Yang Yu followed Li Min to remove iodine, and the disinfection time was saved by almost half.Chen Wenqiang watched Li Min give Yang Yu the oval forceps to use, and he took a middle bend to deal with it, so he whispered to Director Liang, who came to see the operation, "Xiao Li is still quite atmospheric. ”"You think whoever is good, even the microscope can't find anything wrong."
After Director Liang had undergone the general surgery, he heard that Director Li was going to take the stage, so he hurriedly came over and pretended to watch the excitement.He was afraid that Director Li would not be able to hold on to such a major operation."
Then what do you say is wrong with Xiao Li?"
Chen Wenqiang is more serious."
If only it were a boy."
Director Liang blocked Chen Wenqiang."
Hey, what age is it, you still have feudal thoughts."
Li Min took Yang Yu to lay out the middle order, and Director Shi and Director Li began to wear surgical gowns.By the time Li Min took the stage, the two directors had already gone under the skin."
Gauze, little bend."
Li Min stood on his special stepping stool, asked for instruments, and followed Director Li to stop the bleeding.Both Director Zhou and Director Liu came over to support the operation."
Lao Chen, prepare to open your chest and abdomen jointly?"
Chen Wenqiang nodded: "Deal with the chest cavity first, and then explore the abdominal cavity."
Liver contusion and laceration have no subcapsular hemorrhage. ”"What is the estimated time of surgery?"
Director Liang smacked Director Zhou: "No matter what stupid things are, this operation will take four or five hours, and I don't know what time it will be when it doesn't go well." ”Director Zhou immediately said to him: "I know that it will take a long time, and you are still standing here to sell nerds?"
Why don't you hurry up and find a place to sit and change people for a while?
”"Find Xie Xun," Director Liu proposed: "He is young and strong, and it is time for him to resist the big one." ”Director Liang stretched out his foot to hook Director Zhou's round stool, "Old Zhou, borrow me to sit for a while, don't you say that I forgot that I had been standing for half a morning."
That Xiao Wang, go and see how Xie Xun's group is doing, let him and Pan Zhi have dinner and come over to take over the stage. ”The patrol nurse answered, pushed open the door of the operating room, and happened to be the head nurse passing by, so she entrusted the matter to the head nurse.Chen Wenqiang was still standing at the junction between Director Li and the head frame, stilting his feet to look into the field.Because of his height and the patient's position, he couldn't actually see anything."
How?""
It's going to be in the chest right away."
For the operation of the thoracic department, from Director Shi to the medical care, Director Shi is basically the operator.When Li Min participated in chest surgery, Director Li did not have much time to help.But Chen Wenqiang arranged for him to bring a newcomer, so he had to reluctantly appreciate it."
Suctifier."
Li Min quickly pinned the suction device to the surgical sheet, and asked for a middle bend in his hand, ready to cooperate with Director Shi to open the chest cavity."
Blood pressure?"
Director Shi's voice was quite loud.Don't look at his usual smile, he changed his appearance when he got on the operating table."92/66, oxygen saturation 87%.Whole blood went in 400ml. ”Anesthesia is intubated into the left main bronchus with unilateral lobar ventilation.It is not easy for anesthesia to adjust and maintain a patient's basic vital signs.Director Shi nodded at Director Liu, thanking her for her kindness.Then he said to Li Min: "Xiao Li, are you ready?"
”"Alright."
Director Shi immediately asked for a sharp knife and opened the pleura.Li Min followed the crack picked out by the tip of the sharp knife and stretched the suction device in.With the roar of the suction device, dark red blood was sucked out.Suddenly, Li Min loosened the suction device under his feet and nodded at Director Shi."
Tissue scissors.Rib retractor. ”Director Shi asked for something and did it with Director Li.Li Min held the suction device in one hand, slowly rotated his head with the other, and then took out the suction head.A blood clot is clogged in the head of the suction device.Li Min threw it to the instrument nurse.Then put two fingers deep into the open ribcage, place the bare suction tube on the finger, and suck the blood in the pleural cavity through the gap between the fingers."
Doctor Li, it's okay."
The instrument nurse cleaned up the suction head and exchanged it for Li Min."
