I. Recommended hospitalization If after examination and diagnosis, it meets the indications for surgery, in order to facilitate postoperative observation of the condition, timely treatment, timely change of medication is recommended to be hospitalized, if you need to be hospitalized, please bring your daily necessities, food utensils, bidet and other items, in addition, those who have medical insurance should go to the lobby on the first floor of the outpatient clinic to register first, and then go to the inpatient department to pay the fee. Pre-operative Preparation Like other departments, anorectal department must do relevant laboratory tests before treatment, according to the test results to determine the nature of the disease, severity, urgency and danger, as well as the presence of other diseases or contraindications to surgery. The first and second days of admission for the preoperative routine examination time (in case of holidays postponed), routine examination includes: blood routine, blood coagulation four, stool routine + latent blood test, HIV + HCV + HBsAg, liver function, kidney function, etc., the biochemical examination requires patients to get up in the morning and fasting to draw blood, and if the examination of the urinary and reproductive systems, must hold urine. In the anal and intestinal specialties, due to the severity of the disease, the length of the operation, the age of the young and old, often need to take different anesthesia methods, the most commonly used clinical anesthesia methods are: local infiltration anesthesia, lumbar and hard anesthesia, pediatric anesthesia, and so on. If you take local anesthesia surgery before surgery, normal eating, empty bowel movement, cleaning the anus. If you take the lumbar and hard anesthesia painless surgery, anesthesia before the 6 hours of fasting, water, otherwise, easy to vomit and aspiration phenomenon. In addition, the urine and feces should be emptied before the operation, and those who can not be emptied need enema to avoid abdominal distension and urinary retention after the operation. Patients should not hide the history of serious medical diseases and drug allergies so as not to affect the doctor’s diagnosis and treatment plan, and even affect the patient’s disease treatment. Third, intraoperative cooperation Many patients will be involuntarily fear of surgery, in fact, there is no need, the current surgical methods have been reduced to a very low level of pain, the entire process of surgical anesthesia will have a short pain, in the injection of drugs will also have a sense of constipation and anal distension, will generally be relieved in 10 to 20 minutes. The rest of the time during the operation the patient is basically painless. Excessive nervousness will lead to sympathetic nerve excitation, inhibit the respiratory system leading to dyspnea, inhibit the urinary system leading to urinary retention, inhibit the digestive system leading to constipation, and promote the circulatory system leading to peripheral vasoconstriction, rapid heartbeat, and elevated blood pressure. At the same time nervousness also reduces anesthetic efficacy. Therefore, patients should first eliminate the fear of surgery and maintain a relaxed and natural state of mind and body. Postoperative reaction Patients with local infiltration anesthesia can be in automatic position after surgery, while patients with lumbar and rigid combined anesthesia should go to pillows and lie flat for 6 hours, so as not to cause dizziness, panic, etc. A few patients may still have dizziness after surgery. A few patients may still have panic, nausea, dizziness after surgery, which is the reaction of anesthesia, can do deep breathing, and will be relieved soon; if it is serious, notify the doctor in time to deal with it. Anal swelling, strong sense of urgency is a normal reaction after injection of drugs, will be relieved within 20 minutes ~ 1 hour. Anal pain, mild cases do not need to deal with, serious cases notify the doctor to give pain relief treatment. Patients need to press the anal area for about half an hour after the operation to avoid blood seepage from the wound, and notify the doctor to stop bleeding when the local gauze seeps blood a little bit more. V. Postoperative bowel movement Except for special explanation, patients are generally required to defecate as much as possible after 24 hours after surgery. In addition, patients generally have anal swelling after the operation, thinking that it is the precursor of defecation and very worried and afraid, in fact, this is not necessary. This is not necessary. The feeling of anal swelling is a normal phenomenon, and the patient should not go to defecate, so as not to cause anal edema and infection. Before defecation, patients should remove the bandage and gauze from the anus, and the oil and sand in the anus will be discharged with the defecation; if it cannot be discharged on its own, the doctor will remove it when changing the medication. If you have difficulty in defecation, slowly exert yourself, do