If a person lives his whole life and does not wet the bed after the age of three, and can take care of himself without relying on others when he gets old, he is a winner in life. Many, many people once dominated the world and had unlimited glory, but in the end...
"How many operations are there today?" After the morning meeting, Zhang Fan left Zhuang Hongxu and the head nurse of the anorectal department behind and started asking about the work.
"There are five operations, two for anal fistula, two for hemorrhoids, and one for perianal abscess debridement." Zhuang Hongxu became the director of the department inexplicably, and he was also very nervous.
"Is it difficult?" As a leader, you can be approachable and get along with your subordinates, but when talking about work, you must have a work-talking attitude.
Zhang Fan is young and high-ranking. Although he is young, his skills are at the bottom, so he has unconsciously developed his own unique aura.
"There is an anal fistula that Director Zhao scheduled for surgery a few days ago!" Zhuang Hongxu brushed it off and blushed. Because he had an anal fistula, he was not sure, and because of Lao Zhao's domineering attitude, there were not many surgeries he could truly do independently.
"Organize doctors and nurses to do a ward round first. Head nurse, leave the nurse who is dispensing liquids while the doctors and nurses do ward rounds."
"Okay, I'm going to gather the nurses now." The head nurse hurried out and out of the office. The head nurse couldn't help but stick out her tongue, and she was also surprised in her heart: "Yuan Zhang and Director Zhang are just different. It makes me feel sad." Up and down."
The head of the department irresponsibly leaves at will, causing panic among both doctors and nurses. Zhang Fan must calm their shaking hearts as soon as possible.
Hospitals are not just playing house. Once a patient makes a mistake due to the department's own fault, then...
During the ward round, Zhuang Hongxu was on the left side of Zhang Fan, and the head nurse was on the right side of Zhang Fan. Following closely behind were the doctors from the department, and then the nurses.
"This was operated on yesterday. He is thirty-four years old and has internal hemorrhoids. He is recovering well after the operation." Zhuang Hongxu introduced the patients one by one to Zhang Fan.
"Medical records." Zhang Fan looked at the patient's wounds and said without looking back. The naked buttocks of a prime man appeared in front of dozens of people, including many girls, who were so blushing that they could get angry.
At this time, the doctor in charge immediately came forward with medical records. "Zhang Yuan, medical records."
"Well, what kind of treatment were given?" Zhang Fan started asking about the treatment without opening the medical record.
The significance of ward rounds is that the superior doctor checks the patient number and solves the problems that the subordinate doctor cannot handle on the spot. Another feature is that the superior doctor inspects the doctor through actual medical records.
During Ouyang's ward rounds, the doctors in the cardiology department, especially those who don't usually work hard, had trembling livers. Once she couldn't answer Ouyang's question, she would not care about the doctor's face.
"After the operation, hemostatic, anti-inflammatory, regular dressing changes and other related treatments were given, and the patient's recovery is acceptable." The doctor in charge began to report and reported to Zhang Fan in front of the patient.
In the entire ward, before the ward rounds, the head nurse has asked the nurses to clear out the family members. Only for special patients, one or two necessary family members will be left behind.
"How do you feel?" Zhang Fan asked the patient with a smile after listening to the doctor's report.
People are actually like this. It's very strange. If Zhang Fan came alone today, without this formation, the patient would probably not be nervous.
"Very good, very good." He stuttered a little.
"How many times does your bedside doctor make rounds a day?" Zhang Fan asked, still smiling.
"Several times, four times, three times, five times!" The patient looked at his doctor. The doctor was very responsible and dedicated before and after the operation.
People's hearts change people's hearts, and he can see it. Although the person who asked the question was young, he looked like a leader. So he didn't want his doctor in charge to suffer.
"Tell yourself, have you done three ward rounds a day?" Zhang Fan turned back and looked at the doctor in charge.
Today, Zhang Fan came to help Zhuang Hongxu stand up. If he said something unpleasant, he would be a black face.
"No! Too busy..." The doctor in charge lowered his head in embarrassment.
"Are other departments busy? Isn't general surgery busy? Isn't orthopedics busy? Why can they all do it?"
Zhang Fan didn't give a good face. After talking about the doctor in charge, he said to Zhuang Hongxu: "Director Zhuang is here to emphasize the work discipline and rules and regulations of the department. Any irresponsible doctors and nurses should be reported to the hospital office."
"Yes, Zhang Yuan." Zhuang Hongxu straightened his back unconsciously.
