Bacteremia after proctoscopy and hemorrhoidal injection sclerotherapy

The incidence of bacteremia following proctoscopy and hemorrhoidal injection sclerotherapy was studied in 50 outpatients undergoing both procedures. Bacteremia was found in 2 per cent of the subjects after proctoscopy and in 8 per cent after sclerotherapy. None of the subjects developed symptoms of septicemia following the procedure. It is concluded that autibiotic prophylaxis should be used before sclerotherapy in patients with valvular heart disease or compromised host defense     

急性嵌顿痔的Ⅰ期手术处理

目的：探讨I期手术处理急性嵌顿痔的可行性及效果。方法：68例急性嵌顿痔分为I组（手术治疗组）和Ⅱ组（保守治疗组），对治疗效果进行比较分析。结果：I期手术治疗组病例术后恢复良好，未出现严重并发症，在疼痛缓解时间、住院时间及恢复工作时间方面有明显优势，保守治疗组病例中有3例因疼痛难以忍受而中转手术。结论：急性嵌顿痔铁I期手术处理安全、可行，相对于保守治疗Ⅱ期手术有明显优势。     

梁林江痔科经验介绍

介绍国内著名痔科专家梁林江医师在诊治痔疮、肛裂、肛瘘等方面的独特治疗经验。     

痔血胶囊治疗内痔的临床观察

目的:观察痔血胶囊治疗Ⅰ期、Ⅱ期内痔的疗效及影响疗效的相关因素。方法:对符合Ⅰ期、Ⅱ期内痔诊断标准的261例患者采用痔血胶囊口服,一次2粒,一日2次,7d为一疗程。结果:Ⅰ期内痔的治愈率34.2%,总有效率86.5%;Ⅱ期内痔的治愈率9.3%,总有效率84.0%。不良反应为腹痛(2例)。结论:痔血胶囊是治疗Ⅰ、Ⅱ期内痔安全、有效的药物。     

化痔栓治疗痔疮的临床药理研究

[目的]观察化痔栓治疗痔疮的临床疗效。[方法]化痔栓治疗内痔、外痔、混合痔属风伤肠络型及湿热下注型患者 ,并以九华痔疮栓为对照 ,观察对便血、脱出、局部不适、肛门分泌物等疗效。[结果]化痔栓与九华痔疮栓疗效相近 ,化痔栓治疗便血优于对照组(P<0.05)。[结论]化痔栓治疗痔疮属风伤肠络型及湿热下注型患者安全有效。     

吻合器治疗脱垂性内痔(附30例报告)

目的 :探讨利用吻合器通过直肠下端黏膜及黏膜下层环形切除 ,肛垫悬吊治疗脱垂性内痔的可行性和安全性。方法 :采用该术式治疗 3 0例 期、 期环形脱垂内痔患者 ,分析经 PPH治疗的临床资料。结果 :平均手术时间 15m in,术后平均住院 4d。 2 6例患者吻合后内痔立即完全回缩 ,4例手术后第 2天完全回缩。 3例术后第 1天～第 6天有便血 ,经保守治疗后好转。术后诉肛门部疼痛者 3例 ,尿潴留 5例。随访 10个月效果良好无复发。结论 :PPH治疗 期、 期环形脱垂性内痔是一种新技术 ,具有安全、显效、快捷、住院时间少、恢复快等优点 ,远期效果有待进一步观察     

马应龙麝香痔疮膏质量标准的改进

目的：在现有基础上，改进马应龙麝香痔疮膏的质量标准。方法：对处方中的珍珠进行显微鉴别，对人工牛黄进行薄层鉴别，对处方中的冰片进行气相色谱含量测定。结果：平均回收率101．7％，RSD0．92％。结论：方法简便、快速、灵敏度高、重现性好，可作为马应龙麝香痔疮膏质量标准项目。     

Is simple mucosal resection really possible? Considerations about histological findings after stapled hemorrhoidopexy

Introduction  The common removal of smooth muscle during stapled hemorrhoidectomy had raised concerns about its effects on postoperative anorectal function. The purpose of the study is to confirm the high frequency of the involvement of smooth muscle fibers in stapled hemorrhoidectomy and to determine its association with postoperative findings. Methods  This retrospective study evaluated 241 cases of stapled hemorrhoidopexy treated from 2003 to 2006. Data include the most common postoperative complications such as bleeding, anal pain, and recurrence. Histological doughnuts were examined, and the presence of muscle fibers was evaluated. Results  Early complications occurred in 27/241 patients (11.2%) including bleeding (14), anal pain (eight), incontinence (two), abscess (two), hematoma (one). Recurrence was observed in 11 cases (4.5%). Muscularis propria fibers were identified in 217 of 241 (90%) pathologic specimens. Five complications occurred in the group in which muscle fibers were not identified (4/24). The frequency of complications in the group with and without smooth muscle tissue in the resected specimens was 9.6% and 25%, respectively. Conclusions  The presence of muscle fibers is not an occasional finding in the histological specimens, even if the presence of smooth muscle does not seems to influence the outcome of stapled hemorrhoidopexy. The idea of a simple mucosal resection needs to be revised.     

吻合器痔上黏膜环切钉合术加外痔切除术治疗混合痔的疗效分析

目的研究吻合器痔上黏膜环切钉合术（PPH）加外痔切除术治疗Ⅲ、Ⅳ度混合痔的临床疗效。方法将112例混合痔患者随机分成PPH1组34例、PPH2组36例、剥扎组42例，PPH1组采用单纯PPH术，PPH2组采用PPH加外痔切除术，剥扎组采用外剥内扎术治疗。观察和比较3组患者术后24h疼痛程度及术后排便疼痛指数、出血、伤口水肿、尿潴留、肛门坠胀、肛门控便能力、手术时间、住院时间和费用等指标；肛肠测压仪检测手术前后3组患者肛管动力学变化指标；随访0．5。1年并记录痔复发或发生血栓外痔情况。结果PPHl组术后24h疼痛指数低于另外2组（P〈0．05）：3组患者在出血、肛门坠胀、肛门控便能力方面差异无统计学意义（P〉0．05）。在术后排便疼痛、伤口水肿、手术时间、住院时间方面，PPHl组和PPH2组优于剥扎组（P〈0．05）：在术后尿潴留、费用方面剥扎组处于优势（P〈0．05）。手术前后剥扎组肛管静息压变化值小于另外2组（P〈0．05），手术前后3组患者直肠感觉阈和直肠耐受量变化值差异无统计学意义（P〉0．05）。随访半年至1年，PPH1组无复发患者，有3例发生血栓外痔；PPH2组无复发患者；剥扎组复发2例，发生血栓外痔1例。结论PPH加外痔切除术是治疗混合痔的安全有效术式，适合外痔严重的混合痔。     

PPH结合直肠黏膜纵行缝合术治疗直肠黏膜内脱垂与脱垂痔

目的探讨PPH结合直肠黏膜纵行逢合术治疗直肠黏膜内脱垂与脱垂痔的疗效。方法用PPH切除松弛脱垂的黏膜袖外加于痔右前、右后及左侧环状母痔处齿状线上方1cm处纵行缝合直肠黏膜6~8cm以上,以缩短悬吊脱垂的黏膜及痔,解除排便困难。结果本组45例患者术后直肠黏膜内脱垂引起的便秘症状明显改善,痔脱出症状减轻甚至消失。结论利用PPH环切黏膜的有效性以及纵行逢合悬吊脱垂黏膜的彻底性,减少了术后复发,以及阻断直肠黏膜脱垂与便秘间的恶性循环,是一种简单、安全、有效的方法。