Li Min whispered: "I'll go to the operating room immediately." ”Even so, she still waited for the nurse to finish her shift, and Kevin Lu also reported on the morning rounds.Despite this, Li Min still couldn't completely put her mind at ease, and she went to Corey to see the patients who Kevin Lu thought had changed their condition.After adjusting the doctor's order, he took Kevin Lu to ward 16."
Dr.
Yang, there is an emergency surgery in the pediatric department, and I have to go to the operating room.What's going on with our Cory, you can help the trail to take a look. ”"Okay, no problem, you can go to the operating room without worry."
Dr.
Yang responded very solemnly.Corey's affairs were arranged, and Li Min dared to leave the 11th floor and hurried to the operating room.Dr.
Song was standing at the door of the operating room to explain the patient's condition to the parents of the child.Li Min crossed over to the parents of the children surrounding Dr.
Song and raised his voice to greet him: "Dr.
Song." ”Doctor Song looked up and saw Li Min, and immediately responded to her with a smile: "Oh, Director Li is here." ”The parents of the child immediately opened a vacancy and let her walk into the small encirclement.In the process, the men, women and children looked her up and down.And Li Min has long been accustomed to being looked at by the patient's family.She nodded to the parents of the child and only spoke to Dr.
Song."
Teacher Song, what is still missing from the preoperative preparation, I'll do it."
This sentence of Teacher Song made Dr.
Song's heart iron like drinking honey.This sentence of Teacher Song made him swallow dates early in the morning for breakfast, and the unwillingness to have to come to the rescue turned into willingness.He replied to Li Min with a little urgency: "Now the parents are left to sign, and the other documents are ready." ”Then he introduced to the parents of the children: "This is Director Li of the Department of Neurosurgery of our Provincial Hospital.I told you about the surgeries she did.Not to mention the craniotomy of a one-year-old child, she also participated in the heart valve repair surgery of the pediatric surgeon.In a moment, she and I will operate on your child. ”The parents all cast eager eyes on Li Min's face.Li Min nodded at everyone and said to Dr.
Song, "I'll go first to see the child and the CT film." ”"Okay, you go in first."
Li Min motioned to the people around her, and she wanted to go around and enter the locker room.The child's grandmother and grandmother grabbed Li Min's arm left and right and begged, "Director Li, please ask me to do a good operation on my Dabao later, okay?"
”"Okay!"
Li Min replied to the two old ladies very seriously: "I am as serious and careful as a craniotomy and heart surgery for a child. ”"Okay, thank you!"
One of the old ladies wiped her tears and said, "My three sons are just such a golden grandson."
Director Li, I'm all please. ”The other said: "Director Li, my daughter spent half her life, and this son born by caesarean section, please." ”"Uh-huh, Doctor Song and I will be attentive."
Li Min hung one on one arm, and she couldn't walk.She had no choice but to say to the old ladies, "I still have to see how the children are doing, and you let go." ”The child's grandmother stuffed a roll of money into the pocket of Li Min's white coat, then nodded with her mother-in-law, and the two let go of Li Min's arm.* In the locker room of the operating room, Fu Yunxiang has changed into her hand clothes and is fiddling with her long hair."
Teacher Li.""
Well, have you seen the patient?"
Li Min took off his clothes quickly, and soon even took off his socks, and there were only three points left on his body.Her pregnant belly and enlarged bust are too different from the figure when she was stabbed in the back by glass the year before last.But the beauty of the pregnant woman made Fu Yunxiang blush slightly, and she quickly half-turned her body to avoid Li Min's body, "I've seen it." ”Fu Yunxiang quickly reported the child's condition and all the examinations.Then he said, "Dr.
Song went to the CT room to see the abdominal CT and then called me to inform me to make preoperative preparations."
I asked Dr.
Song to read all the preoperative documents. ”"Alright, let's go."
Li Min quickly put on his hand clothes.But Fu Yunxiang's long hair has not been pulled up yet.Li Min glanced at it, turned around and pulled out a few rubber bands from his locker, tied Fu Yunxiang's long hair in sections, quickly pulled it to the top of her head, and then used a ballpoint pen to fix her hair on top."
