The one-hour dance made Li Min come to the trauma surgery department refreshed and energetic after the exercise.The head nurse stretched out his hand and twisted Li Min's face, and asked with a smile: "What did you wipe on your face, so good-looking?"
”"I was exercising.Director Xie is not there?
The nurse said he was looking for me. ”"In the middle of the room."
Zhang Zhengjie and Xie Xun were discussing things inside, and Xiao Cao, Xiao Zhan and several interns were listening to it."
Director Zhang, senior brother.""
Xiao Li is here.I'm looking for you. ”Zhang Zhengjie smiled and spoke, while Xie Xun just nodded at Li Min.Li Min was surprised, Zhang Zhengjie was looking for himself, and he didn't come if he wouldn't come, so why bother to use Xie Xun's banner?"
That's right, our department just accepted a liver space-occupying lesion.I mean, you and Director Xie teamed up to do this operation, and I hooked the two of you, how about it?
”"Director, you are too modest.At my level, I only work as an assistant for my senior brother. ”Li Min hurriedly humbled himself.Xie Xun looked at Li Min, who had sweaty fine fluffy hair on his forehead and a face as fresh and ruddy as a peach, and pushed his glasses slightly unnaturally and said, "The patient was admitted almost noon today."
I didn't do any checks. ”As he spoke, Xie Xun pushed the open outpatient medical records to Li Min.Zhang Zhengjie waited for Li Min to finish the outpatient medical records and said, "Xiao Li, when the examination results come out, I will almost arrange for surgery next week." ”"Okay."
Li Min closed the outpatient medical record, and Zhang Youdao, an intern brought by Xie Xun, immediately took it."
Senior brother and Director Zhang gave me the opportunity to operate, I thank you in advance.Where is the patient?
I'll go see the patient. ”Zhang Zhengjie said: "Let's go, let's go together."
We didn't look at it either. ”* A group of about a dozen people went to the ward, and the small ward was immediately filled by them.Patients and their families are inevitably a little panicked and scared when they see so many people coming in.Xiao Zhan, as a newcomer led by Xie Xun, stepped forward to ask about his medical history.Zhang Youdao watched Li Min take out a note notebook to record, and he also took out a piece of paper from his pocket, folded it, folded it, and began to remember.The patient appears to be in general condition."
I had a lump on my stomach when I was a kid.I usually don't delay eating, drinking, and going to work.Nothing has happened for more than 20 years.But after I gave birth last year, I felt that this lump was starting to grow.In the past six months, especially in the last two or three months, I have grown faster and faster, and I feel uncomfortable eating most of the bowls of rice. ”This is similar to what is recorded in the outpatient medical record.After all the medical history was asked, Li Min stepped forward to examine the patient.In order to dissipate the patient's nervousness, she said: "Don't look at so many of us, the results of the examination are out, it was Director Xie who operated on you, and he has done liver surgery better."
Director Zhang took me and Dr.
Zhan as assistants.These are all internship students. ”"You're going to have surgery too?"
The patient asked Li Min while undressing.So many men staring at themselves, knowing that it was surgery, but it was really unbearable."
Hmm.My surname is Li, and I've had more than a dozen liver surgeries.Come, open your mouth first.The tonsils are swollen and not red, the uvula is centered, and the pharynx is not red.Raise your neck. ”A female doctor examined her, and even though there were male doctors in a circle, the patient's emotions gradually calmed down.Because of the intern's presence, Li Min gave the patient a full set of physical examinations.When she reported as she was doing: "There is no swelling of the submandibular lymph nodes, no swelling of the axillary lymph nodes, and the heart sounds are normal......
When she went to the abdomen, Li Min said to the patient: "Come, follow what I say."
Inhale deeply and hold it.Okay, exhale. ”Her fingers delicately and gently touch the edges and surfaces of the liver as her breath rises and falls.After a full set of physical examinations, Li Min pulled the patient's clothes."
Director Xie, Director Zhang," Li Min's fingers slid over the patient's clothes."
The lower edge of the liver is more than two transverse fingers below the cost."
Li Min stretched out his finger to show everyone."
But the surface is uneven, hard and soft at the same time, and the sensation on palpation is obvious.I would recommend no further physical examinations.Let's go and do B ultrasound together. ”Li Min's action of pulling the patient's clothes immediately surprised everyone, and then she didn't let others go for another physical examination, even Xie Xun was a little surprised.It stands to reason that after Li Min's physical examination, he should, even if he only do a partial examination.So Xie Xun asked directly: "Senior sister, what do you suspect?"
”Li Min frowned slightly and said, "It's very similar to the teratoma I encountered during my internship."
But it's in the spleen.The sensation on palpation is very similar.Whether it is a teratoma or not depends on the results of B-ultrasound and CT examinations, and surgical resection and pathology can be confirmed. ”The latter words are to reassure the patient.Xie Xun also thought that it might be a teratoma, but Li Min said that hard and soft coexist, and with his understanding of Li Min, he guessed that Li Min was worried that this teratoma would have malignant transformation, and he was afraid that the tumor cells would fall off and metastasize due to heavy palpation.Xie Xun nodded and agreed not to check the body again, if he didn't stretch out his hand, Zhang Zhengjie wouldn't even stretch out his hand.And Zhang Zhengjie's efforts for a while, from Li Min's words and Xie Xun's attitude, guessed the possible reason why Li Min didn't let others touch it.He immediately said: "In this case, I will call the B-ultrasound room to see if the director is not there, and can arrange an emergency examination." ”Zhang Zhengjie is very positive.Comprehensive development is the requirement of the provincial hospital for clinical doctors below the attending doctor, and only seeing that the internal medicine department now also adopts the duty method of surgery, he keenly repositioned himself.
