To Explore The Clinical Efficacy Of Treatment Of U-shaped Anoscope For External Hemorrhoidectomy And Internal Hemorrhoid Suspension Combined With Hemorrhoid Fistula Lotion

ObjectiveTo observe the clinical efficacy of U-shaped anoscope for external hemorrhoidectomy and internal hemorrhoid suspension combined with hemorrhoid fistula lotion in the treatment of circular mixed hemorrhoids and to explore the advantages and disadvantages of this operation.Introducing a surgical method that not only effectively removes hemorrhoids,but also conforms to the physiological functions,pathological changes and anal canal dynamics of the anus,protects the fine functions of the anus and performs clinical verification.Providing a new idea for clinical precision medical treatment of annular mixed hemorrhoids.MethodsSixty patients with an circular mixed hemorrhoid diagnosed in the Department of Anorectal Diseases of Anhui Provincial Hospital of Traditional Chinese Medicine from January 2018 to July 2019 were selected.Randomly divided into a treatment group(using U-shaped anoscope external hemorrhoidectomy,internal hemorrhoid suspension combined hemorrhoid fistula lotion fumigation,n=30)and a control group(using traditional external stripping and internal ligation combined with hemorrhoid fistula lotion fumigation,n=30).Through the comprehensive evaluation of the efficacy of the two groups after treatment,and postoperative pain,anal marginal edema(phase points of observation were on the 1st,3rd,and 9th days after surgery)and urinary retention(24h after urinary tube removal),and anal stenosis(3 months after operation),wound healing time,anal canal pressure measurement before and after surgery,balloon expulsion test results and changes in anal function in the two groups,to evaluate the clinical efficacy of the two groups of surgery.Results(1)In terms of comprehensive postoperative efficacy of the two groups:the effective rates of the treatment group and the control group were 100.00%and 96.67%,respectively.After?~2test,there was no significant difference between the two groups(P>0.05);(2)Comparison of postoperative pain,anal marginal edema,urinary retention,and anal stenosis scores:Patients in postoperative pain(3rd,9th day after operation),anal edema(the 1st,3rd,and 9th day after operation),and anal stenosis were better than the control group in terms of statistical significance(P<0.05).In terms of postoperative urinary retention,there was no significant difference between the two groups(P>0.05);In terms of postoperative pain,the difference between the two groups of patients was not statistically significant on the first day after surgery due to incomplete anesthesia metabolism and symptomatic treatment of conventional postoperative analgesia(P>0.05);(3)In terms of postoperative wound healing time:the treatment group was better than the control group,and the difference between the two groups was statistically significant(P<0.05);(4)Comparison of changes in anal canal pressure measurement between the two groups before and after surgery:The maximum anal canal systolic blood pressure in both groups increased after surgery.After t-test analysis,there was no significant difference in the maximum anal canal systolic pressure between the treatment group and the control group.P>0.05);The anal canal resting pressure was increased before surgery in the two groups.There was a statistically significant difference in the anal canal resting pressure between the treatment group and the control group before and after surgery(P<0.05).There was no significant difference in the maximum systolic blood pressure of the anal canal between the two groups after surgery(P>0.05);The postoperative anal canal resting pressure difference was compared between the two groups.The postoperative anal canal resting pressure difference was greater in the control group than in the treatment group(P<0.05).(5)The balloon expulsion test treatment group was positive,28 cases were positive in the control group,accounting for 93.33%,and statistically verified,P<0.05,indicating that there was a significant difference in the balloon expulsion test between the two groups.(6)Comparison of changes in anal function(US Wexner score):The preoperative scores of the treatment group and the control group were tested by rank sum test,and there was no significant difference(P>0.05).The anal function score before and after surgery in the treatment group was not statistically significant by rank sum test(P>0.05);The anal function score of the control group before and after surgery was statistically significant after rank sum test(P<0.05);Comparison of postoperative points between the treatment group and the control group was statistically significant after rank sum test(P<0.05).ConclusionU-shaped anoscope for external hemorrhoidectomy and internal hemorrhoid suspension combined with hemorrhoid fistula lotion maximally protects the shape and fine function of the anus.It is helpful to shorten the healing time of wound surface,reduce the pain of patients,and avoid distant and recent postoperative complications caused by V-shaped incision and excised excessive number of hemorrhoids.It has certain advantages and is worthy of further clinical research and discussion.