If you do this, you won't fall apart when you jump back and cross the style.Go back and practice well, there is no time for you to waste on your hair before the surgery. ”Li Min locked the locker, tied the key to the belt of the washsuit, and urged Fu Yunxiang to say, "Hurry up." ”"Hmm."
Fu Yunxiang's face was as red as a glow.She followed Li Min and whispered, "I forgot to bring a rubber band today." ”Li Min ignored her explanation, took the mask and hat from the sterilized hat pot, and put them on as she walked.
*Dr.
Song walked out of the locker room a few steps behind them."
Director Li."
Doctor Song called Li Min.Li Min turned around and replied: "It's better to call me Xiao Li like the original." ”She continued to wear her mask.Director Song smiled and told Li Min what he saw on abdominal CT: "CT can see mesenteric edema, thickened walls of the small intestine, and multiple fluid gas levels.I just did a paracentesis before my child went into the operating room, and what came out was a reddish non-condensable fluid?
”Lesions with mesenteric vessels are not uncommon.But "what's wrong with the pancreas?"
”Li Min looked at Dr.
Song in surprise, and her surprise made her immediately turn her head to look at Fu Yunxiang who was following her on the right."
You didn't report to me the test results of pancreatic lipase and amylase just now, only urine amylase."
Her range of movements was a little large, and she turned too fast, Doctor Song's eyes were quick, he reached out and grabbed Li Min's arm, and took Li Min a step in his own direction, which prevented Fu Yunxiang, who was following her closely, from bumping into her, and avoiding the possibility that she would be knocked into and knocked down."
The emergency department opened a test order, and sent blood to test pancreatic lipase and amylase.I didn't have the results before I went into the operating room. ”Fu Yunxiang hurriedly explained."
According to abdominal fluoroscopy and CT, we can only do laparotomy to see if the child has intestinal necrosis, and how large the necrosis is.Xiaofu, you call the laboratory department to ask about pancreatic lipase and amylase. ”"Yes."
Li Min followed Dr.
Song into the No. 9 operating room, Jiang Ma had already been intubated and was listening to breath sounds.An intern holds a curved disc in one hand and oval pliers in the other, ready to be sterilized.Instrument nurses and patrol nurses count gauze.Two CT scans are inserted into the reader.Doctor Song walked over and pointed out a few problematic places to Li Min: "Here, here, this place is not very good."
What I fear most is that this child's disease will progress too quickly. ”There is vascular embolism in all of these places.Without waiting for Li Min to speak, Fu Yunxiang came in and said, "Teacher Song, Teacher Li, pancreatic lipase and amylase are normal. ”Li Min shook his head, dragged down the CT film, and pointed to the ones that Dr.
Song said to explain to Fu Yunxiang: "Look here, this is enteritis that causes edema of the mesenteric arteriovenous wall, narrowing of the blood vessel wall, less arterial blood flow, slow venous blood flow, and coagulation factors and exotoxins released by bacteria can cause hypercoagulability."
The pancreas may not have been affected two hours ago, but now it's hard to say. ”After Jiang Ma listened to the breath sound and confirmed that the tracheal intubation was in the correct position, he said to the intern who was ready, "It's ready to be disinfected." ”Dr.
Song reached out to draw the disinfection range for the intern, and then said to Li Min, "I'll go brush my hands first." ”Li Min nodded, saw that the intern's movements were similar, and asked him, "Have you had surgery with Director Liu?"
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”"I've been on it three times, and I've disinfected it.""
Then I won't look at you."
But Li Min turned his head and pleaded with the anesthesiologist: "Jiang Ma will help you." ”Jiang Ma readily agreed: "Okay, you can brush your hands, I'll watch him disinfect for you." ”At this time, Li Min saw that the two nurses had checked the contents of the surgical instrument bag, so she said: "Sister Wang, help me draw blood for the child, and then test pancreatic lipase, amylase, and coagulation in the emergency."
