In the operating room, Chen Wenqiang first looked through all the inpatient examination materials brought by the patient before brushing his hands on stage.But he didn't take over the position of the surgeon who stood in the position of Dr.
Wang, but just stood in the position of the second assistant and pulled the hook, and let Dr.
Wang continue to do it.But his appearance made Dr.
Wang immediately settle down.To be honest, if it weren't for the thick fat in the patient's abdomen, gallbladder removal can be said to be the operation that Dr.
Wang is currently actively striving to do.Cholecystectomy is not difficult, the key is to avoid secondary damage during the operation, do not cause bile to overflow into the abdominal cavity, do not damage the liver, if you encounter a clear anatomy, first break the cystic duct and gallbladder artery, and then you can "follow the vine" to lift the gallbladder down.This is an antegrade cholecystectomy.However, cholecystectomy is almost the most difficult and uncertain of the secondary surgeries.Conditions like this one can be as difficult as some tertiary surgeries.Because of the thick fat layer in the patient's abdomen, the "underground operation" is really staged on the operating table.Although Dr.
Wang had prepared for a long time and the incision was half longer than that of the patient, after entering the abdominal cavity, he still could not avoid such a situation.Therefore, he muttered as he operated: "Who, if you turn the light for me, I can't see anything clearly in this 'bottom of the well' deep." ”Regardless of whether others agree with the words "underground operation", at least Chen Wenqiang and Dr.
Liu, who are standing on the operating table, sympathize with Dr.
Wang's complaint - they are both assistants, and neither of them can see what is in the surgical field, so they can only rely on experience to hook Dr.
Wang.Chen Wenqiang saw that Dr.
Wang's forehead was already a fine and dense layer of sweat, and beckoned the nurse to wipe his sweat.Then he comforted Dr.
Wang and said, "Don't worry, follow the normal surgical steps."
His fat layer is too thick, and if the incision is not enough, then open it a little bigger.Our purpose is to save lives.As long as the inside is done, the outside incision doesn't matter. ”Doctor Wang nodded, and accepted Chen Wenqiang's comfort: he extended the incision as if it were good.Shuno was a little clearer."
Dean Chen, it still seems impossible to do it smoothly."
With Chen Wenqiang to rely on on the side, Dr.
Wang subconsciously wanted to find support."
Then reverse cut.You first peel off the adhesions around the bottom of the gallbladder, and then slowly process the cystic duct and blood vessels in the gallbladder. ”The truth is that Dr.
Wang understands everything, but the difficulty of doing it is only known to him as a practitioner.The fat is stretched open with a retractor, but the adhesions between the gallbladder and the surrounding area also prevent the liver from being pushed away.Dr.
Wang had no choice but to separate the gallbladder from the surrounding adhesions little by little.Under the shadowless lamp, Dr.
Wang's ten fingers were slender, and in the surgical field that expanded into a "crypt", he used small curved hemostats to carefully separate the adhesions layer by layer.After Director Li smoked a cigarette in the duty lounge, his tightly knit brow revealed his inner uneasiness.After hesitating for a while, he decisively stuffed the unlit Hongta Mountain in his hand back into the cigarette case.Walked to the nurse's office to explain Xiao Zhai's whereabouts, and walked to the general surgery ward.Near noon, in the corridor of the general surgery ward, there was a steady stream of family members who came to visit the patients and deliver meals, but there was no medical staff in white coats.He walked to his office, where only two nurses were writing and talking.He walked in, and the nurse didn't look up, as if not noticing someone coming in.When he buttoned the table, they both looked up at the same time."
Oops, Director Li is here.You may be seated. ”The two nurses were quite enthusiastic about him."
Where's your Director Cheng?"
Director Li asked Director Cheng as soon as he opened his mouth."
We're going to have four surgeries today, one in a row.Now it's all empty city plans.Just now the outpatient clinic called and said that there was a patient to be brought in, and we all told them that there was no doctor in the ward. ”"What kind of surgery do you have?"
Director Li sat down and asked questions as if gossiping.The two nurses thought it was strange to him for questioning, when did Director Li be willing to talk to the nurse?
But the old director asked, and the older nurse still answered: "Director Cheng's group has stomach cancer and a ......
Give me the book. ”A notebook with a blue plastic cover was handed to her."
Director Cheng's group first did a large thyroid resection, and then a gastric ulcer was suspected to be gastric cancer.It's been almost two hours since the stomach cancer was received.In addition, Director Mu's group first performed an inguinal hernia repair and then a radical mastectomy. ”Director Li nodded, so it seems that no one in the general surgery department has taken care of the gastric perforation and cholecystitis.It's still because of the lack of people.In those years, the rebels in the provincial courts took advantage of the "May Seven" instructions and the "June 26" road to eliminate dissidents, and sent the backbone cadres of various departments who had escaped from the net of the "reactionary technical authority" and refused to bow their heads to the county hospitals at the grassroots level and even to the commune hospitals.Now the provincial court wants to transfer these people back, but the children of those people have already married and settled in the county seat.As a result, the need to transfer one person back to the provincial capital has turned into a job of mobilizing a large family to return, providing several houses, and housing more than a dozen people.It's so difficult......
