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环形混合痔术后水肿形成的原因主要有习惯性便秘、术前清洁灌肠不彻底导致术后过早排便挤压;术后排尿困难使肛门部的血液和淋巴回流受阻,循环障碍而形成水肿;术中过度牵拉、缝线过多过紧、填塞物过多、过早中药坐浴等造成局部水肿;局部炎症、充血而产生炎性水肿。术前清洁灌肠、纠正习惯性便秘,预防术后过频、过早的排尿,术中动作轻柔、减少手术损伤范围、避免暴力牵拉及过度钳铗健康组织、留有足够的皮桥、切断部分内括约肌、术中尽量减少缝线、防止局部形成血栓等是预防水肿的有效措施。并采用局部湿敷高渗盐水、50%的硫酸镁或葡萄糖溶液、拆除过多过紧的缝线、局部按摩、减少活动、卧床休息及将脱出的内痔及时推入肛门内等措施减轻、消除水肿。本文观察48例患者发生水肿者36例,二次修剪者5例,经治疗后均痊愈出院。平均住院天数14.25d。
The main reasons for the formation of postoperative edema in ring-shaped mixed hemorrhoids are habitual constipation, preoperative cleansing enema does not completely lead to postoperative defecation premature bowel obstruction; difficulty urinating postoperative anorectal blood and lymph circulation obstruction, circulatory disorders and the formation of edema; Surgery excessive traction, too much suture too tight, stuffing too much, premature medicine bath caused by local edema; local inflammation, congestion and inflammatory edema. Preoperative cleansing enema, to correct habitual constipation, prevention of postoperative frequency, premature urination, intraoperative movements gentle, to reduce the scope of surgical injury, to avoid violent stretch and excessive clamp 铗 healthy tissue, leaving enough skin bridge, cut off Part of the sphincter, surgery to minimize sutures to prevent the formation of thrombosis, etc. is an effective measure to prevent edema. And the use of local wet compress hypertonic saline, 50% magnesium sulfate or glucose solution, removal of too much tight suture, local massage, reduce activity, bed rest and prolapse of the hemorrhoids timely push anus and other measures to reduce and eliminate Edema. In this paper, 48 cases of edema were observed in 36 cases, 5 cases of secondary trimming, were cured after treatment were discharged. The average hospital stay 14.25d.