The results of the laboratory test are noted on the test sheet and the operating room is notified immediately. ”"Okay."
Li Min took Fu Yunxiang to brush his hands.The patrol nurse received blood from the infusion tube, and Jiang Ma watched the intern disinfect while looking for a test sheet, and he had to fill in the examination items.He muttered to the nurse, "Xiao Wang, look at their surgeon's shelf."
We're both going to have to do extra work. ”"Then you didn't say yes just now."
The nurse on the patrol table tightly covered the two small test tubes and stood at the small anesthesia table waiting for Jiang Ma's test sheet."
How dare I do that.You are Li Min or the little doctor the year before last.He is now the director, Dean Chen's senior apprentice, and it's too late for me to stammer. ”Sister Wang sneered, took away the test sheet he had filled out, and went out of the operating room to find the patient's family to send blood samples.* Li Min brushed his hands back and instructed the nurse on patrol and said, "Sister Wang, please give me a No. 2 stepping stool and put it here." ”Jiang Ma joked: "Old Song, the director has a stage for you, you are majestic today." ”Li Min blamed him and said, "Jiang Ma, Teacher Song has been in Puwai for almost 20 years, you can't sow discord like this." ”"You guys are so close, I can't pick it if I want to."
Li Min pretended not to hear, anyway, when something else happened, she treated her as if she didn't answer.She never cares if it's cold or not.But Dr.
Song can't let this happen!
Because at this time, people are swordsmen, and I am fish and meat.On the operating table, the anesthesiologist loosened and tightened, and only the surgeon understood what the indescribable pain was.For example, the anesthesia is not in place, the abdominal muscles are tense, how do you say this abdominal surgery is done?
Or is the patient's blood pressure and heart rhythm instability during the operation, how do you say the operation will be carried out?
with an anesthesiologist?
On pharmacology?
Tying up the surgeons on stage is not an opponent of an anesthesiologist.Of course, when you meet a surgeon like Chen Wenqiang who can get started with general anesthesia, well, all of them work honestly.Li Min's respect for himself, Dr.
Song accepted it all.He smiled and gave Jiang Ma a round field: "Old Jiang, you are really good."
You have forgotten that Director Li is the same as Dean Chen, he can use his left and right hands, and he can stand on the same side.Here, wash your hands. ”Jiang Ma originally wanted to joke, and when he saw this, he said, "Director Li called you a few times, teacher, and you thought that you were side by side with Dean Chen, didn't you?"
”Doctor Song said: "Old Jiang, you, you, you, you are not afraid that Director Li will ask for oval pliers, don't get involved with me."
She was in the same league as the nurses.Come on, it's time to start.Gauze, large round knife. ”"Gauze, little bend, two handfuls."
Li Min followed behind Dr.
Song to ask for something.At the beginning, Fu Yunxiang and the intern were able to follow the small bend to stop the bleeding.But as the operation progressed, the two of them were too frightened to reach out when they saw the discolored intestine that opened the posterior peritoneum and then bulged out."
Sister Wang, prepare a few bottles of warm saline.""
Hmm.I've got it for you. ”There is a stainless steel basin on the electric stove in the corner of the house, and several bottles of saline stand in most of the basin.Jiang Ma stood there at the head frame, looked into the field, and said worriedly: "The color of this intestinal tube doesn't look very good." ”"It's not good.Ischemia is too extensive.I'll see if I can find the starting point of the embolization. ”"What do you want to do?""
Removing the thrombus.He is so small, so many small intestines have been removed, and his future growth and development will definitely be affected. ”"Old Song, you are a benevolent bodhisattva.""
Or else?
This large area of ischemia has been removed, and I have the most effort.But I thought about it well, and I don't know if I can do it. ”Doctor Song watched Li Min carefully wrap the discolored intestines and mesentery that he had taken out with a large warm gauze pad.He quickened his movements.He wants to find the embolism of the blood vessel on the mesentery as soon as possible, in addition to determining the extent of the affected intestine and whether there is a possibility of retention, the fundamental purpose is to preserve the intestinal tube for the child."
