The next day, Li Min went to Corey very early to take over.Chen Wenqiang took her, Dr.
Zheng, the chief inpatient doctor, two doctors, and a few intern students to quickly check the patients on the 11th and 12th floors.It was said that it was a quick ward round for treatment only, and it took more than half an hour.But they both have a good idea of the condition of the hospitalized patients.After checking the room, Li Min handed over the original manuscript he had sorted out to Chen Wenqiang to see."
What is this?"
Chen Wenqiang didn't understand for a while, and was a little surprised."
I sorted out all the neurosurgical medical records in the past two years and summarized the 20 craniotomy pathways.""
That's a good picture."
Chen Wenqiang looked at the stick figure of the base of the skull on the cover, and praised it fondly."
Mujay painted it for me.""
Well, that's good.I didn't expect Mu Jie to be able to draw.This can be used to draw pictures for textbooks. ”Chen Wenqiang flipped through it.Xiao Yin came with a lunch box bag and a daughter who was taller than her."
Aunt Yin.""
Xiao Li, I have to trouble you to accompany Xiao Yan'er to review today.""
Aunt Yin is polite, it's not troublesome.""
Sister Li."
The little girl's results in the monthly exam have improved again, and the whole person is full of energy and momentum."
Hmm.Teacher, then I'll take Xiaoyan'er to the office. ”"Okay, you two are reading on the eleventh floor, and I'm going to the twelfth floor.I'll talk about this later. ”Chen Wenqiang and Xiao Yin went upstairs.Li Min took Chen Hongyan into the office where it was restored to its original position.She arranged for the little girl to sit at Chen Wenqiang's desk, and the two of them made rolling paper with their heads bored and looked down at professional English, starting a new Sunday learning mode.* Chen Wenqiang was eating breakfast while reading the materials handed to him by Li Min.Xiao Yin saw him scooping porridge with a spoon, and the rice porridge was about to be sprinkled on the table, and reminded him: "Old Chen, let's see after eating." ”"Hmm."
Chen Wenqiang agreed, but his eyes still did not leave the material in his hand.Xiao Yin walked over and grabbed it."
You eat well first.What kind of treasure is this, I can't even let go of eating. ”Chen Wenqiang saw that the things were dragged away by his wife while he was unprepared, so he turned his head back to breakfast.After he finished breakfast, he took his lunch box and went to the water room to wash it.When I came back, I saw that Xiao Yin was still looking very seriously, so he said, "Look at Xiao Li's words, has there been progress?"
”"Hmm.It's not much worse than our two children. ”"That's a long way off.I taught the two of us how to practice calligraphy.Xiao Li wanted to catch up with their brother and sister and let her practice for another three years, but the two children in our family had to stop. ”"You think you're a good kid.To be honest, Xiao Li's handwriting is quite good. ”"Look at whom.It's still a long way from being a family. ”Xiao Yin smiled, this person's requirements for children and students are as high as for himself."
Xiao Li, is this going to publish a book?"
Xiao Yin closed the material and handed it back to Chen Wenqiang."
Do you think it's possible?""
I've only seen the first few craniotomy paths, and her ideas are very good, and the pictures are good.If it had been left until 10 years ago, it would have been printed.But now, it should be accompanied by CT and MRI films, which will be more helpful for beginners. ”Xiao Yin thought for a while and said, "Then let Lao Hu match it." ”"It wasn't an easy job.Do you think Lao Hu will do it for nothing?
”Chen Wenqiang replied as he opened it."
No matter how much you don't do it in vain, I think Xiao Li is mainly based on clinical surgery.Even if he wants to add an editor's name, he deserves it.But this book, after all, is not a specialist book for his imaging major, and he will not want the position of editor-in-chief.You say yes, right?
”Chen Wenqiang nodded: "What you said makes sense."
I'm afraid that there are still people who are optimistic, and I have to add the name.Let me tell you, Xiao Li's summary, although it is superficial, is very practical.It is most suitable for young doctors who are new to neurosurgery, or who have been in contact for a long time but have not done much craniotomy.However, this book should be accompanied by corresponding pictures of CT and MRI, which can completely allow the doctors I just talked about to have an intuitive understanding of the craniotomy path.Of course, you can also take it as a golden rule and prepare for surgery. ”Xiao Yin thought for a while and said, "You are going to take the position of chief judge, right?"
