Effect of electroacupuncture at different time points on postoperative urination function in patients with mixed hemorrhoids surgery / 中国针灸

OBJECTIVE@#To observe the effect of preoperative, intraoperative and postoperative electroacupuncture (EA) intervention on postoperative urination function in patients with mixed hemorrhoid surgery.@*METHODS@#A total of 240 patients with mixed hemorrhoid surgery under lumbar anesthesia were randomly divided into an EA preconditioning group (group A, 60 cases, 9 cases dropped off), an intraoperative EA group (group B, 60 cases, 4 cases dropped off), a postoperative EA group (group C, 60 cases, 6 cases dropped off), and a non-acupuncture group (group D, 60 cases, 3 cases dropped off). In the groups A, B and C, EA was exerted at Zhongliao (BL 33) and Huiyang (BL 35) , with disperse-dense wave, 4 Hz/20 Hz in frequency, and lasting 30 min, at 30 min before lumbar anesthesia, immediately after lumbar anesthesia and 6 h after surgery, respectively. No EA intervention was performed in the group D. The postoperative urination smoothness score in each group was observed 24 h after surgery. The first urination time, first urination volume, urine residual volume after first urination were recorded, and incidence of indwelling catheterization, postoperative visual analogue scale (VAS) score, number of remedial analgesia, and the incidence of postoperative nausea and vomiting were observed in each group.@*RESULTS@#In the groups A, B and C, the postoperative urination smoothness scores were superior to the group D (P<0.05), and the time of first urination was earlier than the group D (P<0.05). In the group C, the time of first urination was earlier than the group A and the group B (P<0.05), the first urination volume was higher than the group D (P<0.05), and the urine residual volume after first urination was lower than the group D (P<0.05). There was no significant difference in the incidence of indwelling catheterization and postoperative nausea and vomiting among the 4 groups (P>0.05). The VAS scores of the group A, B and C were lower than that in the group D (P<0.05), and the number of remedial analgesia cases was lower than that in the group D (P<0.05).@*CONCLUSION@#EA intervention could promote the recovery of urination function and relieve postoperative pain in patients with mixed hemorrhoids surgery. Early postoperative EA intervention is more conducive to the recovery of urination function.

Progress of suspension in the treatment of severe mixed hemorrhoids / 国际外科学杂志

The incidence of severe mixed hemorrhoids is increasing year by year, and its surgical method has always been the focus in the study of anoenterology. On the basis of anal cushion downward movement theory, anal cushion suspension surgery moves up prolapsed anal cushion by suturing or ligating the mucosa above the dentate line. This not only ensures the effect of surgical treatment, but also protects the structure and function of the canal and anus in the most fine, which is in line with the minimally invasive treatment idea of severe mixed hemorrhoids, and is gradually widely used in clinical practice. As a new surgical method, anal cushion suspension surgery has unique advantages in treating severe mixed hemorrhoids, especially in severe prolapsed hemorrhoids. This paper will analyse the key points of anal cushion suspension surgery combined with procedure for prolapse and hemorrhoids, milligan morgan, hemorrhoidal artery ligation, automatic ligation of hemorrhoids, injection sclerotherapy, laser ablation and mixed surgeries respectively, in order to provide reference for clinicians to operate on severe mixed hemorrhoids.

Analysis of the status quo of early postoperative pain belief in patients with mixed hemorrhoids and its influencing factors / 中国实用护理杂志

Objective:To investigate the current situation of early postoperative pain beliefs in patients with mixed hemorrhoids and its influencing factors, and to provide a basis for formulating targeted intervention measures.Methods:Totally 242 postoperative patients with mixed hemorrhoids who were treated in Guilin Integrated Traditional Chinese and Western Medicine were selected by convenience sampling method from January 2020 to January 2021 as the research object. The general information questionnaire, Pain Belief and Perception Scale, Visual Analogue Scale, Positive and Negative Emotion Scale were used to investigate. Multiple linear regression was used to analyze the factors influencing of early postoperative pain beliefs in patients with mixed hemorrhoids.Results:The total score of early postoperative pain belief in patients with mixed hemorrhoids was -21-30 (5.32 ± 2.57) points; the results of multiple linear regression analysis showed that age, education level, anal visual analogue score, and negative emotion scores were main factors affecting their pain beliefs ( r=0.736, P<0.05). Conclusions:Patients with mixed hemorrhoids have negative pain beliefs in the early postoperative period. Patients with advanced age, primary/junior high school, high anal pain intensity, and high negative emotion scores are more likely to have negative pain beliefs. Nursing staff should promptly formulate targeted intervention measures according to the main influencing factors in order to reduce the occurrence of negative beliefs about pain.

