714 Piano (Fanwai 12) Collection 4244—97.7.19W6 After Chen Wenqiang replied to Director Shi's call, he took Li Min and Chi Yongbo to the director's office of cardiothoracic surgery.When they arrived, Director Sun from the laboratory department was chatting with Director Shi, and Pan Zhi was standing on the phone.This office is also almost the same, not only the desks and chairs are old, but more obviously, Director Shi is old."
The Dean is here."
The short and fat Director Sun, there is no trace of time on his white face.He stood up, gave up Pan Zhi's seat, and beckoned Chen Wenqiang and said, "You come here to sit, I have to go back." ”Chen Wenqiang was polite to him: "You sit down."
For this transplant to be successful, no department can do without the support of you, the hero behind the scenes. ”Director Shi stood up and said, "Lao Chen, you sit on my side." ”Seeing that Chen Wenqiang had the intention of refusing, he smiled and said: "The one who comes is a guest, and the guest is as the host is." ”Chen Wenqiang walked over and scolded him with a smile: "I am the dean, this hospital is mine, why have you become the master." ”Director Shi smiled so hard that he couldn't see his eyes, and replied nonchalantly: "The provincial courtyard is yours, and the 12th floor is mine." ”"Your 12th floor is an independent kingdom in the provincial courtyard."
Chen Wenqiang joked with him, and sat in the seat he gave up.Director Sun ignored the two of them, and asked Li Min with a smile: "Xiao Li, this is your junior brother?"
”Li Min hurriedly introduced the two of them: "Well, this is my junior brother Chi Yongbo, come over to Corey first to familiarize yourself with the situation."
Xiao Chi, this is Director Sun of the Laboratory Department of our Provincial Hospital.Ten years ago, Director Sun brought the laboratory department to the level of a test sheet that was common to the whole province. ”Chi Yongbo hurriedly stepped forward, and he bowed slightly and shouted, "Hello Director Sun." ”Chen Wenqiang smiled and watched Li Min introduce Director Sun to Chi Yongbo.Director Sun smiled kindly at Chi Yongbo, and then said to Chen Wenqiang: "Dean Chen, you have picked too many students.Tell me about you, ah, in the past six years, you have only recruited a second graduate student.If this were a different person, the neurosurgery department would have been all your Chen family's disciples a long time ago. ”Chen Wenqiang smiled and said: "It's not much more expensive.Neurosurgery does not have as many patients as cardiothoracic surgery, and it doesn't take as many people. ”Director Shi smiled and did not puncture the patients of neurosurgery are no less than thoracic surgery, and there are two or three doctors who help with the work all year round.Director Sun laughed and said, "Dean Chen, look at Lao Shi, you are a scholar, he has turned this 12th floor into the Shi Family's army." ”Chen Wenqiang and Director Shi were unmoved by these words.Especially Director Shi, he just smiled and distributed the stack of inspection reports on his desktop to Chen Wenqiang and Li Min.After Pan Zhi finished calling, he tentatively asked Chen Wenqiang: "Dean, do you want to invite Director Liang to come?"
Liver transplantation has been going on for 30 years, and maybe Director Liang and they also have ideas. ”Chen Wenqiang said without raising his head: "I called him, and invited Director Qian of the Department of Gastroenterology and Director Jin of Infectious Diseases." ”"Yes."
Pan Zhi immediately called the Department of General Surgery and asked Director Liang for a meeting.Pan Zhi has always respected Director Liang with the attitude of Director Shi over the years, and he has always maintained a good relationship with Xie Xun.Without Director Shi's permission, he wouldn't ventilate Director Liang and Xie Xun in private, just like he didn't mention the transplant to Li Min during dinner last night.But in front of Director Shi, he asked Chen Wenqiang for Director Shi, this is the method of several lights.He won't miss it.As Pan Zhi expected, Chen Wenqiang agreed, and Director Shi also bowed his head approvingly.said that the meeting would be held at half past eleven, and other people might be preparing to step on the time, but Director Liang was the first to arrive after receiving the call.He was followed by Director Qian and Director Jin.Except for the sentence that Pan Zhi mentioned on the phone that the content of the meeting was about liver transplantation, he didn't think about it.Director Liang came in, not to mention that Director Sun of the Laboratory Department stood up and gave way, even Chen Wenqiang stood up and greeted: "Old Liang, come and sit." ”Director Liang sat opposite Chen Wenqiang.He took the stack of inspection sheets that Pan Zhi handed over and had just sorted out.He didn't look at the test sheet in his hand, but asked Director Shi directly, "Are you ready for a heart transplant?"
