肛周脓肿手术前后
2014年7月因长期饮用高度酒诱发三颗外痔肿痛,自用马应龙“三剑客”配合用药一周后恢复正常无痛;到了2020年1月内痔间断便血至2月底,3月6日又发现肛周脓肿,活了半辈子还是第一次挂掉瓶打消炎针,三天消炎针后虽然缓解疼痛但病灶未除。多方询求治疗方法,3月12日经同事亲身体验介绍后联系好了云南赵树生肛肠病医院,3月13日从早上准备到路途颠簸(半躺在微型面包车后直排座椅上)直到下午3:00住进313病房待诊,准备好了人生中的第一次小手术和打病假住院治疗。
2020年3月14日9:30上了手术台后,先询问一下病情,发现肛周有个小孔后再询问,我如实描述多年就一直伴随着的小孔后,诊断是肛瘘,这次的浓肿就是因其併发……开始手术第一步打麻醉,方法是把肛门扩张后在里面注射麻药,要在那里手术就打那里,打了好几处,打麻药时很疼,过后变成了胀不是疼,这个胀比疼好受多了……10:30做完了“肛瘘遂道式切除根治术+脓肿根治术+外痔分段切除术+肛门整形术”手术,主刀医生是肛肠病老专家赵树生,手术很成功,就是说我这个不是简单的痔疮手术,是2005年就形成的的老肛瘘併发脓肿,住院换药时间会长,需要一段时间的住院换药观察,痊愈后两个月内再打针根治内痔……
专业手术特色,打破传统引流方法,在长效麻醉下从内到外做根治术,只感觉胀而无痛,减少手术痛苦。
【住院观查与治疗换药】
住院治疗方法:改良传统手术方法和术后治疗方式,不打点滴,少用消炎防感染抗生素,采用专利药物辅助手术后继续注入脓腔消除腐肉,加强运动和营养,以加快长肉填满空腔等治疗方法,每天2~3次专业精心护理,清洗分泌物和换药以杜绝病灶感染,重点是用药物吸收方法根除肛周组织脓毒,坚持三周以上坐药物浴盆消肿消炎杀菌,避免二次感染。
2020年3月15日赵院长亲自检查换药,16日主管高医生换药改为引流管,17日主治赵医生解决几天不解大便的便秘问题,掏粪及灌肠终于把因前期消炎药消炎针导致胃寒便秘问题解决了。18日经过昨天赵医生精心处理,今天恢复正常大便了,赵医生第4次换药,叮嘱要加强营养和步行运动,加快脓腔组织的康复。
总结长期康复临床经验,痔疮手术一般满两周,第15天可以康复出院;肛周脓肿手术一般满三周,第22天可以康复出院。
病情变化细节:3月18日15:00第一次出现刺痛感,之后17:00第二次17:30第三次,每次持续几分钟,18:00口服止痛药休息。21:30换药时发现流脓和其它分泌物,在护士的清洗伤口时适当挤压流了不少,当晚就不再有刺痛感了。
3月19日赵医生第5次换药,又加了点麻药,防止疼痛。开始第1次坐浴高锰酸钾。
3月20日高主管第6次换药,为了快速康复,又重新增加5次微波照射。高医生强调脓腔肉慢慢长起来,脓液会减少就不会疼痛了,麻药用多了会影响长肉。
3月21日高医生慈母般呵护换了第7次药,晚上换药的护士也学会了象高医生一样的方法减轻换药疼痛。
3月22~23日第8、9次换药,高医生检查伤口及肛周是否疼痛,伤口康复了许多,分泌物减少,创面有点大,还要继续换药治疗……
3月24日另一个主治医师黄医生来检查康复情况,总体而言康复治疗良好,有点水肿,坐浴时可用50克淡盐水消肿,5天后看缝线自然脱落情况,会越来越好,坐立走都会感觉一身轻松……
3月26日赵树生院长检查康复情况并进行了第12次换药,说手术时为了方便解手就多留了一点皮肤,现轻微水肿,慢慢会消掉变小不影响什么,伤口愈合正常,还观察几天就可以出院了……
3月28日刚好手术后满两周,第14次换药,高医生检查认为缝线还有长线没有脱落,伤口还有几天才会完全愈合,这几天就是伤口正在快速愈合,发出了痒的信号,行动方便,一切向好。高医生要求在手术后20天做全面复查或出院。
4月3日刚好手术后第20天,高医生最后一次换药检查说是恢复得很好,稍微有点水肿,下午办理出院手续,出院后继续坐浴治疗一周就可以痊愈,两个月后再来复查或打内痔针。
4月6日手术后第23天,按出院医嘱开始为期三天的伤口处硫软膏治疗,至少一周的下班后食盐高锰酸钾坐浴,外瘘中药膏捈摩、睡前中药粉坐浴。6月份回医院复查或内痔打针治疗。
【出院到家自我护理】谨遵医嘱继续坚持每天一到两次坐浴高锰酸钾浸泡,先发现手术创口有微量浸血现象,按要求第23~25天连续三天坐浴后睡前外用硫软膏涂抹手术创口处,到了手术后第28天满四周时,发现创口基本愈合并无浸血现象、老肛瘘开口彻底愈合不复流浓现象、第三周水肿处明显减小并且可以塞进肛门内、没有汾泌物和无痛痒感觉。
天佑好医生,天佑康复,阿弥陀佛!
