Circumferential mixed hemorrhoids have a high incidence in hemorrhoid disease. The external hemorrhoids are partially distributed in 360°, and the nucleus and the nucleus are often not separated from the normal skin, and the pathological pattern is characterized by connective tissue hyperplasia and varicose veins; the internal hemorrhoids are generally above grade II. The treatment of this disease is more difficult. The author selectively performed external hemorrhoidectomy and suturing and internal hemorrhoid injection with hemorrhoid elimination in 120 cases of circumferential mixed hemorrhoids, and the cure rate was 100%, and the recent and long-term results were satisfactory. 1.Clinical data There were 65 male cases and 55 female cases in this group. The age of 30~40 years old was 52 cases, accounting for 43%; the age of 41~60 years old was 68 cases, accounting for 57%, with an average age of 46 years old. The shortest duration of the disease was 7a, and the longest duration was 42a. 2, treatment method Preoperative routine intestinal preparation, local infiltration anesthesia with 1% procaine and a little epinephrine. After disinfection of the anal canal and lower rectum, the anus was dilated with the index finger or trumpet-shaped anoscope, and then the arterial pulsation was touched with the index finger above the parent hemorrhoid area, and a 1:1 concentration of injection solution (1 ml of procaine plus 1 ml of anti-hemorrhoid solution) was prepared with 1% procaine and anti-hemorrhoid solution, which was injected in four steps (the first step was injected in the superior rectal artery area; the second step was injected in the submucosa; the third step was injected in the lamina propria; The fourth step is injected in the cavernous vein area), and the amount of injection is determined according to the size of the hemorrhoid nucleus and the laxity of the rectal mucosa. Then external hemorrhoid dissection is performed. First, the external hemorrhoid in the parent hemorrhoid area is selected for dissection. The external hemorrhoid is lifted with hemostatic forceps in a “V” shape, and a radial incision is made and extended to 0.5 cm above the dentate line, and the hemorrhoid is peeled without damaging the superficial layer of the external sphincter, and the base of the peeled external hemorrhoid is clamped with curved forceps and the internal hemorrhoid above it is clamped together, and then a circular needle is placed at the base of the peeled internal hemorrhoid and a No. 7 silk thread is used to perform a The external hemorrhoid flap and a portion of the ligated internal hemorrhoid are cut off with an “8” thread through the ligature. It is important to clamp the internal hemorrhoid as little as possible to prevent excessive damage to the mucosa and cause rectal stricture. Other external hemorrhoids are treated in the same way. The width of the anal canal skin bridge between the incision and the incision should be kept above 0.5 cm, at this time the skin bridge outside the anal verge is often folded and protruding, so the skin bridge should be cut transversely, the cut part should be on the outside of the anal verge, and the inner end should keep the anal canal skin as much as possible, peel out the external hemorrhoidal plexus or the hyperplastic tissue under the skin, remove the excess skin, and close the skin with a small triangular needle “0” The skin is excised and closed with small triangular needle “0” silk suture. After the operation, anti-inflammatory pain plugs or chlorhexidine plugs were placed in the anus, and Vaseline oil gauze and gelatin sponges were applied as pressure bandages. Most of the cases in this group had 4 incisions, with at least 2 and at most 3 skin bridges sutured. After the surgery, we treated with gentamicin for anti-infection and phenylephrine for oral control of stool for 3 days without fasting. Before the first bowel movement, 100 ml of warm water with a little oil was used as an enema to facilitate defecation and prevent edema of the incision caused by forceful struggle. After the first bowel movement, take a decoction of Chinese herbal medicine “Exorcism soup” to clear heat and detoxify the blood and remove blood stasis. The stitches were removed on the 3rd or 4th day depending on the incision. There was no bleeding, anal canal skin defect and mucosal prolapse after surgery; 20 cases had moderate pain (the rest had mild pain); 2 cases had mild rectal stricture; 5 cases had mild urinary retention; 8 cases had mild postoperative edema and 2 cases had severe edema. 4, Discussion In foreign countries, cricothyrotomy and ligature resection are mostly used for cricoid mixed hemorrhoids. The former is easy to cause severe mucosal ectasia, mucus flow and pain due to excision of too much anal canal skin; at the same time, excision of low rectal mucosa and anal canal destroys the normal defecation reflex and causes sensory anal incontinence; some patients have rectal stenosis due to scar formation. In the latter case, although the internal hemorrhoid is sutured and the external hemorrhoid is peeled and opened, postoperative complications and sequelae such as secondary hemorrhage and anal stenosis cannot be completely avoided. In China, external hemorrhoids are mostly peeled and lanced, but it is still not an ideal method because the skin bridge folds, incisions and the skin bridge are easily edematous, and uneven external hemorrhoids are still left in the anal area after surgery. This treatment preserves a certain number of anal canal bridges, the sutures are mixed, the ligature area is small and there is no painful area on the dentate line, so there are generally no sequelae such as defect of the anal canal epithelium and mucosal ectasia, and the postoperative pain is also mild and often disappears within 24 hours. Since the sclerosing agent is injected into the hemorrhoidal artery and nucleus, the chance of postoperative hemorrhage is reduced. In addition, after the operation, we use the traditional Chinese medicine “Exorcism Soup” to take a sitz bath to clear heat and detoxify the blood and reduce swelling, and there is no edema in general. The treatment is complete, the surgical wound is small, the course is short, and the damage to the anal canal tissue is small, so the postoperative anal canal is soft and smooth, and there are few clinical complications and no sequelae, so it is an ideal method for treating cricoid mixed hemorrhoids.