”Director Shi nodded and said, "Yes, after several years of preparation, everything is ready, only the donor is owed." ”After Li Min greeted Director Liang and the others, he stood behind Chen Wenqiang's side.She motioned with her eyes for Ji Yongbo to follow her.Chi Yongbo received Li Min's signal and followed her to stand behind Chen Wenqiang.Pan Zhi, as one of the owners, adjusted the wind speed of the floor shaking head fan to the maximum.In the whirring wind, only Director Liang looked through the test sheet for a slight movement.Chen Wenqiang waited for Director Liang to finish reading before asking him, "Are you interested in a liver transplant?"
It's a rare opportunity.This donor, our hospital has wasted the old nose.Finally, I don't have to share it with the Affiliated Hospital of the Medical University. ”Director Liang evaded: "Do you want a kidney transplant at the same time?"
”"Yes."
Chen Wenqiang asked: "Are you interested in liver transplantation?"
”Director Liang hesitated for a moment and said, "It depends on whether Director Qian and Director Jin have suitable receptors."
I don't have a primary lesion in the liver, and I am a suitable patient for a liver transplant.As for metastatic cancer, I do not advocate transplantation for patients with liver metastases.Also, the cost of liver transplantation is not a small amount, and this must be explained to the patient and family members first. ”The question of whether to transplant patients with metastatic cancer is an issue that is still controversial in the academic community.Specifically, the removal of the tumor from the primary lesion and the appearance of the tumor on the liver determine the attributes of metastatic cancer, which indicates that metastatic cancer may also be present in other parts of the body.- And the current development of medicine is not to the extent that wherever there is a tumor, it is removed and then replaced with the corresponding organs.Another reason that is still being inferred and explored is not fully confirmed: a major surgical blow such as liver transplantation may lead to a certain "collapse" of the patient's body mechanism, which may lead to the "opportunity" of latent tumors in other parts to get the opportunity to thrive.Chen Wenqiang saw Director Liang's confident and determined appearance, he grinned at the corners of his mouth, and took the position of doing liver transplantation if he did not continue liver metastasis.Because he couldn't "force" Director Liang to have a liver transplant.But Director Qian, who came in behind Director Liang, said: "Lao Liang, you don't do metastatic cancer, you don't have a suitable case for primary cancer, those patients with liver cirrhosis in my department, let's talk about it in the front, those who basically have no money for liver transplantation."
Then you're going to miss this donor liver. ”To a certain extent, liver cirrhosis is a "poor disease", which is basically a recognized fact.Director Liang has done a lot of research in the field of liver cancer, and he has used the research results in this area when he was promoted to Zhenggao.Not only him, but Xie Xun followed him and participated in his special research on liver cancer, and last year he used his papers in this field to get to the top of the ranks.Director Liang said very sadly: "The existing liver transplant surgery in China and abroad, in terms of postoperative survival time and the patient's money payment ratio, is honestly too far from the patient's expectation.Nowadays, people can basically accept that liver cancer dies quickly, and cancer is treated in the end.This liver transplant is costly, and postoperative anti-rejection drugs are much more used than kidney transplantation, and the monthly cost of Xiaoxi, FK506, and imported cyclosporine alone is not affordable for ordinary patients. ”Chen Wenqiang shook his fingers, he understood what Director Liang said, in the final analysis, it was just one word: money!
It's not that he doesn't want to do liver transplantation, but he doesn't want to encounter the dilemma of the kidney transplant patient after surgery - the operation was successful, the transplanted kidney has also passed the rejection barrier and assumed the function it should have, and the follow-up is also very good, but within half a year after the operation, the patient can't afford to use anti-rejection drugs.Removing a transplanted kidney?
That's nearly 100,000 yuan in transplant costs.If it is not removed, rejection will kill the patient!
After removal, the patient cannot be removed from the dialysis machine.Dialysis three times a week, then dialysis also costs money!
And the most important thing is that dialysis is still irreversible in the end......
A kidney transplant is the only life-saving route for people with kidney failure.Director Liang's embarrassment and his words made Director Shi, who was actively striving for a heart transplant, fall silent.But the moment he pushed the door to the director and came in, after nodding to the director, he immediately persuaded Director Liang: "Old Liang, you can't think so much.You'll have to have a liver transplant.It's like I have to have a heart transplant.We don't have any room to survive.You say, don't you?
”Isn't it?
Director Liang looked up at Chen Wenqiang, who was rubbing his nails, understood the expectation in his eyes, understood that Director Shi was speaking for him, understood that the "head replacement technique" he talked about last time was not a simple joke, and understood his determination to push the provincial hospital to a higher level.