Qualitative study of pain catastrophic experience of patients after mixed hemorrhoid surgery / 中国实用护理杂志

Objective:To deeply understand the pain perception and experience of patients after mixed hemorrhoid surgery, so as to provide reference for taking targeted intervention measures to relieve pain symptoms.Methods:Purpose sampling method was used to conduct semi-structured in-depth interviews with 9 patients with postoperative pain of mixed hemorrhoids admitted to Guilin Hospital of Integrated Traditional Chinese and Western Medicine from February to March 2021, and Colaizzi phenomenological analysis method was used to analyze data and refine themes.Results:The pain perception and experience of patients after mixed hemorrhoid surgery can be summarized into 5 themes: fear of pain, persistent negative thinking about pain, perception of inability to cope with pain, emotional expectation, and expectation of Traditional Chinese Medicine nursing techniques.Conclusions:Patients after mixed hemorrhoid surgery have many burdens and needs in terms of pain experience. Medical staff must establish a complete pain management system for patients after mixed hemorrhoid surgery, aiming at the catastrophic pain experience of patients, correcting their cognitive level of pain management, and satisfying patients Alleviate the need for pain, establish an effective emotional and family support system, improve its pain self-management ability, and promote postoperative recovery.

A new mixed surgical treatment for grades iii and iv hemorrhoids: modified selective hemorrhoidectomy combined with complete anal epithelial retention / Um novo tratamento cirúrgico para hemorroidas mistas graus iii e iv: hemorroidectomia seletiva modificada combinada com retenção epitelial anal completa

ABSTRACT Background: Varicose veins appear above and below the dentate line in mixed hemorrhoids, which seriously affects anal function and quality of life. Aim: To propose an improvement in tissue-selecting therapy repair of anal pad combined with complete anal canal epithelial retention comparing with Milligan-Morgan surgery. Methods: A prospective randomized controlled study was designed enrolling 200 patients with grade III and IV hemorrhoids. They were divided into control and observation groups. The control received Milligan-Morgan surgery, and the observation the modified tissue-selecting therapy stapler combined with complete anal canal preservation surgery. All patients were followed for six months to evaluate the treatment differences. Results: In final, control group included 82 and observation 87. The average operation time of the control group was significantly lower than that of the observation, while the bleeding volume was significantly lower in control group. The control group VAS score was 3 (1, 4), and observation 4 (2, 5). There was no significant difference in the incidence of urinary retention, bleeding and wound margin edema after surgery at one month postoperatively. Digital incidence of anal stenosis in the observation group was significantly lower than in control; the same occurred with residual anal margins. The postoperative anal canal diameter was significantly larger than the control group. Wexner anal incontinence score showed that no anal incontinence occurred in both groups, and the control group scored was significantly higher than observation. In final six months follow-up, the observation group did not experience any relapse and four cases were found among controls. The treatment satisfaction of the observation group was better. Conclusions: In grades III and IV hemorrhoids, modified tissue-selecting therapy combined with complete anal canal preservation had better prognosis and treatment satisfaction than Milligan-Morgan procedure, and it is a new surgical method for patients with advanced mixed hemorrhoids.