”"Sure enough, you know me best.I must take a good look at this, and don't have any omissions or mistakes.Xiao Li made a mistake, and people who knew that Xiao Li was my student would say that I taught Xiao Li wrong.If a book is published, it will affect more people, and then it will cause endless harm. ”"You're right.But there are more people majoring in neurosurgery, and it is not interesting for Lao Hu, the editor of the imaging department.It's better for us to tell him that the editor-in-chief is Xiao Li, he is the only editor, just you, and the rest of the troubles will be solved by him. ”"The rest of the trouble is gone.Lao Hu is not necessarily willing. ”"Try it first.This is the child's brainchild, how can a person with a big beard be embarrassed to reach out?
They want to publish a book, decades of work experience, and write deeply. ”Chen Wenqiang smiled: "You have a good idea, so it's decided." ”"Why don't you talk to Xiao Li first?""
No, I don't.Let her and Xiao Yan'er read a good book.I just told the nurse that I had something to do with the hospitalization, but the hospitalization couldn't solve it and came to me. ”"Did you sleep last night?"
Xiao Yin was worried that Chen Wenqiang's body would not be able to bear it."
Slept.I slept all night.Otherwise, how dare you stay in Corey today.The inpatients of Napu Surgery and Orthopedics are always attending physicians, and the two of them took Xiao Zheng and two inpatient doctors, and a few of them resisted the night shift. ”"Okay?
Don't make a mistake.Your surgeon is going to see blood from your men at every turn. ”Although Xiao Yin was worried, he still joked with Chen Wenqiang.Chen Wenqiang replied confidently: "The two attending doctors both graduated in 86, and they have been working for so many years, and the difference is that the senior doctors give them a chance."
I was on the night shift last night, and I knew that I was in charge, no matter how reckless I was, I would have restrained myself a little.They know it's wrong, they know it's fine, and I'll do it for them. ”"And what about your urology boy?""
You said Xiao Huang.He was too impatient.That Yang Weiguo is the same as him, both of them want to run before they learn to walk.But he is a little clever, and he knows that he is guarding patients in the ICU for the past two days.I went over last night, in the middle of the night, and he hasn't left yet. ”"Is the patient okay?""
It's okay to look at it for now.If the next 24 hours are so smooth, I can pick it up tomorrow morning. ”Xiao Yin saw that the patient was like this, so he stopped asking.Otherwise, just seeing that Lao Chen listened to Director Shi's phone call, she was so angry that she was worried that Lao Chen would stop the diagnosis and treatment of urology under impulse.Chen Wenqiang looked down at the materials, Xiao Yin packed the lunch box and said, "I'll go home and make lunch."
What do you want to eat?
”"Don't do it at noon, go to the cafeteria and buy some.I'm going to drink at Lao Shi's house tonight.After dinner, you answer correctly early and go back to school. ”"Good.So we're staying here tonight?
”"Well, I'll call my parents and I'll go back tomorrow night."
Xiao Yin saw that Chen Wenqiang had an arrangement, so he left with a lunch box.* At ten o'clock, Xie Xun called the nurse's office on the twelfth floor."
I'm Xie Xun.Where's Dr.
Lee?
”"She's in the director's office on the eleventh floor.""
Why can't I get through on the phone?"
Xie Xun questioned the nurse.The nurse on duty pondered for a moment, but it was still Dean Chen's explanation.After listening to the nurse's explanation, Xie Xun understood that Dean Chen must have assigned Li Min some work, so he called Dean Chen again."
Dean Chen, I'm Xie Xun.There is an emergency surgery on this side of the general area, and a laparotomy will be done.I'm going to bring Xiao Chen and Xiao Zheng from your department to the stage, and I have to trouble you to take care of this side of general surgery. ”"Okay."
