The patient with the hernia who was sent also drank a lot of wine, probably in response to the saying "wine is a color matchmaker", and was so happy after drinking that he forgot that he had a history of oblique hernia, and chose to stand upright.When you snap too hard, the abdominal pressure increases, causing the bowel to slide out of the inguinal ring......
Later, the patient actively took self-rescue measures at home, including the usual effective lying flat and bent knee position, but could not reduce the intestinal tube that was stranded in the yin sac, and then had to come to the provincial hospital.The place where he lives is remote, and he wants to find a place to call an ambulance, and he has walked a long way.After he entered the hospital and was sent to the operating table by the emergency department, Li Min cut the hernia ring and found that the color of the incarcerated intestinal tube had changed, not only could not touch the arterial vascular fluctuations in the corresponding blood supply range, but also the warming could not restore the color and peristalsis of the intestinal tube, and only the part of the discolored and necrotic intestinal tube could be removed.Minor surgery has become bigger.* After the operation, Li Min couldn't care that it was already three o'clock at night, and wrote wildly with medical records, the first trip, surgical records, and major medical records.It's a pity that the big medical record was only written a little, and there was an appendicitis.After Li Min asked about the medical history and did a physical examination of the patient, he was diagnosed with acute simple appendicitis.She knocked on the door of the duty room.Chen Wenqiang listened to Li Min's report, rubbed his eyes and said, "You take the doctor on duty in general surgery to operate first."
I'll take a look at the operating room in a moment.Okay?
”Okay, great!
With Chen Wenqiang to see it after a while, Li Min still has the confidence to complete this appendicitis with Xiao Wang.The doctor on duty on the side of the general outside is Li Min's classmate, although it is not a large class, but because he entered the university, he has a girlfriend in the same class, and he is also a conspicuous figure in the grade.When Xiao Wang came over, Li Min had already finished writing the first trip, and was writing the surgical consent form while making a preoperative explanation with the patient's family.He looked at Li Min's preoperative explanation and asked, "Do you want to do it under anesthesia?"
”"Hmm."
Li Min looked up at him, and suggested nonchalantly: "Why don't you go for another physical examination?"
”Dr.
Wang was not polite, and went directly to ask about the onset history again, and gave the patient a detailed physical examination.By the time he got back to the office, Li Min had everything ready."
What do you think of local anesthesia?""
Yes.Typical acute uncomplicated appendicitis.Dean Chen is not there?
”"Ah, he'll be in the operating room in a moment."
Li Min didn't say that Chen Wenqiang let him take Xiao Wang for surgery first.Hurting people.Dr.
Wang disinfected the patient, and when he came back after soaking his hands, he saw Li Min standing in the surgeon's position.He asked Li Min: "Dean Chen hasn't come yet?"
”"He told us both to do it first."
At this point, although Xiao Wang was not satisfied with Li Min standing in the position of the surgeon, Li Min had to write a major medical record and the patient was in charge of her after the operation, so he could only retreat to the position of an assistant.In fact, he was very uncomfortable.During his time in the operating room, he had already heard that Dean Chen had not only asked Li Min to have a craniotomy tonight.He has never been involved in craniotomy surgery, and he does not climb Li Min; - But the one that Li Min did just now was a real general surgery.It's not Li Min's night shift, why did she grab the operation and grab her head, he wanted to reason with Li Min, but he knew that Dean Chen accepted Li Min as a student, and he couldn't come up with a theory.He hated it......
Oh, and you can't put Li Min in any way.He is now looking forward to Li Min getting married, pregnant, and having a child as soon as possible, and then naturally disappear from the surgical ward, and it is impossible to rush the operation.
*Acute simple appendicitis is nothing to say, the operation went well.Li Min was very happy.However, after sending the patient back to the ward and placing it, Xiao Zhai told Li Min that Dean Chen had been sleeping all the time and had not left the duty room at all.At this time, if someone comes to ask Li Min, is it cool to take his classmates for surgery?
- Cool!
How did Dean Chen feel when he didn't go to the operating room?
- I didn't think of him during the operation, and I wanted to scold after the operation.It's really not as serious as Xie Xun, Xie Xun is so good that he brushed his hands and changed his surgical gown, stood on the side of the operating table and watched-that he could save the table at any time.But Dean Chen was sleeping in the duty room, so he was relieved?
