2016年12月28日 星期三

足部傷口的護理

足部傷口非常普遍,如運動創傷、鞋子不適,甚至剪甲時弄損等。一般情況下,傷口可在數天或周內自行愈合,但若患者是腳部血液循環欠佳人士,傷口可以數星期 甚至數個月仍未愈,故若發現自己足部有此情況,應及早接受醫生檢查,以作出正確診斷。最重要是診斷出因動脈或靜脈問題而引起的潰瘍,並根治背後的血管毛 病。並非所有個案都需要手術的,當血管問題已處理或排除,傷口便會由足部治療師或傷口專科護士協助,提供傷口護理支援。

足部治療師主要就病人的足部健康問題,提供傷口護理及制訂日常預防及保養方案,是治療足部傷口團隊裏的重要成員。 他們會用適當的敷料護理傷口潰瘍,並會測試足部的神經線感覺、動脈血液循環是否良好,最重要是於傷口進展情況不理想時,能作出適時的轉介至血管外科,避免 病情惡化或出現併發症等。

即使傷口已愈合,足部治療師亦會就着患者本身的健康狀況,提供日常護理建議,避免傷口復發。他們會評估是否需訂製具保護性能的鞋襪或特製鞋墊,並教導病人 如何清潔足部、修剪腳甲等。這些服務,對高危一族,如糖尿病、慢性靜脈功能不全,下肢動脈阻塞,足部神經麻木等病人,實在非常重要。

外科專科醫生謝卓華











新闻来源:  http://www.am730.com.hk/
以上所提供的资讯仅作为教育及参考用途,如果你有任何医疗问题,
应向医生查询,而不应单倚赖以上提供的资料。

2016年12月21日 星期三

Gastroscopy (2)



4. During the Gastroscopy, what do I need to cooperate for making procedure go smooth?

Firstly, doctor will give the anesthetic throat spray for local anesthesia. If necessary, relaxants or painkillers may be given intravenously to relieve the patient anxiety or stress. Patients should follow the doctor advice and gradually swallow the slender endoscope. Meanwhile, patient is able to breathe as usual. If keeping relax and cooperate, the whole procedure can be completed in minutes. Doctor can also get biopsy or specimen from the patient's stomach for laboratory test. Patient will not feel the pain under this process. Also for some other cases, doctor can treat the bleeding site in case it is found during the endoscopy.

 
5. After Gastroscopy, any follow-up or points to note for patients?

The throat anesthesia will last for about an hour after the endoscopy examination. Do not do the mouthwash immediately. Allow to drink or eat after at least 1 hour or doctor assessment. If patient has under the relaxant injection, he/she will forget some examination memory, so it is advised they should be accompanied by relatives or friends, to listen to the preliminary examination report and take care of patient when going home.

 
6. What is the adverse effect(s) of Gastroscopy?

Patients usually feel a sore throat, a small amount of flatulence and dizziness after gastroscopy, which will be subsided shortly. Gastroscopy may cause the stomach perforation, inner lining bleeding, but very rare to occur.





Reference information:  http://esteemmedical.com.hk/gastroscopy.html
It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your physicians for diagnosis and treatment. 

2016年12月20日 星期二

Gastroscopy (1)




1. What is Gastroscopy?

Gastroscopy is the use of endoscope, going into upper digestive system through the patient's mouth, esophagus, into the stomach, duodenum and jejunum. The doctor can observe the internal status in order to carry out the examination, diagnosis and appropriate treatment.

2. What is the function of Gastroscopy?


By the use of endoscope, doctor can check the internal conditions of the upper digestive system (esophagus, stomach, duodenum and jejunum). If necessary, the doctor can perform some treatments as follow:

    Biopsy collection for lab test
    Removal of foreign body
    Varicose veins treatment
    Laser treatment
    Pyloroplasty for Pyloric Stenosis
    Polypectomy
    Inner lining hemostasis


3. Before Gastroscopy, what do I need to prepare and pay attention?


Points to note for patients before gastroscopy:

Sign the consent form for receiving gastroscopy examination or treatment after well understanding with doctor’s explanation.
   
Do not eat within 6 hours before the examination in order to avoid aspiration when inducing vomiting, and provide a clear vision view for gastroscopy.
   
Follow doctor’s instruction for arrangement of taking the chronic illness medication (diabetes, hypertension, or drug allergy).
   
Follow the date, time and place for meeting the appointment of the gastroscopy.

.......cont'l











Reference information:  http://esteemmedical.com.hk/gastroscopy.html
It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your physicians for diagnosis and treatment. 

2016年12月13日 星期二

九十歲動手術

在新聞中看到英國國民大事慶祝他們女王的90歲大壽,的確,能健康活到90歲是值得慶祝的。其實在香港,90多歲的老人家,比比皆是,但在醫院遇到的,大多是健康有點問題。

最近收了一位九十多歲的婆婆,是長期煙民,那時開始吸煙她已經記不清楚了,故已患有慢性肺氣腫多年,走路快點也會氣喘,上樓梯也上不到一層。

她在作身體檢查時,無意中發現肚內的主動脈血管,不正常地擴張了,由正常的兩公分直徑,擴張至七公分。情況就好像把氣球不斷吹張直至爆破,體積越大,爆裂流血的機會越高。一旦爆裂,是百分百致命的。這情況,醫學上稱之為「腹部主動脈瘤」。

正常的的醫治方法,是接受手術修補血管瘤,雖說現今的手術,大多以微創方式進行,手術風險大大降低,但在90多歲的病人身上動手術,總是有很多變數的,況且婆婆的呼吸系統問題極不理想,稍有點感染或痰阻塞,也可有生命危險的。

若您是婆婆或其家人,你會接受手術嗎?