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Chen Wenqiang immediately responded.Xie Xun led people to the general surgery, and he didn't worry at all.Putting down the phone, Chen Wenqiang continued to watch Li Min hand over the information to him.To be honest, Li Min's summary is still a little rough and superficial.According to your own ideas, there are many places that can be written in a little more depth.Chen Wenqiang wanted to add those thoughts of his own, but in the end, he put the pen back.The positioning of this craniotomy path was summarized by Li Min from the medical records of the past two years, and it is suitable for those who do not have a large amount of surgery and do not have deep infiltration in neurosurgery.I'm going to change it, it's the advanced version, in other words, the suitable crowd has also changed.Those people, hmph, where do they need to write this for them themselves.Which of those people didn't have a good grasp of neurosurgery as early as the beginning.After Chen Wenqiang read it in its entirety, he called Director Hu of the Radiology Department.After he finished finishing the materials sorted out by Li Min, Director Hu understood what he meant."
Old Chen.It's no problem to match this material with CT and MRI images, even if the DSA and MRA images are still there.But I can't Xiao Li write dozens or hundreds of diseases, I have to follow myself to find hundreds of films, I can't do it.Not available.I asked our Cory's Gong Hai to match the image, and then I checked to ensure that there was no problem with the image, what do you think?
”"Are you going to carry Gong Hai?""
Yes.I think the young man is very down-to-earth.Among these boys from the medical university, he has been working for five years, and I have been looking at them coldly as these medical university graduates, and I really didn't notice that he was slippery. ”"One more editor?""
You are the chief reviewer and Xiao Li's editor-in-chief remains unchanged, and you don't care about the rest, will it be successful?"
Chen Wenqiang groaned."
Lao Chen, plus is also an editor, I have this measure.But this book is not an internal publication that we printed for students to make handouts, we have to have a book number, and it has to be something that can be put in the Xinhua bookstore.There are more doorways in this. ”Chen Wenqiang laughed: "Didn't you Lao Hu print a copy?"
”Director Hu immediately said: "I just printed it, and I realized that there are many sayings here."
You don't have to worry about all that messy stuff, you two just write the content, and just see the sample book within two months, how about it?
”"Okay."
Chen Wenqiang agreed.Director Hu said that he was impressed by seeing the sample book within two months."
Lao Hu, I just have one request, you must not make any mistakes.""
This will definitely not, don't worry, you don't know me yet.The main reason is that the book number is difficult to get.M, the person holding the book number, if we don't look for sponsorship, it will be a loss and we won't be able to make a shout.Drag on for a few years, wait for similar things to be printed first and then put on the shelves, we can't even get the original manuscript back after a hard time. ”"How are you going to find sponsorship?
How much sponsorship is required?
”Director Hu on the other side of the phone was silent for a moment and said, "An ordinary editor has at least more than 10,000 names.Your old Chen is the one who has passed the test, and it is worth their money.Don't think I'm going to put this money in my own pocket.This money is not only for the purchase of book numbers.For a purely professional science and technology book like ours, which has limited sales, 10,000 copies will be printed at most.I only had 5,000 copies of that book.Let me tell you, half of this print run is half of what we want to underwrite, and the price is one-third of the list price, the cost price.You calculate the number of prints, and then calculate how much money you want to prepare. ”Chen Wenqiang has never published a book, but he believes that Lao Hu will not deceive himself in such a thing.Adhering to the principle that there is no suspicion in employing people, he decided to leave this matter to Director Hu to do."
I'll give you a copy when I get to work in the afternoon.You ask Gong Hai to find a film for the diagnosis first.I finished the specific finalization as soon as possible. ”"Okay, no problem.When I go to work in the afternoon, I go to your place to pick up something. ”"Okay
.
"* Chen Wenqiang took something and went to find Li Min.When he got to the stairs, he turned back and told the nurse, "I'm on the eleventh floor." ”With so many patients on two floors, it is impossible to find a doctor.The nurse on duty quickly responded.Then she → Dr.
Zheng on the small blackboard on the next line of the operating room and wrote that Dean Chen → the eleventh floor.Chen Wenqiang opened the door of the director's office with the key, and when he saw Li Min and his daughter studying face to face, his heart was overjoyed: it was thanks to Xiao Li that he could influence her.The sound of him opening the door disturbed the two girls who were working hard."
Teacher.""
Dad."
Chen Wenqiang nodded at his daughter and said, "You continue to make rolls."
