我给艾滋病人做手术,因为一个小问题,差点陷入万丈深渊
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">今天是12月1日,世界艾滋病日,<span style="color: black;">大夫</span><span style="color: black;">能够</span>拒绝给艾滋病人做手术吗?给癌症病人做手术有<span style="color: black;">无</span>什么危险?今天曾<span style="color: black;">大夫</span><span style="color: black;">经过</span>一个案例来分析一下这个问题。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">一年以前,我还是普外科二线,负责急会诊和急诊手术。有一天<span style="color: black;">夜晚</span>10:00的时候,急诊来了一位20岁的男大学生。<span style="color: black;">由于</span>右下腹痛来就诊的,急诊的<span style="color: black;">大夫</span><span style="color: black;">已然</span>给他做了彩超,提示阑尾肿大,<span style="color: black;">周边</span>有渗出、有炎症,<span style="color: black;">思虑</span>是急性阑尾炎。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">急诊<span style="color: black;">大夫</span>打<span style="color: black;">tel</span>叫我下去会诊,我去了之后,<span style="color: black;">发掘</span>是一位<span style="color: black;">青年</span>的帅小伙子,眉清目秀,疼的蜷缩在<span style="color: black;">检测</span>床上面,嘴里不时地呻吟,可见非常的痛苦。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic4.zhimg.com/80/v2-63f1fb8c5ed25741f884873b645ce4db_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">我给他做了一个仔细的<span style="color: black;">检测</span>,右下腹压痛非常<span style="color: black;">显著</span>,<span style="color: black;">况且</span>有反跳痛的症状,提示炎症<span style="color: black;">已然</span>扩展到了腹壁,他的阑尾炎属于比较严重的,应该要急诊做手术,<span style="color: black;">倘若</span>不做手术,有可能<span style="color: black;">显现</span>阑尾穿孔,弥漫性腹膜炎,感染中毒性休克,可能危及生命。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因此</span>我就<span style="color: black;">意见</span>他立即手术,当天<span style="color: black;">夜晚</span>做腹腔镜手术,把阑尾切掉。<span style="color: black;">然则</span>,<span style="color: black;">由于</span>他在这边上学,<span style="color: black;">无</span>家属,<span style="color: black;">由于</span>这是急诊手术,<span style="color: black;">倘若</span>不做手术的话,有生命危险。<span style="color: black;">因此</span>,即使<span style="color: black;">无</span>家属在,他的<span style="color: black;">朋友</span>帮他签字,<span style="color: black;">亦</span>是<span style="color: black;">能够</span>的。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">做手术之前,我们都<span style="color: black;">必须</span>常规问诊,问<span style="color: black;">病人</span>有<span style="color: black;">无</span>乙肝、丙肝、艾滋病等传染性<span style="color: black;">疾患</span>,<span style="color: black;">病人</span>均<span style="color: black;">暗示</span>否认,他<span style="color: black;">无</span>传<span style="color: black;">患病</span>。尽管如此,<span style="color: black;">咱们</span>还是会在手术前抽血查传<span style="color: black;">患病</span>指标。<span style="color: black;">然则</span>,这些指标不会立即出结果,还<span style="color: black;">必须</span>等一到两天的时间,<span style="color: black;">才可</span>出报告。<span style="color: black;">因此</span>,<span style="color: black;">常常</span>是做完了急诊手术,<span style="color: black;">次日</span><span style="color: black;">或</span>第三天<span style="color: black;">才可</span><span style="color: black;">晓得</span>,他有<span style="color: black;">无</span>乙肝和艾滋病。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">手术<span style="color: black;">火速</span>就安排上了,手术和预想的<span style="color: black;">同样</span>,阑尾非常肿胀,有化脓,局部坏死,<span style="color: black;">咱们</span>叫做坏疽性阑尾炎。<span style="color: black;">倘若</span>再拖下去,阑尾有穿孔的可能。手术过程是比较顺利的,做完手术,<span style="color: black;">已然</span>是凌晨2点。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">手术后的<span style="color: black;">次日</span>,我看了一下<span style="color: black;">病人</span>,生命体征是比较<span style="color: black;">安稳</span>的,腹痛的症状<span style="color: black;">显著</span>好转了。小伙子问我:“谢谢<span style="color: black;">大夫</span>这么晚给我做手术,手术过程顺利吗?”“挺顺利的,你安心养病吧,过几天就<span style="color: black;">能够</span>出院了”我说到。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">“<span style="color: black;">大夫</span>,你们做手术的时候,是不是经常被针扎伤<span style="color: black;">或</span>划伤呀?碰到这种<span style="color: black;">状况</span>,你们都是怎么处理的?”小伙子怯怯的问道。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">“这种<span style="color: black;">状况</span>时有<span style="color: black;">出现</span>,<span style="color: black;">倘若</span><span style="color: black;">显现</span>这种<span style="color: black;">状况</span>,<span style="color: black;">咱们</span>会立即把血挤出来,用水冲洗,<span style="color: black;">而后</span>消毒,更换手套后,继续做手术,<span style="color: black;">咱们</span>都<span style="color: black;">已然</span>扎习惯了,常在河边走,哪有不湿鞋的”我回答道。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">小伙子似乎还有话说,话到嘴边,又咽回去了。我<span style="color: black;">亦</span><span style="color: black;">无</span><span style="color: black;">留意</span>,<span style="color: black;">由于</span>我实在是太困了,<span style="color: black;">已然</span>值班24小时,大脑<span style="color: black;">已然</span>不太灵光了,反应有点慢半拍。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">处理完<span style="color: black;">病人</span>,跟同事交班之后,我就回家了,到家<span style="color: black;">已然</span>是十一点,我叫了一个外卖,吃完就睡觉了。不<span style="color: black;">晓得</span>过了多久,我被<span style="color: black;">tel</span>吵醒了,我一看是科里的<span style="color: black;">tel</span>,赶紧接起来,我怕科里有紧急<span style="color: black;">状况</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">同事问我,昨天<span style="color: black;">夜晚</span>做手术的时候,有<span style="color: black;">无</span>并有<span style="color: black;">无</span>被针扎,<span style="color: black;">或</span>被刀划伤。同事说,检验科的<span style="color: black;">大夫</span>打<span style="color: black;">tel</span>过来,昨天新收的这个阑尾炎的<span style="color: black;">病人</span>,艾滋病初筛是阳性的。同事们马上去问<span style="color: black;">病人</span>,他知不<span style="color: black;">晓得</span>自己有艾滋病<span style="color: black;">病人</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">病人</span>承认了,他说自己<span style="color: black;">已然</span>诊断艾滋病有三年了,他是男同性恋,<span style="color: black;">出现</span>男男高危性<span style="color: black;">行径</span>被传染了。问他为什么昨天不说实话,昨天<span style="color: black;">大夫</span>问的时候,<span style="color: black;">为何</span>不告诉<span style="color: black;">大夫</span>。他说害怕告诉<span style="color: black;">大夫</span>,<span style="color: black;">大夫</span>不给他做手术。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">听到这位<span style="color: black;">病人</span>是艾滋病的时候,我的心里一惊,难怪他今天早上欲言又止,我马上<span style="color: black;">起始</span>回想,昨<span style="color: black;">夜晚</span>做手术的时候,有<span style="color: black;">无</span>不小心被扎到,手套破没破,手术有<span style="color: black;">无</span>破损,眼睛有<span style="color: black;">无</span>被血水溅到,我一一确认之后,确定<span style="color: black;">无</span>这些<span style="color: black;">状况</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">除了我,参与手术的其他医</p>
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