痔外剥内扎术后下消化道大出血的非手术因素分析及对策

Analysis of Non-surgical Factors of the Lower Digestive Tract Hemorrhage After Hemorrhoidectomy and Their Countermeasures

目的探讨混合痔外剥内扎术后下消化道大出血的非手术原因,并提出正确有效的对策及处理措施。方法回顾性分析四川大学华西医院收治的混合痔外剥内扎术后,发生下消化道大出血患者24例的临床资料,探究其产生的相关危险因素及临床处理效果。结果患者术后大便解出困难引起的大出血4例,术后感染导致大出血1例,血液系统疾病引起的大出血1例,口服抗凝药物引起的大出血3例,出院后剧烈活动引起的大出血10例,不明原因大出血5例。经过对症处理后,所有患者的大出血症状均得到有效控制并康复出院,患者均无复发。结论通过对行混合痔外剥内扎术患者,其术后发生大出血的相关危险因素及临床处理效果的分析发现:手术方式及创伤范围是根本,合理饮食及排便管理是关键,基础疾病的治疗是重点,正确护理和充分休息是保障。

Objective To explore the non-surgical reasons of the lower digestive tract hemorrhage after hemorrhoidectomy and put forward the effective countermeasures. Methods The clinical data of 24 patients with lower digestive tract hemorrhage after hemorrhoidectomy treated in West China Hospital of Sichuan University were analyzed retrospectively to probe into the related risk factors and clinical treatment effect. Results There were 4 cases of massive hemorrhage caused by difficulty in defecation after operation, 1 case by postoperative infection, 1 case by hematological system diseases, 3 cases by oral anticoagulant drugs, 10 cases by strenuous activity after discharge, and 5 cases by unknown causes. After symptomatic treatment, the massive hemorrhage symptoms of those patients were effectively controlled and they were discharged from hospital with no recurrence. Conclusion By analyzing the related risk factors of massive hemorrhage and clinical treatment effect of the patients undergoing hemorrhoidectomy, it is found that the surgical methods and traumatic scope are fundamental, the reasonable diet and defecation management are essential, the treatment of basic diseases is the key, and the proper care and adequate rest is the guarantee.