Chapter 483

People live for a lifetime, don't wet their beds after the age of three, don't rely on others after aging, and can take care of themselves. This is the winner of life. Many, many people once dominated the Jianghu with boundless scenery, 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 and began to ask about his work.

"There are five operations, two anal fistulas, two hemorrhoids, and a debridement of perianal abscess." Zhuang Hongxu inexplicably became the director of the Department. He was also very nervous.

"Is it difficult?" As a leader, he can be approachable and form a group with his subordinates, but when talking about work, he should have an attitude of talking about work.

Zhang Fan is young and high. Although he is young, he has technology at the bottom, so he unconsciously has his own unique momentum.

"There is an anal fistula that director Zhao arranged a few days ago!" Zhuang Hongxu brushed it and blushed. Because there was an anal fistula, he was not sure, and because of Lao Zhao's overbearing, he could not do many operations independently.

"Organize doctors and nurses to make rounds first. Head nurse, leave the nurse with liquid. The doctor and nurse make rounds. "

"OK, I'll gather the nurses now." The head nurse hurried out of the office. When she got out of the office, the head nurse involuntarily stretched out her tongue. She was also surprised: "Zhang Yuan is different from director Zhang. It makes me feel uneasy."

The director of the Department irresponsibly said that he would leave. No matter doctors or nurses, people were in panic. Zhang Fan must pacify their shaking hearts as soon as possible.

The hospital is not a family. Once the patient makes a mistake because of the Department itself, it will be

During the ward round, Zhuang Hongxu is on Zhang Fan's left and the head nurse is on Zhang Fan's right. Followed by the doctors in the Department, followed by the nurses.

"It was operated on yesterday. 34 years old, internal hemorrhoids, good postoperative recovery. " Zhuang Hongxu introduced the patients to Zhang Fan one by one.

"Medical records." Zhang Fan looked at the patient's wound and said without looking back. The naked buttocks of young men appear in front of dozens of people, and there are many girls who can burn when they blush.

At this time, a doctor in charge immediately came forward with the medical record“ Zhang Yuan, medical record. "

"Well, what treatment was given?" Zhang Fan didn't open the medical record and directly began to ask for treatment.

The significance of ward round is that the superior doctors check the patient number and solve the problems that the subordinate doctors cannot deal with on the spot. Another feature is that the superior doctors inspect the doctors through the actual medical records.

Ouyang ward rounds, cardiologists, especially those who don't work hard at ordinary times, have liver tremors. Once she can't answer Ouyang's question, she won't take into account the doctor's face.

"After the operation, the patient was given hemostasis, anti-inflammatory, regular dressing change and other related treatments, and now the patient's recovery is OK." The doctor in charge began to report to Zhang Fan in front of the patient.

In the whole ward, before checking the room, the head nurse has asked the nurse to clear the family members. Only special patients will leave one or two necessary family members.

"How do you feel?" After listening to the doctor's report, Zhang Fan smiled and asked the patient.

That's how people are. It's strange that if Zhang Fan came alone today, the patient would not be nervous without this formation.

"Very good, very good." I'm a little stuttering.

"Your bed doctor, how many rounds a day?" Zhang Fan still asked with a smile.

"Several times, four times, three times, five times!" The patient saw his doctor. The doctor was very responsible and devoted before and after the operation.

People change people's hearts, and he can see it. Although he is not old, he is a leader according to his posture. So he doesn't want his doctor in charge to eat.

"Tell yourself if you have done three rounds a day." Zhang Fan looked back at the doctor in charge of the bed.

Today, Zhang Fan came to help Zhuang Hongxu stand on the stage. If he said something bad, he came to be a black face.

"No! Too busy... "The bed doctor lowered his head.

"Are other departments busy? Aren't ordinary foreigners busy? Isn't orthopedics busy? Why can they all do it? "

Zhang Fan didn't give a good face. After finishing the doctor in charge, he said to Zhuang Hongxu, "director Zhuang should emphasize the discipline and rules of the Department when he comes down. Doctors and nurses who are not responsible should report to the hospital office. "

"Yes, Zhang Yuan." Zhuang Hongxu unconsciously stood up.

