Zuber Thomas J
Saginaw Cooperative Hospital, Michigan, USA.
Am Fam Physician. 2002 Apr 15;65(8):1629-32, 1635-6, 1639.
External hemorrhoids represent distended vascular tissue in the anal canal distal to the dentate line. Persons with thrombosed external hemorrhoids usually present with pain on standing, sitting or defecating. Acutely tender, thrombosed external hemorrhoids can be surgically removed if encountered within the first 72 hours after onset. Hemorrhoidectomy is performed through an elliptic incision over the site of thrombosis with removal of the entire diseased hemorrhoidal plexus in one piece. Caution must be exercised to avoid cutting into the muscle sphincter below the hemorrhoidal vessels. Infection after suture closure is rare secondary to the rich vascular network in the anal area. Stool softeners must be prescribed postoperatively to help prevent tearing at the suture line. Training and experience in general and skin surgery are necessary before the physician attempts this procedure unsupervised.
外痔是指齿状线远侧肛管内扩张的血管组织。患有血栓性外痔的人通常在站立、坐下或排便时出现疼痛。急性压痛的血栓性外痔如果在发病后72小时内发现，可通过手术切除。痔切除术通过在血栓部位做椭圆形切口进行，将整个病变的痔丛整块切除。必须小心避免切入痔血管下方的肌肉括约肌。由于肛门区域丰富的血管网络，缝合后感染很少见。术后必须开大便软化剂以帮助防止缝线处撕裂。在医生尝试在无监督的情况下进行此手术之前，必须具备普通外科和皮肤外科的培训及经验。
