Chen Wenqiang and the others, although they have not directly done colonoscopy for any patient, they still have a bottom in their hearts about colonoscopy, especially what kind of complications will occur after the pathology is taken at the same time.In particular, Director Liang, as the director of the Department of General Surgery, not to mention that he has heard about this case, he must explore the root cause, and be sure to know what it is and why it is true, so that he can feel at ease.Just mentioning that he is not only a general surgeon, but also orthopedic and neurosurgery, and he is also involved in it, so he will not let go of this intestinal obstruction of unknown etiology."
Colonoscopy for polyps is an invasive procedure.I've followed up on reports of this, and it's not uncommon for clinical perforation complications to occur in the early days of colonoscopy.However, in recent years, with the improvement of the level of operation and the accumulation of clinical experience, the incidence of postoperative perforation has been effectively reduced.Let's be honest, the two doctors in the laparoscopy room of our hospital have to do at least two or more cases of colorectoscopy every day.What the root of the polyp looks like, the operator sees it under the camera when taking the polyp.Whether there will be a perforation after surgery, I think so, they should still have some skimming in their hearts. ”Director Liang's remarks were recognized by everyone present.What has become of your own work, you don't know the bottom of your heart, so take off this white coat as soon as possible, don't mislead others and yourself."
But it's the first time I've heard of mesenteric torsion, internal hernia incarceration, strangulated hernia, and finally necrosis of the small intestine, and so many bowel tubes have been removed."
Director Liang lamented that he had missed an excellent opportunity for an intuitive rare case."
I should have gone to the operating room if I knew there was such a thing.""
I think it's easy for you to rest at home for a day, so I didn't let Xiao Li call you."
Chen Wenqiang continued: "Actually, this case is nothing special.Opening the abdominal cavity, the necrotic intestinal canal is clearly separated from the normal small intestine, and I watched the whole operation very seriously, there is really nothing special about it. ”"No adhesions?"
Director Liang frowned and asked."
If there is no adhesion, this situation does not make sense.""
She has peritonitis like this, and there must be adhesions.I'm referring to the kind that causes intestinal obstruction.And it is not easy to tell whether the adhesion is before or after the peritonitis.On the contrary, the mesentery looks looser than normal.Maybe this is the physiological condition for torsion to occur.Later, the rupture of the colon was only half the size of a grain of rice. ”"If there are adhesions, after the gas enters the abdominal cavity, it affects the normal peristalsis of the intestinal tube......
Coupled with the congenital mesenteric abnormality, several factors are added together, and it is possible for such a thing to happen. ”"But this patient has no previous history of abdominal surgery or abdominal trauma, so where does the adhesions come from?"
During the operation of Dr.
Wang and Li Min, Chen Wenqiang read the medical records in detail.Director Shi interjected and asked, "Does this patient have abdominal pain, bloating and other symptoms after surgery?"
Also, is it eating early?
It is important to know that when the intestinal peristalsis is not fully recovered, there is gas entering the abdominal cavity through the rupture, and even if there is no food residue, the intestinal fluid can enter the abdominal cavity, which will cause adhesions. ”Xie Xun said: "When I took over today, I saw that the general state of the patient was fine.Since I am not a specific bed doctor, I did not ask for a medical history.Later, I had surgery for rectal cancer, and I realized that there was no single disaster.So he leaned over and looked at it. ”His remarks were also explaining to Director Liang that he had conducted ward rounds for general practitioners when he took over the shift in the morning.However, most of the ward rounds on duty are to stand at the door of the ward and ask if there is any discomfort, just to see the general state of the patients, and it is impossible to check the patients one by one.Director Liang understood what Xie Xun meant, and he also knew that Xie Xun was a reassuring person at work, so he bowed to him slightly.Xie Xun saw that Director Liang understood what he meant, so he continued: "Actually, I received a case of iatrogenic intestinal perforation caused by colonoscopy when I was studying at the Medical University before.It was a patient sent from a city hospital in our provincial capital.He developed abdominal distention, abdominal pain, and progressive worsening within 12 hours after colonoscopic polypectomy.But he refused to have a laparotomy done at the hospital where he had a colonoscopy.He also refused surgery at the medical university. ”"The examination is a sign of pneumoperitoneum, nothing else special.By the way, he didn't eat any food until he went to the emergency department of the medical university after the operation, which helped him a lot.Professor Zhang, who was in the third-line class at the time, found the attending doctor of the second-line class who led the group from home.When Professor Zhang came, he inserted a needle next to his umbilicus, and the needle of the disposable syringe was deflated.It's really deflating.I remember looking stupid. ”"What happened?"