*Organ transplantation, especially liver transplantation, is really a sweet bait for Director Liang, who takes the liver as his research direction, but it is also a heavy load that cannot be shaken off.Many cities in the south have carried out kidney transplantation, and many hospitals have begun to try lung transplantation and liver transplantation, and there have been successful cases of heart transplantation in China.The provincial hospital does not want to lag behind the affiliated hospital of the medical university, and the transplant surgery of these projects must be carried out in a short period of time, so as not to be thrown into the ranks of second-rate and third-class hospitals.This is really something that has no way back and cannot be avoided.The latest round of competition in tertiary hospitals is to look at the level of surgical transplantation, how many transplant projects have been carried out, how many cases have been done, their respective success rates and postoperative survival time.Failure in this round of competition will inevitably be despised by the "opponents" of the same sequence.Director Liang can't "escape", because he is now the director of surgery, and Chen Wenqiang's hope and the hope of the provincial hospital all fall on him!
The Department of General Surgery has already carried out a kidney transplant program.Although it was presided over by Dr.
Yang of the Department of Urology, it was also carried out under the supervision of Director Liang.Urology is a long story to be drawn to general surgery.Because urology transplantation did not have the basic conditions for a single department, when the Department of Obstetrics and Gynecology and Pediatrics moved to the new inpatient building of the Women's and Children's Center a few years ago, the Department of General Surgery was able to divide the vacant floor with the increasing number of patients.Considering the number and increasing trend of cardiothoracic surgery and neurosurgery patients, Chen Wenqiang wanted to transfer the urology and burn wards to the general surgery ward and let Director Liang take care of them.Director Liang accepted Chen Wenqiang's arrangement with a smile.But he hit the snake with the stick, and immediately grinded another layer of the inpatient ward from Chen Wenqiang's hand.As a result, the general surgery department of the provincial hospital has four floors of inpatient wards, which is not only the department with the most inpatients, but also the department with the most diseases.There are so many of them, but there is no slightest negligence, coping, fooling and other situations in clinical medical treatment.In addition to Director Liang's tight grasp, it is also related to the strong technical force of Puwai.First of all, Director Bian and Director Xu, who are the same age as Director Liang, have not yet reached retirement age, and they have also mixed up one after another.Counting Xie Xun, there are four chief physicians; Secondly, in the past few years, Dr.
Song, Dr.
Zhou, and Dr.
Chen have been promoted to deputy high school one after another.is Yang Weiguo, Dr.
Yang and Dr.
Wang Dazhi, and Dr.
Wang have also been promoted to deputy high; In the end, those undergraduates who were separated from Li Min at about the same time were also promoted to attending physicians.With such a strong technical force, it is not weak in terms of technical titles to the Affiliated Hospital of the Medical University.Director Liang was also naturally appointed by Chen Wenqiang as the director of surgery.This position is well-deserved by his personal strength.But now he is encountering economic problems, which are the Himalayas that his old Liang has been practicing medicine for many years and cannot cross in the face of patients, and the Mariana Trench that his old Liang cannot cross with his personal efforts in his life.To cure diseases and save people, technology alone is not enough!
He can't help the postoperative cost of transplant patients!
Money!
Director Liang closed his eyes in pain.He really didn't want to see a functional, well-grafted organ because he couldn't afford to use rejection drugs.Money!
What is money?
There may be people who are of high character and regard money as dung.But anyone who thinks life is priceless has to accept the price they are labeled for in the hospital.In the hospital, the "dung" of money, it means that patients with kidney failure can be replaced with a healthy kidney without 100,000 yuan; Then, with the support of two or three thousand imported anti-rejection drugs every month, we can avoid falling into the dilemma of "the kidneys are fine, and the liver dies first" by taking domestic anti-rejection drugs.Money, and it means the hope of survival!
It means that even if it is end-stage cirrhosis, acute or subacute liver failure, or even congenital metabolic diseases, the previous clinical doctors were helpless and watched the patient die, well, it should be said that those who can only be treated conservatively can now be reborn through liver transplantation.As long as there are 200,000 or 300,000!
Money, it also means that patients with advanced primary cardiomyopathy, severe coronary heart disease, complex congenital heart disease, etc., no longer have to lie on the hospital bed with various tubes and wait for death; It means that they have the opportunity to live like a normal healthy person.As long as there is money!
As long as there are hundreds of thousands!
※※※※※※※※※※※※※※※※※※※※ the cost of transplantation here is about the same time in the late nineties, and there is a big difference between the north and the south, in the same city, in different hospitals, due to different donor sources and different use of postoperative anti-rejection drugs, and the end will be different () The distance is a little far