大家意見紛紜,有的說都90多歲了,還想一百歲嗎?還是順其自然吧!萬一手術有什麼差池,出現併發症,死可不怕,最怕受苦啊!

有的說可以醫的為什麼不醫,難道等爆破了流血時才動手術嗎?況且每天帶着計時炸彈,不知何時爆,什麼也做不了,像在等死,這才最受罪! 正是公說公有理、婆說婆有理。

醫生,你有什麼建議呢?….........待續。

外科專科醫生
謝卓華











資料來源: AM730
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向醫生查詢,而不應單倚賴以上提供的資料。

2016年12月7日 星期三

Causes of Goiter



Goiters are not equivalent to hyperthyroidism. Goiter describes hyperplasia of the thyroid gland which most commonly due to problems with the immune system. However, the increase in size of the thyroid gland does not have any relationship with the amount of hormone to be secreted.

In the more underdeveloped countries, goiters could be caused by iodine deficiency, as patients may not be able to intake enough iodine from seafood to fulfill their body needs. This causes the thyroid hormones T3 and T4 in the blood to be lower than normal, prompting the pituitary glands to continuously secrete TSH (Thyroid Stimulating Hormones), stimulating growth of the thyroid glands.


Amazing Seaweed – Nutritious, Low in Calorie and Prevent Goiter

 

Seaweed, which grows in the ocean, has excellent source of minerals especially iodine that can possess powers to prevent goiter. Goiter refers to over-production of thyroid hormones, leading to enlargement of the thyroid glands. Iodine is essential to maintain proper functioning of thyroid glands, which helps to regulate body’s metabolism, growth, temperature, heart rates etc., and deficiency in iodine can lead to a disease called goiter. Large and thick neck resulted from goiter that affects nearby organs such as esophagus and trachea may lead to dysphagia and breathing difficulty, while stunted growth and mental retardation can be seen in children with goiter due to hypothyroidism.

Seaweed is categorized into three main groups, and they are red, green, and brown seaweeds. Brown seaweed has the highest iodine content, with dry kelp contains 1500-8000 ppm (parts per million), while red and green seaweeds have lower contents, about 100-300 ppm in dried seaweed, but still considered as high when compared to other land plants. Adults and children who are actively growing are recommended to have a daily intake of 150 µg and 90-120 µg iodine respectively, which is actually covered by very little amount of seaweed, as only one gram of dried brown seaweed can already provide 500-8,000 µg of iodine. Thus, just a tablespoon of seaweed is already enough for recommended daily intake.

In addition to iodine, seaweed is also an excellent source of calcium and iron, which is especially suitable for vegetarians who avoid dairy and meat products. Therefore, seaweed is highly recommended to be included in our diet. This can be done by sprinkling kelp flakes onto a salad or soup, wrapping rice or vegetables using nori sheets or having seaweeds snacks during tea time. Although iodine intake may be related to the situation of Goiter, other factors can also lead to Goiter. Thus, it is recommended to seek a doctor immediately for medical check when the problem of thyroid enlargement arises.




Reference information: http://www.thyro.com.hk/goiter-thyroid.html
It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your doctor for diagnosis and treatment.

2016年12月6日 星期二

爆破的靜脈怎止血?

上星期報章上報道,一名老伯在海邊垂釣時,突然腳部的靜脈曲張爆破,血流如注,需要友人報警求助,救護員替他止血及包紮後,情況穩定過來,伯伯竟然拒絕送院,有趣的是,他還跟記者說,這情況在家中已多次發生,好像完全不覺得是甚麼一回事。

若靜脈曲張已經到達流血的狀況,可以肯定的說,已到達後期或嚴重階段。倒流的靜脈血液,過量地積聚於小腿附近的靜脈血管,令血管膨脹,血管壁薄弱,加上過高的靜脈壓力,令皮膚出現慢性發炎,引致濕疹及痕癢。很多時患者會不自覺地抓癢的地方,一不小心便會把靜脈抓破,導致出血。此外,若患者進行長期站立的活動,好像這位老伯的海邊垂釣,曲張的靜脈也可因過分膨脹而自動爆破出血。

這情況若出現的話,只要有一點急救知識,保持鎮定,幾個步驟已可把血止過來。首先,是在流血的位置用力按下,因為靜脈的壓力是不會很高的,即使是用一隻手指,也足以堵住流血的靜脈。接着就是躺下來,並把腳部提起,置於高於心臟的位置;靜脈內的血液,便以水向低流的原理,回流到心臟,當靜脈內的壓力降低,血流便會自然停止。這時便應再傷口上包紮,保持傷口上的壓力,再到醫院求診。記着,這樣做只是於急症的情況下止血,並沒有根治問題,正確的做法是進行掃描找出有問題的靜脈,並以適當的手術清除。否則,流血的情況是肯定會重複出現的!

作者為外科專科醫生 謝卓華














資料來源: AM730
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向醫生查詢,而不應單倚賴以上提供的資料。