RESUMO Racional: Veias varicosas aparecem acima e abaixo da linha dentada nas hemorroidas mistas, afetando seriamente a função anal e a qualidade de vida. Objetivo: Propor melhoria na terapia de seleção de tecido de reparo do coxim anal combinado com retenção completa epitelial do canal anal em comparação com a operação de Milligan-Morgan. Métodos: Estudo prospectivo randomizado controlado foi desenhado envolvendo 200 pacientes com hemorroidas graus III e IV. Eles foram divididos em grupos de controle e observação. O controle recebeu operação de Milligan-Morgan, e o de observação procedimento de seleção de tecido modificado combinado com operação completa de preservação do canal anal. Todos os pacientes foram acompanhados por seis meses para avaliar as diferenças de tratamento. Resultados: No final, o grupo controle incluiu 82 e o de observação 87. O tempo médio de operação do grupo controle foi significativamente menor do que o de observação, enquanto o volume de sangramento foi significativamente menor no grupo controle. O escore VAS do grupo controle foi 3 (1, 4) e no de observação 4 (2, 5). Não houve diferença significativa na incidência de retenção urinária, sangramento e edema da margem da ferida no pós-operatório de um mês. A incidência de estenose anal digital no grupo observação foi significativamente menor do que no controle; o mesmo ocorreu com as margens anais residuais. O diâmetro do canal anal pós-operatório foi significativamente maior nele do que o grupo controle. A pontuação de incontinência anal de Wexner mostrou que nenhuma incontinência ocorreu em ambos os grupos, e a pontuação do grupo de controle foi significativamente maior do que no de observação. Nos últimos seis meses de acompanhamento, o grupo observação não teve nenhuma recaída e quatro casos foram encontrados entre os controles. A satisfação com o tratamento do grupo observação foi maior. Conclusões: Nas hemorroidas graus III e IV, o tratamento de seleção de tecido modificado combinado com a preservação completa do canal anal teve melhor prognóstico e satisfação do que com o procedimento de Milligan-Morgan, e é um novo método cirúrgico para pacientes com hemorroidas mistas avançadas.

Effect of preoperative intervention of electroacupuncture at point on postoperative complications of procedure for prolapsed and hemorrhoids / 中国针灸

OBJECTIVE@#To explore effective treatments that can alleviate postoperative complications in patients with procedure for prolapsed and hemorrhoids (PPH).@*METHODS@#Sixty patients with pre-mixed hemorrhoids PPH were randomly divided into a simple operation group and a preoperative electroacupuncture intervention group, 30 cases in each group. PPH routine treatment was given in the simple operation group. Electroacupuncture (EA) was applied at point 30 min before PPH in the preoperative electroacupuncture intervention group, and EA was applied at Ciliao (BL 32) and Xialiao (BL 34) for 30 min. The scores of anus pendant, pain degree and persistent time and first urination time were compared within 24 h after operation between the two groups.@*RESULTS@#The scores of anal pendant and pain degree in the 6 h, 12 h, 18 h, the persistent time of anal pendant and pain degree within 24 h and first urination time were better in the preoperative electroacupuncture intervention group than those in the simple operation group, and there were statistically significant differences (all <0.05).@*CONCLUSION@#Electroacupuncture at point 30 min before PPH can not only decrease the degrees of anal pendant and pain in the 6 h, 12 h, 18 h, but also shorten the persistent time of anal pendant and pain within 24 h after surgery and promote the first urination.

Effect of electroacupuncture preconditioning with different frequencies on anal pain after milligan-morgan hemorrhoidectomy / 中国针灸

OBJECTIVE@#To compare the effect of electroacupuncture preconditioning with different frequencies on anal pain after milligan-morgan hemorrhoidectomy.@*METHODS@#A total of 120 patients with mixed hemorrhoids were randomly divided into an electroacupuncture group A (dilatational wave, 2 Hz/100 Hz in frequency), an electroacupuncture group B (continuous wave, 2 Hz in frequency) and an electroacupuncture group C (continuous wave, 100 Hz in frequency), 40 cases in each group. Electroacupuncture at Xialiao (BL 34) and Chengshan (BL 57) was applied with tolerant intensity for 30 min before operation in all groups. The number of additional anesthetic drugs in the 3 groups, the visual anal pain score (VAS) and limb activity score at 4, 12, and 24 h after operation, the maximum VAS score within 24 h after surgery and oral dose of aminophenol dihydrocodeine were compared.@*RESULTS@#The number of additional anesthetic drugs in the electroacupuncture group A, the electroacupuncture group B and the electroacupuncture group C were 4, 5, 4 respectively, and there was not statistically significant (>0.05). There was no significant difference in the anal pain VAS score and limb activity score at 4 h after operation among the 3 groups (>0.05), at the 12 h after operation, the VAS scores and limb activity scores in the electroacupunctures group A and B were lower than those in the electroacupuncture group C (<0.05), at 24 h after operation, the VAS score and limb activity score in the electroacupuncture group A were lower than those in the electroacupuncture group B and C (<0.05), the maximum VAS score within 24 h and oral dose of aminophenol dihydrocodeine within 24 h after operation in the electroacupuncture group A were lower than those in the electroacupuncture group B and C (<0.05).@*CONCLUSION@#Different frequency electroacupuncture preconditioning has the effect of alleviating anal pain after milligan-morgan hemorrhoidectomy. The analgesic effect of electroacupuncture with different frequencies is different. The electroacupuncture analgesic effect of 2 Hz /100 Hz dilatational wave is better than 2 Hz and 100 Hz continuous waves.