Everyone present was very interested."
After half an hour, the patient felt a lot more comfortable.After being admitted to the hospital, he repeatedly inserted needles around the umbilicus to deflate.In the last week or so, the symptoms disappeared.Then I had another colonoscopy at the medical university and was discharged.I also went to see the examination report, and the report showed that the wound had healed on its own," Xie Xun spread his hands: "This person also has an idea, and he refuses to operate on anything, and in the end the operation is useless." ”"His intestinal perforation is still very different from the one he operated on today.""
It's different.But he also had iatrogenic intestinal perforation, and gas entered the abdominal cavity from the rupture.The difference is that he didn't eat after the surgery, and he didn't eat anymore. ”"Have you been hungry for more than ten days?""
yes.Sugar and salt water hang every day.If you don't eat or drink, the small intestine will also secrete several liters of intestinal fluid.Fortunately, in addition to his pneumoperitoneum, no intestinal fluid entered the abdominal cavity, otherwise he would still not be able to dodge the knife. ”"The fact that he was able to dodge that knife also has something to do with the fact that the piercing happened after the intestines were cleansed.If this were not the case, the vast majority would still have to be operated. ”Director Shi said, "Oh, I remember, when I was working in the Affiliated Hospital of the Medical College, another chest team helped the general surgery for a hernia after colonoscopy on the night shift.It was a transverse colon hernia into the chest.Do you think it's rare?
”"Rare.""
It's rare.""
How did this pass?"
Dr.
Yang interjected and asked.How did I get by, you ask?
Is the abdominal anatomy used on this wine table?
However, Director Shi did not explain to Dr.
Yang, but still explained to Dr.
Yang: "The relationship between the two thoracic groups is not harmonious, and each other's patients are not related to each other.So I didn't dare to risk the world's condemnation and look through other people's post-operative records.Naturally, I don't know what path this transverse colon followed to drill into the chest cavity. ”Chen Wenqiang understood what Director Shi meant without even thinking about it.He sneered, "Regret it, right?"
”Director Shi nodded: "Naturally, I regret it."
I want to have Xiao Li's studious spirit, and I have to take advantage of the night shift to copy down the operation records. ”"Why use the night shift to copy it, and when the patient is discharged, go to the medical record room to borrow medical records, and copy it as much as you want."
Director Liang teased him."
Oops, I didn't think of it.Why don't you think my head is spinning?
”Director Shi made a remorseful and cooperative look, and in exchange for a few words of "Liang's" ridicule from Director Liang.Everyone laughed and drank again, and calmed down to look at Chen Wenqiang, who was about to speak.Chen Wenqiang asked: "Is it true that this patient started abdominal pain so long after surgery?"
During the operation, the intestinal tube was found to be black and necrotic.Although once mesenteric torvulus occurs, it is easy to cause irreversible and rapid intestinal necrosis, it should not have happened this afternoon.I have met patients with pain in mesenteric torsion and intestinal necrosis in the south before, and I really haven't been so calm as this patient.I'm not saying that the patient isn't in pain, but that the signs and symptoms don't match.So I suspect when her abdominal pain began.I always feel that there are a lot of things I don't understand here.It is said that with such a small rupture, there will not be so much gas in the abdominal cavity.If it was within 12 hours after the microscopic examination, or let's relax a little bit and say that it was ruptured within 24 hours, how long did it take for her to have abdominal pain after the surgery?