The beating that should be struck and the praise that should be praised. After checking 80 or 90 patients in more than 40 wards, Zhang Fan said to Zhuang Hongxu, "director Zhuang, there are many problems in the Department. It's up to you next. If you have anything, report directly to me. Have an operation. "

Zhang Fan raised it high and put it down gently. A group of doctors and nurses hurried to work. It's not a big deal whether you change the director or not. The most important thing is to solve your own problems, otherwise you will face a black face

Six major diseases of anorectal department.

Anal fissure is a simple anal opening. At present, the cause is unclear! However, mechanical anal fissure accounts for the majority, especially more and more people with special hobbies.

Perianal abscess. The cause of perianal abscess is simple, which is caused by infection.

Anal fistula, with complex etiology, is one of the refractory diseases in anorectal surgery.

Hemorrhoids, the etiology is unknown, and conservative treatment is recommended for most patients.

Rectal prolapse, unknown etiology, combination of conservative treatment and surgical treatment.

Constipation, if surgery is needed, is an anorectal disease.

The last one is the boss in the disease, cancer.

In the operating room, anorectal patients are very special. Because it is polluting the operation, there is a designated operating room. And most patients are stone cutting positions.

That is, the patient lies on his back on the examination bed with his hips close to the bedside and placed on the leg support, which can expose the perineum to the greatest extent. It's actually lying in bed squatting.

If the operating table is advanced, the doctor can operate it relatively well. If it is an old-fashioned operating table, the doctor will suffer. Bend over and lower your head. After a few hours, my waist is not my own.

Today is an operation for anal fistula, but the cause of this patient's anal fistula is very clear, which is the anal fistula caused by perianal infection.

The patient is not old, 26 years old, female, unmarried, occupation: company clerk. Long term office.

Why wear leather shoes, not because the leather is beautiful, but because it is breathable. In fact, human skin is the same. It should have certain air permeability.

The girl sat on the company's low-quality artificial leather chair for a long time. With the temperature rising, sweat stains and bacteria gathered on her hips.

One day, she felt a little itching and pain around her anus. When she touched it quietly, she found a small pimple, a small pimple the size of a soybean, and the surface temperature of the pimple was still a little high.

The girl who grew up in this place was a little shy because she was unmarried and a woman. She didn't tell anyone, let alone go to see a doctor.

She took care of it herself. The girl had acne and had experience in dealing with such pimples. She was also more hygienic. She scalded her eyebrows with hot water with a small knife and gave bacteria a hot bath. As for killing bacteria, she was joking.

Then he groped and cut a small pimple. Then she bent her arms and squeezed hard. On the night of squeezing, the girl slept well. There was no friction pain, no burning pain, and no swelling pain.

Very proud, good medical skills!

Results three days later, the little pimple next to the anus began to flow. Because it didn't hurt, the girl didn't care. As a result, a few days later, she suddenly had a high fever and trembled all over, shaking like a chicken with a plague.

The family rushed to the hospital. The doctor checked bacteremia and then anti-inflammatory, but the effect was always bad. After repeatedly searching for the cause, it turned out that it was perianal abscess, and then transferred the girl to the anorectal department.

Results perianal abscess complicated with anal fistula because of early improper treatment.

Early perianal abscess, to tell the truth, is a simple infection. As long as it is a regular hospital, how can it be handled. Anal fistula is different. Hospitals with insufficient general level can't handle it well!

Not to mention anything else, the girl's pre-processing is very wrong. There are abscess and mass on the skin. Because of swelling, it involves and stimulates the cutaneous nerve, which will make people feel pain.

This is a warning from the body.

The girl made a small cut and squeezed it hard. Yes, the swelling is reduced and the pain is reduced. This is deceiving the body's early warning system.

It also squeezes pus infection into deep tissue.

The structure of the human body is very complicated. It's also very scientific. Don't squeeze this abscess. Because the infection originally in the shallow tissue is because the bacteria enter the deep tissue after extrusion.

Most of the superficial tissues are very dense, and the infection generally can't expand to any place. Bacteria will be wrapped by dense tissues, which will make people feel painful. However, this is a very scientific protection mechanism.

The deep tissue is soft and sparse in order to reduce friction.

Once bacteria enter deep tissue, they are happy to have children. A small abscess can kill a lot of people.

