Li Min came to the operating room a few minutes later than Chen Wenqiang.Director Liu saw Li Min come in and asked, "Dean Chen, have I started anesthesia?"
”"Hemp.What is Lao Li looking for you?
”Chen Wenqiang has already turned a few times in his heart, today's glioma is not a good operation, and during the preoperative discussion, Director Li also reminded him to pay attention to it.What is it that deserves him to find Li Min before the operation?
Director Li asked Dr.
Qin and Dr.
Yang how to arrange for surgery.Li Min reported his arrangement.Now that Zhang Zhengjie is not in the ward, Cory is not hospitalized, and Chen Wenqiang never cares about chores like this; Director Li is old, and he is basically in a state where he doesn't contribute much; If Director Shi doesn't come out, the four on the eleventh floor will leave at the beginning of next month; The rest is clearly left to Li Min.She could only take the initiative to come over and make arrangements as well as she could.In fact, it is not a big matter, but it is quite cumbersome to sit up and arrange it fairly.In addition to the four interns on the twelfth floor, the four students who interned on the eleventh floor were also involved, and the eight of them had to take turns for thoracotomy and craniotomy operations, and the four interns downstairs participated in the surgery, Li Min also had to watch a little postoperative management.Chen Wenqiang listened to Li Min's arrangement and expressed his approval, nodded and said, "It's good to arrange this way, you go and brush your hands first." ”"Hmm."
Lu Kaiwen followed Li Min to brush his hands, and it was his turn to take the stage today."
Mr.
Li, is this glioma patient not going to live for too long?""
It's hard to say.If the tumor can be cut almost completely, there is still a glimmer of hope for chemotherapy after radiotherapy, otherwise it is difficult to say. ”Today, this glioma is located in a wide range of locations.Preoperative brain CT examination showed a round, irregular hypodense shadow in the right frontal lobe, a far more dense shadow, with unclear boundaries and compression of the right ventricle.MRI of the brain showed that the right frontal lobe and temporoparietal lobe were mass-like, uneven, slightly longer T1, and longer T2 signal shadows......
The frontal angle of the right ventricle is compressed, and the midline structure is shifted to the left.Initial evaluation was glioblastoma of the right frontal, temporal, and parietal lobes.And the tendency is high-grade glioma.This is the most malignant type of tumor, and it is also the type of tumor with the least promising prognosis.It often recurs soon after surgical removal.However, the current effective treatment is surgery + radiotherapy and/or chemotherapy.Otherwise, the patient who has developed neurological symptoms and increased intracranial pressure will soon enter the dying stage.Although Chen Wenqiang treated him with anti-epileptic drugs for more than a month, the disease progressed too quickly and he had to undergo surgery early.This is a case of a dead horse being used as a live horse doctor.If it weren't for the discussion of the death record yesterday, Li Min would have used the time yesterday afternoon to organize interns to listen to Chen Wenqiang talk about glioma.Now he can only wait for Dr.
Liu to finish dealing with it, and Chen Wenqiang can be in the mood to give a lecture to the interns.Hopefully, this lecture will distract him a little.lest Chen Wenqiang, who has a black face, walk around everyone who looks at him, it's too scary."
Mr.
Li, is chemotherapy done in our department?""
It's not.The radiotherapy and chemotherapy of cancer patients of the provincial doctor were handed over to the Department of Medical Oncology. ”For this kind of classification and treatment of tumors, Li Min has dealt with the Department of Medical Oncology many times.But that's fine, she doesn't have the energy to focus on chemotherapy anymore.However, with Kevin Lu's question, she felt that it was necessary to take these interns to the Department of Medical Oncology to understand the rough postoperative chemotherapy plan.During the six-week internship, Li Min felt that there were quite a few things that interns had to see."
