你老公的痔疮应该是属于Grade III.治疗建议是:1.Surgical Excision2.Stapled Anopexy

Grading: Internal Hemorrhoid

1. Grade I
   1. Present without prolapse
   2. Usually asymptomatic
2. Grade II
   1. Some prolapse with spontaneous regression
3. Grade III
   1. Prolapse with manual replacement
4. Grade IV
   1. Prolapse with inability to replace Hemorrhoid

Management: Approach

1. Grade I-II Internal Hemorrhoids
   1. Rubber Band ligation (Baron Ligation)
   2. Infrared Coagulation (IRC)
   3. Bipolar Electrocoagulation (BICAP)
   4. Low-Voltage direct current (Ultroid)
2. Grade III-IV Internal Hemorrhoids
   1. Stapled Hemorrhoidectomy (Stapled Anopexy)
   2. Surgical Excision (Hemorrhoidectomy)

Surgical Excision (Hemorrhoidectomy):

1. Most effective treatment to decrease recurrent symptoms in Grade III and IV Internal Hemorrhoids and mixed Hemorrhoids
2. Absence from work for up to 4-6 weeks (much longer than with Rubber Band ligation)
3. More painful post-operatively than Rubber Band ligation
4. Complications: Perianal Skin Tags, Perirectal Abscess, anal fistula, anal leakage, anal stenosis and bleeding

Stapled Hemorrhoidectomy (Stapled Anopexy):

1. Alternative management of Grade II to IV Hemorrhoids
2. Interrupts Hemorrhoid blood supply by removing proximal mucosa and submucosa
3. Staples are placed above the Dentate Line and bury into the mucosa over time
4. Revisions are required twice as often as with Hemorrhoidectomy
5. Common procedure in Europe
6. High rate of persistent complications (30%)
   1. Pain post-Defecation
   2. Fecal urgency
   3. Awareness of staples in the rectum for months after the procedure
   4. Bleeding at the staple site

Management: Postoperative analgesia:

1. NSAIDs
2. OpioidAnalgesics
3. Compounded preparations that offer post-operative analgesia
   1. Metrogel 10% applied topically three times daily
   2. Glyceryl Trinitrate ointment 0.2% applied twice daily
   3. Topical Nifedipine 0.3% and Lidocaine 1.5% ointment applied twice daily

来源: http://www.fpnotebook.com/GI/Rectum/IntrnlHmrhd.htm

 

 

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• thanks -kwx- ♀ (0 bytes) () 02/07/2012 postreply 17:09:12