Xiao Li, Xiao Zheng went to the operating room for laparotomy exploration, you go home for dinner at noon, and make a copy of this by the way.I told Director Hu that I wanted him to match the corresponding CT, MRI and other pictures.If you have a record of these medical records, you can bring them back by the way, and it will be easier for them to find the films. ”"Good.So what do you do when you eat?
”"Your Aunt Yin will send it."
Li Min looked at his watch and said, "Then I'll go back now." ”"Well, go ahead."
Li Min changed into a white coat.When she was wearing her coat, Chen Wenqiang added: "I am the chief reviewer of this book, you are the editor-in-chief, and there will be some editors I don't know, you must be mentally prepared." ”"Well, teacher, I listen to you, you have arranged it."
Li Min didn't expect to get the position of editor-in-chief.In this way, no matter how hard it is, it is not much hardship.* After Li Min returned home, he told his mother and Mu Jie about Chen Wenqiang's arrangements.Liang Gong nodded Li Min's forehead and said, "Got it."
What is yours is yours. ”Because Xiaofang was still there, Liang Gong didn't say the rest of the words.Li Min said to Mu Jie: "It's a pity that the credit for your illustration is gone." ”Mu Jie smiled and said: "I said it a long time ago, it's better not to have it, otherwise I have to make a report." ”After lunch, Liang Gong said, "I'm going back."
You two call me for something.Minmin, don't be vague about what I tell you.Mu Jie, you have to take care of it for a hundred days, this is a lifelong thing. ”Li Min blushed when he said this, and although Mu Jie heard the meaning of his mother-in-law's words, he pretended not to understand, and only said cheekily: "Mom, don't worry, I will take good care of my foot injury."
will also take good care of Min Min and their mothers. ”Liang Gong saw that the two understood what they meant, so he went out with Li Min, who had packed his work notes, copies, and held a file bag.Li Min took her mother's arm and wanted to take her mother to the bus station."
You go back to duty quickly, and you will have an hour of rest at noon.In case something happens, it's not good if you're not on duty. ”"Well, Dean Chen is here.Okay, I'll go back here.Mom, you and my dad can come over when we have time. ”"Okay, come over when you have time.Minmin, remember to act magnificently, ah!
”"Hmm.I remember. ”Li Min looked at her watch and stopped, watching her mother turn to the bus station and leave, until she couldn't see anyone, she turned around and went to the hospital.* When Li Min arrived on the eleventh floor, he saw that Xiao Yin was helping him put on the quilt, and before she could come forward to help, Chen Wenqiang and Xiao Yin put the quilt cover."
Teacher, I've brought all the materials.""
Then let's go upstairs and talk."
Xiao Yin stopped: "Xiao Li wants to rest for a while at noon." ”"I'm fine, Aunt Yin, let Xiao Yan'er sleep for a while.I don't always have to get off the stage on time when I have surgery. ”Li Min followed Chen Wenqiang upstairs with the information, and according to Chen Wenqiang's request, she took another stack of paper, copied down the hospitalization number, patient name, and diagnosis of the medical records involved in the surgical path, and then Chen Wenqiang nailed it to the corresponding page of the copy.When Director Hu brought Gong Hai over, Li Min still had a little left in his hand that he hadn't finished copying.Gong Hai took the stapler in Chen Wenqiang's hand and continued, and at the same time listened carefully to the work requirements put forward by Chen Wenqiang and Director Hu."
This has a hospitalization number, and the diagnosis is easy to find the corresponding film.Director, you'll have to give me a few floppy disks, and I'll copy them onto the floppy disks. ”"Okay.I'll go back and get it for you.It's just 65 yuan per plate, you can use it for me leisurely. ”"Okay."
Gong Hai almost kowtowed to Director Hu in the face of the beauty that flew from outside the sky.I have passed the foreign language test for the intermediate title, and the thesis has been published, so I am waiting for the autumn to sign up for the defense.But Director Hu's arrangement for publishing the book is not more secure.But in front of Dean Chen and Director Hu, Gong Hai didn't even call his junior sister.He only politely called "Director Li".So he worked with his head bored and listened attentively.It was Director Hu, who saw that Li Min had accumulated several thick work notes, as well as the discarded manuscripts scattered in the archives and sorting out materials, and sighed to Chen Wenqiang: "Old Chen, I thought it was a book you compiled and wanted to name Xiao Li." ”Chen Wenqiang glanced at him and said with a smile: "Do you see Xiao Li using me to do such a useless thing?"