The provincial hospital could only pick and choose to transfer back some of those who had fewer children and could arrange jobs and housing, and the rest were forced to give up.Director Li's thoughts were scattered, and he left a sentence in the surprised eyes of the two nurses: "When you Director Cheng comes back, tell him that I will come to him for a drink." ”The two nurses responded very neatly, glanced at each other, and both felt that something was wrong with Director Li.But Director Li reversed the heavy mood he had when he came over just now, and went back with ease.He walked around the nurse's office, asked if the patients in the ward were okay, and then walked back to the duty room.As long as the clinic does not intentionally stuff the 84-year-old patient with a perforated stomach or cholecystitis who is too fat to see his feet.But he turned to worry about Chen Wenqiang, worried that he would not be able to take the operation.But this mood only lasted for a while, and was interrupted by Xiao Zhai who knocked on the door and came in."
Director Li, the outpatient department sent an emergency to our department: appendicitis.Male, 26 years old. ”Xiao Zhai was a little embarrassed, if he hadn't used any appendicitis as an excuse when he was looking for Dr.
Li, there shouldn't have been appendicitis sent over at this time.Dr.
Li quipped to himself: "Look, you have recruited appendicitis." ”Another is that she is still a little grateful to Director Li for relieving her in the morning.Director Li's performance in the face of the 84-year-old man's performance of not disliking and picking up the past made her want to take the initiative to report the patient's gender and age and let Director Li know."
Dr.
Li went to receive the doctor?""
Hmm.The patient rested in the 5th ward, which had just been vacated. ”Looking at the time, it was time for lunch, Director Li didn't immediately go to the 5th ward, and started the phone first."
Hey."......"
It's me.Corey just got an acute appendicitis. ”......, "Okay, then you can send it." ”Leaving the phone, Director Li stepped to ward 5 to see the patients who had just been admitted to the hospital.Ward 5 is a small room for four people, which is generally reserved for patients transferred from the intensive care unit.Putting people here now means that there is a greater possibility of needing surgery.Although the head nurse is a gentle person, she is also very quick in her work.In the middle of the morning, she made an adjustment to the patients in the ward: those who could be discharged before the holiday and were relatively close to home left the requirements for discharge with medicine, and then left the ward, and waited for tomorrow to pick up the medicine and go through the discharge procedures; If you live relatively far away, you can stay another night, and then leave tomorrow after taking the medicine with you.After some adjustments, several intensive care units and a few small rooms for 4 people were vacated.Director Li opened the door of ward 5 and listened to Li Min talking."
If you want to treat conservatively first, it's fine.You can give him a drip and give him the best anti-inflammatory drugs.However, once he has aggravated symptoms, such as perforated appendix or even peritonitis, he can no longer be treated conservatively, and emergency surgery is necessary.Be ye mentally prepared. ”Director Li walked in and saw a young man in his twenties, lying on a hospital bed with a somewhat pale face.Bedside was accompanied by a young girl."
Then Dr.
Li, he has been in pain all morning, can you give him a painkiller injection?""
Painkillers will mask the condition.I used painkillers, and my appendix was perforated, and I didn't know it.You don't eat at noon.The nurse will come and give you the infusion right away.Director Li, this is an appendicitis patient who has just been admitted. ”Li Min explained and explained to the patient and the accompanying staff, and when he saw Director Li coming, he reported to him."
Hmm.He doesn't want surgery?
”"Yes.The patient started to have pain in the upper abdomen before breakfast this morning.Now transferred to the right lower quadrant, the McCephalis point is tender, rebound tenderness positive.The temperature was 37.6 and there were no other abnormalities.I ate half a bowl of rice porridge for breakfast. ”The patient and the girl accompanying him interlocked their fingers, and when they heard Li Min call the old man who came in as the director, they wanted to sit up and talk."
Director Li, we originally planned to use the 'Eleventh' holiday to travel and get married.So can you not have surgery......"
"Hmm.I understand.Come on, I'll check it out for you first. ”Director Li reached out and pressed the patient who was about to sit up.The girl helped untie her clothes again.After carefully palpating and auscultating his abdomen, Director Li pulled up his clothes, straightened his waist and said, "Since this is the case, we will treat conservatively first."
If there is an indication of an appendix perforation, surgery is required. ”"Good.Thank you, Director Li, and thank you, Dr.
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Li. ”Li Min walked over and shook the bed for him.Let him lie down on the bed, and tell them: "If you have something, go to the office to find it." ”Then he followed Director Li and left.Back at the nurse's office, Director Li immediately said, "Xiao Li, you go to eat first."
I guess this patient will have to have surgery in the afternoon.I can't get off work. ”"Shall I bring you some back?""
No, I don't.My wife will bring me food in a moment.You go to the cafeteria now and there are fewer people, and you will come back after eating.I'll do this doctor's order. ”"Thank you, Director Li."※※※※※※※※※※※※※※※※※※※※ collection and reading volume is embarrassing.Last night, I was struggling with whether to finish the first unit first...... () The distance is a bit far