Segmental resection combined with anoplasty for the treatment of circumferential mixed hemorrhoids

Circumferential mixed hemorrhoids are very difficult to treat non-surgically. Therefore, it is important to explore the surgical methods for its complete resolution as well as maintenance of normal anal anatomy and function. The present study was designed to evaluate the effect of segmented and plastic hemorrhoidectomy (SPH) on patients with circumferential mixed hemorrhoids. A total of 300 patients with circumferential mixed hemorrhoids were divided into experimental group (n=150) undergoing SPH and control group (n=150) undergoing Milligan-Morgan hemorrhoidectomy. There were no differences in cure and effectiveness rates between two groups. Compared with the control group, patients in the experimental group had shorter healing time (15.7±1.3 vs 12.5±0.7 days) and recovery to normal activity (18.5±2.7 vs 14.7±1.2 days). In addition, anal function of all patients in the experimental group was normal during short- and long-term follow-up. However, more cases in the control group showed anal dampness and itching, and poor control of intestinal liquid. Compared with the control group, patients in the experimental group had better outcomes in overall anal function and smoothness at 6, 12, and 18 months after operation as well as patient satisfaction. Furthermore, the rating in the visual analogue scale for defecation pain and edema in the experimental group was less than that in the control group. SPH was more effective, had fewer complications, better protection of anal function, and a better cosmetic result.

The clinical effect of RPH combined with Milligan versus that of PPH in treatment of severe mixed hemor-rhoids / 实用医学杂志

Objective To compare the clinical effects of RPH combined with Milligan and PPH in the treatment of severe mixed hemorrhoids. Methods 168 patients with severe mixed hemorrhoids were assigned to a study group or a control group,84 patients for each group. The control group received PPH therapy,while the study group received RPH combined with Milligan procedure. Results The procedures were completed successfully in all the patients. The postoperative hospital stay and surgical duration were shorter and the amount of bleeding was smaller in the study group than in the control group(P<0.05). Three months after surgery,the rate of compli-cations including urinary retention,anal incontinence,anorectal stenosis,and secondary anal fissure was lower in the study group than in the control group(P < 0.05). The total effective rate was 97.6% in the study group and 85.7% in the control group,with a higher rate in the study group(P<0.05). Anal PSV and EDV values were lower in both groups three months after the procedures as compared with one day before the procedures(P<0.05),and the values were smaller in the study group than in the control group(P<0.05). Conclusions Milligan combined with RPH in the treatment of severe mixed hemorrhoids can reduce hemorrhoids blood flow. This procedure is mini-mally invasive and it can reduce the development of postoperative complications and improve efficacy.

Comparison of curative effect between tissue-selecting therapy stapler and procedure for prolapse and hemorrhoids for stage Ⅲ and Ⅳ hemorrhoids / 国际外科学杂志

Objective To compare the curative effect of tissue-selecting therapy stapler and procedure for prolapse and hemorrhoids in the treatment of patients with stage Ⅲ to Ⅳ hemorrhoids.Methods The patients with stage Ⅲ to Ⅳ hemorrhoids who underwent prolapse and hemorrhoids or tissue-selecting therapy stapler surgery in the department of General Surgery,Shanghai Ninth People's Hospital and Xinhua Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Chongming Branch,from Jan.2013 to Jun.2014 were accepted and allocated to prolapse and hemorrhoids or tissue-selecting therapy stapler group.The peri-operative parameters about operative time,blood loss,postoperative hospital stay and the time required to return to normal activity were compared by t test,The postoperative complications including pain assessment and the incidence of postoperative bleeding,urine retention,faecal urgency,fecal incontinence,anal stenosis,rectovaginal fistula and recurrence rate were compared by t test and chi-square test.Rank sum test was used to compare the recurrence rate and patient's satisfaction between the two groups.Results The operation time,intraoperative bleeding volum,postoperative hospital stay and the time required to return to normal activity in the procedure for prolapse and hemorrhoids group were signifcantly higher than those in the tissue-selecting therapy stapler group (P =0.021,P =0.003,P =0.001,P ＜0.001).The pain score of procedure for prolapse and hemorrhoids group were all higher than those of the tissue-selecting therapy stapler group in the first post-operative defecation and in post-operative 24 hours and 72 hours (all P ＜ 0.001).The incidence of faecal urgency of the procedure for prolapse and hemorrhoids group in post-operative 1 month (18.6％) was higher than that of the tissue-selecting therapy stapler group (6.6％) (P =0.036).There were no statistically significant differences in the incidence of postoperative bleeding,urinary retention,recurrence rate and patient's satisfaction between two group (P ＞ 0.05).Conclusion Tissue-selecting therapy stapler was superior to the procedure for prolapse and hemorrhoids in operation time,intraoperative blood loss,postoperative pain and the incidence of faecal urgency.Long-term results demonstrate that tissue-selecting therapy stapler and prolapse and hemorrhoids have similar effectiveness.