Will he be able to sleep?
Regardless of how many questions Li Min had in her stomach, she washed her face with cold water and continued to write medical records.She had to complete all her medical records before she could go home with peace of mind.Who let himself sleep in the ward?
Then she comforted herself that as long as the patient was admitted to the trauma surgery, Chen Wenqiang would not write a big medical record for the night shift, and he would not write any medical records.Sooner or later, these tasks are all done by themselves, and if you don't finish it today, you will have to do it yourself tomorrow afternoon.It's early.Not to mention, Chen Wenqiang is really relieved that Li Min will have appendicitis surgery.He slept until Li Min came again and knocked on the door of the duty room.Through the door of the duty room, Li Min raised his voice and reported: "There is another appendicitis, there is a plate-like abdomen, you come and take a look?"
”Chen Wenqiang was not ambiguous this time, and immediately came over after listening to Li Min's report.After asking about the medical history and physical examination, he read Li Min's preoperative preparations and surgical consent forms, nodded and said, "Just follow you."
I'll go to the operating room first. ”Then he walked away with the surgery notice.Seeing him leaving, the patient's family chased after Li Min and asked, "Who will do the operation?"
”"Dean Chen.Didn't you see that?
”The patient's family immediately chased Chen Wenqiang out.Li Min shouted to the nurse's office: "Xiao Zhai, after preparing the skin to give her diazepam, I gave a doctor's order." ”After a while, the intern nurse brought by Xiao Zhai came back to read the doctor's order: "Doctor Li, Teacher Zhai asked me to copy the doctor's order." ”Li Min took out the temporary doctor's order and gave it to her: "Take it to her, you don't need to copy it." ”"Thank you, Dr.
Li," the little nurse stumbled and ran again.The patient's family soon came back and said with a hint of caution: "Dr.
Li, Dean Chen said that you were the one who did the operation. ”"Yes, I went on stage with Dean Chen.If the abdominal cavity is opened, the situation in the stomach is more complicated and the operation is more difficult, then Dean Chen will take over and continue to do it, otherwise I will always be the operator. ”The patient's family members' expressions were very entangled, and he didn't know who to expect from the surgeon.But in front of Li Min, he was reluctant to say that Li Min looked too young and doubted whether Li Min would have surgery.Li Min knew what he was thinking by looking at his expression, and comforted him while writing about the first journey: "Dean Chen is my teacher, and he will naturally let go of the surgery that is suitable for me."
If I can't do it, he'll take over.If you are too worried, ask the nurse, I have already had three surgeries tonight, craniotomy, partial bowel removal of Kunton's hernia, and appendicitis.Except for the appendicitis, which was simpler, the other two cases were not simple. ”The patient's family can only nod their heads again and again and say, "We believe in you." ”Xiao Zhai took the students to push the patient back: "Dr.
Li, the preoperative preparations are done, the procaine skin test is negative, and diazepam is also given." ”"Okay, thank you.Help me get a medical elevator. ”Li Min inserted the temporary doctor's order into the medical record and said to the patient's family, "Let's go, let's go to the operating room now." ”*Medical elevators are manned 24 hours a day.When the elevator worker saw that Li Min was taking the patient to the operating room again, he asked with a smile, "Doctor Li, this is the fourth one." ”"yes.After this is done, it will be the day shift. ”"Aren't you on the Saturday night shift?""
I drank beer at the party last night, I was sleeping in the department, and I was called up by Dean Chen for surgery.And then one after the other. ”The elevator worker said sympathetically, "The surgery is really hard.The obstetrics and gynecology department was the same, and they also had four caesarean sections that night. ”Li Min nodded and cooperated with the patient's family to pull the flat car out of the elevator, and she sighed in her heart that she originally wanted to be an obstetrics and gynecology doctor.Nowadays, it seems that both surgery and obstetrics and gynecology inevitably work all night long.It turns out that I am a hard worker!"
My daughter-in-law had a caesarean section last year, no, the year before last."
The patient's family pushed the flat cart and introduced it to Li Min."
yes, I know."
The history of childbirth and childbirth is an important part of female patients, and the patient has a large cesarean section scar on the abdomen."