”Everyone understands what Chen Wenqiang meant, and the intestinal tube that took the pathology was definitely not ruptured on the spot.There is no doubt about it.Xie Xun immediately said: "I'll go to work tomorrow and ask carefully." ”Director Liang said, "Lao Chen, your suspicions are reasonable.Single symptoms and signs do not match, if this is an old man, he may have come to the hospital very early.Men have a low tolerance for pain.It's an old lady, I guess, that's what I thought in my heart, and she probably thought that her patience was over.Do you think this is the case, so you delayed her coming to the hospital in time?
”The big men here have already received many patients of different genders, and they all nodded seriously when they heard this."
This medical record is quite special.Lao Liang, Xiao Xie, you go back and ask about the medical history carefully, could this patient have eaten early after surgery?
When I opened my abdominal cavity today, it was full of sour gases and liquids. ”The two of them quickly nodded and came down.Because Chen Wenqiang is arranging work as a medical director.
*Director Shi waited for a while, and saw that Chen Wenqiang had no more instructions, so he continued: "Lao Liang, this medical record of your department is so special, you should submit it."
Didn't Director Zhang add a bonus point to the essay in the evaluation of each subject?
”"That's what you're talking about.Tomorrow, I will tell Dr.
Wang to write a case report.Lao Chen, do you want Xiao Li to write with him?
”Without waiting for Chen Wenqiang to nod, Director Shi said, "Cross-discipline also adds points."
Lao Chen, the second author also has a score of 0.3. ”Chen Wenqiang smiled at Director Shi: "You also have to be free for Xiao Li."
Let me tell you, Xiao Li has summarized all the craniotomy surgeries she has done in the past two years, and sorted out 20 craniotomy paths for me.Dozens of medical records are followed by hospitalization numbers, diagnoses, etc.I haven't looked closely to see if there are any additions or decreases, but I asked Lao Hu to match all the relevant images.It's a big deal.Lao Shi, you won't be 0.3 points at that time. ”Director Shi heard the sound of the strings, and immediately picked up the wine glass and said, "Come on, let's have a toast to Xiao Li's book." ”Director Liang sighed after drinking the glass of wine: "Lao Shi, your old boy has a good life."
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Sitting at home, pie will fall from the sky.Now you can be the first in the whole hospital in a single assessment. ”Director Shi was proud: "Haha, my life is good."
Hopefully, no one will publish any more books this year.But Director Zhang's assessment, I think it's pretty good.You say yes, right?
”"Naturally.Without this assessment, the directors of each department will write the thesis for which of you want to be promoted.Now, in order to look good on the face, I not only urge, but also help young people find cases.Alas, there's a lot of extra work.Alas, Lao Chen, do you have to worry about the fee?
”"No.You can be the second or third author at the end, and you can get paid a little bit. ”"I have to be shameless to add my own name to other people's articles."
Director Liang scoffed at the proposal: "Pay back the manuscript."
Lao Chen, it's not that you don't know, now is not what it used to be, and you can still get fame and fortune by submitting your manuscripts.Now if you want to publish an article, not only the level of the article is enough, but you also have to give people another money, 3,000 yuan for an article.I have that money, so I might as well buy sugar gourds for my grandson to eat. ”Director Shi joked: "Lao Liang, you don't pay for just adding your name, and the young people of your department don't dare to ask for it." ”Director Liang scolded him: "That's not enough for young people to laugh at me behind my back." ”Chen Wenqiang said with a smile: "You said that the adoption fee of 3,000 is the beginning of the Chinese word."
