Four Hundred and Seventy Eighth Hands Don't Be Cheap

People live a lifetime, do not wet the bed after the age of three, and do not rely on others after aging, and can take care of themselves, this is a winner in life. There are many, many people who used to dominate the rivers and lakes, and the scenery is infinite, 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 began to ask about the work.

"There are five operations, two for anal fistula, two for hemorrhoids, and one for debridement of perianal abscess." Zhuang Hongxu became the director of the department for no reason, and he was also very disturbed.

"Is it difficult?" As a leader, you can be approachable and get along with your subordinates, but when talking about work, you must have an attitude of talking about work.

Zhang Fan is young and high-ranking. Although he is young, he has the lowest skills, so he already has his own unique aura unconsciously.

"There is an anal fistula that Director Zhao ordered a few days ago!" Zhuang Hongxu swiped, blushing. Because he has an anal fistula, he is not sure, and because of Lao Zhao's overbearing, he can't really do many surgeries independently.

"Organize doctors and nurses to make rounds first. The head nurse, leave the nurse who dispenses the liquid, and the doctors and nurses will make rounds."

"Okay, I'm going to gather the nurses now." The head nurse hurried out and out of the office. The head nurse stuck out her tongue involuntarily, and she was also surprised: "Zhang Yuan and Director Zhang are just different. Up and down."

The director of the department walked away irresponsibly, no matter whether it was a doctor or a nurse, everyone was panicked. Zhang Fan had to calm down their shaking hearts as soon as possible.

The hospital is not a play house, once the patient's account goes wrong due to the department's own reasons, then...

During the ward round, Zhuang Hongxu was on the left of Zhang Fan, and the head nurse was on the right of Zhang Fan. Immediately behind are the doctors in the department, and then the nurses.

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

"Medical records." Zhang Fan looked at the patient's wound and said without turning his head. The naked buttocks of a middle-aged man appeared in front of dozens of people, and there were also many girls whose blushing could be set on fire.

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

"Well, what kind of treatment was given?" Zhang Fan didn't open the medical record, and asked about the treatment directly.

The significance of ward rounds is that the superior doctors check the patient numbers and solve the problems that the subordinate doctors cannot handle on the spot. Another feature is that the superior doctors inspect the doctors through the actual medical records.

During Ouyang's ward rounds, the cardiology doctors, especially the ones who don't work hard at ordinary times, all had liver quivering. Once she can't answer Ouyang's question, she won't take the doctor's face into consideration.

"Hemostasis, anti-inflammation, regular dressing changes and other related treatments were given after the operation, and the patient is recovering well." 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 had asked the nurse to clear the family members. Only special patient numbers would leave one or two necessary family members.

"How do you feel?" Zhang Fan asked the patient with a smile after listening to the doctor's report.

People are like that. It's very strange, if Zhang Fan came alone today, without this formation, the patient probably wouldn't be nervous.

"Very good, very good." They all stammered a little.

"Your bed doctor, how many times a day does the ward round?" Zhang Fan still asked with a smile.

"Several times, four times, three times, five times!" The patient looked at his doctor, who was very responsible and dedicated before and after the operation.

People change people's hearts, and he can see it. The person who asked the question, although young, looked like a leader. So he didn't want his doctor in charge to suffer.

"Tell me yourself, have you done three ward rounds a day?" Zhang Fan turned to look at the doctor in charge of the bed.

Today Zhang Fan came to help Zhuang Hongxu stand on the stage, and if he said something unpleasant, he came to make a bad face.

"No! I'm 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 do it.

"

Zhang Fan didn't give a good face. After talking about the doctor in charge, he said to Zhuang Hongxu: "When Director Zhuang comes down, he must emphasize the work discipline and rules of the department. Irresponsible doctors and nurses should report to the hospital."

"Yes, Zhang Yuan." Zhuang Hongxu straightened his back unconsciously.

What should be beaten, what should be praised, after checking eighty or ninety patients in more than forty wards, Zhang Fan said to Zhuang Hongxu: "Director Zhuang, there are many problems in the department, and it will be up to you next. What's the matter?" , report directly to me. Get surgery."

Zhang Fan raised it high and put it down gently. A group of doctors and nurses hurried to work. Whether to change the director or not is not a big deal now, the important thing is to solve my own problems, otherwise I will get a bad face...

Anorectal six major diseases.

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

Perianal abscess, the cause of perianal abscess is simple, it is caused by infection.

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

Hemorrhoids, the etiology is unknown, and most of them recommend conservative treatment.

Rectal prolapse, the etiology is unknown, conservative treatment combined with surgical treatment.

Constipation and, if surgery is required, an anorectal disorder.

The last one is the boss of diseases, cancer.

In the operating room, patients in the anorectal department are very special. Because it is a pollution operation, there is a designated operating room. And most of the patients are in 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 outrigger to maximize the exposure of the perineum. In fact, it is lying on the bed and squatting.

If the operating bed is advanced, the doctor can operate it relatively better, but if it is an old-fashioned operating bed, the doctor will suffer. Bend over, head down. After a few hours, the waist is no longer my own.

Today is an operation on 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 young, 26 years old, female, single, occupation: company clerk. Sitting in the office for a long time.

Why wear leather shoes is not because the leather is beautiful, but because it is breathable. Human skin is actually the same, it must have a certain degree of air permeability.

The girl sat on the company's inferior artificial leather chair for a long time. As the temperature rose, sweat stains and bacteria gathered on her buttocks.

As a result, one day, she felt a little itchy and painful around the anus. When she touched it quietly, she found a small bump the size of a soybean, and the surface temperature of the bump was still a little high.

