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首页> 中文期刊> 《浙江临床医学》 >痔出血致重度贫血临床分析

痔出血致重度贫血临床分析

         
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Objective To?investigate?the?clinical?features?and?diagnosis?and?treatment?of?severe?anemia?caused?by?hemorrhoid?hemorrhage.?Methods The?clinical?characteristics?and?therapeutic?effects?of?31?patients?with?severe?anemia?caused?by?hemorrhoid?hemorrhage?were?retrospectively?analyzed?from?May?2012?to?May?2018.?Results All?patients?were?mixed?hemorrhoids(grade?II-IV?internal?hemorrhoids),22?males?and?9?females,aged(36.91±11.32)years,BMI(23.01±3.41)kg/m2,all?of?them?were?small?cell?hypochromic?anemia.?Seventeen?cases?of?circular?mixed?hemorrhoids?were?treated?with?stapler?hemorrhoidectomy(PPH)combined?with?hemorrhoidectomy,and?14?cases?with?mixed?hemorrhoids?were?treated?with?external?stripping?and?internal?ligation.?Short-term?observation:?operation?time(59.52±17.89)minutes;postoperative?wound?bleeding?in?2?cases;postoperative?hemorrhage?in?1?case;postoperative?urinary?retention?in?2?cases;total?hospitalization?time(7.16±3.10)days, including?postoperative?hospitalization?time(2.87±1.79)days;wound?healing?time(2.63±0.84)weeks.?Long?term?follow-up:recurrence?of?hemorrhoids?in?6?cases,mild?treatment?without?treatment,anal?stenosis?in?1?cases,recurrent?massive?hemorrhage?in?1?cases.?There?were?no?deaths.?Conclusion? Hemorrhoid?hemorrhage?caused?by?severe?anemia?mostly?mixed?hemorrhoids,small?cell?hypochromic?anemia,more?men?than?women, mostly?young?and?middle-aged,BMI?normal?high.?According?to?the?shape?of?hemorrhoids?PPH?or?mixed?hemorrhoids?exfoliation?and?internal?ligation?can?achieve?good?results,postoperative?reasonable?diet?can?prevent?recurrence.?Hemorrhoid?bleeding?should?be?paid?attention?to?and?treated?early?to?avoid?serious?complications?and?improve?the?quality?of?life.%目的 探讨痔出血致重度贫血的临床特点及诊疗方案.方法 回顾性分析2012年5月至2018年5月31例痔出血致重度贫血患者的临床特点及治疗效果.结果 所有患者均为混合痔(Ⅱ~Ⅳ度内痔),男22例,女9例;年龄(36.91±11.32)岁.BMI(23.01±3.41)kg/m2,均为小细胞低色素性贫血.17例环状混合痔行吻合器痔上黏膜环切术(PPH)联合痔切除术,14例行混合痔外剥内扎术.近期观察:手术时间(59.52±17.89)min;术后创面渗血2例;术后大出血再次手术1例;术后尿潴留2例;总住院时间(7.16±3.10)d,其中术后住院时间(2.87±1.79)d;创面愈合时间(2.63±0.84)周.远期随访:痔复发6例,症状轻均无需处理;肛管狭窄1例;再发大出血1例.无死亡病例.结论 痔出血致重度贫血多为混合痔,小细胞低色素性贫血,男性多于女性,多为中青年,BMI值正常偏高.根据痔的形态行PPH或混合痔外剥内扎术可获得良好疗效,术后合理膳食可预防复发.痔出血应早重视,早治疗,避免严重并发症,提高生活质量.

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