I thought I had sucked my kidneys or lungs just now, and it scared me a lot."
Li Min muttered quietly."
I thought so, too."
Director Shi answered opposite Li Min.This made Li Min very embarrassed.She immediately tied a layer of gauze to the head of the suction device.Slow down, it doesn't have to be that fast now, anyway.As the pleural hemothoris is aspirated, the right kidney, which has been squeezed into the pleural cavity, is exposed.Director Shi gently examined his right kidney: "The capsule is intact.There is a very contusion on the adrene, consistent with CT imaging.Dean Chen, let's not move this kidney for now, shall we?
”"It's better not to move."
Director Shi carefully put the kidneys back and said with emotion: "This person is also blessed.If the renal artery and renal vein are torn a little, I am afraid that the person will not be saved if he does not reach the county hospital. ”"What about the liver?"
Director Liang moved a high step stool and stood there to ask Director Shi."
I'll take a look."
Director Shi washed his hands again, touched down the ruptured diaphragm, and only stretched down his palm and said, "Xiao Li, you come to me."
You have small hands, see if you can touch it. ”Director Li said, "It's okay here." ”As he spoke, he turned to the right and gave up Ichisuke's position to Li Min.The patrol nurse immediately ran over and replaced the stepping stool.The instrument nurse stretched out the saline basin to Li Min: "Wash your hands." ”Li Min cautiously stretched out his right hand down, pulled out his hand for a moment and said, "I didn't feel an obvious rupture, but I felt that the liver membrane was very tense." ”Director Liang nodded and said, "That's the damage of small blood vessels." ”"Director Li, get it back?"
Li Min turned his head and asked."
No, you and Director Shi continue to do a good job."
Director Liang tugged on Chen Wenqiang's back collar, "You still say that Xie Xun is unprincipled." ”Chen Wenqiang looked at Director Li and pretended not to hear Director Liang's accusation.Such a thoracic surgery should not be done by Li Min.But so many people are watching, and Lao Li is also on stage, it should be fine.But he was silent, Director Liang didn't spare him, stabbed him in the neck and said, "I said you."
Ears back?
Why don't you go on?
”"Wash your hands."
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Chen Wenqiang pouted back."
I'll be on it later."
The two of them talked back and forth lively, and Director Shi and Li Min were busy in silence.The diaphragm should be repaired, the bruised lung blood vessels and ruptures should be repaired, and the broken ribs should be fixed internally.After all these things were dealt with, Li Min found that Director Li had already gone to sit on the side."
Come, rinse with warm salt water.Again. ”When there was no bleeding in the chest cavity, Director Shi smiled."
Old Zhou, reopen your right lung and take a look."
No bubbles were seen coming out of the fluid in the chest."
It's done.I'm ready to close my chest. ”Now it's time to reopen the closed chest drainage bottle, place a silicone drain, suture the pleura, and close the chest layer by layer.When they reached the subcutaneous layer, Director Shi and Yang Yu switched positions."
Yang Yu knotted."
Director Shi carried the line scissors and gave the order.Director Liang said to Xie Xun and Pan Zhi: "You two go and brush your hands." ”Li Min sutured by herself, and when Yang Yu couldn't keep up with her speed in knotting, she stitched one stitch at the top and one stitch at the bottom, and occasionally helped Yang Yu tie a few knots by herself.When it comes to the skin layer, Li Min uses the intermittent horizontal mattress valgus suture method.Director Shi reminded Yang Yu softly: "This is to reduce the tension of the skin.Have you ever sewn it?
”"Nope.""
Xiao Li, let Yang Yu get a stitch.""
Okay."
Li Min agreed, and handed the needle holder in his hand to Yang Yu.She used forceps to lift the skin and pointed at the needle insertion point with hemostats: "Insert the needle vertically from here." ”Then press the skin with hemostat forceps and say, "Get the needle out of this." ”Then separate the needle distance, "Here the needle is inserted, the needle is released." ”Li Min used a small bend to connect to Yang Yu's corner needle that penetrated the skin, and with a slight turn of his wrist, he said, "You go out along the angle of this needle bend, you don't need much strength."
