Faroo's triad, Li Min was excited, almost at the speed of a trot, and rushed to the director's office on the 12th floor.The Department of Pediatrics had previously received a child under the age of one year with an atrial septal defect in addition to the typical tetralogy of Falloo: pulmonary ostium stenosis, ventricular septal defect, aortic straddle, and right ventricular hypertrophy.It's a pentagram.After the contrast examination, due to the severe stenosis of the pulmonary artery ostium, the poor development of the pulmonary artery, and the malformation of the left pulmonary artery, Director Wailiu made a preoperative explanation with the parents of the child and asked them to prepare for the second or third stage surgery......
However, the parents of the child were discharged from the hospital the next day with the child in their arms.He was blind to the surgical plan formulated by Director Liu, as well as the policy of halving the cost he fought for the children."
Xiao Li, let's take a look at the film."
Director Shi's desk was full of materials."
The patient, a 23-year-old adult female, said that the abnormality was found during the marriage examination."
Li Min looked over one by one, and finally pointed to the details on the film and reported to him under Director Shi's waiting gaze: "There is a stenosis of the pulmonary artery ostium, this is an atrial septal defect, and the right ventricle is hypertrophied, all of which are not too serious, and there is no aortic riding."
Director, the difficulty of this surgery is in dealing with pulmonary valve stenosis, right ventricular outflow tract reconstruction?
”"What else?"
Li Min looked at the film in his hand, hesitated for a moment, and then said, "Director, I think this is much lighter than the child we went back to the pediatrics to see."
This can be done in one stage, right?
”After the last case, under the guidance of Director Liu, she has improved her reading, diagnosis, and treatment of congenital heart disease a lot.Director Shi nodded: "The first phase of surgery should be fine."
It's this atrial septal defect, you don't look at the defect as small, you have to use a patch to repair it. ”Li Min was surprised, she watched the film before asking: "Is it okay to simply stitch up?"
The defect is not very large. ”Director Shi shook his head, took out a pencil from the pen holder, pointed at the piece with the tip of the pen and said, "These are sieve holes, once we pull them when we repair them, these sieve holes may be torn or enlarged due to inability to bear the force." ”Li Min took the film and faced the window, she really didn't see that there was a sieve."
Director, is this a sieve hole?
I thought it was a problem with the film processing. ”Director Shi explained: "I went over to look at the imaging examination and confirmed that there was a sieve hole in addition to the main regurgitation of the atrial septum. ”"That's right."
Li Min nodded, if he saw it during the filming, it would be a different matter.Then she asked, "Does this patient have any obvious symptoms?"
”"I usually just don't like to move, and cyanosis is not obvious."
This is after the separation of the 12th and 11th floors, the thoracic surgery department is fully equipped, not only Zheng Qiang, the general inpatient officer, but also Pan Zhi, the deputy director who has just been promoted, Li Min can't go to see any patient admitted to the thoracic surgery department anytime and anywhere, and keep abreast of the results of the patient's condition in the ward.Another reason is that she feels that her specialty is neurosurgery, and there is no need or energy to be distracted in cardiothoracic surgery.Of course, she didn't want to meet Dr.
Yang, who worked on the 12th floor.Although Dr.
Yang is very polite when he sees her now, the distance is 1 meter away.Director Shi put away all the films he had watched, and handed over all the examination reports to Miao Yuesheng to put in the medical records.Miao Yuesheng showed the sorted medical records to Li Min.Li Min carefully went to see the medical records.The long-term medical order covers completely, the preoperative preparation of the temporary medical order does not pull down any items, and the complete major medical records and the first course of illness records are written in a decent manner.Miao Yuesheng is indeed the kind of person with limited qualifications as Dean Chen said, but he is very serious.Li Min looked at the medical records carefully, and Pan Zhi applied to Director Shi: "Director, can I go and see this operation?"
”There are only two places to visit the surgery, so if you want to see it, you have to book it early."
Yes."
Director Shi immediately agreed.Then he said to Li Min: "Xiao Li, you ask Dean Chen if you want to see it." ”"Good.I'll ask when I'll get back in a moment. ”*Director Shi waited for Li Min to read the medical records and took Li Min and others to see the newly admitted patients.Ward 11 has 8 beds and only 5 patients are accommodated.Li Min followed behind Director Shi and did not forget to glance at the bedside card that passed by, lung C, lung abscess, lung C, lung C......
