| ObjectiveThe diagnosis and treatment of hemorrhoids(moderate and above haemorrhoid anemic anemia)from March,2017 to February,2018 in our department of surgery was observed,summarized and analyzed,and the optimal diagnosis and treatment of hemorrhoids in our family was put forward.On the basis of the 2006 edition of the "Guidelines for Clinical Diagnosis and Treatment of Hemorrhoids",the"Anaemia Hemorrhoids Diagnosis and Treatment Program(Draft)" was compiled.MethodsThe basic data of anemia hemorrhoids(moderate hemorrhoid anemia)and ordinary hemorrhoids patients(age,sex,length of stay in hospital)and hemorrhoids patients undergoing exfoliation and internal ligation in our department from March,2017 to February,2018 were analyzed.Hospitalization expenses,preoperative diagnosis and treatment measures(disease characteristics,examination and examination,distribution of TCM syndromes,preoperative Chinese and western medicine treatment measures,hemoglobin concentration at admission,etc.),perioperative period(pre-admission hematochezia,hematochezia from admission to preoperative hematochezia,etc.)The methods of bowel preparation before enteroscopy,the concentration of hemoglobin before operation,the days before operation,the duration of operation,the amount of blood lost during the operation,the days after operation,the use of antibiotics and so on,the treatment measures of traditional Chinese and western medicine,the postoperative complications(using painkillers,etc.)Statistics and analysis of postoperative bleeding,postoperative urinary catheterization and curative effect were carried out.The database was established and analyzed by spss17.0 software.ResultsIn this observational study,94 cases were included,including 52 cases in the general group and 42 cases in the anemia group.The basic data were as follows:(1)Basic data:The average age of anemia group was 41.69±12.45 years old,ranging from 18 to 71 years old,and the average age of general group was 44.46±12.23 years old,ranging from 25 to 78 years old.There was no significant difference in age and sex between the two groups.The average length of hospitalization was 8.07±1.44 days in anemia group and 5.31±0.88 days in normal group.The average length of hospitalization in anemia group was longer than that in normal group(P<0.05).The average hospitalization cost of anemia group was 13195.4±2549.45 yuan,ranging from 9743-20469 yuan,and that of common group was 8498.52±1015.75 yuan,the range was 7058-13582 yuan.The hospitalization cost of anemia group was higher than that of common group(p<0.05).Preoperative diagnosis and treatment measures:duration of disease course,characteristics of main complaint symptoms,number of hemorrhoids,hemorrhoids stage,There was no significant difference in whether or not to use traditional Chinese medicine treatment before operation;at the time of the attack,examination,examination,hemoglobin concentration at admission,pre-operation western medicine treatment measures(whether blood transfusion,expansion of capacity,replenishment of hematopoietic raw materials,in the treatment of hemostasis and other treatments),the difference in TCM syndromes was statistically significant(P<0.05).(2)Preoperative diagnosis and treatment measures:There was no significant difference between the two groups in the course of disease,the characteristics of the main complaint symptoms,the number of hemorrhoids,the stages of hemorrhoids and whether or not to use traditional Chinese medicine before operation.There were significant differences in hemoglobin concentration,preoperative western medicine treatment measures(whether blood transfusion,expansion,hematopoietic raw materials,hemostasis,etc.).There were significant differences in TCM syndrome types(P<0.05).The average onset time of anemia group was 26.76±28.88 days,ranging from 3-180 days,while that of common group was 8.29±6.16 days,ranging from 3-30 days.The onset time of anemia group was longer than that of normal group.Routine examination was performed in both groups(including three major routine tests,blood group,coagulation function,liver function,biochemistry,blood transfusion 4 items,electrocardiogram,chest radiography,anemia group).The probability of tumor index examination and enteroscopy examination were higher than that of the normal group.(61.9%vs 0)(23.8%vs 3.8%)(100%vs 1.9%).The hemoglobin concentration was 137.02±9.64 g/L in the normal group and 65.98±16.48 g/L in the anemia group,which was significantly lower than that in the normal group.The probability of blood transfusion was 52,4 in anemia group and no transfusion in normal group.(3)Perioperative conditions:There was no statistical difference between the two groups in the operation,the frequency of the blood,the blood time,the blood volume,the blood time,the blood time,the blood volume,the concentration of red egg white before the operation,the number of preoperative days,the amount of bleeding and the number of days after the operation.Statistical significance(p<0.05).The average amount of bleeding in the anemia group was 11.26+5.48ml,the range fluctuated in 3-25ml and the average group was 8.27+2.60ml.The range fluctuated in the number of days before 5-15ml,the average of the anemia group was 3.05+0.88 days,the range fluctuated at 2-5 days,the average group was 1 days,the range fluctuated at 1-1 days.For 4.12+0.89 days,the range fluctuated at 3-8 days,the average group was 3.25+0.81 days,and the range fluctuated in 2-7 days.The difference of the number of days before the operation of the two groups was more obvious than that after the operation.The anemic group enteroscopy was mainly oral cathartic,accounting for 88.1%.(4)Postoperative treatment measures:There were significant differences between the two groups in Western medicine treatment measures(blood transfusion,volume expansion,hematopoietic supplement,hemostasis and so on).There was significant difference between the two groups(P<0.05).There was no statistical difference in the use of traditional Chinese medicine after surgery.Anemia group in the treatment of Western medicine in the common group on the basis of supplement hematopoietic raw materials and other treatment measures to correct anemia;after the treatment of traditional Chinese medicine anemia group all oral Chinese medicine such as Bazhen decoction Buzhong Yiqi decoction.Common group all oral Chinese medicine,such as Huai Hua San,Bixie osmotic decoction.The application rate was the highest in the two groups(four yellow ointment for external application of anus,hot drying(infrared radiation),hot ironing(Evodia rutaecarpa,fried salt,hot compress for abdomen),fumigation and washing(hospital preparation,hemorrhoids,external sit bath).Other external remedies are almost zero.(5)Postoperative complications and efficacy:There was no significant difference between the two groups in the use of analgesic drugs,postoperative massive bleeding,postoperative urinary catheterization and clinical efficacy.There was no postoperative hemorrhage in both groups.After 1 month follow-up,the cure rate was 42.9%vs 38.5%,the improvement rate was 57.1%vs 61.5%,the ineffective rate was 0,there was no significant difference between the two groups(P>0.05).ConclusionThe hospitalization time and the waiting time of hemorrhoids are longer than those of ordinary hemorrhoids,and the hospitalization cost is higher than that of the latter.This has a direct relationship with the preoperative blood transfusion of hemorrhoids and the waiting for enteroscopy.Aemia hemorrhoid patients this attack to the time of admission to the general group leader.In comparison between the two groups,the anemia group had a higher probability of three examinations and tumor index examination than the ordinary group.On the inspection side,the anemia group all performed colonoscopy,intended to exclude hemorrhagic intestinal diseases such as intestinal tumors.There was no significant difference in postoperative complications between the two groups of patients.For hemorrhoids patients,the traditional external exfoliation was a relatively safe procedure.The operation time of hemorrhoid patients is not longer than that of ordinary hemorrhoids,but the amount of bleeding in surgery is more than that of ordinary patients.This may be related to the anatomy and vascular morphology of anemic hemorrhoid nuclei.In addition to routine treatment,anemic hemorrhoid patients were treated with more blood transfusions,additional hematopoietic raw materials,and hemorrhoids than ordinary hemorrhoids before and after surgery.Both groups lacked the use of Chinese medicine before surgery. |
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