The Anorectal Department is on the fifth floor of the outpatient building. After Bai Ye reported the dressing changes to Song Jie, Song Jie said: "It's just the right time. I've been seeing patients after treatment these two days. Let's take a look at the main symptoms of patients in our department today.
Symptoms, and how to diagnose, mainly refer to digital diagnosis.”
At this time, a man nearly forty years old came in: "Doctor, I handed over the charge sheet."
Song Jie nodded and said, "Follow me."
Having said that, he arrived at the treatment room next door. When Bai Ye walked in, he found an anoscopy machine and an examination bed.
Song Jie said to the man: "Climb up, take off your pants, and stick your butt up. There are pictures on the wall. Take a look."
The man glanced at Bai Ye, looked up at the examination diagram on the wall, hesitated for a moment, shook his head, lay down on the bed, and then took off his pants.
Song Jie took the finger cot, handed it to Bai Ye, and said, "Put on the gloves, and then put on the finger cot."
Bai Ye nodded and followed Song Jie's example in putting on the finger cots.
Song Jie patted the man and said, "Put your butt up."
The man hesitated shyly and suddenly said: "Doctor, what do you want to do?"
Song Jie said: "Look at what's going on inside, relax a little and cooperate."
The man hummed: "Please be gentle...it's my first time..."
Song Jie chuckled, hummed, and then put his index finger in.
After a while, after stretching it out, he said to Bai Ye: "Feel it, 2cm above the dentate line. Bai Ye nodded, then gently stretched it in, and sure enough he felt soft hemorrhoids of different sizes.
After the man came out of the treatment room, he looked depressed: "Doctor, am I okay?"
Song Jie then picked up the anoroscope, put it in and took an endoscopic image, and said to the man: "You have mixed hemorrhoids, and they are ring-shaped. They are already third degree and...so, you need surgery. I think
Should have had surgery sooner,”
After hearing this, the man asked: "What should I do?"
Song Jie said: "I will issue you a hospitalization certificate and go through the hospitalization procedures as soon as possible. Let's arrange an operation as soon as possible. Your situation is serious. You have mixed hemorrhoids. You have had internal hemorrhoids for three times. You cannot defecate on your own. If you continue,
It will become more and more serious if it gets worse."
When the man heard this, he hesitated: "I have to go to work to ask for leave first. Doctor, can you give me a diagnosis certificate?"
After the patient left, Song Jie looked at Bai Ye and asked: "Actually, digital anal examination is often better than microscopic examination. The intestinal mucosa is more folded, and microscopic examination can find some obvious ones. For some patients with ulcers or slight early morning sickness,
Fistula tracts are not easy to see, and digital examination can reveal some depressions and lesions, so the two must be combined to achieve a more effective effect.”
Bai Ye has a certain foundation in digital anorectal examination. Anorectal technology level 3 is a comprehensive skill that includes some common methods and treatment methods in the undergraduate department.
Surgery outpatient clinics are different from internal medicine. Most of the patients who come to surgery come for the purpose of surgery. After all, there are fewer internal treatment methods compared with surgery, and for example, for hemorrhoids, simple ones don't need to be treated, but for serious cases, surgery is more effective.
In the past few days, Song Jie's dressing change has been contracted by Bai Ye, and having a leisurely time every day is a priority.
At the end of the first week of admission, Bai Ye heard the system prompt sound.
[Ding! Complete the dressing change task 50/50 and get an exclusive dressing change package. 】
Bai Ye found a deserted place and clicked to open the dressing pack:
[Ding! You opened the exclusive dressing pack and got the new lidocaine spray. 】
Bai Ye was stunned. Lidocaine spray? What is this?
[Tip, the new lidocaine spray is a lidocaine anesthetic preparation, mainly used for dressing wounds, which can reduce the pain of dressing changes for patients. 】
Bai Ye understood what it was. Spray this spray before changing the dressing. Then when changing the dressing, the pain will be reduced a lot. There is no need to inject with a syringe, just a gentle spray is enough.
And the main difference from traditional lidocaine aerosol is that it is absorbed quickly and has few side effects. It is especially suitable for careful operations and dressing changes such as oral cavity, mucous membrane, tooth extraction, and hemorrhoids.
The blood concentration and absorption degree of this new type of spray are different, and it is also very useful in pharmacology and toxicology.
This is good stuff!
Bai Ye was overjoyed. After all, there were so many dressing changes in the anorectal department, and it was still very painful in many cases. Having such a thing would at least be much more convenient and reduce the patient's pain.
But...there is only one bottle of this stuff!
Is there a recipe?
I saw a small book inside the dressing pack, which recorded the production process.
Good stuff, I'll study it carefully when I get back. By the way, my lab plan should be put on the agenda. There will be a lot of things to study in the future, so it seems that I have to make preparations early.
[Ding! Clinical skills: debridement and dressing change skills upgraded to lv3.]
[Ding! The dressing change task is completed, a new task is triggered: debridement and dressing change 200 times, the task is completed, and an intermediate exclusive dressing change package is obtained. 】
Exclusive dressing pack for intermediates? The beginners were given a lidocaine spray. What good stuff will the intermediates have?
Bai Ye was suddenly full of expectations for the dressing change. Looking at the buttocks of the patients walking in the corridor one after another, his heart was filled with fire.
On Monday, the director makes rounds.
Pan Xiangnian will conduct ward rounds with the general practitioner every Monday, mainly to gain an understanding of the patient's condition and designate appropriate diagnosis and treatment plans for the patient's special circumstances. Sometimes he will look at the patient's wounds to see how the healing is going.
Pan Xiangnian looked at Qian Rou and asked Song Jie: "How is the patient doing now?"
After Song Jie reported Qian Rou's perianal abscess, he explained the current treatment plan and medication. After hearing the thread, Pan Xiangnian nodded and said to the patient: "Let me take a look at the wound."
Qian Rou blushed and looked a little embarrassed looking at so many people around her.
Pan Xiangnian smiled: "Everyone except the doctor in charge should go out for a while."
Suddenly, only Pan Xiangnian and Song Jie were left in the room. After Qian Rou took off his pants, Pan Xiangnian looked at the situation and nodded: "It's only been a week since the operation, right? Three days of hanging lines? The recovery is really good. Than
The average patient is much better. The dressing change is good. Song Jie, did you change the medicine?"
Song Jie shook his head and smiled slightly: "No, it's my intern. He changed the medicine and did the hanging line."
When Pan Xiangnian heard this, he suddenly frowned, nodded, and went out.
After closing the door, Pan Xiangnian frowned: "How do you let your interns change dressings and hang up threads by themselves? Who is responsible if something goes wrong?"
Song Jie nodded: "I was there to help him at the time, but that child is really good. You can see other patients in a while. They are all recovering well."
Pan Xiangnian nodded. Changing dressings is indeed not a big deal, but the level of interns varies. Generally, they are not allowed to change dressings. If there is any problem, it will be a doctor-patient dispute.
After several ward rounds, Pan Xiangnian found that the patients were recovering well. He suddenly became curious and asked Song Jie in a low voice: "He changed them all?"
Song Jie nodded.
Pan Xiangnian was stunned and whispered: "No wonder...he is better than you."
Song Jie was stunned and almost choked on his saliva. Pan Xiangnian and he were senior brothers and had a good relationship in private.
The people around them were a little stunned when they saw Song Jie and the director not knowing what to say, and Bai Ye followed behind with a lot of cases in his arms.