”"No, no.Xiao Li is much stronger than you and me when I was younger.Lao Chen, I said that you have been saving for decades, and you have time to summarize it, otherwise you will keep it for the crematorium to burn. ”"I'm free.Xiao Li has a heart, and when he accumulates information, he will be classified, and I will record it like a running account.Just looking at the notes of the past few decades is not something that can be completed in a year and a half.That's like you, if you say a book, you will publish a book. ”Director Hu said with deep feelings: "If it weren't for the paper you prepared in August last year, I wouldn't have thought of publishing a book.I was afraid that in a year, the paper would not be published, so I sifted through the things I had accumulated over the years for several months and made a book out of a random manner. ”"That's as easy as you say.Lao Hu, you are a person with an inner show, and you have a wide range of friends outside, so I will hand over all this book to you. ”Chen Wenqiang said solemnly.Director Hu nodded: "Don't worry, if you come out a day earlier, I will also be relieved a day earlier."
When it was time for the autumn defense, I went up with two books in my hand, and Jin Zhenggao also had a little more weight. ”Chen Wenqiang nodded, with the same goals and interests, and he didn't worry about Lao Hu not doing this well."
Are you all set?"
Director Hu asked Chen Wenqiang."
I've published two papers, and I'm still short of a foreign language score."
Chen Wenqiang replied with a little reserve."
Who doesn't know a foreign language?
Exam in June. ”Director Hu glanced at Chen Wenqiang, this thing was fake when he was modest.He turned to ask Li Min: "Then Xiao Li, are you promoted to deputy high this year?"
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”Director Hu asked Li Min when he saw that she was starting to pack her things."
I listen to the teacher's arrangement."
Li Min stopped what he was doing and replied to Director Hu.Director Hu looked at Chen Wenqiang and said, "Old Chen, it's an exception anyway.I remember that in your two papers, Xiao Li is the second author, isn't it?
”After Chen Wenqiang nodded, he continued: "Xiao Li is no different from next year this year.Let her try. ”"I have this plan, I have to see if she can pass the English test."
Chen Wenqiang left room to answer.Gong Hai put the copy in his hand into his own schoolbag, and said in his heart: "A few of them even have to memorize the fourth volume of "New Concept", is it possible to take the title exam?"
It's impossible to score more than 90 points in the test. ”Gong Hai sorted out the materials, and said to Chen Wenqiang and Director Hu: "Dean Chen, Director, I'll go back to the department to prepare first."
I'm trying to get all the films right this week. ”Director Hu also stood up, and he said to Chen Wenqiang: "Old Chen, I'm going back too."
The key to Corey's archives is with me. ”"Then I won't keep you."
Chen Wenqiang stood up, took Li Min to send Director Hu and Gong Hai to the door, watched them go to the elevator, and said to Li Min: "I'll go to the operating room to see, why hasn't the laparotomy been stepped down yet."
General surgery, you can also take a look. ”"Good.Then I'll be here on the twelfth floor. ”Chen Wenqiang nodded, it is better for Li Min to stay in the office on the twelfth floor, and it is difficult to find people if there is something to do outside.* Chen Wenqiang entered the operating room and changed into hand clothes to go to the operating room.At ten o'clock, Xie Xun called him, and there was a laparotomy investigation, and now it's almost three o'clock, why hasn't he come down yet?
He does not doubt Xie Xun's technical level, these young doctors who came to power today are already the leaders of the new generation of the provincial academy.He was worried that they were in trouble.When he entered the operating room, he found that his worries were not wrong at all, and Xie Xun was in trouble at this time.Chen Wenqiang saw that the people on the operating table were operating with serious faces, so he went to the anesthesia table to take the patient's medical records.This patient came during the day shift.The chief complaint was abdominal pain for 5 hours, but the following medical history, physical examination, auxiliary examinations, etc., were completely inconsistent with the content of the chief complaint.Chen Wenqiang looked back, saw the end, and found that the medical record was also attached to the back of the medical university's outpatient medical records and discharge summary.He was afraid that he would be dazzled, so he looked through the outpatient medical records of the medical university and compared them with the names of patients on the operating table.Jiang Ma explained to Chen Wenqiang: "Dean Chen, this is the medical record that the family has just handed in. ”Xie Xun heard Jiang Ma talking to Chen Wenqiang on the operating table, raised his head and glanced at it, and saw that it was indeed Chen Wenqiang, so he complained: "Dean Chen, I will be pitted on the operating table by this patient today." ”Chen Wenqiang patted the medical record book and said, "I see that you have done a very comprehensive job before the operation.You just relax and do the surgery slowly.I just can't get off the stage, and I don't blame you for this. ”Jiang Ma sighed: "Why did this person bother."