Relief effects of Compound Carraghenates Cream on edema and pain after mixed hemorrhoid surgery / 中国生化药物杂志

Objective To observe the clinical effects of compound carraghenates cream on edema and pain after mixed hemorrhoid surgery. Methods 180 cases of patients with mixed hemorrhoids divided into the observation group and the control group, 90 cases in each group according to the random number table method. The control group was treated with Vaseline oil gauze to cover wounds after operation, and the observation group was treated with compound carraghenates cream after operation. The clinical efficacy, VAS pain score , the edema symptom scores and the pain relief time, edema symptom relief time, the wound healing time ,untoward effect were compared and observed after treatment between the two groups. Results The total effective rate of treatment in the observation group was significantly higher than that in the control group (95.56％ vs 85.56％) (P<0.05). The VAS pain scores of the observation group on the 1st day, 3rd day and 7th day after treatment were significantly lower than those of the control group (P<0.05), and the edema symptom scores on the 3rd day and 7th day after treatment were significantly lower than those of the control group (P<0.05). The time for pain relief, the time for edema relief and the wound healing time in the observation group were significantly shorter than those in the control group (P<0.05). Conclusion Compound carraghenates cream can effectively relieve edema and pain after mixed hemorrhoid surgery, and it also can shorten the course of disease and promote wound healing with safety.

Comparison of curative effect between tissue-selecting therapy stapler and procedure for prolapse and hemorrhoids for stage Ⅲ and Ⅳ hemorrhoids / 国际外科学杂志

Objective To compare the curative effect of tissue-selecting therapy stapler and procedure for prolapse and hemorrhoids in the treatment of patients with stage Ⅲ to Ⅳ hemorrhoids.Methods The patients with stage Ⅲ to Ⅳ hemorrhoids who underwent prolapse and hemorrhoids or tissue-selecting therapy stapler surgery in the department of General Surgery,Shanghai Ninth People's Hospital and Xinhua Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Chongming Branch,from Jan.2013 to Jun.2014 were accepted and allocated to prolapse and hemorrhoids or tissue-selecting therapy stapler group.The peri-operative parameters about operative time,blood loss,postoperative hospital stay and the time required to return to normal activity were compared by t test,The postoperative complications including pain assessment and the incidence of postoperative bleeding,urine retention,faecal urgency,fecal incontinence,anal stenosis,rectovaginal fistula and recurrence rate were compared by t test and chi-square test.Rank sum test was used to compare the recurrence rate and patient's satisfaction between the two groups.Results The operation time,intraoperative bleeding volum,postoperative hospital stay and the time required to return to normal activity in the procedure for prolapse and hemorrhoids group were signifcantly higher than those in the tissue-selecting therapy stapler group (P =0.021,P =0.003,P =0.001,P ＜0.001).The pain score of procedure for prolapse and hemorrhoids group were all higher than those of the tissue-selecting therapy stapler group in the first post-operative defecation and in post-operative 24 hours and 72 hours (all P ＜ 0.001).The incidence of faecal urgency of the procedure for prolapse and hemorrhoids group in post-operative 1 month (18.6％) was higher than that of the tissue-selecting therapy stapler group (6.6％) (P =0.036).There were no statistically significant differences in the incidence of postoperative bleeding,urinary retention,recurrence rate and patient's satisfaction between two group (P ＞ 0.05).Conclusion Tissue-selecting therapy stapler was superior to the procedure for prolapse and hemorrhoids in operation time,intraoperative blood loss,postoperative pain and the incidence of faecal urgency.Long-term results demonstrate that tissue-selecting therapy stapler and prolapse and hemorrhoids have similar effectiveness.

