Analysis of factors impacting postoperative pain and quality of life in patients with mixed hemorrhoids:A retrospective study

BACKGROUND Hemorrhoids are among the most common and frequently encountered chronic anorectal diseases in anorectal surgery.They are venous clusters formed by con-gestion,expansion,and flexion of the venous plexus in the lower part of the rec-tum.Mixed hemorrhoids bleed easily and recurrently,and this can result in severe anemia.Hence,they may have a negative effect on the health of the patient and surgical treatment is required.Milligan-Morgan hemorrhoidectomy has been widely used since 1937 for the treatment of grade III and IV hemorrhoids.How-ever,most patients experience different degrees of postoperative pain that may cause anxiety.with mixed hemorrhoids post-surgery.METHODS The clinical data of patients with mixed hemorrhoids who underwent Milligan-Morgan hemorrhoidectomy were collected retrospectively.The basic character-istics of the enrolled patients with mixed hemorrhoids were recorded,and based on the Goligher clinical grading system,the hemorrhoids were classified as grades III or IV.The endpoint of this study was the disappearance of pain in all patients.Quantitative data were presented as mean±SD,such as age,pain score,and QoL score.Student’s t-test was used to compare the groups.RESULTS A total of 164 patients were enrolled.The distribution of the visual analog scale pain scores of all patients at 3,7,14 and 28 d after surgery showed that post-surgery pain was significantly reduced with the passage of time.Fourteen days after the operation,the pain had completely disappeared in some patients.Twenty-eight days after the surgery,none of the patients experienced any pain.Comparing the World Health Or-ganization Quality of Life-BREF self-reporting questionnaire scores of patients between 14 and 28 d after surgery,we observed that the quality-of-life scores of the patients post-surgery had significantly improved.There were six items that were compared at 14-and 28-d post-surgery.The mean QoL score 28 d after surgery(4.79±0.46)was higher than that at 14 d post-surgery(3.79±0.57).The mean health condition score 28 d after surgery(4.80±0.41)was also higher than that at 14 d post-surgery(4.01±0.62).The mean physical health score 28 d after surgery(32.10±2.96)was significantly higher than that at 14 d post-surgery(23.41±2.85).The mean psychological health score 28 d after surgery(27.22±1.62)was significantly higher than that at 14 d post-surgery(21.37±1.70).The mean social relations score 28 d after surgery(12.21±1.59)was significantly higher than that at 14 d post-surgery(6.32±1.66).The mean surrounding environment score 28 d after surgery(37.13±2.88)was significantly higher than that at 14 d post-surgery(28.42±2.86).The differences in quality-of-life scores at day 14 and day 28 post-surgery were ob-served to be statistically significant(P<0.001).CONCLUSION Milligan-Morgan hemorrhoidectomy can significantly improve the postoperative QoL of patients.Age,sex,and the number of surgical resections were important factors influencing Milligan-Morgan hemorrhoidectomy.

Clinical Observation of Chinese Medicinal Prescriptions for Swelling and Pain in The Postoperative Treatment of Mixed Hemorrhoids

Objective:To observe the clinical effect of traditional Chinese medicine(TCM)on reducing swelling and pain in patients with mixed hemorrhoids.Methods:Sixty patients with mixed hemorrhoids who were admitted to the Hospital of Traditional Chinese Medicine of Qiqihar from January 2023 to January 2024 were selected and divided into two groups.The treatment group(n=30)was treated with mixed hemorrhoid ligation combined with traditional Chinese swelling and pain medicine,and the control group(n=30)was only treated with mixed hemorrhoid ligation.The pain level,edema score,and prognosis of the two groups after the intervention were analyzed.The clinical efficacy was used as the evaluation criterion to compare the clinical effects of different treatment options.Results:After the treatment,the pain score,edema score,and prognostic wound score of the treatment group were all lower than those of the control group(P 0.05).The total clinical effectiveness of the treatment group(100%)was higher than that of the control group(76.67%),(χ^(2)=4.2857,P<0.05).Conclusion:The application of traditional Chinese swelling and pain medicine in treating patients with mixed hemorrhoids effectively reduced the patient’s pain,reduced the degree of wound edema,promoted wound healing,and improved the patient’s prognosis.The curative effect was significant and had a positive impact.