To tell you the truth, it's so hard to tell our doctor about your medical history. ”Xie Xun listened to Chen Wenqiang's words, and his heart was much more relaxed.But his reaction on the operating table was still strong.scolded a few swear words in a row.It was to the effect that "I have decided to give up the treatment, and I will wait until the peritonitis intestinal perforation is completed, and I will stick to it at home for two more days."
I don't want to die and have surgery early.This opens a belly of fecal water, which is going to pit who is going to die. ”The more Xie Xun spoke, the more angry he became.Chen Wenqiang asked, "Then how did the medical records of this medical university come in?"
”Jiang Ma replied for Xie Xun: "After opening the abdominal cavity in the morning, Lao Xie went to explain to his family that the abdominal cavity was seriously inflammatory, and he could only do palliative surgery, remove the necrotic intestinal tube, stoma and other second-stage operations.Then the family members understood that they were going to have a second operation, so they sent in all the examinations from the medical university. ”The patient's hospitalization at the University of Medicine, the discharge summary is recorded in detail, and it is also clearly written: "The patient's family complained that they had no money to bear the cost of surgical treatment, and the patient asked for conservative treatment."
Therefore, he was discharged and transferred to a primary district hospital. ”Cooperate with the patient's diagnosis: advanced rectal cancer.This is a patient who gave up clinical treatment and chose to go home and wait for death.However, he went to the emergency department early this morning with abdominal pain for 5 hours.Emergency department with peritonitis and abdominal pain pending investigation (intestinal obstruction cause unknown, colon cancer?)
）Admission to the hospital.After Xie Xun received the patient, after a comprehensive physical examination, he prescribed an emergency CT to the patient.Soon the CT room called back, the sigmoid colon wall was thickened, and the intestinal obstruction was accompanied by perforation, and the abdominal cavity was infected; Hypodense lesions in the left lobe of the liver, suspected metastases; multiple enlarged lymph nodes retroperitoneum, suspicion of tumor metastasis; Right kidney cyst.Xie Xun got the CT call and knew that the patient had to have emergency surgery, otherwise peritonitis would soon cause the patient to go into shock.He explained to his family that he had an emergency laparotomy + a proposed descending colostomy, with the purpose of relieving intestinal obstruction and repairing the perforated intestine.This exploratory laparotomy includes a quasi-resection of the intestinal tumor.All in all, when the patient came to the hospital, Xie Xun said that he couldn't watch him die from peritonitis →.The family agreed very well, signed very cooperatively, and happily paid a hospitalization deposit of 5,000 yuan.…… After hearing these words, Chen Wenqiang had no choice but to comfort Xie Xun a few more words: "There are many people who are afraid of death when they die."
This person didn't want to be treated in the front, and he was reluctant to die in the future.If he had been discharged from the hospital attached to the Medical University, he would have had surgery a month earlier," Xie Xun immediately continued: "The operation is definitely ten times better than today." ”"Definitely, yes."
Chen Wenqiang calmed Xie Xun's emotions."
Nobody asks you to go to what level.You let Xiao Chen and Xiao Zheng exchange you.I don't blame you for not coming down. ”"Dean Chen, with your words, I am not afraid.If I hadn't done an emergency CT, I would have done a fluoroscopy according to the treatment of intestinal obstruction, taken a plain film, and then the patient's family would not agree to the operation, and finally the person died, and then relied on the puncture, and still did not agree to the autopsy, where would I have time to talk nonsense with them. ”Chen Wenqiang grinned silently.He looked at Xie Xun doing rectal cancer resection, and he was doing it very seriously, and said in his heart that this was simply a waste of the energy of the young talents in our provincial hospital.Jiang Ma said on the side: "Lao Xie, you still have to let him step down."