Go back and tell your classmates that there will be a glioma class this week, depending on Dean Chen's schedule.Let's talk about the specific time. ”"Hmm.I'll let you know first.By the way, I saw a notice today, saying that tomorrow after the renovation and study in the large conference room, the Youth League Committee will hold a dance party.Mr.
Li, are you going?
”"I'm not going, I'm not free."
Li Min stepped on the linkage device and grabbed two hand towels.After Lu Kaiwen also took a hand towel, Li Min wiped his hands and said to him: "Tomorrow there will be no craniotomy in our group, you and Wang Dali will go to see Director Li's group for surgery." ”Qin Zhang came back from disinfection to soak his hands, just when he heard Lu Kaiwen and Li Min talking about the dancing of the Youth League Committee, he pinched his eyes at Lu Kaiwen when Li Min turned around and threw the hand towel.Lu Kaiwen whispered in his ear: "Okay, Mao knows that he wants to hook up with your teacher before he grows up." ”Lu Kaiwen opened his mouth to speak, but Li Min turned around and said to him: "Lu Kaiwen, hurry up, you go to disinfect." ”"Yes."
Lu Kaiwen left Qin Zhang and went to the operating room excitedly.* The operation was performed by Chen Wenqiang himself, but after the craniotomy, this time he did not give Lu Kaiwen a meningeal hook to sell him, but asked the nurse to prepare a monocular for him.The tumor was infiltratively growing in the right frontal, temporal, and parietal lobes, and the surrounding area of the tumor was wrapped by a wound edema area."
Just watch it for a while, don't run into Dr.
Li."
Chen Wenqiang told Lu Kaiwen."
Yes."
Being able to get a monocular to see microsurgery, Lu Kaiwen was so excited that his voice trembled a little."
It's not quite the same as the MRI films we watch."
Li Min said to Chen Wenqiang when Sister Feng helped her put on her eyepieces.The unclear boundaries of the tumor in the surgical field are known early.From the CT and magnetic resonance imaging images, the tumor has not yet passed through the corpus callosum to form a butterfly shape, but the tumor in the surgical field has obviously gone to the corpus callosum.The two gently peeled off the edema zone little by little, exposing a reddish-brown tumor."
M's, that's how many capillaries have been proliferated, no wonder they grow so fast.Xiao Li, on electrocoagulation. ”Li Min stretched out his hand to Xu Li, the instrument nurse, and said, "0.5 gun-shaped electrocoagulation tweezers, 3mm toothed cup-shaped tweezers."
Kevin Lu, you must not touch me. ”Kevin Lu leaned to the side again.Sister Feng turned on the power supply of the electrocoagulation box."
Dean Chen, is it okay to give 110?""
Try it first."
Chen Wenqiang used a knife in one hand to peel ions in the needle, and Li Min carried the blood vessels of the tumor with toothed cup-shaped forceps, followed Chen Wenqiang's progress, pinched the 0.5 mm gun-shaped electrocoagulation forceps, and kept burning the proliferative capillaries that supplied blood to the tumor.The hand could not shake or deviate, and he had to keep up with the progress of the surgeon, and Li Min was highly nervous."
It's been half an hour."
Sister Feng reminded Chen Wenqiang.Chen Wenqiang raised his head, moved his neck and said to Li Min: "Change your position, you will be the operator." ”Li Min handed the instrument back to the nurse, and then said to Lu Kaiwen: "You stand up first, don't touch the surgical gown." ”After changing positions, Li Min slowly peeled off the tumor like Chen Wenqiang did just now, while Chen Wenqiang followed her speed and clamped the blood vessels and electrocoagulation to stop the bleeding in time.Xu Li watched Li Min dance the knife and needle tweezers, and said to Director Liu with a smile: "I like to watch Dr.
Li use microscopic instruments the most, it seems to be her fingers, so flexible that she can't feel the tweezers." ”"She was born to eat this bowl of rice, isn't she Dean Chen?"
Director Liu never misses every opportunity to praise Li Min."