At the provincial level, there are not so many, 1,000 yuan is enough.If you have a 'name', you naturally have to let a little 'profit' come out.Like I've already gone out for 6,000 yuan this year.If you do it again in the summer, the little 10,000 will be gone. ”"Lao Chen, you should be beaten.You're showing off your article with a Chinese prefix. ”"None of you have one.If you want to enter Zhenggao, there are not a few articles with Chinese prefixes, and you are embarrassed to sign up. ”"That's it.Come on, come on, ask us to 'spend money' to buy registration qualifications and toast. ”After clinking glasses, Moutai wine entered the stomach, and several people ate vegetables.Putting down the chopsticks, Director Shi said, "Lao Liang, even if you pay money, you should have your name embellished."
If you think about two articles and four people, compare them with two articles, and report them to the director of the academy together, that is, the number of people who have published papers in the former has reached the standard, and the number of articles has also reached the standard. ”Chen Wenqiang heard this, but smiled silently.The so-called policies at the top and countermeasures at the bottom are reflected here.The starting point of Director Zhang's request is very good, but it is a pity that when it falls to the implementation below, there will be this disguised "coping" situation.Even if Shi Lei doesn't say this, other section directors may not be unexpected, and they may not be able to do it.But I can't refute what Director Shi said on this occasion, let alone go back and ask Director Zhang to only count the first author, and some papers are still cooperative.
*After talking about the cases and papers for a while, Director Shi talked about Dr.
Yang's kidney tumor patient.The purpose of this drinking.Xie Xun had the heart to make friends with Director Shi, so he said to Chen Wenqiang: "Dean Chen, I later asked for the CT film of Dr.
Yang's patient and read it carefully.Adhesions can be seen from the film, but it is not as severe as what you can see when you open it.Conventionally speaking, if it is really consistent with what is shown on the film, Lao Yang will still be able to peel off the tumor. ”Director Shi hurriedly followed and said, "Lao Chen, behind closed doors, I'll talk about our own people."
You know I'm not worried about this surgery, so there was no surgery scheduled in the chest department on Friday. ”Chen Wenqiang nodded.This is something that has been said a long time ago."
I'm in the operating room, and I've really been standing behind Xiao Huang and watching.There are so many people in the operating room, and I can't say it's fake: Lao Yang's previous operation is decent.If there were no accidents, he would have been able to get the operation done.So he didn't go beyond the mark to do this surgery. ”Director Liang was entrusted by Director Shi and drank Dr.
Yang's wine, so naturally he couldn't help but speak at this time."
Lao Shi is right.We can't wait until we are promoted to a senior title before we have a third- or fourth-level surgery, right?
”Doctor Yang was stunned and said: "It's because my basic operation level is still a little worse, so I have the panic after the accident."
Dean Chen, I will also go to the lab next week to practice my basic skills. ”Chen Wenqiang was satisfied with Dr.
Yang's attitude, he nodded and said: "It is appropriate to make amends and learn lessons, but this matter will definitely be discussed at the hospital meeting."
Huang has Xiao Huang's mistakes, and you also have to take your responsibility.Let's ignore the final result, Dr.
Yang, did you go to see the patient today?
”"Go.I went to see it every morning and afternoon.Xiao Huang has also been guarding the ICU for the past two days.The drainage has been pulled out this afternoon.If it's okay, I'll pick up the patient after the shift tomorrow morning. ”Chen Wenqiang affirmed Dr.
Yang's approach.Then he said to him: "Surgical accidents, especially on the operating table, can easily mean a patient's life."
This arterial injury has been encountered by any of us during surgery.You are wrong after the arterial bleeding、You failed to keep up in time to stop the bleeding。
Do you recognize it?
”"Yes."
Dr.
Yang couldn't hide his shame."
Now that I think about it, I should have mistakenly thought that it was the renal artery that was damaged, and I thought that the patient was hopeless.Alas!
”Dr.
Yang slapped his forehead vigorously.Thanks to Director Shi's presence, Xiao Pan reacted quickly.Dean Chen, if Director Xie and Li Min hadn't come to the rescue, this operation would have to be completed by Director Shi in the end.I'm worse, so far worse. ”Director Shi continued Dr.