Change to a hot one."
Li Min threw the large gauze pad back to the instrument nurse.At her request, another hot gauze pad was handed to her......." and then change. ”"Change again."…… After changing it several times, Li Min lifted a corner of the large gauze pad and showed it to Dr.
Song: "The hot compress is effective." ”"Hmm.You continue. ”Dr.
Song carefully turned the mesentery with two large tweezers.The hard work paid off, and finally found a thrombosis for him."
Director Li, how about we cut and remove the thrombe?
You see that the intestinal tube is effective for heating and rewarming, and the blood vessel should not be completely thrombosed, and the thrombosis is not long.If the thrombectomy is successful, the child's bowel can be saved. ”Dr.
Song ordered the mesenteric blood vessels under his hand, and discussed with Li Min with expectation and seriousness: "From here, a longitudinal incision and thrombectomy will be made, and then you will do the vascular suture, what do you think?"
”Dr.
Song put the most beneficial surgical plan for the child in front of Li Min.Li Min saw that he felt that he could do it, so he replied: "I listen to you."
Then change the heat gauze pad.Xiaofu, you two pay attention to the temperature, and change it when it's cold.Sister Wang, you can help me bring the eyepieces.Prepare two more 5-0 threads and disassemble one first.Prepare me two pugs, two 0.5 mm straight tweezers, microbent shears and straight shears. ”"Okay."
Sister Wang, the patrol nurse, shuttled back and forth, she carefully gave the same things that Li Min wanted, and then carefully put the eyepiece on Li Min."
Doctor Song has already asked me to prepare these things for you.Otherwise, when you ask for it now, I won't be able to change it for you. ”These microscopic instruments are additionally sterilized.Doctor Song watched Sister Wang shuttle and prepare, and he asked Li Min, "Do you want to change my side?"
”"No, I don't.Sister Wang, prepare a sodium heparin, diluted at 1:50.A while to flush the blood vessels with. ”"Okay."
Sister Wang went to the medicine cabinet and got a heparin sodium.She first took it to Jiang Ma and looked at the name of the medicine on the bottle.After showing it to the instrument nurse again, she broke the ampandan bottle and asked the instrument nurse to extract the medicine.She took away the ampoule and placed it separately, and took the water for injection to dilute the heparin sodium for the instrument nurse.Li Min slowly peeled off the embolic blood vessels on the mesentery with microscopic forceps in one hand and microscopic scissors in the other, and at this time the instrument nurse also prepared what she needed.She stretched out her hand and asked, "Pug, sharp knife." ”After blocking the blood flow, she carefully picked a small 0.2mm incision in the blood vessel wall, grabbed the scissors, and prepared to expand the incision along the blood vessel wall.She carefully pulled the exposed adventitia of the blood vessel with microscopic forceps, and cut the wall of the blood vessel longitudinally according to Dr.
Song's plan.She used two pairs of forceps to begin the embolization.The man on the operating table held his breath.The first thin blood clot, about 2 centimeters long, was removed.Li Min put the thrombus in the curved tray and asked for a syringe containing sodium heparin to flush the blood vessel.The intern sighed, "This is a standard fresh blood clot!"
”After flushing the blood vessels, Li Min began to suture the walls of the blood vessels that had just been cut with 5-0 sutures.Jiang Ma couldn't see Li Min's action of suturing the blood vessel wall clearly at the head frame, and he said to Dr.
Song: "The eyepiece in our operating room is advanced enough." ”"Is this still what Dean Chen brought back from the south?"
Dr.
Song asked."
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This one isn't.The pair I brought back was put in the lab, and this one was bought later.It seems that I bought it in the autumn of the previous year.Now for neurosurgery and orthopedics. ”The patrol nurse knows better.Jiang Ma sighed: "Let's not talk about President Chen's contribution to the provincial hospital in the past two years, just when he came back from the south and set up the brand of neurosurgery, our provincial hospital will be promoted from the second class to the ranks of the third level hospital." ”"That's it.Without neurosurgery, the two Jiajia are mysterious. ”Dr.
