Generally speaking, general surgery includes the following diseases:
First, neck diseases, such as neck injuries and thyroid diseases.
Second, breast diseases, such as breast cancer, breast cyst, breast abscess, breast fibroma and so on.
Third, peripheral vascular diseases, such as varicose veins of lower limbs.
Fourth, abdominal wall diseases, such as inguinal hernia, umbilical hernia, incisional hernia and so on.
Five, abdominal emergency, such as trauma, peritonitis, gastrointestinal bleeding, etc.
Six, gastrointestinal diseases, such as gastric perforation, appendicitis, intestinal obstruction, gastric cancer, colon cancer and so on.
Anorectal diseases, such as hemorrhoids, anal fistula, colorectal cancer, etc.
Eight, hepatobiliary pancreatic spleen diseases, such as end-stage liver disease, liver cancer, cholecystitis, gallstones, pancreatitis, portal hypertension, splenomegaly, etc.
Nine, others, such as congenital abdominal diseases in children, retroperitoneal tumors, etc.
In addition, general surgery is closely related to the basic knowledge of surgery, such as wound repair, burns, electric injuries, animal bites, surgical infections, tumors, shock, aseptic principle, blood transfusion, body fluid balance, enteral and parenteral nutrition, critical organ failure, ICU, transplantation, microscopic examination, reduction, body surface tumors and so on.
In some hospitals, anorectal, burn plastic surgery, vascular surgery, pediatric surgery, transplant surgery and nutrition were originally developed from general surgery.
Pediatric general surgery
Including neonatal surgery, tumor surgery, the main contents of diagnosis and treatment:
1, Neonatal Surgery: esophageal atresia, hiatal hernia, congenital diaphragmatic hernia, gastroschisis, omphalocele, duodenal atresia, annular pancreas, pyloric hypertrophy, congenital intestinal malrotation, intestinal atresia, biliary atresia, Hirschsprung's disease, congenital anorectal malformation, etc.
2. General surgery major: thyroid mass, pyriform fossa fistula and other anterior cervical tumors and fistulas; Diseases of liver, gallbladder, pancreas and spleen such as choledochal cyst, biliary atresia and pancreatic cyst; Congenital gastrointestinal malformations, such as Hirschsprung's disease and intestinal duplication; Various hernias, such as indirect inguinal hernia; All kinds of acute intussusception, incarcerated hernia, acute appendicitis, acute intestinal obstruction, acute gastrointestinal bleeding, acute pancreatitis, abdominal trauma and other pediatric surgical acute abdomen.
3. Tumor surgery: diagnosis and operation of neuroblastoma, nephroblastoma, benign and malignant teratomas in various parts, sacrococcygeal tumors, liver tumors, rhabdomyosarcoma, hemangioma, lymphangioma, etc.
Routine nursing before operation
1, explain to patients, eliminate their worries about the operation, introduce matters needing attention before and after the operation, guide patients to practice defecation in bed when necessary, give them health education and ask them to quit smoking.
2. Inform the family members or the person in charge of the unit to come to the hospital, the doctor will introduce the operation, and fill in the consent form for the operation.
3, preoperative skin preparation according to the doctor's advice (observation of skin condition, shaving and skin cleaning). If the patient is found to have fever, cold, menstrual cycle of female patients, skin injury or infection, etc. He should report to the doctor in time and consider stopping the operation.
4. Requirements and methods of skin preparation
( 1)? Determine the scope of skin preparation according to various surgical requirements.
(2)? Wash skin thoroughly with soapy water, and pay attention to navel and skin wrinkles. Oil stains and adhesive tapes on the skin can be cleaned with turpentine, gasoline or ether. If there is a wound, change the dressing after cleaning.
(3)? When shaving and cleaning, care should be taken not to damage the skin to prevent patients from catching cold.
5, do a good job of body cleaning, shampoo, bath, toenail, change clothes, not by the nurse.
6, according to the doctor's advice with blood, skin test. Prepare special medicinal materials and inform the patient to stop eating on the day of operation.
7. Before operation, tell the patient to fast 12 hours, drink water for 4-6 hours, and hang a fasting card.
8. Pay attention to the patient's sleep, ensure that the patient has enough sleep, and take sleeping pills when necessary.
9, according to the need for preoperative preparation, such as indwelling catheter, etc. Female patients take off hair clips, those with long hair are combed into double braids, and those with dentures take them off. Pee in front of the operating room. Prepare medical records, X-rays, special drugs and materials and send them to the operating room with the patient, and stop all preoperative orders.
10, before being sent to the operating room, measure the body temperature, pulse, respiration and blood pressure, check whether there are any physiological and pathological changes in the operating field, and report to the doctor in time if it is not suitable for operation.
1 1. After the patient is sent to the operating room, prepare the ward and materials according to anesthesia, disease and operation mode.
( 1)? Bed preparation: all sheets, pillowcases and quilt covers should be replaced. Prepare glue and sheets as required. When the room temperature is lower than 18℃, try to raise the bedding temperature, and when it is lower than 12℃, try to raise the room temperature.
(5)? Material preparation: prepare an infusion stand, a sphygmomanometer and a stethoscope at the bedside, and prepare first-aid medicines and instruments and nursing records according to the needs of the illness.
General nursing routine after surgical operation
1. Ask the anesthesiologist about the anesthesia mode, intraoperative situation, the nature and location of the operation, the amount of transfusion and the handling of special circumstances. When the patient returns to the ward, it is necessary to prevent all kinds of catheters from coming out and increase the tension of the wound.
2, pay attention to keep warm, prevent colds, and keep warm with hot water bottles. , should prevent scalding patients.
3, according to different anesthesia methods, do the corresponding nursing. Under general anesthesia, the patient lies flat with his head tilted to one side, and his blood pressure, pulse and breathing are measured every half hour until the patient is fully awake and his blood pressure is stable. After spinal anesthesia, remove the pillow and lie flat for 6-8 hours, and after epidural anesthesia, lie flat for 4-6 hours. After spinal anesthesia, blood pressure, pulse and respiration were measured every half hour for four consecutive times until normal.
4, closely observe the wound with and without oozing blood, oozing liquid, etc. When the dressing is wet, change it at any time or inform the doctor.
5, all kinds of drainage tube to keep unobstructed, prevent distortion, compression, closely observe the nature and color of drainage fluid, accurately record the drainage situation.
6, keep blood transfusion, infusion vein unobstructed, according to the doctor's advice and illness, reasonable arrangement of infusion sequence and drip rate, etc.
7、? For those who still can't urinate by themselves after 7-8 hours, those who check bladder fullness should consider aseptic operation for catheterization and stay in the catheter for 24-48 hours.
8, according to the condition, adjust the position, turn over, pat the back, etc. , to prevent bedsores and pulmonary complications.
9. Within three days after operation, take temperature and pulse four times a day. Patients with high fever should be treated according to routine nursing care of high fever.
10, nutrition supplement and diet, those who can't eat are given nasal feeding or intravenous high-priced nutrition according to the doctor's advice to maintain the nutrition, water electrolyte and acid-base balance of patients.
1 1. Keep the respiratory tract unobstructed, remove secretions in the respiratory tract in time, encourage fingertip patients to take a deep breath and expectorate, and prevent lung infection.