How many lung cancer patients are there already?
A young woman with 4 beds, thin, thin, and weak.She half-sat on the bed and took oxygen, staring nervously at Director Shi who led people over.Among the several people standing in front of her hospital bed, two of them greeted Director Shi and then Li Min."
Doctor Li, are you okay?""
It's good."
Li Min felt that the person who greeted her was a little familiar, but she couldn't tell who it was, so she replied with a smile."
You're married, how many months have you been pregnant?""
It's been almost 5 months."
The two of them sincerely said a few words of blessing.Li Min smiled and stood beside Director Shi to see Director Shi's physical examination.Li Min waited for Director Shi to finish the auscultation, and also took the stethoscope to listen to the heart sounds.When she finished the auscultation, the female patient asked weakly and softly, "Director Shi, Director Li, can I be cured?"
”"Yes.Don't delay your marriage. ”"What about having a baby?""
Wait a year or two.Looking at the recovery of the heart, it is not impossible. ”"Director Shi, when will she be able to operate on this day?""
It's within this week.You have to pay another 3,000 yuan for hospitalization. ”The faces of the families of these patients changed.Director Shi looked at the expressions of several people, and he didn't know what they were thinking.He nodded to the group and led out of the room.Before they could walk back to the director's office, the patient's family members followed.One of the middle-aged women, like the patient's mother, twisted her hands together, anxious, apprehensive, and very uneasy, and asked Director Shi, "Is 3,000 yuan enough?"
”Director Shi shook his head: "Not enough."
She had spent a lot of money on those tests. ”"But, but......"
The woman looked blankly at the few people around her, and then whispered, "Director Shi, we can't scrape together more money." ”Director Shi was stunned for a moment, and then said slowly: "She is now having surgery and has been delayed."
If she had surgery before going to school, the results would be better than now, and her school and work would not be affected.If she doesn't have surgery, well—as long as she doesn't catch a cold, doesn't work, she can maintain the status quo, but she must not have children.Think about it. ”Li Min said to Director Shi: "Director, I'm going back to Hu downstairs, it's time for the evening rounds." ”"Okay, you can go back
.
"* Li Min returned to the 11th floor and saw Chen Wenqiang arrive at Corey ahead of schedule."
Teacher, Director Shi accepted a female patient with Faroe's triad.23 years old, found by a marriage examination.There is pulmonary artery stenosis, atrial septal defect, and right ventricular hypertrophy.Her defect had several small sieve holes, which Director Shi found when he looked at the imaging.He asked you to go and see the surgery?
”"Go.It's a pity that the child with pentagram didn't have surgery last time, so I asked Director Hu to arrange a video for future publicity. ”Chen Wenqiang is very regretful.Director Liu also said that such severe cases are difficult to encounter.It's a shame to miss it.He also said that if the child is not operated on as soon as possible, and if he has a few colds, his health will get worse and worse, and he may not have a chance to operate in the future. ”Li Min regretted it even more.Not only did she regret that a difficult operation was missed, but she was even more sad for the child, and if she did not hurry up the operation, the child's hope of surviving past the age of 5 was very slim."
yes."
Chen Wenqiang had already let go of his thoughts about congenital heart disease.If it weren't for the promotion of pediatric cardiac surgery, half of the cost would not be enough."
Have you gone to see those patients in the morning?""
Free novels bring you joy and joy ---> storyskyline.net
Look, I'll look at it when I get back from the operating room.The doctor's order was also changed. ”Li Min dragged the medical record cart over, took out a medical record and held it to Chen Wenqiang, and then took out a few more and put them on top of the medical record cart to prepare.Chen Wenqiang carefully read several medical records and said, "It's okay, that's all."