not squat for a long time and do not exert yourself excessively, otherwise it will easily lead to anal edema. You may notify your doctor to use corkscrew to assist in defecation. A small amount of bleeding during bowel movement is normal, and can be stopped by putting a clean dressing on it; if the bleeding is more than that, you should tell the doctor in time to do the corresponding treatment. Postoperative urination A few patients have difficulty urinating after surgery, mostly due to excessive tension and local stimulation caused by spasm of the urethral sphincter. Nervousness caused by the patient to relax, rest, or in the perineum and less abdominal hot compresses, or can be fixed dressing bandage relaxation, gently rubbing or hot compresses on the lower abdomen, at the same time, relax the anus, generally can be released. If the above treatment can not be relieved, the catheter can be used to catheterize. Family members should accompany the patient when urinating or defecating, because dizziness may be caused when the patient suddenly stands upright from the lying position. If there is little urine, urine leaking, urinary pain, emergency urine routine to diagnose whether there is infection, and develop appropriate anti-infection treatment program; incision pain intolerable people can take painkillers or intramuscular injection of painkillers, ineffective, then you should ask the doctor for further treatment. Post-operative diet, the patient shall rest in bed, the same day can enter the liquid diet, and appropriate intravenous fluids. The second day after surgery, can enter the semi-fluid diet, and eat more nutritious and easy to digest food, the third day, can be a normal diet, in order to maintain smooth stool, can eat more fresh vegetables, fruits. For those who have bowel movements, they can take medicines with laxative effect, such as Ziyin Lunjun Oral Liquid, Ma Ren Soft Capsules, honey, etc. Avoid eating spicy, fatty, sweet and sweet foods. Avoid eating spicy, fat, sweet, thick taste, fried and stir-fried products, two weeks to ban alcohol. (1) The purpose of dressing change is to clean and disinfect the surgical wound, drain the wound, protect the wound, use the drugs to detoxify, reduce swelling and pain, and promote the growth of the wound, trim the pterygium of the wound and remove the thread, etc. Scientific and reasonable dressing change can reduce the postoperative pain, shorten the course of treatment and avoid the occurrence of some complications. (2) Frequency of medication change The medication change should be done after each bowel movement on the next day after the surgery, in principle, once a day, and the frequency of medication change can be increased for a few special diseases. Excessive local cleansing and dressing change is detrimental to the growth of the wound. In Chinese medicine, there is a saying that “simmering pus grows flesh”, which means that keeping a small amount of purulent fluid and secretion on the wound surface can promote the healing of the wound. (3) preparation before changing the medication After each bowel movement with the regular medication sitz bath, according to the ratio of 1:50 with water, need to use hot water to warm up the sitz bath, do not hot water and cool water. Each sitz bath time, hemorrhoids, anal fissure, etc. can be slightly shorter, anal fistula, abscess should be slightly longer, the recent postoperative period should be slightly shorter, the specific time control in about 15-20 minutes. Contraction of the anus when sitting in the bath, can sit directly in the medicinal water soak or wipe with medicinal water. Take the sitting position instead of squatting position, squatting is easy to cause anal edema. Notify the doctor to change the medicine after sitting in the bath. Nine, postoperative hemorrhoidal shedding period 7 to 9 days after surgery for the internal hemorrhoid necrosis shedding stage, easy to bleed, should minimize the patient’s activities. If the patient appears panic, pale, abdominal distension, intestinal tinnitus, anus falling, urgent fecal feeling, pulse counting, etc., this is the performance of postoperative hemorrhage, should immediately report to the doctor, and be ready to rescue. Ten, postoperative activities Generally speaking, the surgical wound is large, and the wound has not completely healed during the period, should walk as little as possible, so as to avoid the edge of the incision due to friction and the formation of edema, prolonging the wound healing time. Do not ride a bicycle for a long time after the wound has healed for about 3 months, in order to prevent the healing wound from bleeding due to excessive friction. Note: As the saying goes: “Three parts treatment, seven parts support”. By nourishing, I mean nursing. Nursing work is good or bad, directly related to the patient’s recovery speed, visible nursing in the disease treatment process can not be ignored. Do a good job of preoperative and postoperative care of anorectal diseases, in order to better treatment of anorectal diseases.