【病史】2005年发现肛周脓肿,但自己不知道是“肛周脓肿”,以为是自己吃热了长个小浓包,就用针挑破引流而造成肛瘘后遗症,2020年3月6日再次发现肛周脓肿,经医生诊断,其实是肛瘘串到外面的症状,内部已形成了马蹄形凹槽脓肿积浓已久,只是这里少神经痛觉不易发现。
截止2020年3月做手术时已经是长达15年的肛瘘史,赵树生老专家手到病除,1个小时的根治手术成功解决15年的肛瘘隐患……手术后半年内老肛瘘口子愈合、无痛痒、不流脓,无症状但指诊还是能明显发现瘘管,并在高位又不易手术。换句话说,所谓的“肛瘘遂道式切除根治术”并没有根治。
2023年3月复查老肛瘘并陈述手术半年后复发症状,与手术前一样时不时就痛痒、流脓血,特别是夏天或吃牛羊肉后就会口子打开、痛痒、流脓血,院方经查手术记录认为对“肛瘘遂道式切除根治术”没有根治有一定责任,表示可以免费补做一次手术,适当收取一点药费就行了。但考虑手术风险及手术痛苦,决定改为用“肛瘘脓肿草本膏”治疗方案。2023年5月22日开始每天两次用药粉坐浴、外涂抹药膏、肛门内注射药膏、口服药丸,一周后肛瘘口子愈合,没有流脓血,也不发痒了,微信问孙老师还需要坐浴和注射肛门内药膏吗?医嘱:继续治疗一个疗程,必须彻底消除病灶,铲除病根,根治顽固老肛瘘。2023年5月29日继续每天一次治疗,目标是消除瘘管,彻底根治顽固老肛瘘。
【启示】生病不可怕,怕的是“好了伤疤忘了痛”。肛门附近有脓包千万不可小觑,这叫“肛周脓肿”,无论手术根治还是药物治疗都必须到专科医院专业救治,切莫自己简单排浓处理,这会埋下肛瘘隐患,引发新的肛周脓肿。
亚健康都是无知造成的“因小失大”,便秘问题是小,最后引发痔疮、脓肿、肛瘘是大,记得还是二十多年前的饮食饮酒无节制,“不吃水果、喝水少、运动少、饮食单一少纤维少维生素、便秘、口臭”、“过度使用电脑”、“久坐不动”等办公室综合症没有引起高度重视而埋下隐患……
[医嘱] 注意休息,加强营养,多吃黄色水果粗纤维饮食,保障通便,避免久坐久站,确保肛周微循环,注意个人卫生,改用冲洗器解手,加强运动,提高免疫力。
【常识】屁股长坐疮与夏季温度高导致局部温度升高,再加上血液循环差,卫生清洁措施做的不到位,出汗后没有及时换洗衣服,局部有细菌滋生等因素有很大关系,患者首先要祛除病因,针对中医理论中坐疮由湿热邪毒凝滞引发的因素,治疗时应该采取清热祛湿止痒的原则。
有很多人平时坐着的时候感觉自己的屁股疼,伴随着瘙痒的症状,检查可能会发现屁股出现红肿的疙瘩,这就是坐疮的症状了,临床中认为,这是金黄色葡萄球菌和表皮葡萄球菌感染毛囊或汗腺导致的一种急性化脓性感染。中医称坐疮这种疾病为疖肿,若不及时处理可能会长出更多。
一、屁股长坐疮的原因是什么?
治疗坐疮,首先要知道它的发病因素,在临床中总结认为屁股长坐疮的原因如:1、夏季温度高,很多人坐着导致局部温度升高,再加上血液循环差,就非常容易引起坐疮发生。2、卫生清洁措施做的不到位,比如有些人出汗后,没有及时换洗衣服,皮肤潮湿就会导致局部有细菌滋生,从而引起坐疮的症状。3、中医学认为,坐疮是因为局部有湿热邪毒凝滞所致。
二、有哪些治疗坐疮的方法?
屁股上长坐疮的患者,首先要祛除病因,同时外用针对性的药物治疗,针对中医理论中坐疮由湿热邪毒凝滞引发的因素,治疗时应该采取清热祛湿止痒的原则,可以内服的药物方剂是五味消毒饮,同时配合外用黄柏或苦参汤煎汤熏洗、坐浴,每次治疗20分钟,每日可使用2次。
屁股长坐疮的患者也可用五倍子末、冰片等药物来调糊涂于患处,每日可使用1次或2次。同时还可以外敷提毒生肌膏这种中成药来治疗,此药的作用是提毒生肌,清热利湿,散坚消肿,消淤止痛,化腐敛疮,可帮助患者迅速修复病变溃疡组织而达到治愈目的。
除了通过上述方法治疗外,屁股长坐疮的朋友们还应该做好其他各项护理措施,比如在平时要注意卫生清洁,出汗后要尽快清洁皮肤,保持皮肤干燥和通风,勤换洗内衣,同时避免吃辛辣和油腻的食物,经常坐着的朋友可垫上一张竹席,都能有效预防和治疗坐疮。
有什么样的坏习惯,就会有什么样的伤害。这次病变与自己几十年工作中长时间久坐不动有关。中医说不管任何活动,活动过度都会对身体产生不良的影响。在《黄帝内经》当中提到久视伤血、久行伤筋、久立伤骨、久坐伤肉、久卧伤气,即是说长久的任何动作对身体都会产生损害,坐的久对身体的局部是会产生影响的,具体如下:
1、由于长期的久坐,其周围组织会产生损伤,可出现坐骨结节周围的囊肿;
2、久坐会导致局部的血液循环不好,局部组织的抵抗能力下降,可出现痔疮、肛周脓肿、肛门周围湿疹的发生,甚至肛门周围皮脂腺感染形成疖肿。
因此,一定要避免久坐,长时间的坐在电脑桌前或者是有打麻将的习惯都是不好的,一般,建议坐1-2小时后,起来适当活动,促进局部血液循环,可避免很多疾病的发生,当发现肛门周围由于久坐而发生疮疡感染,一定要去正规的医院就诊,并进行正确的治疗。
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