab and wash it. It should be used strictly according to the usage and dosage. If the concentration is too high, it can damage the skin and mucosa.

⑤ Compound keratinate cream: in order to facilitate intrarectal administration, each cream is equipped with a plastic sleeve. When in use, tighten the sleeve and the aluminum tube of the cream, put the top of the sleeve into the rectum, and slowly squeeze the aluminum tube.

⑥ Povidone iodine: This product is a disinfectant and preservative. It can kill a variety of bacteria, spores, viruses and fungi. Its mechanism is that the product can depolymerize and release the iodine after contacting the wound or affected area, so as to play a bactericidal role. It is characterized by low irritation to tissues and is suitable for skin and mucosal infection.

1. Defecation habits:

Constipation and abnormal bowel habits (such as tension, sitting for a long time and frequent defecation) are one of the important causes of hemorrhoids. Therefore, it is recommended that patients maintain good defecation habits and a happy mood.

2. Eating habits:

It is recommended to increase the intake of fiber (such as wheat cellulose particles) and liquid, which can improve the symptoms of bleeding.

Reviewers: Li Xiaoyan and Zheng Zhuoling of the Sixth Affiliated Hospital of Sun Yat sen University

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