Effect of moxibustion combined with five‑element music therapy on postoperative pain relief after mixed hemorrhoid operation

Objective:To investigate the effect of moxibustion combined with five‑element music therapy on the postoperative pain relief of patients undergoing surgical operation for mixed hemorrhoid with damp‑heat syndrome.Methods:Totally,159 patients meeting the inclusion criteria were assigned to the control group,study group 1,and study group 2,with 53 cases in each group.All patients received routine care after surgical treatment,including acupoint application and Chinese herbal fumigation.In addition,patients in the study group 1 received moxibustion,and those in the study group 2 were given moxibustion combined with five‑element music therapy.The degree of postoperative pain was evaluated using visual analog scale(VAS).Results:There was no significant difference in VAS score on pain during dressing changes among three groups(P>0.05).After 3,5,and 7 days of intervention,there was a significant difference in VAS score on pain at rest among three groups(P<0.001),and VAS score in the study group 2 was lower than that in the study group 1 and the control group after 3 and 5 days of intervention,respectively(P<0.05).Conclusion:Moxibustion combined with five‑element music therapy is effective to relieve the postoperative pain of patients undergoing a surgical operation for mixed hemorrhoids with damp‑heat syndrome.

Research progress of traditional Chinese medicine nursing techniques for the management of postoperative complications in mixed hemorrhoids

Mixed hemorrhoids,especially ring-shaped mixed hemorrhoid,is still a headache for anorectal surgeons due to its post-operative complications.In recent years,clinicians have been studying and exploring to avoid and alleviate these complications.In the Chinese medicine industry,the application of traditional Chinese medicine nursing technology has good and unique effect in prevent local pain,perianal edema,promote wound healing,relieve urinary retention,improve constipation,relieve anxiety,and so on.This article summarized the evidences of investigated the role of traditional Chinese medicine nursing technique in preventing and treating mixed hemorrhoid so that practitioners can make decision based on the best available evidences.

Clinical Observation on 80 Cases of Anal Edema after Mixed Hemorrhoids Operation with Chinese Medicine Hot Election Package

The subjects of this study were 80 patients who underwent mixed hemorrhoids surgery in our hospital from January to October 2020 (mixed hemorrhoids external and internal ligation, internal hemorrhoids ligation or Xiaozhiling injection) and developed anal edge edema after surgery. According to the order of hospitalization, the patients were randomly divided into treatment group and control group, with 40 cases each. In the control group, blank hot pack was applied on the basis of anorectal No. 1 lotion for prevention and treatment of anal edge edema after operation;in the treatment group, hot pack of Traditional Chinese medicine was applied on the basis of anorectal No. 1 lotion for prevention and treatment of anal edge edema. The course of treatment was 7 days. The edema subsidence and postoperative pain scores were observed in both groups. Results: The scores of anal edema and pain in the treatment group were significantly lower than those in the control group (P < 0.05), and the significant efficiency and total effective rate in the treatment group were significantly better than those in the control group, with statistical difference (P < 0.05). Conclusion: Chinese medicine hot election package is effective in treating postoperative anal edema of mixed hemorrhoids, and the method is simple and suitable for clinical promotion.

Effect of auricular acupoint sticking and pressing on postoperative pain of patients with mixed hemorrhoids:A Meta-analysis

Objective:To systematically evaluate the application effect of auricular acupuncture in postoperative analgesia in patients with mixed hemorrhoids.Methods:We searched Chinese Biomedical Literature Database,CNKI,WanFang,PubMed,Embase,and The Cochrane Library to collect randomized controlled trials about auricular acupuncture on Postoperative patients with mixed hemorrhoids.According to the inclusion criteria and exclusion criteria screening literature.RevMan 5.3 software was used for meta-analysis.Results:A total of 20 articles and 21 studies were included,including 1999 patients after mixed hemorrhoids.The control group was treated with routine nursing analgesia.The experimental group was treated with auricular acupressure beans based on the control group.The meta-analysis showed that the pain relief rate of the experimental group was better than that of the control group[OR=2.84,95%CI(2.12,3.80),P<0.05].Subgroup analysis showed that the application of auricular acupressure after milligan morgan was superior to the control group in the analgesic effect[OR=3.68,95%CI(2.62,5.18),P<0.05],but it is not yet possible to apply auricular acupoint pressing to relieve pain after Stapler hemorrhoidectomy(P>0.05).The pain scores of 24 hours and 48 hours after operation in the experimental group were lower than those of the control group,indicating that auricular acupoint sticking can relieve the pain after operation.The improvement of the postoperative anal margin edema was better in the experimental group than in the control group,24 h[SMD=-1.99,95%CI(-2.84,-1.14),P<0.05],48 h[SMD=-1.92,95%CI(-2.72,-1.11),P<0.05].The adverse reactions were lower than the control group.Conclusion:The application of ear acupoint pressure pea after external exfoliation of mixed hemorrhoids can improve the analgesic effect and reduce the symptoms of postoperative anal edge edema,and the price is low,the operation is convenient,and the side effects are few.It is recommended to be popularized in clinical practice.

