高龄环状混合痔合并慢性病患者的围手术期处理

为总结高龄环状混合痔合并慢性病患者手术治疗时应注意的问题及其临床疗效，对2006年1月至2008年i1月间54例行手术治疗的高龄环状混合痔合并慢性病的患者资料进行回顾分析，其中伴发糖尿病11例，高血压26例，冠心病7例，慢性肺部疾病12例，前列腺肥大2例，失血性贫血5例，凝血障碍3例。结果显示，术后随访1～20个月，成功随访52例，随访率为96．3％，全部治愈。术后平均住院18d。术后肛缘皮瓣轻度水肿4例，经痔疾洗液熏洗坐浴后好转；肛门疼痛4例，予路盖克口服后好转；排尿不畅3例，经热敷、按摩、诱导排尿后好转；继发性出血2例，采用纱布局部压迫或电凝止血，效果良好。无肛门狭窄及大便失禁患者。结果表明，高龄不是痔病的手术禁忌症，充分的术前准备、积极治疗并存疾病、重视围手术期处理可以减少术后并发症，提高患者生活质量。

Perioperative Management on the Advanced Age Patients with Circumferential Mixed Hemorrhoids and Concurrent Chronic Diseases

For the objective of investigating the therapeutic effect of the operation for circumferential mixed hemorrhoids and concurrent diseases of advanced age patients and the issues, which should be noticed during operation,authors analysed the data on 54 advanced age patinets with this diseases（from 2006-01,to 2008-11） retrospectively,among whom there were concurrent diabetes（in 11 cases）,hypertension（in 26 cases） ,coronary heart disease（in 7 cases） ,chronic lung disease（in 12 cases） ,prostatauxe（in 2 cases） ,hemorrhagic anemia（in 5 cases）, and disturbance of blood coagulation（in 3 cases）. As results, postoperative fol- low-up lasted for 1-20 months,52 cases were followed-up successfully,follow-up rate was 96.3% ;all the patients were cured;postoperative average hospital stay was 18 days; after operation,mild edema of anusedge flap was in 4 cases,who obtained improvement through washing ＆ fuming and sitz bath with washing solution for hemorrhoids;anal pain was in 4 cases, who were administered with LuGaiKe orally and were better; dysuria was in 3 cases, who received fomentation, massage and inducing urination, then were better; secondary bleeding was in 2 cases, who received gauze compress and electro-coagulation for hemostasia thus obtained good outeome; no anal stenosis and faeces incontinence was found. Results show that advanced age is not of contraindication to operation for hemorrhoids;reducing postoperative complication and enhancing the quality of life of patients would be possible, provided enough preoperative preparation, active treatment and paying attetion for perioperative management were adopted.