The little pimple that grew in this place, the girl was a little shy because she was not married and she was a woman, so she didn't tell anyone about it, let alone see a doctor.

She took care of it herself. The girl has acne, she has experience in dealing with this kind of pimple, and she is more hygienic. She took a small knife for eyebrow trimming and scalded it with hot water, and took a hot bath for the bacteria. As for killing the bacteria, it is just a joke. .

Then, groping by himself, he cut the little lump. Then she bent her arms and squeezed vigorously. On the night after squeezing, the girl had a good night's sleep, and there was no friction pain, burning pain, or swelling pain anymore.

Very proud, good medical skills!

As a result, three days later, the small lump next to the anus began to flow, and the girl didn't care because it didn't hurt. As a result, a few days later, a high fever suddenly appeared, and the whole body was shaking, shaking like a chicken with plague.

The family rushed to the hospital. The doctor checked for bacteremia and then anti-inflammatory, but the effect was not good. Repeatedly looking for the cause, it turned out to be a perianal abscess, and then the girl was transferred to the anorectal department.

As a result, the perianal abscess was complicated by anal fistula due to improper treatment at the early stage.

The early perianal abscess, to be honest, is a simple infection, as long as it is a regular hospital, it can be treated in any way. However, anal fistula is different. Hospitals that are generally not high enough can handle it well!

Let alone other things, the girl's early processing was very wrong. An abscess mass appears on the skin, which is painful due to swelling, involvement and irritation of the cutaneous nerve.

This is an early warning from the body.

The girl made a small cut and squeezed hard. Yes, the swelling is less and so is the pain, which is tricking the body's warning system.

And it also squeezes the pus infection into the deep tissue.

The structure of the human body is very complicated. It is also very scientific. Do not squeeze this kind of abscess. Because the infection was originally in the superficial tissue, it was because of the extrusion that the bacteria entered the deep tissue.

Most of the superficial tissues are very dense, and the infection generally cannot spread anywhere, and the bacteria will be wrapped by the dense tissues, which will make people feel unbearable pain. However, this is a very scientific protection mechanism.

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

Once the bacteria enter the deep tissue, they will happily have children. A small abscess can kill a lot.

For abscess, the treatment method in the hospital is a cross incision. Just like cutting a watermelon, split the lump horizontally and vertically, open it, and then drain it. It's not that the doctor is cruel, it's for decompression and thorough debridement.

The doctors were afraid that the bacteria would enter the deep tissue, but the girl squeezed and squeezed, which caused a catastrophe.

The human body, especially the lumps around the lips and the anus, should not be handled easily by yourself. These two places are very dangerous.

The area under the nose and above the lower lip is called a dangerous triangle in medicine, and the area called a triangle in medicine is not easy to mess with, let alone this place is called a dangerous triangle, which is even less easy to mess with.

Some people have a pimple on the corner of their mouth, and their hands are squeezed.

This kind of thing is about the same risk factor as dancing on the sill of a high-rise window.

If you dance well, you are awesome, if you dance badly, you are rotten. Because the blood vessels in this place directly lead to the brain, once infected, the bacteria will enter the brain directly, without any delay, it can be fatal.

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

Zhang Fan, Zhuang Hongxu and the bed doctor entered the operating room. The girl hadn't been anesthetized yet, and when she saw three young male doctors aggressively entering the operating room, she felt ashamed long ago, and now she was expecting the doctors 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, stand at the end of the operating table and look at the girl's buttocks.

Not to mention any desires, people who have not undergone long-term medical training may have psychological shadows after reading it. Next to the anus, on the white skin, there is a very obvious hole.

The bloody hole, the hole dripping with blood, is a hole the size of a fist. At first glance, you will never pay attention to other places, and you will be attracted by the hole directly.

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

The gut in the abdomen is protected by thick 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 intestinal tract 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 thick fat.

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

Even more frightening is the concurrent anal fistula.

What is an anal fistula, simply put, is the pathological pipeline formed by the rectum and skin. There are wide and narrow pipes, and the narrow ones will be blocked by feces, causing continuous infection, infection and reinfection, and prolonged infection may become cancerous.

A wider anal fistula is directly the second or third anus, and the stool will come out from here, and it will take paper to wipe the buttocks, and infection will also occur, because the leak is not protected by the mucous membrane!

30% to 50% of perianal cases will be complicated by anal fistula. So the small bumps near the anus are not something you can provoke, don't be cheap, don't be cheap, don't be cheap!

Especially for women of childbearing age, do not provoke them. Once an anal fistula forms, it will be very troublesome. Because of the particularity of their physiology, the anal sphincter is very weak in women of childbearing age.

Once a serious anal fistula occurs, the anal sphincter will definitely be damaged during the treatment process, and then the already weak sphincter may become abnormal.

There may be a permanent sphincter that is not controlled by the brain. In other words, there may be random stools. For a young and beautiful woman, defecation is not controlled by herself, and it is conceivable how painful it is.

Disinfect and wear surgical gowns. Surgical gowns for anorectal surgery are more particular, because it is a polluting operation, and 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 airtight. After one operation, the doctor is like a drowned rat. The hand scrubbing gown inside is directly soaked with sweat.

After the anorectal operation is sterilized, there is a special treatment. It's just sticking tape. That's right, tape.

There is more fat in the buttocks. Although the legs are left aside, the perineum cannot be well exposed. Zhang Fan was putting on gloves, while Zhuang Hongxu and the doctor in charge were busy putting on tape.

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

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

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