Yang's words: "When the accident happened, I was also a little confused.Fortunately, Xiao Pan moves quickly.When Xiao Xie and Xiao Li later took over tumor stripping, I also sweated for them......
Director Liang sneered: "Lao Shi, do you still have a little bit to skim about, what are you worried about when Xie Xun and Xiao Li get started?"
”"The tumor has adhesions with the inferior vena cava."
Director Shi replied confidently.Director Liang immediately asked: "Then why don't you go on stage?"
”"At first, I didn't expect the adhesion to be so heavy.By the time I brushed my hands on stage, Xiao Xie and Xiao Li had already done it.The most difficult part of this operation was done by Xiao Xie and Xiao Li. ”The two sang and harmonized, but they just wanted Chen Wenqiang to accept that it was an accident.Surgical operations will encounter accidents, and the ratio to normal conditions is basically 1:1.Chen Wenqiang saw the excitement of Director Liang and Director Shi, and understood what they were thinking.Seeing that Dr.
Yang was willing to correctly recognize his mistakes and shortcomings, and he was not the kind of character who wanted to force people to be cornered, he also euphemistically responded to the pleas of Director Liang and Director Shi.He picked up his wine glass and said to Dr.
Yang: "This kind of thing is usually discussed at the hospital meeting after the patient is discharged from the hospital.Although I am the dean in charge of medical care, I am still a surgeon in addition to impartiality, and naturally I don't want our surgeons to retreat when they encounter cross-professional and difficult surgeries in the future.You can recognize your own shortcomings, be ashamed and courageous, the past will be over, and we will work how we should work. ”Dr.
Yang thanked him again and again and toasted Chen Wenqiang, and Director Liang and others immediately raised their glasses.After everyone toasted again, Director Liang borrowed wine and said to Dr.
Yang: "You are a little stronger, a big man, if you are ruthless, you won't have numb claws."
Look at Xiao Xie and Xiao Li, they are not decisive on stage, and they never act with ambiguity.Lao Shi, you said yes, right?
”Director Shi nodded: "Xiao Xie and Xiao Li are simple and neat, and they are good materials for surgeons."
However, with a character like Lao Yang, we can all rest assured that we are comrades and friends.But as a surgeon, he lacks a ruthless word that makes a quick decision.It's just nature, and each has its own pros and cons.Come, drink our wine. ”Chen Wenqiang picked up his wine glass again with a lot of face: "Drink." ”Half a glass of wine was entered, and he praised again: "This wine is good today." ”"That's, Moutai.That's why the Friendship Store sells this wine all year round. ”When Director Shi achieved his goal, he talked to Chen Wenqiang and Director Liang about Moutai.Xie Xun was the youngest at the wine table, and he had to snatch the right to drink with Dr.
Yang.A few men said that they were laughing and lively, and a bottle of liquor went down.Dr.
Yang wanted to open another bottle, but Chen Wenqiang said that he would not let anything."
This wine is good, but we can't be greedy, and the days of drinking can be long-lasting.Isn't it, Lao Liang?
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”"yes, we've quit smoking in the past few months.There is only this little appetite left, and it can last a long time. ”* Upstairs drinking to discuss cases, downstairs Li Min, Mu Jie, and Xiaofang have dinner together.Looking at the new dining table that was sitting in one direction yesterday, and today it is empty, Li Min was slightly depressed.Mu Jie guessed what Li Min was thinking, held Li Min's hand and persuaded her: "Next Sunday, my parents will come to see you together." ”"Will it?
My mom told you?
”"I called them before the weekend.Invite them over for one night.Don't delay going to work on Monday. ”"That's it.I'm on duty on Sundays and I can't be at home when they come.It's fine.I'm used to it.When I was in college, I met once a month or two. ”Mu Jie suddenly felt that he should be comforted, a college student who was thousands of miles away from home to study.Most of them only go home once every six months, and some of them even once a year.As for someone like himself who has not returned home for ten years, alas, it is okay not to mention it.Li Min looked at Mu Jie like that, thinking that he remembered the unhappiness of going home, so he changed the topic and said, "You said that let the third child buy you a computer, okay?"