Progress in the Treatment of Edema After Surgery for Mixed Hemorrhoids

Edema is a common postoperative complication in mixed hemorrhoids.With the development of medical treatment,surgical improvement has greatly reduced surgical trauma to the body,but the issue of postoperative edema still exists.In order to explore the treatment progress of edema after surgery for mixed hemorrhoids,literatures on integrated traditional Chinese and western medicine for postoperative edema in hemorrhoids have been reviewed in hope to better understand the complication and provide reference for relevant clinical studies in the future.

Postoperative pain of mixed hemorrhoid treated by embedding needles in rbái(二白 EX-UE 2)

Objective To explore the effectiveness of treating postoperative pain of mixed hemorrhoid by embedding needles in Erbai （二白EX-UE 2） and find possible ways for relieving postoperative pain of mixed hemorrhoids. Methods press needle （SEIRIN pyonexes） were embedded in EX-UE 2 of patients with postoperative pain of mixed hemorrhoid, once a day and totally 7 treatments. Visual analogue scale （VAS） values were adopted for evaluation. Results Complete remission of clinical pain was observed in 34 cases, accounting for 50.00%; significantly effective in 19 cases, accounting for 27.94%; effective in 13 cases, accounting for 19.12%; and ineffective in 2 cases, accounting for 2.94%; the total effective rate was 97.06%. Conclusion The therapy of treating postoperative pain of mixed hemorrhoid by embedding press needle in EX-UE2 is effectively satisfactory.

Effects of electroacupuncture at Chéngshān (承山 BL 57) on postoperative pain of mixed hemorrhoids

ABSTRACT Objective To discuss the effect of electroacupuncture at Chengshan （承山 BL 57） on postoperative pain of mixed hemorrhoids. Methods One hundred and twenty cases with postoperative pain of mixed hemorrhoids were divided into an electroacupuncture group （60 cases） and a medication group （60 cases） randomly. In electroacupuncture group disperse-dense wave in frequency of 2 Hz/100 Hz was adopted at Chengshan （承山 BL 57）, the first treatment was given within 30 min after the operation, from the second day on electroacupuncture treatment was applied once a day and each time after hip bath in the morning. While in medication group 2 tablets of Naproxen Sunstained Release Capsule were administered orally within 30 min after operation, later on 2 tablets were taken before dressing change in the day. After 4 times of treatment, evaluate the changed condition of Visual Analogue Scale （VAS） at 5 h, 24 h, 48 h and 72 b after operation. Results In electroacupuncture group all tested pain scores at 5 h, 24 h, 48 h and 72 h after operation （6.78±2.12, 5.56±1.87, 4.34±2.23 and 3.15±2.11） were lower than those in the medication group （7.56±2.01, 6.23±1.15, 5.57±2.21 and 4.34±2.12）, and the difference was statistically significant （all P〈0.05）. Conclusion Electroacupuncture at Chengshan （承山 BL 57） can reduce the postoperative oain of mixed hemorrhoids.

Clinical Experience Sharing Of 218 Cases without Hemorrhage after Procedure for Prolapse and Hemorrhoids

Objective:To summarize the experience without hemorrhage after PPH of 218 patients with mixed hemorrhoid.Methods:PPH(Procedure for prolapse and hemorrhoids)was performed routinely.During operation,it is paid attention that the hemorrhoid artery should be completely mutilated,the anastomat should be squeezed before and after the anastomosis,the anastomosis should be carefully examined,the hemostasis should be completely performed,and relevant hemostasis measures should be taken after the operation.Results:None of the 218 patients had postoperative hemorrhage.Conclusion:Relevant measures can be taken after operation to prevent the occurrence of postoperative hemorrhage.