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1 病例报告 张某,男,43岁,排便后肛门有鲜血间断性滴出两年,曾外用痔疮栓治疗,症状时隐时现。一日肛门突然有大量鲜血流出,伴有血块,患者头晕、心慌、周身无力,急诊入院。查体:一般状况欠佳,贫血外观,心率98次/分,血压14.0/12.0Kpa,心肺无变化。肛查:胸膝位,3、6、9时位齿线上、下静脉丛扩张,肛管内有大量血块及新鲜血流出,以痔出血急诊行控查止血术。在骶管麻醉后用冷光源拉勾将肛门拉开,未见痔粘膜出血,用组织钳将直肠粘膜往下牵拉,距肛缘8.0cm5时位可见2.0×3.0cm肿物,有蒂活动度好,肿物质软表面呈细小乳头状,似草莓样,质脆,表面广泛性渗鲜血,用
1 case report Zhang Mou, male, 43 years old, after the defecation there are intermittent intermittent bleeding of the anus for two years, had external hemorrhoids suppository treatment, symptoms are hidden. One day, the anus suddenly had a large amount of blood flow, accompanied by blood clots, and the patient was dizzy, palpated, and had weakness. He was admitted to the hospital in an emergency. Physical examination: The general condition is poor, appearance of anemia, heart rate 98 beats/minute, blood pressure 14.0/12.0 Kpa, no change in heart and lung. Anal examination: chest and knee position, 3,6,9 when the bite line, the lower venous plexus expansion, there are a large number of blood clots in the anal canal and fresh blood outflow, emergency hemorrhoids hemorrhage hemorrhage. After fistula anesthesia, the anus was pulled open with a cold light source, no hemorrhage of the orbital mucosa was found, and the rectal mucosa was pulled down with tissue forceps. A 2.0×3.0 cm tumor was visible at an anal distance of 8.0 cm5. The degree of good, swollen material surface is a small papillary, like strawberry-like, crisp, extensive surface bleeding, with