The beatings that deserved, the praises that deserved, after checking eight or ninety patients in more than forty wards, Zhang Fan said to Zhuang Hongxu: "Director Zhuang, there are many problems in the department, and the rest is up to you. What's the matter? , report directly to me. Go to surgery."
Zhang Fan raised it high and put it down gently. A group of doctors and nurses started working in a hurry. Whether or not to change the director is not a big deal now. What is important is to solve your own problems, otherwise you will look bad...
Six major diseases of anorectal department.
Anal fissure, simply an opening in the anus, the cause is currently unknown! However, mechanical anal fissures account for the majority, especially among people with special hobbies.
Perianal abscess, the cause of perianal abscess is simple, it is caused by infection.
Anal fistula has complex causes and is one of the diseases refractory to anorectal surgery.
The cause of hemorrhoids is unknown, and conservative treatment is recommended in most cases.
Rectal prolapse, the cause is unknown, conservative treatment and surgical treatment are combined.
Constipation, if surgery is required, is an anorectal disease.
The last one is the BOSS among diseases, cancer.
In the operating room, patients in the anorectal department are very special. Because it is a contaminated surgery, there is a designated operating room. And most of the patients are in the lithotomy position.
That is, the patient lies supine on the examination bed, with the buttocks close to the edge of the bed and placed on the leg frame to maximize the exposure of the perineum. In fact, it is just lying on the bed and squatting.
If the operating table is advanced, the doctor can operate relatively better. If it is an old-fashioned operating table, the doctor will suffer. Bend over and lower your head. After a few hours, my waist no longer belongs to me.
Today is an anal fistula surgery, but the cause of this patient's anal fistula is very clear, which is anal fistula caused by perianal infection.
The patient is young, 26 years old, female, unmarried, occupation: company clerk. Those who sit in an office for a long time.
Why should we wear leather shoes? Not because the leather is beautiful, but because it is breathable. Human skin is actually the same, it must have a certain degree of breathability.
This girl has been sitting on the company's inferior artificial leather chair for a long time. As the temperature rises, sweat-stained bacteria accumulate on her buttocks.
As a result, one day, she felt a little itchy and painful around her anus. When she touched it gently, she found a small pimple, about the size of a soybean, and the surface temperature of the pimple was still a bit high.
The little pimple that grew in this place, because the girl was not married and was a woman, she was a little shy, so she didn't tell anyone, let alone see a doctor.
She took care of it herself. The girl has suffered from acne and has experience in dealing with such pimples. She is also very hygienic. She took an eyebrow trimming knife and scalded it with hot water. She gave the bacteria a hot bath. As for killing the bacteria, that was just a joke. .
Then, he fumbled around and made a small incision on the pimple. Then she bent her arms and squeezed hard. That night after squeezing, the girl had a good sleep. There was no more friction pain, no burning pain, and no more swelling pain.
Very proud, your medical skills are good!
Three days later, the small bump next to the anus began to ooze. Because it didn't hurt, the girl didn't care. However, a few days later, she suddenly developed a high fever and her whole body was shaking like a chicken infected with plague.
The family hurriedly sent her to the hospital. The doctor checked for bacteremia and tried anti-inflammatory drugs, but the effect was never good. After repeated searches for the cause, it turned out to be perianal abscess, and the girl was transferred to the anorectal department.
As a result, perianal abscess was complicated by anal fistula due to improper early treatment.
To be honest, early perianal abscess is just a simple infection, which can be treated by a regular hospital. But anal fistula is different. Generally, hospitals with insufficient level cannot handle it well!
Putting aside everything else, the girl's early handling was very wrong. Abscesses appear on the skin, which can cause pain due to swelling, pulling on and irritating the cutaneous nerves.
This is a warning from the body.
The girl made a small cut and squeezed hard. Yes, the swelling is reduced and the pain is reduced, which is fooling the body's warning system.
It also squeezes the pus infection into the deep tissues.
The structure of the human body is very complex. It is also very scientific. This kind of abscess must not be squeezed. Because the infection that was originally in the superficial tissue was caused by the extrusion, which allowed the bacteria to enter the deep tissue.
Most of the superficial tissues are very dense, and the infection generally cannot expand anywhere. The bacteria will be wrapped in the dense tissues, which will make people feel unbearable pain. However, this is a very scientific protection mechanism.
In order to reduce friction, the deep tissues are relatively soft and sparse.
Once the bacteria enter the deep tissue, they happily give birth to children. A small abscess can kill a lot of people.
