吻合器痔上黏膜环切术300例术后出血的处理

目的总结吻合器痔上黏膜环切术（PPH）出血的处理经验,以便有效减少出血的发生,提高疗效。方法选择2003年3月～2012年7月在本院接受PPH手术治疗的300例患者,对出血情况等临床资料进行临床分析。结果 300例患者术后存在不同程度出血,其中,术中即刻出血220例,占73.30%,其中,搏动性出血70例（23.30%）,其余为吻合口渗血（50.00%）;术后出血15例,其中,24h以内的3例,大出血1例（〉200mL）;大于24h的12例,大出血2例（〉100mL）;其余为少量便血12例（4.00%）。经积极处理,均停止出血。结论 PPH手术出血值得重视,需积极预防及有效处理。

The treatment on postoperative bleeding of hemorrhoids in 300 cases treated by procedure for prolapse and hemorrhoids

Objective To summarize the experiences of postoperative bleeding of hemorrhoids in 300 cases treated by procedure for prolapse and hemorrhoids(PPH),in order to reduce the occurrence of bleeding and enhance efficacy.Methods Three hundred patients treated by PPH surgery in our hospital from March 2003 to July 2012 were selected and their bleeding clinical data were analyzed.Results Three hundred cases existed varying degrees of bleeding,which immediately intraoperative bleeding occured in 220 cases,73.30% of the total number,the pulsatile bleeding occured in 70 cases(account for 23.30%),and the rest were anastomotic bleeding(account for 50.00%).Postoperative bleeding occured in 15 cases,of which 3 cases within 24 hours and 1 case of hemorrhage(> 200 mL);12 cases more than 24 hours and 2 cases of hemorrhage(> 100 mL),the remaining 12 cases for a small amount of blood after defecating(account for 4.00%).The bleeding stoped after the active treatment.Conclusion The postoperative bleeding of PPH surgery deserve attention,and need to actively prevent and effectively addressed.