The treatment of abscess in the hospital is a cross incision. Directly split the package vertically and horizontally like cutting watermelon, open it, and then drain it. It's not that the doctor is cruel, it's just for decompression and complete debridement.

Doctors are deeply afraid of bacteria entering deep tissue. As a result, the girl crowded and squeezed, causing great disaster.

The human body, especially the package around the lips and the package around the anus, should not be easily handled 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, and the area called the triangle in medicine is not easy to provoke, not to mention the dangerous triangle in this place.

Some people have a acne on the corner of their mouth and squeeze their hands.

This kind of thing is similar to dancing on the edge of a high-rise window.

Jump well, you're awesome. If you can't jump well, it's rotten. Because the blood vessels in this place directly connect to the brain. Once infected, bacteria will directly enter the brain. If you don't give any delay, you can die directly.

And perianal is also very troublesome. Under the perianal skin, there is a loose fat layer. Once infected

Zhang Fan and Zhuang Hongxu, as well as the tube bed doctor, entered the operating room. The girl was not anesthetized yet. When she saw three young male doctors entering the operating room, her shame had long disappeared. Now she was looking forward to the doctor to cure her.

Anesthetized and disinfected, the girl was made to split her legs, and her anus was parallel to the operating bed. At this time, he stood at the end of the operating table and looked at the girl's hip.

Don't say what desire, people without long-term medical training can produce psychological shadow after reading it. Next to the anus, there is a very obvious hole in the white skin.

The bloody hole, the hole ticking with blood, is directly a hole with a big fist. At first glance, I will never pay attention to other places, and I am directly attracted by the hole.

In order to prevent the infection from continuing, doctors had to selectively dig out the fat around the infection, and the depth was very deep. It's scary to watch.

The intestines of the abdomen are protected by thick abdominal fat and strong and dense muscle layer. Moreover, the mobility of abdominal intestine is relatively high.

But when you get to the rectum and anus, the intestine here is fixed. In order to reduce the friction here, the body has only one muscle fixed, that is, the anal sphincter, and the rest is all thick fat.

Once bacteria break through the dermis and enter the fat layer, it will be a very terrible thing. This girl is such a terrible thing now.

What's more terrible is the complication of anal fistula.

What is anal fistula, simply put, is that the rectum and skin form a pathological pipeline. The pipes are wide and narrow, and the narrow ones will be blocked by feces. After continuous infection, infection and reinfection, long-term infection may become cancerous.

A wider anal fistula is directly the second or third anus. Stool will be exposed from here, which will cost paper to wipe your ass, and infection will also occur, because this leak has no mucosal protection!

30% ~ 50% of perianal will be complicated with anal fistula. So the small pimples around the anus can't be provoked by you. Don't be cheap, don't be cheap, don't be cheap!

Especially for women of childbearing age, do not provoke them. Once anal fistula is formed, it will be a very troublesome thing. Because of the particularity of physiology, the anal sphincter of women of childbearing age is very weak.

Once a serious anal fistula occurs, it will definitely cause damage to the anal sphincter during the treatment, and then the originally weak sphincter may be abnormal.

There may be a permanent sphincter that is not controlled by the brain. In other words, there may be random stool. For a young and beautiful woman, defecation is not under self-control. You can imagine how painful it is.

Disinfect and wear surgical clothes. The surgical clothes for anorectal surgery are more exquisite, because they are polluting surgery, and the surgical clothes are all disposable. Ordinary surgical clothes, although thick, are made of cotton. It's not very uncomfortable to wear them.

Disposable surgical clothes. This thing is plastic and airtight. After an operation, the doctor is like a drowned chicken. The hand clothes inside directly make the sweat wet.

After anorectal surgery, there should be a special treatment. Just stick tape. Yes, it's tape.

There is more fat in the buttocks. Although leaving aside the legs, it still can't well expose the perineum. Zhang Fan is wearing gloves. Zhuang Hongxu and the doctor in charge are busy pasting tape.

Stick a three finger wide medical sterilization tape near the anus, pull it hard, and then stick the other end on the thigh.

At this time, at the end of the operating table, looking at the perineum, the anus is like a blooming chrysanthemum.