As soon as Guan Zheng pinched left and right, it looked quite professional. After Guan Zheng inquired, he said, "Appendicitis, take it easy, keep your mind relaxed to relieve the pain, the doctor will come soon." ”

Guan Zheng pulled the passing nurse and said, "This patient has acute appendicitis and needs emergency surgery. ”

"Who are you?" The nurse ignored Guan Zheng.

Guan Zheng took the bandaging items in the nurse's hand and said, "Leave this to me, you can go and see this patient, he is more serious." ”

The nurse didn't let go: "How can this work?" If something goes wrong, who am I going to cry to? ”

"Don't worry about this, I have this." Guan took out a notebook from his pocket like a coup d'état, and the nurse glanced at it and said, "Forget it, I'll call the doctor to show him." ”

Xu Jiuyan asked curiously, "What did you just show the nurse?" ”

Guan Zheng leaned on Xu Jiuyan's ear and said, "Nurse qualification certificate." ”

"You pervert! You even have this? Xu Jiuyan looked at Guan Zheng dumbfounded.

Guan Zheng smiled and said: "I took the exam in my sophomore year, because the employment rate of bioengineering was too low, so I listened to Feng Yuan's words and went to take this exam, I thought I would work in a hospital and be a fashionable male nurse or something." ”

"But I didn't expect to be a police officer by mistake?" Xu Jiuyan said.

Guan Zheng nodded and said, "Before I met Shi Bureau, I never thought that I would be a policeman. ”

Jiuyan pouted and said, "No wonder you know so much about medical knowledge. I'm really curious, how much else are you hiding from me? ”

Guan Zheng smiled and said, "It's me hiding it from you, it's because you have a low IQ." Think about it for yourself, I know so much clinical knowledge, and a fool knows it, right? ”

Xu Jiuyan flew over with a punch: "I despise my IQ again......"

Xu Jiuyan's hand moved, and said, "Hey, hey, what's wrong with him?" Isn't it going to work? ”

Guan Zheng turned to look over and saw that the patient had lost consciousness. Guan Zheng shouted a few times but did not respond. Guan Zheng said: "Go and call a doctor." Acute appendicitis leads to intestinal perforation, hemorrhagic shock, and surgery must be done as soon as possible. ”

The doctor finally found time to push the patient into the operating room.

Xu Jiuyan stood at the door of the operating room, looked at the light on, and asked, "Is this appendicitis so dangerous?" ”

Guan Zheng said: "Is that not it? Appendicitis is an inflammatory change caused by a variety of factors, and is a common surgical disease, most common in young people, more in men than in women. Clinically, acute appendicitis is common and can occur in women of all ages and during pregnancy. Chronic appendicitis is rare. There are many causes of acute appendicitis, firstly, the obstruction of the appendix is a slender tube that communicates with the cecum at only one end, and once obstructed, it can cause secretions to accumulate in the lumen, increase internal pressure, and compress the appendix wall and obstruct distal blood circulation. On this basis, bacteria in the lumen invade the damaged mucosa and are prone to infection.

Secondly, the main factor of infection is direct infection caused by bacteria in the appendix cavity. If the appendiceal mucosa is slightly damaged, bacteria can invade the tube wall and cause varying degrees of infection. Other factors that are thought to be related to the onset of the disease include splanchnic nerve reflexes caused by gastrointestinal dysfunctions such as diarrhea and constipation, resulting in spasm of the appendix muscles and blood vessels, resulting in narrowing of the lumen of the appendix, blood supply disorders, damage to the mucous membranes, and acute inflammation caused by bacterial invasion.

For chronic appendicitis, it can be roughly divided into two categories: recurrent appendicitis and chronic appendicitis. The former is mostly caused by the failure of the lesion to completely remove the residual infection during the onset of acute appendicitis, and the disease is prolonged and does not heal. The latter has no history of acute appendicitis attacks, and the symptoms are subtle and the signs are often inaccurate. ”

Xu Jiuyan nodded and asked, "Then how do you tell that he has appendicitis?" ”

Guan Zheng elaborates: "Typical acute appendicitis begins with mid-upper quadrant or periumbilical pain, which metastasizes and immobilizes to the right lower quadrant after a few hours. When the inflammation spreads to the serous layer and parietal peritoneum, the pain is fixed in the right lower quadrant and the original mid-upper quadrant or periumbilical pain is reduced or disappears. Thus, the absence of a typical history of metastatic right lower quadrant pain does not rule out acute appendicitis. Uncomplicated appendicitis is often paroxysmal or persistent with swelling and dull aches, and persistent severe pain is often suggestive of purulent or gangrenous appendicitis. Persistent, severe pain affecting the middle or both sides of the lower abdomen is often a sign of perforated appendiceal gangrene. That's what this patient is.

Gastrointestinal symptomsThe gastrointestinal symptoms of simple appendicitis are not prominent. In the early stages, there may be nausea and vomiting due to reflex stomach cramps. Pelvic appendicitis or perforation of the appendix may be associated with increased frequency of bowel movements. Fever is usually only low-grade fever without chills, and purulent appendicitis usually does not exceed 38 degrees Celsius. High fever is more common in appendiceal gangrene, perforation, or concurrent peritonitis.

Tenderness and rebound tendernessAbdominal tenderness is a manifestation of inflammatory stimulation of the parietal peritoneum. Appendiceal tenderness points are usually located at the McCereum point, where the middle and outer thirds of the right anterior superior iliac spine meet the umbilical cord. Rebound tenderness is also called Blumberg's sign. In patients with obesity or posterior cecal appendicitis, tenderness may be mild but there is significant rebound tenderness. Abdominal tension is a sign of suppuration of the appendix, and abdominal tension is particularly pronounced in gangrene perforation complicated by peritonitis. However, in older or obese patients, the abdominal muscles are weak, and the contralateral abdominal muscles should be checked at the same time.

A small number of people also have skin hyperesthesia. In the early stage, especially when there is obstruction in the appendix cavity, the phenomenon of skin hyperesthesia in the right lower quadrant can occur, which is equivalent to the innervation area of the tenth to twelfth thoracic medullary segments, located in the highest point of the right iliac crest, the triangle formed by the right pubic crest and the umbilicus, also known as the Sherren triangle, which does not change due to the different position of the appendix, such as the perforation of gangrene of the appendix, the skin hyperesthesia in this triangle disappears.

The symptoms of chronic appendicitis are similar, abdominal pain, pain in the right lower abdomen, characterized by intermittent dull pain or swelling pain, sometimes severe, sometimes mild, and relatively fixed in location. Most patients experience abdominal pain after a full meal, exercise, exertion, cold, and prolonged standing. Patients with gastrointestinal reactions often have mild to severe dyspepsia and decreased appetite. Weight loss and weight loss may occur in patients with a longer course of disease. Nausea and vomiting are usually absent, and abdominal distension is absent, although constipation may occur in older patients. Abdominal tenderness and tenderness are the only sign and are mainly located in the right lower abdomen, which is generally small and constant in location, and can only occur when there is heavy pressure. There is no muscle tension and rebound tenderness, and there is usually no abdominal mass. ”

Xu Jiuyan instantly felt that she had gained a long knowledge, and asked, "What about this appendix surgery?" A while ago, I heard on the news that appendix surgery can kill people, so I really wanted to know if it was real or fake? Can such a small operation kill someone? ”