Song agreed with him."
It's a shame that this hospital was graded after we built this 17-story building, otherwise it would not be as good as those staff hospitals.It's embarrassing to call it a provincial hospital!
It's a shame to be home. ”"We can't compare with those staff hospitals.People have factories to build buildings and buy equipment every year, who allocates funds to us. ”"It would be nice if the salary could be allocated in full."
Doctor Song chatted with Jiang Ma with his mouth, but his hands were not idle.He asked for a mosquito forceps and wanted to assist Li Min in removing the thrombus, but the tip of Wen's forceps was too big to help, so he threw away mosquito forceps, fixed the intestinal tube with both hands, and instructed Fu Yunxiang and the intern to change the gauze pad: "The range of action should be small, don't involve the intestinal tube." ”He actively provided Li Min with a very easy to operate surgical field.The small blood clots in several places were removed, and Li Min also sutured the blood vessels one by one.She took a deep breath and said, "Xiaofu, you should keep an eye on it after surgery." ”"Yes."
Although he couldn't see Shuye clearly, Jiang Ma kept stretching his neck to look at Shuye.When he saw that Li Min was done, he rubbed his neck and sat back.Li Min stepped down to rest."
Old Song, were you going to do this from the beginning?"
Jiang Ma shook his neck from side to side."
yes.I was in the CT room looking at the imaging done.It is calculated that the ischemia will not be long, and there should be room for redemption.The main thing is that Xiao Li came to the stage for this operation, otherwise I wouldn't be able to do thrombectomy and suturing with these two-millimeter-thick blood vessels. ”Dr.
Song was observing the recovery of the intestinal tube while chatting with Jiang Ma."
You also explained this to your family before the operation?""
Naturally, I can't talk to death.I told them about three surgical options, and this is just one of them.Of course, whenever it is possible to keep the bowel, we will try to keep it for the child.It was also the details of Xiaofu's medical records that I dared to have this idea and dare to propose Director Li to do this. ”Dr.
Song praised Li Min and also praised Fu Yunxiang."
What did Doctor Fu ask?"
Although the instrument nurse is young, she is very good at praising the surgeon.Fu Yunxiang was a little shy, and she said shyly: "The pediatric medical history will be so detailed."
I asked the child's grandmother that the child had eaten too much watermelon the night before and had gotten up several times in the middle of the night.I only ate a slice of watermelon before going to bed last night.That's why he was clamoring to eat at dawn.His mother was afraid that it would be bad for him to eat too much cold watermelon, so she distributed it to everyone.As a result, his grandfather walked away, and his grandmother and his father were reluctant to eat.Fortunately, his mother grabbed a few pieces and ate them and shared them for him. ”"How many watermelons?""
Almost 20 pounds of big watermelon.On Sunday night, one person ate one piece, and the child ate three pieces, and when he couldn't eat it, he let go.I ate it this way at noon yesterday.Last night his mother saw that he was not eating well, so she gave him a small piece in the evening.There was almost half a small watermelon this morning, and the mother and mother ate it together. ”A small crack opened in the door of the operating room, and a nurse came in and said, "Jiang Ma, the test sheet you prescribed, pancreatic lipase and amylase are normal." ”"Well, thank you."
Although he received the return of pancreatic lipase and amylase, Dr.
Song still did abdominal exploration, focusing on the pancreas.After dealing with the obstruction and checking that there was no problem, he looked at the intestinal tube, which had rewarmed and regained its color, and shouted with joy: "Abdominal irrigation." ”The instrument nurse handed him warm saline, Fu Yunxiang stepped on the suction device, the intern lifted the abdominal wall with a mid-curved retractor, Li Min stood up, and she wanted to return to the position of the first assistant on the operating table.Doctor Song said, "Xiao Li, I'll take them to close their stomachs." ”"Thank you."
Li Min didn't dare to leave the operating room.She snatched Jiang Ma's stool, lay on the small table to write surgical records and give medical orders.After she finished doing this, Dr.