Rounds are over. ”As soon as he gave the order, the doctors and interns who had been waiting in the nurse's office followed him to start the last work of the day.* The ward rounds are early, and the end is early, Li Min followed Chen Wenqiang to the ICU to see the patient who had the heart valve replacement done during the day.Director Hong hasn't left yet, and is doing his final rounds before getting off work.There were not many patients in the ICU, and only two of the four major wards were used.The sight of the silent patient with various tubes inserted into his body, and the ECG monitor that ticks at the head of each bed.It was the time of the shift change, not only Director Hong was doing rounds, but the night nurses were also doing the rounds on shifts.The voice of low inquiry, low answer, from one bedside to another.Chen Wenqiang and Li Min were at the nurse's station, quietly looking through the patient's medical course records and doctor's orders, and then went to the patient's bed, only to see the patient lying on his back with his eyes closed, not knowing whether he had not woken up from anesthesia or was asleep.On the bedside ECG monitor, the waveform of the ECG is perfect.Heart rhythm and blood pressure are also within the normal range.The nurse in charge of this patient, who was at the head of the patient's bed, stood up and asked when she saw them coming, "Dean Chen, Director Li, is there something wrong?"
”"It's okay, we're just here to see."
Li Min flipped through the nursing records, compared with the entered medicine list hanging on the infusion stand, Chen Wenqiang tilted his head and looked at what was in Li Min's hand."
How?""
That's it."
Chen Wenqiang lowered his head and seriously gave the patient a simple physical examination to clarify the patient's cerebrovascular embolism.Director Hong saw the two of them from a distance, hurriedly explained the matter at hand to the doctor on duty, and then walked towards them quickly."
Dean Chen, the patient is awake after returning to the ICU, and Director Zhou gives some medicine.""
It's okay to put her to sleep.I have read all the biochemical results at three o'clock, is there a recheck at five o'clock?
”"Yes.I guess it's almost time to send the results back.Director Sun of the laboratory said that if there is anything abnormal, he will call me first. ”Director Hong reported the patient's postoperative situation to Chen Wenqiang, "That's good."
You have to worry about this patient, and let the night doctor have a little more care.The recovery of such patients also represents the ability and achievements of our hospital's multi-disciplinary cooperation. ”Chen Wenqiang sincerely encouraged Director Hong."
Well, I understand."
Director Hong said that he understood.If such a serious illness can be cured, it is the meaning and pride of the existence of the ICU.In addition, the people who can be accompanied to the operating room by Director Zhao and bring outsiders in to see the operation are not comparable to the ordinary people who live in the dry ward.Although Director Zhao didn't say anything, he could feel his gratitude.Then Director Hong followed Chen Wenqiang out of the ICU.When he arrived in the small corridor, he turned his head and said to Li Min: "Xiao Li did a good job in today's operation."
The hand is very steady, and it is not affected by anything. ”Li Min took off her mask and smiled, and said, "Teacher Hong, I just need to do the sutures, and I don't have to worry about anything else."
All the pressure is on you, and you are carrying it. ”Chen Wenqiang also smiled and said: "Xiao Li is because we rely on her, she doesn't have to worry about anything, and naturally her hands are steady." ”Director Hong sighed: "Being young is good.If you have something to rely on, you won't panic.In case of trouble, you can go to the senior doctor, and then find the director, carefree and fearless.Like us now, we can only fight on our own. ”Chen Wen emphatically said: "You are now the director, and the serious problems of the whole hospital are waiting for you."
Do you regret coming over to resist the girders?
”"Manly man, how bad it is to say regret."
Director Hong joked."
I regret that you can't go back to the medical university."
Chen Wenqiang also joked."
What am I going to do when I go back?
As long as I want to compete for the top in my life, a few years earlier, a few years later, sooner or later, I have to take the lead by myself.Besides, I seized the opportunity you gave me to carry the beam, and I don't have to make my own decisions about everything, and I don't have to crowd in the tube building anymore, so why not?
Living in a three-bedroom living room, it's better than a collective dormitory, isn't it, Xiao Li?
”Li Min hung up the isolation gown, pursed his lips, smiled and nodded.* At the end of the day's work, Li Minting happily sat at the dining table, pressing on the handlebars of the stroller with one hand and teasing Pan Jia with the other.Pan Baobao, who was salivaing, smiled from ear to ear, and the bib under his neck quickly became wet.Li Min untied his gauze bib, handed it to Yan Hong and said, "Get a new one." ”Pan Zhi stood up, took the gauze bib from Yan Hong's hand, and after going back to the room to get one, he bent down and tied the bib around Pan Jia's neck.Pan Jia was lying in the car, holding the soft leather ball and gnawing hard.Pan Zhi lovingly wiped his saliva, nodded his nose and said, "Silly boy, what did you chew, laughing like this." ”Pan Baobao ignored his father's affectionate movements, and all his attention was on the ball in his mouth.Yan Hong tugged at the small handkerchief he had prepared for him in the stroller and wiped the saliva from the wet ball."
