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Summary of hepatobiliary surgery 1
In a blink of an eye, the one-month surgical internship has ended. Although this internship is a little tired and bitter, it is quite enjoyable. Hand-over rounds, dressing change, vital signs measurement, intravenous infusion, intramuscular injection, blood sugar measurement, and observation of various nursing operations with teachers. Everyday life is spent in this repetitive busyness. Hepatobiliary surgery, rounds at 7: 30 in the morning, and then dressing changes. Of course, the most bitter thing in the operation is the nursing of the patients after operation.
After staying in a department for a long time, I feel that everyone really feels like a family. The care and instruction of teachers and the cooperation of the whole department make the busy work full and happy. Surgeons are mostly temperamental, no matter how good they are at ordinary times. Once they do something wrong, they criticize others and don't give you any face. Nothing seems to have happened since. Doctors are under great pressure when they operate, especially when the operation is not smooth. All we can do is try not to make mistakes. Otherwise, if you really want to cry, you will only be scolded. My teacher is very kind and strict, and has taught me a lot. Patient demonstration and explanation are convenient for young people to communicate. I learned a lot in hepatobiliary surgery, such as changing bile drainage bags and urethral drainage bags. In fact, their operation steps are similar. In this surgical practice, I deeply realized that some patients are unreasonable, but I am also very pleased that most patients and their families are reasonable, and they understand our hard work and difficulty. That kind of complex taste, perhaps only people have experienced, ups and downs, no matter what the taste, it is worth remembering. Of course, more importantly, I learned a lot that books can't.
In hepatobiliary surgery, the biggest feature is the large flow of patients, which also means that our writing workload is greatly increased, and we fall asleep when we are tired in the dormitory. This is the taste of surgery like a five-flavor bottle. The contents of each student's five-flavor bottle in surgery practice are different, either sour, spicy or sweet, but one thing is the same. No matter what the smell is, it is a smell worthy of my life, belonging to surgery and belonging to myself.
This month is a process of adaptation, and many shortcomings need to be improved. This is an internship process, and many concepts have been revised. Although I am very tired, I can overcome it. This is just the beginning of the internship, and we need to explore it in the future. At the same time, I must make demands on myself in order to gain something. I think the next challenge is also an opportunity, and I must seize this opportunity.
Summary of hepatobiliary surgery II
Tomorrow is Friday, and the practice of hepatobiliary department is coming to an end. This is my long-lost fatigue, and I haven't found the passion and feeling of working for a long time. Maybe I like being busy. If I like being tired, I don't have to think about anything. Summary of three-week internship in hepatobiliary department. When I first went there for a week, I followed Mr. Yi, and everyone called him "Brother Mao", which probably means don't mess with him, or you will suffer. He brought a high flyers (Mr Mo). I prefer to work with senior students at this stage of internship, because they are generally not as famous as teachers, they will teach me many small details, and they are much more skilled than us interns, so we can learn slowly. I am a slow learner, and my efforts can make them give me more patience.
Teacher Mo told me that day, "After you go back, you should study for at least one hour every day, study hard for the postgraduate entrance examination and take off your certificate." When I was looking in the mirror, I followed my hand for a long time and talked about the anatomical structure one by one. But by the second week, my life had undergone earth-shaking changes. There was another advanced student, and I had to follow Mr. Yi. So there were four of us, and some of their teachers took care of 20 patients alone. I was tortured and assigned to Mr. Long's staff, and I cried for it. I didn't like the way he spoke at first, so I felt uncomfortable when I heard that I was going to his place, and then I got along. But I have been very tired and comfortable since then, and I have had a hard time every day. I am used to taking a nap, but recently I go back to the ward after lunch every day, and my eyes seem to be hard to open every day. I finally came back to sleep at noon today. I really don't want to get up.
1, the characteristics of biliary colic: right epigastric pain, back pain, related to fat meal, no relief after vomiting.
