妊娠期痔急性发作的治疗（附95例分析）

Treatment of Acute Hemorrhoids in Pregnancy ：Analysis of 95 Cases

观察妊娠期痔急性发作的治疗效果。妊娠早期，以休息、通便、坐浴为主；妊娠中期，若上述治疗痔核外脱不能回纳，可考虑手术治疗；妊娠晚期，尽量保守治疗，无效者可行简单手术，临近预产期且症状严重不处理可导致早产者，可考虑适时分娩，终止妊娠。共治疗95例，18例早期妊娠，1例手术终止妊娠，余保守治疗成功；32例中期妊娠，手术治疗13例，无1例早产或流产，余均保守治疗；45例晚期妊娠，3例剖腹分娩，余均保守治疗。结果表明，妊娠期痔急性发作，除痔核嵌顿坏死等紧急情况外，一般不宜手术，均应保守治疗。针对妊娠不同时期采用针对性治疗措施，可收到良好效果。

Acute hemorrhoids in pregnancy were treated and observed. Generally, acute hemorrhoids in the first trimester of pregnancy should be treated with sitz bath supplemented with catharsis and rest; acute hemorrhoids in the second trimester of pregnancy may be surgically treated only if the hemorrhoids get prolapsed and can not be retracted;acute hemorrhoids in the third trimester of pregnancy should be treated conservatively,simple surgery may be applied if the conservative treatment get failed; and child delivery may be shifted ahead of the expected date if the acute hemorrhoids are severe and the expected date of delivery is nearer（that may give rise to an abortion）. Ninety five patients with acute hemorrhoids in pregnancy were treated in the study. Of the 18 cases in the first trimester of pregnancy,pregnancy was terminated in 1 case and the rest 17 cases were successfully treated conservatively. Of the 32 cases in the second trimester of pregnancy,surgical operation was performed for 13 cases with no abortion or premature labor, and the rest 19 cases were all successfully treated conservatively;Of the 45 patients in the third trimester of pregnancy,cesarean was performed for 3 cases,and the rest 42 cases were all successfully treated conservatively. It is suggested that conservative treatment should,in general, be applied to patients with acute hemorrhoids in pregnancy;and that surgical treatment can be provided only if the conditions such as incarceration or necrosis of the hemorrhoids take place.