Thousands of things. ”"He could.If I had come back two days late, I would have brought back the computer with me. ”Li Min smiled and didn't expose the fact that he and his brother combined for a few days in Beijing didn't have enough money in his pocket to buy a computer."
He said he would send it back in the afternoon?"
That's what he said on the phone.He didn't say when he would deliver it.But when he sends it back, you can handle that handout on the computer. ”“？”"
I see that your handouts are also printed materials, you ask Dean Chen if he has kept them there and revised them on the manuscript, so you don't have to write word by word.""
Really?""
yes.What's so strange about this?
Didn't you learn computers?
”"After that, we learned a Basic language.I had classes twice a week for two and a half months.On the first day of class, the teacher showed us a photo of Momoe Yamaguchi and told us that it was printed by a computer. ”Li Min gestured with his hand to two photos with a large area of eight open sheets, and then said, "It's bigger than our wedding photo."
But after we finished the class and the exam, the teacher said that we were not computer science majors, and if we wanted to learn that, we had to learn another language. ”"That's easy.When the computer arrives, I can show you how to type command statements and teach you how to do it. ”Li Min shook his head and said, "Don't learn."
Last year's continuing education was DOS, and I don't think it's really necessary. ”"In the 21st century, everyone will use a computer, and if you don't know how to use it, you will be obsolete.""
Stop.That's what our computer teacher said.When you finally get on the machine, oops, input, enter, backspace......
I think that when the era described by the teacher comes, when robots can replace doctors to see patients and perform surgeries, they will definitely not need to enter commands line by line, and it is estimated that they can just talk. ”Mu Jie smiled and waited for the computer to come.If you don't believe that you have made something, Min Min will not be interested.The young couple talked for a while, and Li Min took Xiaofang to the door to see Yan Hong and Pan An.When she came back, she saw Mu Jie holding the only copy left, and redrawing the anatomical drawings for Li Min."
I don't need to draw, it's strange that my eyes are tired.""
Okay, I'll paint it tomorrow during the day.It doesn't take much effort.Do you read English or will I read it to you?
”"You read it, I like to hear your voice."
Xiaofang stayed at Yan Hong's house, and the young couple could find special fun just by studying.* A few people drinking upstairs solved the business and were in the mood to talk about special cases.For example, Director Liang is talking about this "small intestine lipoma disease." ”"The patient was a chubby old lady, I remember being 70 years old, with a bulging abdomen that looked like she was close to giving birth.The cause of the visit was abdominal distention, but there was no tenderness and bowel sounds were normal.Lao Chen, you should have an influence, it was the year when our provincial hospital first entered the CT. ”"You say the whole gut is full of lipomas?
The case that Lao Hu beckoned the two of us to see?
”"yes.Does Xiao Xie know?
”Xie Xun shook his head.Director Liang continued: "Lao Hu should have an archived CT film there, and you want to borrow it from him." ”Xie Xun hurriedly bowed slightly, and responded: "Yes." ”This is Director Liang's extra reminder of himself.But Director Liang then asked Xie Xun: "Do you know anything about this diseased intestinal lipoma?"
”Xie Xun thought about it and said: "I have seen the introduction, but I have never met it clinically.Remember multiple lipomas in the small and/or large intestine, which may be asymptomatic or mild, but may also cause intestinal obstruction and intussusception.In terms of treatment, the latter can only be surgically removed.There is no better way. ”Director Liang nodded, "That's basically it."
Although the patient had large and small lipomas all over her intestine, she had neither intestinal obstruction nor intussusception. ”Director Shi asked, "No follow-up?"
”Director Liang shook his head."
The normal diagnosis and treatment work is too busy, and if the doctor doesn't knock on the door, the patient may be fine if he doesn't come for a follow-up."