Clinical Study of Abdominal Acupuncture in Relieving Postoperative Pain of Patients with Mixed Hemorrhoid After Milligan-Morgan Hemorrhoidectomy / 广州中医药大学学报

Objective To observe the curative effect of abdominal acupuncture on postoperative pain of patients with mixed hemorrhoid after Milligan-Morgan hemorrhoidectomy.Methods A total of 100 mixed hemorrhoid patients with postoperative pain after Milligan-Morgan hemorrhoidectomy under spinal anaesthesia from September of 2014 to December of 2015 were included into the study.The patients were evenly randomized into trial group and control group.The trial group was treated with abdominal acupuncture at acupoints of Shuifen,Guanyuan,Qihai,Sanxing needles under Qihai,lower Fengshi,Tianshu for 15-30 min.The control group was treated with intramuscular injection of Tramadol Injection 0.1 g.Before treatment and 0.5,1,2,3 hours after treatment,the pain visual analogue scale (VAS) scores and body activity scores were recorded.Results (1) After treatment,pain VAS scores of the two groups at different time points were obviously decreased(P ＜ 0.05 compared with those before treatment),and the decrease of pain VAS scores of the treatment group 0.5 hours after treatment was superior to that of the control group (P ＜ 0.05),but there was no significant difference between the two groups at other time points (P ＞ 0.05).(2) After treatment,body activity scores of the two groups at different time points were obviously decreased(P ＜ 0.05 compared with those before treatment),but the difference was insignificant between the two groups(P＞ 0.05).(3) The average dose of Tramadol Injection used in the trial group was 0.013 ± 0.034 1 g,while was 0.103 ± 0.017 7 g in the control group,the difference being significant (P ＜ 0.05).Conclusion The analgesic effect of abdominal acupuncture is similar to that of Tramadol Injection.For its safety,and being cheap,practical and painless,abdominal acupuncture can be expected to be another option of effective analgesic method for the postoperative pain of patients with mixed hemorrhoid after Milligan-Morgan hemorrhoidectomy.

Clinical observation on anal pendant expansion after PPH of mixed hemorrhoid treated with acupuncture at Xialiao (BL 34) and Changqiang (GV 1) / 中国针灸

<p><b>OBJECTIVE</b>To compare the difference in the clinical efficacy on anal pendant expansion after PPH (procedure for prolapse and hemorrhoids) of mixed hemorrhoid between acupuncture at Xialiao (BL 34) and Chang-qiang (GV 1) and oral administration of diosmin.</p><p><b>METHODS</b>Sixty cases of mixed hemorrhoids after PPH were randomized into an observation group and a control group, 30 cases in each one. In the observation group, since the 1st day, acupuncture had been applied to Xialiao (BL 34) and Changqiang (GV 1). The needles were retained for 30 min afterarrival, and the treatment was given once a day, totally for 7 days. In the control group, diosmin tablets had been prescribed for oral administration since the 1st day, 0.9 g each time, twice a day, totally for 7 days. The degree, persistent time and the pain score of anal pendant expansion were compared on the 1st, 2nd, 3rd and 7th days after PPH between the two groups and the efficacy was evaluated.</p><p><b>RESULTS</b>On the 1st day after PPH, the diffe-rences in the scores of the degree and persistent time of anal pendant expansion were not significant statistically between the two groups (all>0.05), but the pain score in the observation group was lower than that in the control group (<0.05) and lower than that before treatment (<0.05). On the 2nd, 3rd and 7th days after PPH, the degree and persistent time of anal pendant expansion and pain score in the two groups were all lower than those before treatment (all<0.05). The results in the observation group were better than those in the control group (all<0.05). At the end of treatment (on the 7th day after PPH), the total effective rate in the observation group was higher than that in the control group[90.0% (27/30) vs 83.3% (25/30),<0.05].</p><p><b>CONCLUSIONS</b>Acupuncture at Xialiao (BL 34) and Changqiang (GV 1) achieves the superior efficacy on anal pendant expansion after PPH of mixed hemorrhoids as compared with diosmin tablets.</p>

