Postoperative hemorrhoid bleeding is a common complication in anorectal medicine, and there are many reasons for bleeding. For patients, no matter what kind of bleeding is caused, while giving hemostasis, we must give patients good ideological work, inform them of the cause of bleeding, stabilize their emotions, and at the same time give drugs to stop bleeding and appropriate rehydration. Do everything possible to find the bleeding point and give stitches to stop the bleeding. Post-operative hemorrhoid hemorrhage is divided into primary and secondary, with more causes of bleeding, but mainly local factors. According to the nature of hemorrhoid bleeding can be divided into primary bleeding and secondary bleeding: (a) Primary bleeding: Mostly bleeding within a few hours after surgery, mostly due to improper surgical operation or a kind of bleeding caused by imperfect hemostasis of the surgical surface during surgery, for the following reasons: 1, the wound is too large and too deep, injuring large arterial vessels without ligation, such as the excision of hemorrhoidal rings. 2.Cutting more hemorrhoid tissue on the ligature line, the hemorrhoid nucleus atrophy causes slippage of the surgical line, thus causing bleeding. 3.Anal dressing change is to place oil gauze into the incision with improper force or when the direction is not smooth the surgical line is pushed off, causing bleeding. 4.Incorrect ligation method or slip knot of the surgical thread causes loosening of the surgical thread, which causes bleeding. 5.Para-renin has a vasoconstrictive effect during surgery, and postoperative vasodilation causes bleeding. (B) Secondary bleeding: Mostly occurs 3-14 days after surgery, which is the period when the hemorrhoid nucleus sheds and necrosis, forming trauma bleeding, causing secondary bleeding for the following reasons: 1. 3-14 days after internal hemorrhoid ligation, ligature, necrotizing agent injection, due to necrosis and shedding of the hemorrhoid nucleus tissue, forming fresh trauma when the arterial vasculature is not closed. The thrombus is dislodged, resulting in active hemorrhage. 2.After the hemorrhoid nucleus ligatures fall off, due to the deeper penetration of the stitches and injury to the large arterial vessels, when the hemorrhoid nucleus is necrotic and falls off, the arterial vessels in the deep trauma are not firmly closed, and hemorrhage is formed. 3, trauma injury, post-operative hemorrhoid nucleus off and trauma repair period, strenuous activity or constipation, due to excessive force during defecation, resulting in wound tearing or arterial vascular rupture, causing hemorrhage. 4.Some systemic diseases, such as thrombocytopenia, prolonged bleeding time, portal hypertension, hypertension, remittance and hemophilia, and other systemic diseases with bleeding tendency, are neglected or untreated before surgery and cause hemorrhage after surgery. Signs and symptoms of bleeding: According to the duration of bleeding, they can be divided into: immediate bleeding and secondary bleeding. Immediate bleeding occurs on the day of surgery or within 48 hours after surgery, and the symptoms of such bleeding are more obvious and can be detected earlier. Secondary hemorrhage refers to hemorrhage that occurs within 7 – 14 days after surgery, mostly accompanied by occult hemorrhage in the rectum, which is more serious. The bleeding can be classified according to the site of bleeding flow: bleeding inward and bleeding outward. Inward hemorrhage; i.e., hemorrhage in the rectum, at first there is no feeling, with the increase of bleeding, there is lower abdominal cramping, anal burning, large amount of dull red blood or black blood clots in the stool, accompanied by panic, dizziness, black eyes, weakness of limbs or even fainting, untimely treatment can be accompanied by hemorrhagic shock. Outward bleeding, i.e., bleeding outside the anus, bleeding from the incision outflow, soaked clothing, can be detected and treated early. Treatment and therapy of bleeding: 1. For a small amount of postoperative bleeding, pay attention to observation, and it can be left untreated, while keeping the stool open and controlling activities. 2, a large amount of bleeding, should be immediately under local anesthesia or sacral anesthesia, clear the accumulation of blood in the intestinal cavity, then identify the bleeding point under the anoscope, pull out the trauma with tissue forceps, and use 4 # or 0 # intestinal thread through the suture to stop bleeding. 3, bleeding more than or deeper location of the bleeding point inconvenient ligation, the use of gel sponge, oil gauze, paraprenaline gauze filling to stop bleeding. May also be used to stop bleeding by airbag compression. 4.Enema method, for secondary bleeding, relatively small amount of bleeding and slow bleeding rate, there are many advantages of using alum liquid enema, which is a non-surgical hemostatic measure with simple, convenient, tested and inexpensive hemostatic method. 5, postoperative ligation line off, intraoperative bleeding caused by incomplete hemostasis, can be re-ligated under local anesthesia bleeding point can be. Stitching under anoscope to stop bleeding. If the hemorrhage is caused by infection and necrosis in the injection area, the wound should be carefully cleared before suture ligation to remove all the blood clots retained in the intestinal cavity and then suture ligation. If the bleeding range is relatively large and ligation is taught to be difficult, high-frequency electric knife electrocoagulation can be used to stop the bleeding. While using various hemostatic methods, fluid therapy should be actively cooperated.