Chen Wenqiang continued on the topic of Director Liang and said: "I also deliberately went to check the literature on this kind of intestinal lipoma.It's basically a case report.It is more common in middle-aged and elderly people, and there is no gender difference.Most of the surgeries are due to intestinal obstruction and intussusception.In the past, it was a barium swallow, and the morphology and position could be observed through the peristalsis of the intestinal tube under X-rays. ”"Is it round or quasi-round and defective?""
Yes.But it cannot be qualified.It also has to be distinguished from polyps, hemangiomas, leiomyomas, and leiomyosarcomas in the intestine. ”Director Liang interjected."
Last time, Lao Hu did abdominal and pelvic CT, and compared the CT values before and after the contrast and enhancement, and it was immediately obvious that it was a lipoma.Not even a differential diagnosis. ”As for how not to use it, Dr.
Yang decided to ask privately.Chen Wenqiang was aroused to talk about the special cases encountered in the clinic."
Once, a child in a car accident in the emergency department, in the second or third grade of elementary school, was knocked down by a bicycle and knocked his head.Then the CT came to me.Because brain CT showed that the left temporal lobe, frontal lobe, parietal lobe, and occipital lobe, nearly 1/4 of the cranial cavity is a low-density lesion.However, no significant subdural bleeding was observed.The midline structure is basically in the normal range.There are no obvious symptoms of compression.There is also no significant envelope around the low-density foci. ”Xie Xun's performance was very surprised.Dr.
Yang also listened attentively with his mouth half-open.Director Shi asked, "Does the child have any signs and symptoms?"
”"The child said he had a headache, but he didn't feel a hematoma under his scalp.And guess what?
”"It's definitely not the result of this trauma.""
Yes.""
Is it a arachnoid cyst?""
Yes.""
There are really people who have fewer brains.""
Surgical drainage?"
Chen Wenqiang shook his head."
And then how to treat it?""
The child doesn't have any special reactions, just observes and watches.Teenage children, this is not a matter of one or two days, the child's intelligence is not affected, he can eat, drink and be naughty.What is a craniotomy for?
There are a lot of things that are hard to say after surgery. ”"Lao Liang, you're not surprised at all.""
I've seen a lot of people in the county hospital before.It's an X-ray.In his forties, he is a strong laborer in his family.I remember that it was the spring ploughing that grabbed water, and my head was flattened, and the blood was red and stupefied, and then I was sent to the hospital.Poor middle peasants, we have to treat them seriously.The film did not scare the radiologist to death.But after being hospitalized for a few days of observation, when the scalp stitches were removed, the person was fine, and he was discharged. ”*Talking about sex, Director Shi also talked about a medical tour encounter.It is an acute abdomen caused by uterine perforation."
The cause of the piercing is beyond the imagination of the doctors from the city who killed us."
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Director Shi's words aroused the interest of others."
At that time, family planning was already very tight.Those who have given birth to a second child must be put on the ring, and those who have given birth to a third child must be absolutely sterilized.Those who are not afraid of death use the strip of their bicycle to hook the contraceptive ring. ”Xie Xun has some directions, he can ride a bicycle, but in more than 30 years of his life, he has never had a bicycle of his own, let alone repair tires, change strips and other work.He had no intuitive impression of the car at all.Dr.
Yang explained to him the shape of the car bar, and Director Shi showed him how the 'O' ring was hooked with the car bar."
We had several identical surgeries in a row, and we all found out that we all had a history of common 'ring removal' surgeries.The reason why there are continuous accidents is because the batch has a 'T' ring, not an 'O' ring.If you can't reach it, you push it in, and finally the uterus is perforated."
At that time, there was no CT scan, and the X-ray machine used for itinerant medical treatment was the one used for spot films, and the radiograph, gas peritoneum, peritonitis on examination, and white blood cells also showed inflammation.The first example of palace perforation can toss a few of our doctors enough, and no matter how much they turn it, they can't turn over the lesions......