Minmin, Pan Zhi said that you had a heart valve replacement operation at noon?
Are you tired?
”"Didn't bother me.I only did the suture part of the valve replacement, and before I could suture the heart, Director Shi asked me to step down. ”Li Min took the soup bowl handed over by Xiao Fang, and gently scooped the soup with a long-necked coffee spoon.After months of unremitting efforts by Mu Jie, Li Min accepted the Cantonese habit of drinking half a bowl of soup before meals.Yan Hong added to this behavior, and she drank the soup with the smallest four-inch bone china golden bell bowl and a coffee spoon with a long neck.The two of them drank the chicken soup one by one, talking about their work during the day.Pan Zhi went from not being accustomed to, not participating, and not opposing at the beginning, to occasionally joining them in this way of drinking soup.Half a bowl of warm chicken soup into the stomach, the spirit is much better, and I have an appetite."
Senior sister, I heard that today's operation is very difficult?""
The operation itself is not difficult, and almost ten cases have been done.The difficulty lies in the patient's general condition.Director Zhou was very nervous, and Director Hong of the ICU was also with him in the operating room.In fact, not only Director Shi was afraid that the patients would not be able to come to the stage, but even Dean Chen and Director Zhao were also afraid. ”"With so many directors circling around her, what important person is she?"
Yan Hong asked casually."
Her medicine bill was signed by Director Zhao.Not qualified to live in the dry clinic, but Director Zhao accompanied him throughout the process.Director Zhou of anesthesia was nervous because of the consultation before going on stage, and the patient had left heart failure, shock, and blood pressure had been maintained by vasopressors.Director Hong was nervous because the ICU had died of an infective endocarditis before.Everyone is afraid that they will not be able to get off the operating table. ”"You just went to the ICU?""
Go."
Li Min drank the last bit of soup and went to the kitchen to serve the meal by himself.When Pan Zhi and Yan Hong also came back from dinner, Li Min told the patient about the postoperative situation."
I read the course record written by Director Hong, the patient had a cerebral infarction during anesthesia, and the muscle strength of his left arm decreased, but before getting off work, I went to check with Dean Chen, and the muscle strength was grade III., which is okay.""
Is it a blood clot or a shedding bacterial emboli?"
Although there were signs of thrombosis on the vegetation on the heart valves, Director Hong thought it was a detached bacterial emboli.In terms of the patient's current state, she will be given an MRI tomorrow or the day after tomorrow to see which blood vessels have been embolized. ”"Will there be a craniotomy?
If it is an embolism of the detached bacteria. ”"No, it's antibiotic.The dose was large enough to kill Staphylococcus aureus, and the embolism was naturally resolved.If it is a blood clot, depending on the degree of current involvement, there will be no craniotomy.After that, it was slowly thrombolyzed or treated with traditional Chinese medicine. ”"Won't it be too late?
Missing the best time to dissolve thrombolysis?
”"Yes.But she died of left heart failure and shock this morning.Later, on the operating table, she would definitely not be given thrombolysis.Let's save my life first. ”Li Min patiently answered Yan Hong's question, and then asked Pan Zhi: "Senior Brother Pan, how many days has the patient of Faroe's trilogy been in?"
”"Came in last Tuesday.It was a patient that Director Shi personally managed. ”Li Min was slightly surprised: "Really?
I think it's all the medical records and medical orders written by Miao Yuesheng. ”"The big medical record was written twice, and the first trip was written three times, and the doctor's order was dictated by Director Shi.""
Oh, that's right.I thought Miao Yuesheng had improved. ”Li Min showed a look of sudden realization.Yan Hong asked Li Min why.Li Min said: "When Miao Yuesheng was interned, his medical record writing was much worse now, and I thought he had improved by leaps and bounds."
It turned out to be modified by Director Shi. ”* Pan Zhi added another bowl of rice and came back and said, "Senior sister, you said that if I go on stage for cardiothoracic surgery, do you think it is possible?"