——The profession should be refined, and other related things should not be relaxed.You can't miss the opportunity.He set himself a new goal for this.Not only for the bonus of the whole department, but also for the future of the provincial hospital to have a place to stand, not inferior to other department directors, enough to speak.Therefore, he actively contacted Director Cheng in the outpatient department, and with the help of Director Cheng, the patient who should be admitted to the general surgery department was brought into the trauma surgery.He wished he could be like Chen Wenqiang and Director Liang.Xie Xun is here in the trauma surgery, just like Director Liang was there before, and it is completely reasonable to do liver surgery.But he didn't dare to help rashly, Xie Xun's dog temper didn't matter the occasion, if he was in a hurry on the operating table, if he didn't save face, he would become a joke of the whole hospital.So he discussed with Xie Xun to persuade Dean Chen to find Li Min over.* Director Zhang Zhengjie was very face-saving and allowed him to push the patient over immediately."
Sure enough, it was a teratoma.Look here. ”The probe in the director's right hand pressed slightly on the liver, and the left hand pointed to the screen and said, "This should be the teeth, and this clump should be hair."
The rate of growth is relatively fast this year, which should be when she is pregnant and gives birth, hormonal changes in the body stimulate the growth and development of teratoma.Let's do a CT scan to see the blood supply to the tumor. ”Director Guo conveniently did a B-ultrasound examination of other organs in the abdominal cavity.As he did so, he asked, "Did your mother's generation have twins?"
”"My mom and my second aunt are twins.My sister is also a twin. ”Director Kuang nodded: "Hmm, no wonder. ”Teratomas tend to occur in families with a history of twins, where one embryo is parasitic into the body of another embryo during development.The site of the parasitism is usually different.There is an opinion that teratomas are early incomplete divisions of a single zygote.But this has little to do with the fact that they are pouring all their energy into the clinic, which belongs to the field of those who are engaged in basic research.Coming out of the ultrasound room, the patient was nervous all the way.After entering the elevator, she grabbed Li Min's hand and asked, "Doctor Li, am I benign or malignant?"
”Li Min patted her hand and comforted: "Whether it is benign or malignant, it will increase rapidly in a short period of time, and it is right to come to surgery in time."
But don't be too nervous, I've seen people who grow on their spleens and are alive and well after surgery. ”"Oh my God, it's benign.Please, my daughter is only a year old. ”The woman's mood was not very stable, and she couldn't help but put her hands together and pray to the ceiling of the elevator in anxiety.Li Min had no choice but to continue to comfort her: "There is a high possibility of benignness." ”Sending the patient back to the ward, Li Min immediately wrote a record of the patient's first illness at the trauma surgery.Zhang Zhengjie played with a pen in his hand and asked Xie Xun: "Is there a tendency to change malignantly?"
”Xie Xun was noncommittal, but after a while, he suddenly spoke: "I suspect that there is a possibility of a malignant transformation." ”Li Min glanced up at Xie Xun and didn't understand how he could say that.Although the benign tumor suddenly increased in a short period of time, considering the possibility of malignant transformation, it is not Xie Xun's style to answer Zhang Zhengjie so normally.Shouldn't he snort and leave?
Xiao Zhan is writing a complete inpatient medical record.After he waited for Li Min to finish the first trip, he took it over and copied the physical examination part.I didn't forget to tell Zhang Youdao: "Go and get the test sheet, and follow the examination items written by Dr.
Li on the temporary doctor's order." ”Li Min finished the things at hand, called Fu Yunxiang, who came down, and said, "I have time to follow up this case and chat with this patient more." ”"Yes."
Fu Yunxiang agreed and went out.She's free right now."
Senior sister, how does it feel to take that intern?""
It's okay, Fu Yunxiang is very well-behaved, let you do whatever you want, and it's all very good."
Li Min had Director Liang's words at the bottom, and felt that it was necessary to use every opportunity to correct Xie Xun's dissatisfaction with Fu Yunxiang.Xie Xun felt irritated when he saw Fu Yunxiang, and he really couldn't understand how someone could be so blind.Especially since I have to give such a stupid person a good +.He said with disgust: "She shouldn't have come to the surgery internship." ”Li Min nodded: "Yes."
She didn't want to do a surgical internship either.Director Liang said that she also had no idea of becoming a surgeon. ”Speaking of Director Liang, Xie Xun immediately fell silent.After a while, he told Li Min: "Be careful when you take her to surgery."
Don't let her help you out. ”"Well, I'll be careful."
Zhang Zhengjie interjected: "It's rare for girls like us Xiao Li to be seen.Even a boy can't do her composure on the operating table. ”After half a year of seeing Zhang Zhengjie again, Li Min wanted to avoid such a compliment from him.She smiled a little shyly and said, "Director Zhang, I've been down for a long time, and I have to go back." ”Zhang Zhengjie said with a smile: "Come down when you have time, don't wait for us to call to invite." ”"I've come here at least twice in the morning and evening, but none of you are in Corey.Goodbye director, goodbye brother. ”Li Minqiao left with a smile.※※※※※※※※※※※※※※※※※※※※* After fertilization of a single egg, incomplete division continues to develop to form a conjoined baby.It completely divides into two embryos and continues to develop, which is what we usually see as look-alike twins.
**Also: teratomas can also be fraterozygotes.() The distance is a bit far