不太“普通”的普通外科医生

2018-01-07 佚名 医学生

有一次医院派出“普通外科医生”飞赴某地参与救援,惨遭网民吐槽:“这都什么时候了?还只派普通外科医生?为什么不派高级外科医生?拿得出手吗?”

有一次医院派出“普通外科医生”飞赴某地参与救援,惨遭网民吐槽:“这都什么时候了?还只派普通外科医生?为什么不派高级外科医生?拿得出手吗?”

其实取名字真的很重要,名字取的好不好,决定了一个人的命运,但你可能不知道,医院科别的取名,也有很大的影响,像是看到消化科,就知道是看消化系统的问题,你也绝对不会跑到胸外科,去跟医生抱怨你的膝盖痛,因为很清楚,那是看呼吸系统问题的地方。但在医院里,的确存在一些让人看了雾煞煞的科别,而其中一个就是敝人所属的科别,「普通外科」!

从「普通外科」这个名词看来,实在看不出是要看什么的,我还记得当我是菜鸟主治医师时,我的第一个门诊来了3个病人,果然都是来询问一些「普通」的问题,第一个是来开诊断书的,第二个是来开验伤单的,第三个是来问我手上的那个痣有没有问题(通常应去问皮肤科医师)。

所以我想借这个机会,为「普通外科」这个科别正名一下。为什么会取名为「普通外科(generalsurgery)」呢?其实早年外科,并没有那么多的科别,大致只分成三种科,骨科,妇产科,这两种科别,非常易懂,一个看骨折,另一个处理生产和妇女病,所以所有剩下需要手术的疑难杂症,就归类给第三科,也就称它为普通外科,与其说普通外科医师只看普通问题,不如说普通外科医生照顾几乎人身体大部份的器官。

普通外科医生负责的业务范围其实很广,我常和我的朋友开玩笑说,我的业务范围是从颈部以下一直到骨盆腔以上,听起来有些夸张,但是真的,普通外科医生会处理颈部甲状腺的问题,包括甲状腺囊肿,甲状腺功能亢进,以及甲状腺肿瘤,往下到胸部,乳房手术也是由普通外科医师负责,举例乳房超声检查,良性乳房肿瘤,以至于乳癌根治手术,到术后化疗人工血管管都是植入,都是由普通外科医师包办,在有些医院甲状腺与乳房是被归类到乳甲外科。胸部其他器官,心脏与肺脏就不属于普通外科了,因为这两个器官怎么看都不普通,所以是由心脏及胸外科医生负责。

再往下到腹腔,这才是普通外科医生真正的地盘,消化器官从胃,十二指肠,肝脏,胆囊,胰脏,脾脏,小肠,一直到阑尾,其中大大小小的疾病,需要开刀的,都是由普通外科医生来负责,有些医院如果没有肛肠科,普通外科也会处理结肠的问题,另外一些难以分类的疾病,如疝气,后腹腔肿瘤,也是我们的业务范围。普通外科医生也会在最具挑战的急诊,处理复杂的创伤病人,还有所有腹部急症需要手术的病人。

普通外科可说是所有外科医师训练的基础,不论外科医师进入哪一个次专科,都需要经过普通外科的洗礼,我永远记得,我生平第一次拿手术刀化开皮肤的伤口,第一次缝合伤口,第一次阑尾切除手术,都是在普通外科训练时完成的。也许普通外科不像其他次专科,有许多新颖的器械来辅助手术,我们现在大多的手术还是靠着那几盘从我们老师流传下来止血钳,剪刀,镊子,一针一线地止血,切除,缝补病人。

有些医院的肛肠科、烧伤整形科、血管外科、小儿外科、移植外科、营养科等原来是由普外科分出后设置发展起来的。

所以可以说普通外科是外科系统的基石和基础。普通外科不普通。

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    2018-01-09 Y—xianghai

    学习了新知识

    0

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    2018-01-09 孙文杰

    很不错.算是科普了

    0

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    2018-01-09 jihuaijun1112

    学习学习学习

    0

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    2018-01-07 jihuaijun1112

    学习学习学习

    0

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