Does it have an impact on the surgery?"
The patient also looked at Li Min at this time.The expressions of the couple were expecting Li Min to give them a negative answer."
Don't worry, if there is any impact, we will do our best to give you a good operation."
Li Min handed over the flat car to the nurse who came out to pick up people, and she had no energy to comfort patients and their families at this time.So sleepy.* "What are you going to do?"
”Li Min replied while tying the cuffs of the surgical gown, "I want to make an incision next to the right rectus muscle."
The length of the incision preparation is 8 cm. ”This incision is not specifically for appendicitis, it is to prevent purulent peritonitis and abdominal organ involvement, suitable for abdominal exploration, and the incigo can be extended up and down according to the specific situation during the operation, which is a well-known choice that can be attacked, retreated, and defended.Chen Wenqiang nodded, watching Li Min wear gloves and wash his hands on stage, he did not help Li Min use the tip of the scalpel to cut the location of the incision.He didn't mention that he wanted to call Xiao Wang to the stage, but only asked the patrol nurse to prepare an automatic hook.The fat on the patient's belly is not thick, but the postpartum skin is loose.With the help of Chen Wenqiang, Li Min worked hard to tighten and straighten her skin with gauze, and cut it according to the predetermined line.The blood vessels are then ligated, and the abdominal cavity is progressed layer by layer.…… The sky outside the window was already bright, Jiang Ma covered his mouth and yawned and said, "This night has not stopped."
Dean Chen, you and Dr.
Li are off to a good start. ”"What can we do?
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When the emergency patient comes, do it. ”Chen Wenqiang didn't sleep much this night."
Dr.
Li, it's not your night shift tonight, is it?"
Jiang Ma saw that Dean Chen didn't want to chat, so he asked Li Min to chat.He was so sleepy."
It's not."
Li Min had already cut layer by layer and was about to enter the abdominal cavity, and shouted to the instrument nurse: "Big gauze pad."
Suction device. ”The instrument nurse and the patrol nurse were busy.Fortunately, after opening the abdominal cavity, the omentum converges to the right lower quadrant and wraps the perforated appendix.Although some pus overflowed the omentum and caused peritonitis, it did not have a significant effect on the intestine and other organs.Jiang Ma was so sleepy that he couldn't find anything to say: "This woman is really upright, she can't come to the hospital until her appendix is perforated." ”The patrol nurse answered: "What this woman just said, when she gave birth, she had a trial labor for a day, and finally had to have a caesarean section.Her stomach hurts, and she thought it was menstrual cramps, but she was fine for two days.I didn't expect that taking painkillers didn't work. ”Li Min sighed when he heard this, not wanting to answer the words of the nurse who patrolled the station.The patient was afraid that the operation would leak his vitality, but he ended up in the operating room again and again.She carefully removed the perforated appendix, sucked up as much pus as possible from the omentum and abdominal cavity, and after repeated saline rinsing, she left 6.0 g of Pioneer VI. solution in the abdominal cavity.After the patient is settled, the sky is bright, and it is time to write the shift.Li Min first checked last night's operation, and when he arrived at the intensive care unit, he saw that the patient after the craniotomy was still in a deep coma.She did some examination and couldn't help but shake her head at the patient's family with anticipation on their faces.Chen Wenqiang said for her: "You have to be prepared that he can't wake up." ”The patient's wife couldn't stand on her feet all night, wiped her tears and said, "I know you're all doing your best."
But he has worked hard for most of his life, and the only remaining wish is to hold his grandson.Even if he lives like this for a month or two after surgery, listening to his grandson cry can be regarded as fulfilling his wish. ”One of the two men who was supporting her on the side said: "My daughter-in-law's due date is in mid-January. ”Another man said: "My daughter-in-law gave birth to a daughter, and although my father is very rare, he is still looking forward to having a grandson."
Dean Chen, Dr.
Li, please. ”Li Min immediately understood why the patient had drunk too much wine at last night's meal.This is joy and sorrow!
※※※※※※※※※※※※※※※※※※※※* In the case of a sudden increase in abdominal pressure, a hernia patient will have a hernia attack and an increase in hernia contents, which will make it difficult to retract and cause incarceration.() The distance is a bit far