When the third case was done, he went straight to the uterus. ”These are not Xie Xun, who grew up in the provincial capital, studied in the provincial capital, and worked in the provincial hospital, but he was introduced by Director Shi's special case and taken to another world."
As for why the 'O' ring was changed to a 'T' ring, it is that the local family planning office found that the number of pregnancies increased after the ring.After this change, it caused so many troubles. ”"Removal of the uterus?""
If you have a serious infection, you don't have to have to remove it.It's all fate. ”"Alas.What's the trouble with that?
Giving birth to a daughter has to marry a neighbor, and giving birth to a child is buried with the grass.What age is it?
”"It's still not possible in the countryside.The family is full of girls, not to mention outsiders, and the brothers occupy a few more ridges of land for you.When the grandparents all say, your family is a girl, it is nothing to eat a little, and the little boy has to eat enough. ”Director Liang here only has a daughter, remembering the old things that were ridiculed in those years, if it wasn't for his scalpel, maybe how he would be bullied.* After chatting for a while about special cases, I got to the fact that there have been a lot of complaints recently.Director Shi concluded: "There is a saying that you often go around the river, and you don't get your shoes wet.My experience in the past 30 years is that if you want to be a surgeon, you have to meet four requirements.First, have the ability to do a good job.Second, the anesthesia is level enough to provide the anesthesia we need for surgery.Third, the patient has a strong desire for surgery.In the end, any outcome can be accepted by the family.Missing any of them can end up being a nuisance. ”Doctor Yang nodded with palpitations.I just don't have enough ability this time.Dr.
Liang immediately said: "The anesthesia is not in place, and the general surgery department has encountered a lot."
The abdominal muscles are so tense that I can't get on the automatic hook, M's, I'm afraid of an accident with the manual hook.The liver and spleen touched that, and the operation became bigger. ”Chen Wenqiang sat up straight and asked, "Do you want me to discuss with Lao Zhou to see how to train the doctors of the anesthesiology department?"
”The craniotomy has always been followed by Xiao Liu, deputy director of the anesthesiology department, and the special one is that Director Zhou of the anesthesiology department personally took the stage."
I've mentioned it to Lao Zhou many times.He can't help it, the doctors in the anesthesiology department are uneven, and the workload is heavy, he said that he has done as much time as possible to do in-department training.Lao Chen, be careful that he asks you for someone this year. ”"I said yes, and I've given him a few more this year.Lao Shu deliberately mentioned that he should have good pharmacological results. ”"Then I'll go back and report the good news to him."
Xie Xun waited for the dialogue between Director Liang and Chen Wenqiang to come to an end, and then slowly expressed his opinion: "Director Shi's four points, I think they are particularly good.But we still have to guard against those who are not right-minded.For example, the case of labor induction the year before last, and the liver cancer that we recently had in the general surgery department.Director Liang, I said that the family was holding back a bad heart and wanted to slander the provincial hospital. ”Speaking of that case of liver cancer, Director Liang became angry.He turned his head to Chen Wenqiang and said, "Do you guess the director of the hospital, that fool, what did he say to talk to me?"
”"Say what?"
Chen Wenqiang really didn't pay attention to this matter later.Dean Shu took it over and promised the director to solve it, it was originally the job of Director Qin of the Medical Department, why did Director Zhang of the hospital get involved?
He said the patient's family was no longer ready to go through the medical evaluation process.They said that the experts of the medical appraisal and the doctors of our hospital knew each other, and they would favor us, and they would directly sue the court.He said that the lawsuit with the hospital would affect the reputation of the hospital if it spread to the society.For the sake of the hospital's reputation, I was advised to rest my mind. ”"What's the matter with the law?"
Chen Wenqiang asked."
Let me give 20,000 yuan to the patient's family.Private!
What the hell ......," Director Liang scolded with a string of swear words, "I told him that he didn't have two yuan."
I told him that I was going to go to court to sue his family for ruining my reputation. ”"How can Director Zhang do this?"
※※※※※※※※※※※※※※※※※※※※ catch insects () is a bit far away