ACUTE THROMBOSIS OF HEMORRHOIDS: PATIENT CLINICAL PROFILE AND TREATMENT

The purpose was to study the clinical profile of patients who seek help with acute thrombosis of hemorrhoids and to establish a link between complaints and objective examination by means of determining the association and contingency ratios; and to analyze the influence of methods of treatment of acute thrombosis of hemorrhoids on duration of non-narcotic analgesics use and stay in a hospital. Methods. During 2014-2018, 504 patients were treated for the hemorrhoids in the Ivano-Frankivsk Re-gional Clinical Hospital. Among them, 98 patients with acute thrombosis of hemorrhoids, which is 19.4% of all patients with hemorrhoids. There were 60 (61.2%) men and 38 (38.8%) women. The average age of patients was 47.9 ± 15.3 years. To determine the clinical profile of patients with acute thrombosis of hemorrhoids, the com-plaints were studied at admission, the possible causes of the disease, the duration of the disease before treatment, the data of objective examination. The relationship be-tween complaints and the objective survey data was determined using association and contingency ratios. The influence of conservative and surgical treatment of acute thrombosis of hemorrhoids on the duration of non-narcotic analgesics use and the length of stay in hospital were evaluated. Results. Among the appeals for medical aid for hemorrhoids, the fifth part consists of patients with acute thrombosis of hemorrhoids. Basically, these are patients of working age. For acute thrombosis of hemorrhoids, such symptoms as pain, bleeding, the presence of "for-mation" in the anal area are considered to be characteris-tic. Appeal for three days from the onset of the disease indicates a pronounced pain syndrome. In 70.0% of patients, with complaints of bleeding, with objective examination revealed necrosis of tissues over thrombosed node. 61.1% of patients with constipation had swelling of the tissues of the anal area. In patients with acute thrombosis of hemorrhoids of severity degree I, the duration of non-narcotic analgesicsthe use and the terms of stay in the hospital are reduced in 1.8 and 1.7 times, respectively, during thrombectomy, 1.7 and 1.6 times, respectively, during thrombectomy in combined with necrectomy. The duration of non-narcotic analgesics use is reduced in 1.4 times when delayed hemorrhoidectomy by Miligan-Morgan to 5.3 ± 1.0 days with severity degree II. Conclusions. In acute thrombosis of hemor-rhoids severity degree I, the duration of non-narcotic analgesics use and the duration of stay in the hospital did not differ significantly in the course of conservative ther-apy and the implementation of hemorrhoidectomy in Miligan-Morgan. Thrombectomy and combined throm-bectomy with necretomy in patients with acute throm-bosis of hemorrhoids severity degree I without signs of chronic hemorrhoids, and those with chronic hemorrhoids who have renounced radical surgery, can reduce the hospital stay in 1.7 ± 0.07 times and decrease in 1,8 ± 0,07 times the duration of administration of anesthetics. Therefore, in acute thrombosis of hemorrhoids severity degree I, one must adhere to active surgical tactics. In acute thrombosis of hemorrhoidal nodes of severity degree ІІ-ІІІ, surgical treatment is advisable after reduction of edema, signs of inflammation and course of conservative therapy.