You sew it from the bottom as you did just now, and pay attention to the stitch length as well as this. ”"Give me another corner needle No. 4 line, the needle holder is left for them to explore the abdomen, you can give me a small bend, and I will sew it up."
Li Min stretched out his left hand to the instrument nurse.She began to sew her own knots, and as for the thread cutting, she could save up to the end and cut them together."
Not bad."
Chen Wenqiang praised Yang Yu, although he was much slower than Li Min and the sewing was not so regular, but the main points that Li Min said to him were basically achieved.There is a place for the last stitch left, and Li Min leaves it to Yang Yu.He turned to the nurse and said, "Give me a small horn needle 4 wire, and I'll fix this drain."
Director Shi, give me some thread cutters. ”Director Shi took the two of them to finish the rest of the work, grabbed the dressing prepared by the nurse from the instrument table, and fixed the dressing with the help of Chen Wenqiang.Chen Wenqiang said to Director Liang: "You go and brush your hands."
I'm here to position you. ”"Okay."
Director Liang stood up from the round stool and gave Director Zhou a sentence: "I've returned it to you." ”Over there, Xie Xun and Pan Zhi had already begun to wear surgical gowns.Six or seven people in the operating room worked on the unconscious patient from the lateral decubitus position to lie flat on the operating table.The patrol nurse sighed: "I have lost a lot of people today, otherwise such a strong person would really not be able to move." ”Director Shi sighed: "It's a shame that he is strong, otherwise he wouldn't have been able to get a referral from the county hospital or a referral last night." ”"It's hard.""
Dean Chen, his kidney, if you don't make trouble, it will shrink.""
yes.Let's take a look first.If it doesn't work, he will be dialysed a few times to give his right kidney a chance to breathe. ”"It's okay to try dialysis, Yang Yu, give him an abdominal CT examination.""
Yes."
Li Min didn't look at this part of the abdominal exploration.She hurriedly took a shower and followed Director Li to eat, and when she came back from dinner, Director Liang and their group were not over yet.So she first lay down in the locker room, wrote down the first half of the operation record, and showed it to Director Shi, who had eaten and stood in the operating room."
Okay, that's good.This patient let Yang Yu take care of it, and you have to take Yang Yu with you. ”Director Shi instructed Li Min."
Okay, I'll keep an eye on this patient."
Li Min agreed.Even if it is Director Shi's responsibility to take Yang Yu, at the Friendship Store, Director Shi helps himself a lot.Although she didn't want to see Dr.
Yang, she still didn't have any dislike for Yang Yu, a somewhat shy young man."
Yang Yu, don't look at the operation record I wrote first, go back and write a copy yourself, and show it to me at night.""
Yes."
Yang Yu immediately put down the medical record folder in his hand and answered very happily.Li Mincai instructed him to do skin suturing, and in just a few words, he felt that he benefited a lot.Xie Xun said to Pan Zhi on the operating table: "Old Pan, you see that your student has become a teacher." ”Pan Zhi smiled: "What Senior Brother said is that Xiao Li will stay in the affiliated hospital after graduation, and she can also be a teacher at this time."
During our internship at the affiliated hospital, many of us stayed in school for only one year.Someone like my brother, who is four grades higher than me, rarely takes students anymore, and is busy with his promotion papers. ”Pan Zhi is telling the truth.Xie Xun said: "I graduated more than ten years ago, and I only took students. ”He is telling the truth.But the students he was referring to were Yang Yu and their newly assigned graduates, but Pan Zhi pretended to be stupid and secretly replaced "his students" with interns.Director Liang smiled, there was nothing wrong with Pan Zhi talking like this.But he pondered while working, and finally cherished Xie Xun's talent in surgery and gained the upper hand.- When do you have to remind Xie Xun well.This man is difficult to go far at any time.If he Xie Xun doesn't change, I'm afraid that not only will he not be Pan Zhi's opponent in the future, but I'm afraid he will have to beg for food under Pan Zhi's hands.That's going to suffocate him.※※※※※※※※※※※※※※※※※※※※ this right kidney is a foreshadowing, and I will bring it up again in N years.() The distance is a bit far