If you can't get off the stage, maybe things will be even more troublesome. ”Chen Wenqiang stood for a while, feeling that there was no need for this operation to look at himself, so he told him to go back to the department.
*Li Min is not on the twelfth floor."
Where's Dr.
Li?""
I went to general surgery.They had an old lady with a perforated intestine.Dr.
Li said that after completing the preoperative preparations, he would be pushed to the operating room. ”Chen Wenqiang was slightly exposed, and sure enough, things came in pairs.So he hurried to Puwai again."
What patient, Xiao Li?"
Chen Wenqiang went to Puwai's office to find Li Min.She was only followed by a few interns."
A 56-year-old female patient.Yesterday, the abdominal pain worsened for 10 hours and was admitted for 3 hours.A colonoscopy was done on Wednesday because of a previous history of bowel adenoma.Colonoscopy forceps removed colon polyps, but the pathology report will not be available until next Tuesday.The patient did not have a bowel movement on Thursday before admission, was constipated on Friday morning, started abdominal pain in the evening, and came to the doctor on Saturday morning.Before doing colonoscopy, the intestines must be cleaned, and there is no bowel movement for one or two days after the examination, which is normal.But in the evening after constipation, I had abdominal pain......
"What about physical examination?"
”"The abdomen is distended like a drum, pneumoperitoneum, widely tender, the pain is intense, the percussion is tympan, and the bowel sounds are gone.I arranged for the patient to go for an emergency CT.Now I am doing preoperative preparations. ”Li Min opened the medical record in his hand and handed it to Chen Wenqiang."
I just called to go to the operating room, and I heard that Director Xie is still to be decided.Do you want to find Director Liang for this surgery?
”If Chen Wenqiang can't come, Li Min is ready to wait for the CT results to come out and find Director Liang."
What do you suspect?""
Colon cancer intestinal perforation.I have no obvious evidence, it is speculated based on a history of intestinal adenoma, colonoscopy to remove polyps.You're off the night shift, and I can't do this surgery with the doctor on duty in the orthopedic department. ”"Let's wait for the CT results to come out."
After Chen Wenqiang said this, he went to look through the medical records, he wanted to see who was in charge of this patient.This flip turned to Dr.
Wang Dazhi and Dr.
Wang in charge of the bed, and the colonoscopy was also done by him."
Get Dr.
Wang."
Li Min reminded Chen Wenqiang in a small voice: "Teacher, that doesn't meet the regulations." ”Chen Wenqiang said "um", and didn't say that he wanted to find Dr.
Wang.The CT room was soon called—small bowel dilation, pneumoperitoneum, left lower quadrant small bowel obstruction, mesenteric torsion."
Mesenteric torsion?"
Chen Wenqiang groaned and said, "You don't need to look for Director Liang.Let the orthopedic inpatient always see the ward, and we will bring the students to the stage. ”"Teacher, I've done all the preoperative preparations, why don't you look for Director Liang?""
What are you looking for him?
It's not like I can't do it. ”All right.It's been a long time since I've had general bowel surgery.This case of pneumoperitoneum seems to be explained by intestinal perforation after polyp retrieval, but I can't figure out how colonoscopy can cause obstruction of the small intestine?
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*After Li Min brushed his hands, he took the intern to prepare for disinfection, and Dr.
Wang hurriedly came in.When he came in, he said to Chen Wenqiang, "Dean Chen, the patient's family called me.Said intestinal obstruction and needed surgery.I'm here in a hurry. ”When Chen Wenqiang saw him come in, he hadn't brushed his hands yet, so he said, "You and Dr.
Li should take the students to do this surgery." ”"Okay.So who is the surgeon?
”"Your patients do the surgery yourself.Dr.
Li will be your assistant. ”"Good.Then I'm going to brush my hands. ”…… I haven't had surgery on the same stage with Dr.
Wang for more than a year, and Li Min stands in the position of a helper according to the rules.With Dr.
Wang coming over, the interns outside the general world don't have to take care of themselves.After Dr.
Wang scratched his skin, Li Min hurried forward."