Well, of course.The electrocoagulation is turned off first, give me a 10-0 suture, and this blood vessel needs to be stitched up. ”Chen Wenqiang reached out and asked for something.Li Min stopped and changed the tweezers, asked for scissors, and connected the needle and cut the thread when Chen Wenqiang sewed the blood vessels.Then the two of them changed for about half an hour, and the operation moved forward smoothly and slowly.…… Director Liang walked over with Dr.
Chen."
Lao Chen, is it going well?"
This is a patient who entrusted the relationship of Director Liang's wife."
It's ok.It's harder to cut clean. ”Chen Wenqiang scratched the infiltration part of the field to the left and said, "This piece is obviously different from normal tissue, but the image shows that it is fine." ”"That's the part that has just infiltrated the past and hasn't developed yet.""
yes.This part is intertwined with normal brain tissue, and I am afraid that the patient will not wake up after surgery. ”Li Min coughed lightly and reminded Chen Wenqiang: "The cut off piece is sent to the pathology?"
”"Hmm."
Li Min suspended the tumor part that had been cut off in the air in the direction of the instrument table, and Xu Li immediately handed over the stainless steel basin to pick it up: "Doctor Li, let go." ”Li Min let go and continued to stare at the operation of the surgical field without raising her head after the tumor fell into the specimen basin, but she reminded Sister Feng that "the pathology application form is sandwiched at the end. ”Dr.
Chen looked at it for a while, and asked Director Liang in a low voice: "Director, why do I think Dr.
Free novels bring you joy and joy ---> storyskyline.net
Li is the operator?"
”He had heard of Li Min's craniotomy in the Department of Neurosurgery, but he thought it was just a cerebral hemorrhage or something, but he didn't expect it to be a top-level surgeon for glioma.Director Liang said with a smile: "Dean Chen is not uncommon to be an operator.is lazy, lazy, it's not that if you can push it, you can push it to Xiao Li. ”"You have no one to do it for you, wait for Xiao Xie and a few of them to get up, I don't think you are lazy?""
Lazy people are lazy.Who made the general surgery easier than you, and there are more people who can help me with my work?
”Director Liang smiled and said to Dr.
Chen: "Did you look at it?"
Xiao Li worked her own, and when she came up, she could move the microscope equipment and follow the stage.You have nothing to do to learn from Xie Xun and Xiao Li. ”Dr.
Chen is embarrassed, Dr.
Li has only graduated for a year, what do you learn from her?!
But he complied anyway."
Lao Chen, I have a liver cancer over there tomorrow, you lend Xiao Li to me, I will let her do it with Xie Xun, and give those who have just entered the department what are the surgical skills, so as not to be angry and angry, Pan Zhi told them that they are still unwilling to move.""
Give money!
Don't think about it otherwise. ”Chen Wenqiang understood that this was for Pan Zhi to bring newcomers out to disagree.And Pan Zhi was Li Min's teaching secretary when he practiced surgery, and he took Li Min to surgery, and belonged to the likes of Teacher Banla......
This old Liang is becoming more and more cunning."
Give it, give it.Ming'er Xiao Li went over to help. ”"Thank you, Director Liang."
Li Min was very happy.※※※※※※※※※※※※※※※※※※※※* A little bit about intracranial tumors.The annual incidence of primary central nervous system tumors is 16.5/100,000, of which nearly half are malignant tumors, accounting for about 1.5% of systemic malignant tumors, and gliomas are the most common, accounting for about 40% of central nervous system tumors.
**After 2016, the WTO established a new classification standard for central nervous system tumors.Here I will follow the original classification, but there is a conflict with the new standard.By 2016 standards, it has lost its 90s character.So this passage is too detailed.Regarding glioma, we all know that the high grade is basically high malignancy, and the low malignancy of the low grade is enough.Anyway, it is unlikely that you will be a neurosurgeon if you read the article, and those outdated experiences will not be detailed () The distance is a bit far