Clinical observation of the segmented external dissection and internal ligation and leather bridge ligation plastic surgery in treatment of circumferential mixed hemorrhoids / 中国医师进修杂志

Objective To observe the effect of segmented external dissection and internal ligation and leather bridge ligation plastic surgery in treatment of circumferential mixed hemorrhoids. Methods One hundred and twenty patients with circumferential mixed hemorrhoids were enrolled in this study, and they were divided into observation group and control group according to operation methods, with 60 cases in each group. The patients in two groups were treated with segmented Milligan-Morgan. The patients in observation group were treated with leather bridge ligation plastic surgery, and the patients in control group were treated with slit skin bridge plastic surgery. Postoperative complications and effect were observed. Results The pain scores on the first day and the third day after operation in two groups had no significant differences (P>0.05). On the seventh day after operation, the pain scores in observation group was significantly better than that in control group (P 0.05). The number of broken leather bridge in observation group was significantly shorter than that in control group (P<0.01). The healing time in the observation group was significantly shorter than that in control group:(24.0 ± 3.6) d vs. (29.6 ± 4.70) d, t =- 6.05, P<0.01. Conclusions Segmented external dissection and internal ligation and leather bridge ligation plastic surgery in treatment of circumferential mixed hemorrhoids is safe and easy to operate, and it has a significant clinical effect.

Comparative study of aescuven forte tablets oral at preoperative or postoperative in the prevention of procedure for prolapse and hemorrhoids complications / 中国综合临床

Objective To evaluate the effect of preoperative aescuven forte tablets in the prevention of procedure for prolapse and hemorrhoids(PPH) complications.Methods One hundred and seventy-nine patients underwent PPH in the Erlonglu Hospital of Beijing from June 2013 to June 2014 were divided into postoperative aescuven forte tablets group (n =90) and preoperative aescuven forte tablets group (n =89).The postoperative pain,bleeding,retention of urine,anal swelling,length of stay in hospital and recurrence were compared between the two groups.Results The incidence of postoperative pain,bleeding,retention of urine,anal swelling were lower than in the preoperative aescuven forte tablets group (pain after operations rate:7.9％ (7/89) vs.20.0％ (18/90),x2 =5.484,P＜ 0.05;Wound bleeding:0 vs.6.7 ％ (6/90),P =0.026;retention of urine:9.0％ (8/89) vs.20.0％(18/90),x2 =4.370,P＜0.05;anal swelling:1.1％(1/89) vs.8.9％(8/90),P=0.035),and length of stay in hospital was shorter(11.9±3.9) d vs.(13.3 ±5.0) d,t=3.134,P＜0.05).There was no recurrence both of two groups follow up for more than 2 months.Conclusion Preoperative oral aescuven forte tablets of 2 h can reduce PPH complications and worthy of popularization and application.

Contrast analysis of Milligan-Morgan and Ligasure mixed hemorrhoids surgery under local anesthesia / 重庆医学

Objective To investigate the clinical curative effect of Milligan‐Morgan and Ligasure blood vessels closed system for conducting mixed hemorrhoidectomy under local anesthesia .Methods 68 inpatients with mixed hemorrhoid in the general sur‐gery department of our hospital from April 2009 to April 2012 were selected and randomly divided into the Ligasure group (observa‐tion group ,34 cases) and the Milligan‐Morgan group (control group ,34 cases) .The operation adopted the local infiltration anesthe‐sia .The postoperative followed up lasted for 6‐36 months .The operation time ,intraoperative blood loss ,total hospitalization cost , postoperative hospital stay time ,postoperative pain degree and the postoperative complications were compared between the two groups .Results The average operation time in the control group and the observation group was (32 .35 ± 10 .24)min and (20 .29 ± 7 .88) min(P=0 .000) ,the average intraoperative blood loss was (29 .71 ± 14 .67)mL and (4 .97 ± 2 .89) mL(P=0 .000) ,the aver‐age postoperative pain score was (5 .88 ± 1 .12) points and (3 .47 ± 0 .83) points(P=0 .000) ,the average postoperative hospital stay time was (7 .97 ± 2 .55) d and (2 .29 ± 1 .17) d(P=0 .000) ,and the average hospitalization expense was (1 541 .32 ± 205 .91) Yuan and (2 872 .32 ± 652 .30) Yuan ,respectively ,the differences between the two groups were statistically significant (P=0 .000) .Dur‐ing the hospitalization period and follow‐up ,the anal exudation rate and the average postoperative pain score in the control group were higher than those in the observation group(P=0 .000) ,the occurrence rate of other complications had no statistically signifi‐cant differences between the two groups .Conclusion The Ligasure operation mode has less intraoperative blood loss ,shorter opera‐tion time and shorter postoperative hospital stay time .

