痔上黏膜环形切除钉合术(PPH)术后出血处理

目的探讨痔上黏膜环形切除钉合术(PPH术)术后出血的处理措施。方法选择2005年1月～2008年1月间在我院接受PPH术的术后出血患者18例进行分析,总结PPH术后出血的处理措施。结果本组405例中术后18例发生出血,其中6例患者重新用油纱布团填压;4例患者给予1∶2000肾上腺素冰盐水肛管、直肠内注入,局部使用太宁栓止血;3例患者重新检查吻合口,未见活动性出血,故用纱布团压迫;3例患者出血部给予4号丝线缝扎止血;1例患者应用三腔二囊管的胃囊压迫直肠下段的吻合口止血;1例患者在骶麻下间断缝合吻合口上下直肠黏膜及黏膜下层一周。所有术后出血患者经处理均未再发生出血。结论临床应采用多种止血方法,以达到准确、快速止血的目的。

Treatment on Bleeding after Procedure for Prolapse and Hemorrhoids

Objective To invesgate the treatment measures on bleeding after procedure for prolapse and hemorrhoids. Methods 18 cases who received PPH in our hospital from January 2005 to January 2008 were analysed, and the treatment measures on bleeding after PPH were summarized. Results Of 405 patients, 18 cases were with bleeding after operation, 6 cases were stopped bleeding by pressing of eleo-crumpled gauze. 4 cases received the epinephrine and cryohydrate water by anal canal and intrarectal and titanoreine on local. The anastomotic stomas of 3 cases were checked and there was no active bleeding found, so they were stopped bleeding by pressing of eleo-crumpled gauze. 3 cases received transfixion by silk suture of No 4. One case received the pressing on anastomotic stoma of rectum inferior segment by three cavea and two auditory tube. All patients did not bleed after treatment. Conclusion The doctors should take multitude hemostasis way to stop bleeding promptly.