Abscesses are treated with a cross incision in the hospital. Just cut the mass horizontally and vertically like cutting a watermelon, open it, and then drain it. It’s not that the doctor is cruel, this is just to reduce pressure and completely debridement.
Doctors were afraid that bacteria would get into the deep tissues, so the girl squeezed and squeezed, causing big trouble.
The human body, especially the lumps around the lips and the anus, should not be dealt with easily by yourself. These two places are very dangerous.
The area under the nose and on the lower lip is called the danger triangle in medicine. The area called the triangle in medicine is not easy to mess with, let alone this place is called the danger triangle, which is even more difficult to mess with.
Some people have a pimple on the corner of their mouth and squeeze it with their hands.
This kind of thing is almost as dangerous as standing on the window sill of a high-rise building and dancing.
If you dance well, you are awesome; if you dance poorly, you are a mess. Because the blood vessels here are directly connected to the brain, once infected, the bacteria will directly enter the brain. Without any delay, it can be fatal.
The perianal area is also very troublesome. Under the perianal skin, there is a loose fat layer. Once infected...
Zhang Fan, Zhuang Hongxu and the doctor in charge entered the operating room. The girl had not yet been anesthetized. When she saw three young male doctors entering the operating room aggressively, her shame had long since disappeared. Now she was looking forward to the doctors curing her.
After anesthesia and disinfection, the girl was made to spread her legs, with her anus parallel to the operating bed. At this time, stand at the end of the operating table and look at the girl's buttocks.
Not to mention any desires, people without long-term medical training will probably have psychological shadow after seeing it. Next to the anus, there is a very obvious hole in the white skin.
The bloody hole, the hole dripping with blood, is a hole as big as a fist. At first glance, you will never pay attention to other places, and you will be directly attracted by the hole.
In order to prevent the infection from continuing, the doctor had to selectively remove the fat around the infection very deeply. Just looking at it can make you cringe.
The intestines in the abdomen are protected by a thick layer of abdominal fat and a strong, dense layer of muscle. Moreover, the mobility of the abdominal intestine is relatively high.
But when it comes to the rectum and anus, the intestines here are fixed. In order to reduce the friction here, the body has only one fixed muscle, the anal sphincter, and the rest is thick fat.
Once the bacteria breaks through the dermis and enters the fat layer, it will be a very terrible thing. This girl is experiencing such a terrible thing now.
Even more frightening is the complications of anal fistula.
What is an anal fistula? Simply put, it is a pathological tube formed between the rectum and the skin. The ducts may be wide or narrow, and the narrow ones will be blocked by feces, which will lead to continuous infection, infection and re-infection. If the infection lasts for a long time, it may become cancerous.
A wider anal fistula is directly connected to the second or third anus, and stool will leak out from it. Wiping your butt is a waste of paper, and infection will also occur because this leak is not protected by mucous membrane!
30% to 50% of perianal cases are complicated by anal fistula. Therefore, the small pimples near the anus are not something you can cause. Don’t be mean, don’t be mean, don’t be mean!
Especially for women of childbearing age, they must not be irritated. Once an anal fistula forms, it will be very troublesome. Because of the special physiological characteristics, the anal sphincter of women of childbearing age is very weak.
Once a severe anal fistula occurs, the anal sphincter will definitely be damaged during the treatment process, and the already weak sphincter may become abnormal.
There may be a permanent sphincter that is no longer controlled by the brain. In other words, there may be random stools. For a young and beautiful woman who has no control over her bowel movements, you can imagine how painful it is.
Disinfect and wear surgical gown. Surgical gowns for anorectal surgery are quite particular. Because it is a contaminated surgery, all surgical gowns are disposable. Ordinary surgical gowns, although thick, are made of cotton and are not very uncomfortable to wear.
Disposable surgical gowns are made of plastic and are not breathable. After an operation, the doctor is like a drowned rat. The scrubbing gown inside is directly soaked by sweat.
After anorectal surgery is disinfected, special treatment is required. Just put tape on it. Yes, just put tape on it.
There is a lot of fat in the buttocks, so although the legs are set aside, the perineum is still not well exposed. Zhang Fan was putting on gloves, while Zhuang Hongxu and the doctor in charge were busy applying tape.
Apply a three-finger-wide piece of medical sterilization tape starting near the anus, pull it hard, and then stick the other end to your thigh.
At this time, looking at the perineum from the end of the operating bed, the anus looks like a blooming chrysanthemum.