Observation of the effect of procedure for prolapse and hemorrhoids and selective Milligan-Morgan hemorrhoidectomy in surgical treatment of Ⅲ ～ Ⅳ stage hemorrhoids / 中国基层医药

Objective To compare the clinical outcome of procedure for prolapse and hemorrhoids (PPH) and PPH + selective Milligan-Morgan hemorrhoidectomy(MMH) in surgical treatment of Ⅲ ～ Ⅳ stage hemorrhoids and research the best surgical procedures.Methods Retrospective analysis was made on the clinical data of 125 cases with Ⅲ ～ Ⅳ stage mixed hemorrhoids,they were non-randomized-controlled divided into PPH group (group 1) and PPH + selective MMH group(group 2),comparing the data of recurrence,complication and symptoms relief including anal prolapse,bleeding,anus fall feeling,wet anus and pruritus ani.Results While observing 3 years after operation,group 1 and group 2 both relieved symptoms of anal prolapse,bleeding,anus fall feeling,wet anus and pruritus ani.The relief rate of these symptoms in the two group were all high than 92%.There was one cases relapsed in the group 2 (the recurrence rate of 2%) was better than the group 1 (the recurrence rate of 13%) which were 8 case,there was a significant statistical significance (x2 =4.629,P ＜ 0.05) in the recurrence and clinical outcome.Conclusion Radical choose of PPH and selective MMH to treat Ⅲ ～ Ⅳ stage mixed hemorrhoids patients,which could relieve postoperative symptoms and acquire better long-term clinic outcomes.

Clinical Effect Observation and Cost-effectiveness Analysis on Different Operation Types of Ring Mixed Hemorrhoids Treatment / 世界科学技术-中医药现代化

This study was aimed to compare clinical effect and safety of ring mixed hemorrhoids treatment with pro-cedure for prolapsed and hemorrhoids (PPH) and Milligan-Morgan (M-M) in order to evaluate their effects of health economics. Retrospective analysis was given on clinical data of 100 cases (including 48 cases in P group, 52 cases in M group) which met the inclusion criteria from June 2008 to June 2010 in the Affiliated Hospital of Luzhou Med-ical College. Statistical analysis was made on short- and long-term effect, patient satisfaction, perioperative and postoperative complications of two groups. The cost-effectiveness was analyzed with the effect of health economics methods. The results showed that there was no obvious difference on short-term effect between two groups. However, aspects such as surgery time, hospitalization time, back to work time, duration of pain, bleeding condition, postopera-tive pain and anal swelling in P group were significantly better than M group (P< 0.05); long-term effect and cost-effectiveness in M group were obviously better than P group (P < 0.05). There was no obvious difference on inci-dence rate of adverse reaction between two groups. It was concluded that the traditional external dissection and inter-nal ligation for circumferential mixed hemorrhoids had better clinical effect of both short- and long-term with better cost-effectiveness. It is still a better surgical treatment for circular mixed hemorrhoids.

Long-term efficacy and safety of PPH plus partial internal anal sphincterotomy for severe mixed hemorrhoids / 重庆医学

Objective To observe and evaluate the long-term efficacy and safety of PPH plus partial internal anal sphincterotomy for severe mixed hemorrhoids .Methods Choose 103 patients who were diagnosed with severe mixed hemorrhoids from May 2008 to May 2010 .Then divided these patients into the experimental group of 52 patients and the control group of 51 patients ,randomly . The patients of experimental group were treated by PPH plus partial internal anal sphincterotomy ,and the patients of control group were treated by the simple PPH operation .Have a postoperative followed up for 24 months to check and compare the long-term ef-ficacy and safety of two groups .Results The incidence of prolapse recurrence ,anus pain and hemafecia in experimental group were significantly lower than that in control group(P0 .05) .Conclusion The therapy of the PPH plus partial internal anal sphincterotomy for severe mixed hemorrhoids can significantly reduce the recurrence ,and improve the long-time efficacy ,but not to increase additional risk .