Doctor Li, no, Director Li, you're getting faster and faster."
Dr.
Wang wanted to say a few words to Li Min.It's a terrible feeling for this surgeon to be chased and urged by his assistant."
It's okay, this abdominal CT has mesenteric torsion, let's not hurry up, I'm afraid of intestinal necrosis."
Li Min doesn't want to talk nonsense.But what needs to be said has to be said."
Why did you remember to do a CT?""
Yes."
Li Min's answer was concise and to the point, saying the same as not saying it.Dr.
Wang rolled his eyes.Shout to the instrument nurse: "Peritoneal puff."
Large tweezers, "" suction device. ”took two interns to the stage, and Li Min was so anxious that he wanted to kick people down.The peritoneal protective towel has arrived in the field, why don't you know how to get started?
Li Min was helpless, so he put the protective towel on his side against the incision to prepare, and then left the suction device, the right hand bent a small bend, and each of the two ring fingers hung a small bend."
Okay?
Director Li.I opened my peritoneum. ”Li Min snorted sullenly, never felt that Dr.
Wang was talking too much nonsense.The peritoneum was sliced open, and the sour gas choked people's faces.But Li Min had to use a suction device to suck the pus in the abdominal cavity, and at the same time, he had to clamp the bleeding point on the peritoneum with small curved forceps.Luckily, I brought two masks.But you can still smell the sourness."
Towel pliers."
Six pairs of towel pliers are used to secure the peritoneal protector.Without probing, the intestines gushed out.The normal intestinal tube and the blackened intestinal tube are piled up in the surgical field, and the boundaries are clear."
Salt water gauze."
Li Min asked for two large pieces of gauze to wrap the normal intestines.I asked for another piece of dry gauze and put the necrotic bowel in my pocket."
Dean Chen, do you want to rewarm?"
Dr.
Wang asked."
What's more?
It's all blackened.Cut it. ”Chen Wenqiang is not angry.Do you need to ask about this?
Necrotic intestinal tube, protruding from the sigmoid omentum, which is the result of incarceration, what is the cause?
It is not yet known.The most important thing was that the piercing was not found.So where does the gas in the abdominal cavity come from?
The necrotic small intestine of more than one and a half meters was removed, and Li Min cooperated with Dr.
Wang to do intestinal anastomosis.But the breach was never found.Xie Xun pushed the door and came in."
Dean Chen.""
You're stepping down?""
Hmm.The patient was admitted to the ICU. ”"Congratulations."
Xie Xun smiled with crooked eyes, and it was naturally worth congratulating for stepping down.He asked Chen Wenqiang with a smile: "Dean Chen, what are you looking for here?"
”"Look for a place with a perforated intestine.The sour smell of the stomach □□ body, and there are no perforations. ”Dr.
Wang's face was stinky.Chen Wenqiang couldn't help but remind him: "Look for the place where you took the polyp." ”Sure enough, a rupture of only 2 or 3 mm in size was found in the middle of the descending colon.After Dr.
Wang dealt with the perforation, he checked all the places where the polyps were taken, confirmed that everything was fine, and closed the abdomen."
This is unlucky!"
It's not bad luck.Endoscopic polyp removal, which causes intestinal rupture, is considered a complication.But that little hole, it stands to reason that it should be able to heal on its own, but peritonitis appeared......
But the patient had mesenteric torsion, small intestine incarcerated necrosis, and the operation was done, and everyone couldn't understand why."
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If the patient has pre-existing intestinal adhesions, the gas brought in by the colonoscopy causes an incarcerated hernia, or it may make sense.However, intestinal adhesions are contraindications for colonoscopy. ”Xie Xun, who got off work on time, sat at Director Shi's house and picked up his wine glass, and he still didn't forget the two surgeries in the afternoon."
Have you ever seen anything like this, Director Liang?"
Director Liang shook his head: "I haven't seen it."
I've never seen a colonoscopy with a polyp perforated.The county hospital originally did not have a endoscopy room, and the colonoscopy of the provincial hospital has only started to be done in the past few years.Lao Chen, Lao Shi, have you seen it?
”Both shook their heads.As for Dr.
Yang, no one asked him, he was a urology specialist, and he had less knowledge.() The distance is a bit far