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一、一般治疗 (1)卧床休息,可给镇静剂;(2)给少渣流质饮食,如出现休克或准备急诊手术时,则需禁食,予以输液;(3)如出血量超过400ml以上,血红蛋白下降,应予输血;(4)根据出血和凝血机制情况,给予止血药;(5)静脉补液,维持水、电解质平衡;(6)应用抗生素,在肠道炎性疾病合并出血时,如混合痔感染、溃疡性结肠炎急性发作,可给庆大霉素或氨苄青霉素等。二、疾病的病因治疗确定出血部位和病变性质后,需手术者术前应考虑是否有多个病灶同时存在,如痔疮伴有直肠癌,直肠癌呈多位性等。 1.肛裂:对出血的肛裂用0.3%的美兰加0.3%丁卡因混合液,在肛裂基底部封闭注射2～3ml即可止痛止血。对顽固出血的肛裂,要将溃疡连同哨兵痔作棱形切除,清除肛裂底部的坏死组织,并在肛管后方正中线上,作外括约肌皮下环形垂直切开。切口周围皮内注射长效麻醉剂,创面不缝合,塞入抗生素纱布,用丁字带压迫止血。
First, the general treatment (1) bed rest, can be sedatives; (2) to give less fluid diet, such as shock or emergency surgery, you need to fasting, to be transfusion; (3) If the amount of bleeding more than 400ml, Hemoglobin decreased, should be transfused; (4) according to the bleeding and coagulation mechanism, given hemostatic; (5) intravenous rehydration to maintain water and electrolyte balance; (6) the use of antibiotics in the intestinal inflammatory diseases with bleeding, such as Mixed hemorrhoids infection, acute attack of ulcerative colitis, gentamicin or ampicillin can be given. Second, the etiology of disease treatment to determine the bleeding site and the nature of the lesion, the operator should be considered before surgery whether there are multiple lesions exist, such as hemorrhoids associated with rectal cancer, polyposis and other rectal cancer. 1. Anal fissure: anal fissure bleeding with 0.3% Meilan plus 0.3% tetracaine mixture in the anal fissure base closed injection of 2 ~ 3ml to stop pain and stop bleeding. For stubborn bleeding anal fissure, the ulcer together with the Sentinel hemorrhoids for prismatic resection, remove the necrotic tissue at the bottom of the anal fissure, and in the midline of the anal canal after the midline, perpendicular to the external sphincter subcutaneous ring. Intradermal injection of long-acting anesthetic injection around the incision, the wound is not sutured, stuffed with antibiotic gauze, with T-strap compression to stop bleeding.