Song began to ask Fu Yunxiang to stitch up the subcutaneous skin."
Teacher Song, I have finished writing the operation record, and the doctor's order has been issued, you will see if there is anything to change and add in a while.""
Okay, thank you.Thank you for your hard work.Today's surgery is up to you. ”Teacher Song was polite.It's okay, I'll go back first. ”"Good.Go back. ”Li Min shuffled and left.As the number of months of pregnancy increases, it is easy to feel tired when you used to look at indifferent jobs.Especially when Dean Chen is not present, you still need to pay full attention and take on all the pressure yourself.The pressure on her heart is much more than the technical pressure.Sister Wang, a nurse patrolling Taiwan, said: "It's not easy for Li Min."
You people are all calculating to use her. ”Jiang Ma said: "Being able to be calculated and used by others shows that she is capable."
That's better than not being able and no one remembering to use her.Otherwise, a woman who is a surgeon usually pulls the hook on the surgical table, at most serves special patients during physical examinations, what is the meaning of being a surgeon in this life?
It's better to go to internal medicine. ”Fu Yunxiang's hand immediately crooked.Dr.
Song tapped her needle holder with small curved pliers and instructed her, "This needle is heavy." ”"Yes."
Fu Yunxiang immediately removed the needle.Dr.
Song already knew about Fu Yunxiang's marriage, but for the sake of Director Qi of Pediatrics, who had taken care of his children for many years, he was willing to say a few more words."
Some patients' families don't know how the inside is doing, they just look at whether the outside is sewn beautifully.We had put so much effort into it just now, and when we turned around and the skin was crooked, they would wonder if the inside was even more crooked.Therefore, the spacing between your needle and needle must be completely consistent. ”"Yes.Thank you, Mr.
Song. ”After a year of internship, Fu Yunxiang is very able to put herself in the right position.She crooked her hand just now because she was distracted and touched by listening to Jiang Ma.Jiang Ma glanced at Fu Yunxiang's state and knew what the reason was.He sat back on his three-legged leather stool and silently filled out all the anesthesia notes.In order not to be distracted by Fu Yunxiang, he didn't open his mouth to chat with Dr.
Song.So, bored, he began to reverse the left circle and turn the right circle forward to pass the time.The patrol nurse was already packing up.The instrument nurse was very patient and waited for Fuyunxiang and the intern to stitch up.Not only Dr.
Song, but also their operating room and anesthesiology department also heard that Fu Yunxiang would marry Dean Fu's son on National Day.When Dr.
Song finished sewing, he asked for a large tweezer to match the skin by himself, and carefully aligned it with a needle, and there was only one thread in the stitch, and then he put down the tweezers with satisfaction.Fu Yunxiang took the prepared dressing from the instrument nurse, but seeing that Dr.
Song asked for thread scissors again, he carefully cut half a gap in a small piece of gauze and put it under the drainage tube.She held the dressing and waited, and when Dr.
Song had set up the gauze, she covered the dressing.The patrol nurse brought a dressing to fix the incision with adhesive tape."
Doctor Song, you did a beautiful job today.""
Really?
I think it's beautiful myself. ”The surgery was perfect!
Dr.
Song praised himself in his heart.He was proud that the surgical plan he had designed according to Li Min's technical characteristics had been implemented perfectly.This is the least invasive procedure for the child.Thinking back to the blood vessels that Li Min had sutured, he even wondered if he should also actively seek to practice microsurgery.Li Min stepped down and went to the bathroom first, and then called back to Corey.After asking if there was anything wrong, she told Kevin Lu: "I'll lie down on the women's side of the operating room for a while, and you can ask the nurse in the operating room to find me if you have something." ”"Okay."
Kevin Lu agreed, and then asked worriedly, "Teacher Li, are you okay?"
”"I'm fine, I'm just tired, I'll go back after a while."※※※※※※※※※※※※※※※※※※※※ contamination inside the refrigerator, be careful.Raw and cooked should be separated, and wrapping and covering with plastic wrap is the most basic.() The distance is a bit far