外切内剥内扎治疗混合痔404例临床分析

According to the main principles of Milligan’s Hemorrhoidectomy integrated with the TCM method of high ligation of internal hemorrhoid,404 cases of mixed hemorrhoid were treated.320 were male and 84 female.This new therapy applied from 1967 to 1985 was proved to be simple,practical,and the operation time was shortened.It caused less pain,few complications,and only one operation instead of staged opera- tions were necessary.There were 278 cases with mixed hemorrhoid,49 wreath shaped mixed hemorrhoid,44 complicated with anal fissure,18 with ano-fistula,15 with hypertrophy of anal papillae and 15 cases with previous hemorrhoideetomy history.Operation procedure:It consists of external hemorrhoidectomy, separation of internal hemorrhoid with high ligation at its pedicle,and local infiltrative injection with "procaine methylene blue".Postoperative complications such as urine retention,pain,difficulty in defecation were negligible.Duration of operation:10 to 65 minutes,with an average of 26 minutes.Immediate complica- tion was markedly reduced.Results:376 cases were cured and 28 improved.110 patients were followed up for 2 to 17 years:Anal pain with occasional bleeding and external skin tag occurred in 8 patients,mild constriction of rectal mucosa in 2 and recurrence after 3 years in 2 cases.Satisfactory results Were found in the remaining patients(89.09%).Discussion:Local anesthesia to the left,right and posterior sphincter groove using fine needle to avoid tension-induced pain and bleeding after operation.Adoption of high ligation and pressed with Lasiosphaera fenzlii sponge to prevent from bleeding and constriction of anus and rectum.Appropriate excision of the skin flap over external hemorrhoid refrain from injury to the anal muscles and the recurrence of hemorrhoid.The internal and external varicose veins should be completely removed. From the above-mentioned,we considered that external excision and internal separation with high ligation is a fairly ideal operation for mixed hemorrhoid.

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