2. When the liquid drained by the peritoneal drainage tube is gone, don't pull out the peritoneal drainage tube immediately to avoid being blocked by the omentum. You can take a short-term withdrawal observation for one day and then pull it out the next day when there is no drainage.
3. When changing the medicine, the cotton swab iodophor not only disinfects the skin, but also squeezes around the incision to see if there is exudate.
4. Test tube:
(1) Before pulling out the T tube, choledochoscope should be done, and the oil gauze should be folded into triangular rows to prevent the dressing from getting damp quickly.
(2) It is written in the book that laparoscopic surgery for T tube removal takes 2 weeks and laparotomy 10 day, but laparoscopic surgery takes 3 months and laparotomy takes 2 months.
(3) before extubation, clamp the tube before and after meals 1 hour, and clamp the tube all day for 1-2 days before extubation. If there is no abdominal distension, abdominal pain, fever, jaundice and other symptoms, it means that the common bile duct is unobstructed and can be extubated.
5.Mirizzi syndrome refers to the clinical syndrome of obstructive jaundice, biliary colic and cholangitis caused by stones incarcerated in the neck of gallbladder or cystic duct and/or other benign lesions pressing the common hepatic duct. It is a rare complication of chronic cholecystitis and cholelithiasis. 6. Upper gastrointestinal bleeding "400ml does not cause hematemesis, but this does not mean that upper gastrointestinal bleeding does not occur, but if hematemesis occurs, it must be upper gastrointestinal bleeding. 7.
(1) Blood clots will form under the common bile duct, and blocking the common bile duct will cause jaundice.
(2) Now the intra-abdominal pressure should be greater than when the T tube was just pulled out, and the bleeding will be more serious.
Summary of hepatobiliary surgery 3
During the internship around the liver and gallbladder, I learned a lot of knowledge that I didn't learn in the last department, and I also got to know more excellent teachers. Have a certain understanding and mastery of specialized diseases and their nursing in hepatobiliary surgery, especially perioperative nursing.
During the operation, I can better understand the meaning of "three-point treatment and seven-point care". Surgical nursing work is quite heavy, with many classes of nurses and more detailed division of labor. Follow the teacher to the main class, disinfection class, mobile class, morning and evening class, middle and evening class, etc. Understand the general working procedures, including basic nursing, specialist nursing, such as T-tube nursing, drainage bag replacement, diet guidance and education, various examinations before and after operation or nursing preparation observation. Nursing plays an important role in operation, especially before and after examination and operation. It is the best reward and encouragement for us to watch the patients go home safely after receiving high-quality treatment and care in the ward.
Moved by the patient guidance given by the teacher, whether it is knowledge or skills, depression or work habits. Here, not only my teaching teacher, but also all the nurses and teachers in hepatobiliary department. Even though I have been in the clinic for two months, I am still a freshman in hepatobiliary department, and I am not familiar with many aspects. Whether the theoretical knowledge is not solid enough to answer questions or the nursing operation skills are not skilled, the teachers smile and encourage, seriously comment on the shortcomings, without any anger or impatience, and all the bits and pieces are branded in their hearts. Even after the small process of measuring blood sugar can be skillfully operated, the teacher said, "Everything will only get better and better." Such a short and simple sentence gave me great encouragement and will be realized together with my later internship life.
What you have gained is not only the knowledge and experience you have learned from your work. I also benefited a lot from the weekly teaching rounds. For example, as the head nurse said, pancreatic diseases, operation and nursing of three cavities and two bladders, special examination and nursing of gallbladder diseases, and nursing of patients with biliary diseases. These are the consolidation and supplement of my theoretical knowledge, and let me better master the basic knowledge of specialized diseases and nursing.
Thank you, I am about to leave the department, and I would like to extend my deep thanks and blessings to all the medical staff and aunts in Hepatobiliary Area B! The new year is coming. I wish you all good health and new breakthroughs and progress in all aspects in the new year!
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