”"What's impossible.You've done a good job of those basic sutures, as long as you're given the opportunity, and there is time for cardiopulmonary bypass, you will naturally be able to get up quickly.Suturing the valve wasn't a big deal. ”"Isn't that a big deal?!
Director Liu and Director Shi both asked you to sew up the valves. ”Pan Zhi was extremely envious."
Free novels bring you joy and joy ---> storyskyline.net
I don't say three or five years, I just can suture the valve in ten or eight years.""
You really want to?""
yes.Who wouldn't?
If you don't have cardiothoracic surgery, you can't go to heart surgery, to tell you the truth, I definitely can't get over it in my heart and face. ”"If you really want to practice with Rainbow.As long as Director Shi sees that your speed is faster, you can surpass him and be stable, he will definitely ask you to have heart surgery.It's true!
You see the last vascular replacement, he gave you a start, which means that he still trusts you. ”Li Min put down his job and said to Pan Zhi seriously: "I will start classes next month, and I will only be able to go on stage on the second, third, and fourth days a week in the future." ”"Director Shi will arrange the operation of the heart surgery within these three days."
Pan Zhi's disappointment was mixed with his determined tone."
If you really want to have an extracardiac operation, don't just look at these three or four months.You can practice for the past three or four months, and as long as you practice fast enough, I will have to take maternity leave at the end of the year.It happened to be the operation season, as long as you had a chance to go on stage, Director Shi saw that you could, and you would be able to do it in the future. ”"Thank you, thank you.I'm a fan of the authorities. ”"Thanks, I'm just sewing it up a little faster.Senior Brother Pan, I don't know if you have noticed, but now there are more and more pediatric surgeries, and Director Liu may not be able to arrange them by the end of the year.It's your chance. ”Also.Pan Zhi put down the dishes and chopsticks and shook Li Min.Li Min smiled and replied to him, saying, "But I can say the ugly things first."
If you're not fast enough, when Director Shi and his son turn around, you won't have a chance. ”Li Min reminded Pan Zhi with a joke."
Shi Yi is now rotating in orthopedics, and he should go to Puwai next year."
Pan Zhi's tone seemed to be confirmed with Li Min again."
I should go to Puwai and learn from Director Liang for half a year."
This Li Min knows, and he is not afraid to tell Pan Zhi.Yan Hong interjected and asked, "Which subject will Shi Yi be set in the end?"
”Li Min shook his head: "Then it's hard to say."
It turned out that Yang Yu and their rotation for two years this year, but they were determined in one year.God knows if Shi Yi and their session will change by this time next year, and what changes will there be. ”"If I were Director Shi, I would also take my son with me.All the surgeries in the Department of Cardiothoracic Surgery are performed by Director Shi, what an opportunity to train his son. ”"Yes, look at Shi Yi's chances.When rotating orthopedics, follow Director Wang; When he turns to Puwai, he will definitely follow Director Liang.If he is determined to go to the outside of his chest, it is normal for Director Shi to take it personally. ”"People will be reincarnated.But we don't have to envy Shi Yi, when Bao Pan grows up, he will take turns to go to Puwai with Senior Brother Xie in the future, I can take him to neurosurgery, and you can take him to cardiothoracic surgery.We're no worse than other people's sons, baby, don't you say?
”Yan Hong covered her mouth and laughed: "We can't fight for our father, but we can let our son fight for it."
Lao Pan, come on. ”Li Min leaned over, pulled the hand of the baby and said, "Come, baby, talk to your aunt - Lao Pan, come on." ”Pan Zhi was embarrassed by Li Min and Yan Hong.He knows that his family is not as good as the classmates around him, and he has always relied on his own efforts......
After twenty years of hard work, he was able to stand at the same height as most of his peers, but he was laughed at by two girls whose family conditions were better than his own.He smiled awkwardly and secretly resolved to work harder.It is necessary to increase the speed as soon as possible and get the approval of Director Shi.Because Li Min said that her maternity leave was her only chance.If you can't catch it, when Shi Yi comes over, you may not have a chance.※※※※※※※※※※※※※※※※※※※※6.18, it's ^_^ a bit far away to catch insects again