外剥内扎术后痔核脱落期大出血住院患者临床特点的回顾性分析  

The Clinical Features of the Admitted Patients Suffered from Massive Hemorrhage admist Hemorrhoids Core Exfoliating after External Dissection & Internal Ligature: A Retrospective Analysis

作　　者：陈富军[1] 刘昌萍 李杉[1] 程英杰 原相军[1] 李成书[1] 贺平[3] CHEN Fu-jun;LIU Chang-ping;LI Shan;CHENG Ying-jie;YUAN Xiang-jun;LI Cheng-shu;HE Ping(Longquanyi District's Ist People's Hospital of Chengdu City/Longquan Hospital of Huaxi Hospital of SichuanUniversity,Chengdu,Sichuan 610100;The Affiliated Hospital of Chengdu University of TCM and Medica Materia,Chengdu,Sichuan 610075;Chengdu Special Coloproctological Hospital,Chengdu,Sichuan 610000)

机构地区：[1]成都市龙泉驿区第一人民医院/四川大学华西医院龙泉医院,四川成都610100 [2]成都中医药大学附属医院,四川成都610075 [3]成都肛肠专科医院,四川成都610000

出　　处：《中国肛肠病杂志》2023年第3期27-30,共4页Chinese Journal of Coloproctology

摘　　要：目的:了解外剥内扎术后痔核脱落期大出血住院患者的临床特点,为临床防治提供参考。方法:回顾性分析2013年3月至2021年3月,本院82例痔核脱落期大出血住院患者的病历资料,分析患者性别、年龄、混合痔类型、术后排便困难比例、痔核脱落期大出血时间、出血量、出血方式、出血部位、血常规及治疗方式等数据。结果:82例患者中,男性占62.20%,20~60岁占81.71%,非环状混合痔占68.29%,伴排便困难者占21.95%。痔核脱落期大出血多发生于术后6~20 d,中位数为10.50 d,其中术后7~14 d占71.95%。出血量<400 mL者占65.85%,渗血出血中母痔区渗血占61.54%,搏动性出血中,母痔区出血占97.47%。出血前后红细胞计数、血红蛋白量、白细胞计数、中性粒细胞计数及血小板计数比较,差异有统计学意义(P<0.05),采用缝扎止血治疗者占85.37%。结论:痔核脱落期大出血的确切原因及机制尚有待于进一步研究,应进一步提高对痔核脱落期大出血的认识,及时在麻醉下探查,缝扎止血是有效的治疗方法。Objective To investigate the clinical features of the admitted patients suffered from massive hemarrhage admist hemorrhoids core exfoliating after external dissection internal ligature, so as to provide reference for clinical prevention treatment of this condition. Methods Retrospectively reviewed the data of disease history of 82 cases met above conditions and treated in authors' hospital(2013-03-2021-03),analysed their gender, age, the typies of mixed hemorrhoids, the ratio of who having dyschesia, as well as the time for massive hemarrhage happened, the bleeding volume, the bleeding patterns, the bleeding sites;what's more, blood routine examination results, and therapies, etc. Results In the 82 cases, male patients accounted 62.2%,who being at 20-60 yr. accomted 81.71%;non-circumferential mixed hemorrhoids accounted 68.29%,the type of dyschesia accounted 21.95%;the massive hemorrhoidage happened at 6-20 days after surgery(medium, 10.50),ones at 7-14 days accounted 71.95%,who having bleeding volume 400 mL accounted 65.85%;in exudative hemorrhage the exudation from primary hemorrhoids accounted 61.54%,meanwhile, in pulsatile hemorrhage, ones from primary hemorrhoids area, accounted 97.47%;before and after bleeding in RBC count, Hb amount, WBC count, neutrophil count, as well as platele count there was statistical difference(P<0.05);the ratio of patients treated with suture ligature was 85.37%. Conclusion The determined causes and its mechanism of massive hemarrhage admist hemorrhoids core exfoliating are to be researched further, therefore, it should be to enhance knowledge about this hemarrhage, timely to explore it under anesthesis, and suture ligature for stopping bleeding is effective therapy.

关 键 词：混合痔 外剥内扎术 术后大出血 

分 类 号：R657.18[医药卫生—外科学]