| The In-carceration of Internal Hemorrhoids is anus bowel division, one of the common emergency when its outbreak hemorrhoids nuclear of emergence, anal straining, local swelling pain that activities limited, defecate walk, such as dysuria patients themselves caused great suffering, and treatment inferior or cure is undeserved, embedded meal time is too long, and easy to cause illness worse, the mucosal surface erosion and nuclear hemorrhoids hemorrhoids nuclear necrosis, ooze blood, drainage, infection, fibrosis even happen bacteremia or sepsis and septic etc. In embedded bolton on TCM syndrome differentiations hemorrhoids, especially with a burning hot ChiCheng type and the most common type bets. And there's no embedded in the treatment of mixed hemorrhoids medical type has achieved consensus, but for the treatment of In-carceration of Internal Hemorrhoids, together with the principle of differences still exist in the In-carceration of Internal Hemorrhoids pathological mechanism of and its causes at home and abroad, and still not saw many scholars in their treatment in principle to whether should go to emergency operation has been not agreed.Objective:in view of the above, this research will through collecting the different type ChiCheng USES (fire poison, hot and humid betting type) the hemorrhoids hemorrhoid organization embedded meal in the surgical resection specimen, observation methods, compared to light the pathological changes observed specimens organization. Through the organization of pathology and TCM syndrome type of research and comparison, observed differences between them, and then discusses the pathogenesis of hemorrhoids embedded meal with TCM syndrome type relationship. And according to the different treatments (emergency operation, and emergency operation of the group of cases) further group, and observed and compared the pathological changes his specimens organization so as to whether the incidence hemorrhoids embedded bolton's an infection and clinical embedded in treatment of hemorrhoids whether do emergency operation of pathology and provide scientific basis, for traditional Chinese medicine clinical better treatment In-carceration of Internal Hemorrhoids provide the theoretic basis and clinical reference value.Methods:refers to the 1992 seventh anorectal conference of the In-carceration of Internal Hemorrhoids formulated clinical diagnosis standard and July 2006 zimmet pz colorectal surgery in anus et al, Chinese society of TCM surgery illness professional committee, China samples of itcwm learn colorectal anal disease professional committee of the discussion through treatment guidelines hemorrhoids (2006 edition) ", and according to the patient arrives and systemic symptom embedded bolton TCM syndrome differentiations grouping. Will comply with the clinical diagnosis standard In-carceration of Internal Hemorrhoids patients 24 patients divided into treatment group 1 (fire poison ChiCheng type) in 12 cases and treatment of two groups (hot and humid betting type) in 12 cases, the treatment according to occur in patients and In-carceration of Internal Hemorrhoids syndrome differentiation and treatment parting, depending on the seriousness of the divided into two treatment strategies:for embedded meal time is short, and although more severe symptoms such as pain but not see hemorrhoid nuclear necrosis and obviously infection, then the operation contraindication disease patients to treatment plan 1 (emergency surgery); For some time embedded meal is long, and the embedded's hemorrhoid emergence of larger nucleus, or other reasons, such as hemorrhoids nuclear necrosis, apparent infection is unfavorable immediate treatment with surgery, then be treatments plan 2 (first be conservative treatment, stay current symptoms, edema, debaucjed already ease such local inflammation is under control and improvement, poste operation after treatment). Including pathological take, treatment 1 plan take postoperative pathologic organizations; Treatments 2 plan take preoperative instabilities antiphlogistic, detumescence processing measures, namely the histopathology preoperative pathology organization. Pathologic evaluation index:mucosal inflammation infiltrating degree, mucosal inflammation degree, inflammatory cells infiltrating types, thrombosis machine the degree of and edema degree and statistics found colonies specimens quantity.Results:ChiCheng type and burning hot betting type In-carceration of Internal Hemorrhoids hemorrhoid histopathological each integral nuclear situation through statistical analysis concluded that both groups cases in mucosal inflammation infiltrating degree, mucosal inflammation degree, inflammatory cells infiltrating kinds aspects quite does not exist significant differences (P> 0.05), but in thrombosis machine, the degree of comparative degree of edema existing statistically significant (P< 0.01), and variance show hot and humid betting type thrombosis machine, edema the degree of integration is a burning ChiCheng degree type more serious; And with the emergency surgical emergency surgical In-carceration of Internal Hemorrhoids hemorrhoid histopathological each integral nuclear situation through statistical analysis concluded that both groups cases in mucosal inflammation infiltrating degree, mucosal inflammation degree, inflammatory cells infiltrating types, thrombosis machine and the degree of the degree of edema compared does not exist statistically significant difference (P> 0.05). And not all pathological a colony there. See obviousConclusion:embedded with hot meal hemorrhoid bet ChiCheng type type burning in related to inflammation aspect such as inflammatory cells infiltrating degree types, etc., and its histopathological not obvious statistical differences, and hot and humid betting type In-carceration of Internal Hemorrhoids significantly longer than the disease ChiCheng type, namely, burning with progression delay or time is too long and increased its edema of the extent of the situation and thrombosis machine, and then lead to local pain, oozy and even necrotic accentuate further, can say to hot and humid betting type embedded meal in ChiCheng hemorrhoids burning the hemorrhoids type based on embedded meal more accentuate further performance, both the syndrome differentiation and treatment USES its established after the systemic symptom should be closer, the difference in histopathological is mainly focus on course to extend with the thrombus machine, edema, etc. In addition, all histopathological slices are not seen obvious existence, and emergency surgical colony and the postoperative pathologic emergency surgical pathology found before two groups in contrast histologic aspects does not exist significant differences. Namely the onset of In-carceration of Internal Hemorrhoids patients can not think the reasons caused by bacterial infection, its emergency surgery does not cause complications such as bacteria infection spread, only in embedded meal time is too long, duration extension, illness aggravating deterioration ability may cause secondary bacterial infection, so should be as guidance will affect the In-carceration of Internal Hemorrhoids treatment is not appropriate, factors and emergency surgery can quickly remove symptoms such as pain and swelling patients, and can effectively prevent hemorrhoid nuclear necrosis, infection, etc, these are happening obviously superior to the emergency surgical treatment method. |
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