Chapter 1561: Full set of physical examination
-
Live Surgical Broadcast
- 真熊初墨
- 1322 characters
- 2021-03-01 09:02:00
Genius one second to remember the address of this station: [February novel network] https:// fastest update! No ads!
"Cloud brother, you see what you said, this is a normal complication, but we did not deliberately get it. I am looking forward to the patient, who can deliberately knock the K-wire out of the bone." Zhou Zong listens to Su Yun That being said, the face is scared, and I explain it again and again.
"There is the ability to go out and explain to the family members of the patient." Su Yun does not care.
"Zheng boss, do you think that Zhou is always on now, or is it going to be a while?" Wang always came to the round.
I have been in Haicheng for a while, and I have a lot of communication with orthopedics. I know that Mr. Zhou is honest and has a bit of a mother.
Such a person, if he is singled out, he must be bullied by Yun Geer. After one side of the crushing, I finally can cry Zhou.
He does not care about the death of Zhou, but if he wants to die, he must first die again.
"Well..." Zheng Ren indulged. "A few minutes, the pericardial fiber tissue was peeled off, and trouble Zhou always took the K-wire."
Zhou Zong realized that the patient's K-wire is still...
Also, if you don't, it won't be such a big deal.
Before the operation, the Kirschner wire is taken out after half a year. Even if he did it himself, Zheng estimated that there were three years after the operation, and the patient did not come to the second stage of surgery. This should be something to say.
The shock was a little bit fixed, and Zhou Zong finally figured out the problem.
I was too flustered, and Zhou always blamed himself for two sentences.
When they chat, Zheng Ren has cut the happy bag in the left ventricle, the position is as far as the posterior side, and the calcified area is selected.
The stratification was seen below the incision and the pericardial effusion had been sucked clean.
The stratification was found outside the epicardium, bluntly separated along the stratification, and gradually expanded.
The blunt separation is the unique skill of Zheng Ren. At this time, it is also handy to separate the adhesion between the outer membrane of the heart and the fiberboard.
"Zheng Zong, how come you are back?" Zhou always looked at Zheng Ren in the operation. Suddenly remembered that Zheng was not going to the emperor? Did not take the brain, suddenly asked.
When this was an export, Zhou Zong immediately realized that it was wrong, and he bowed his head directly, saving the gaze of Su Yun.
But bowing down to pretend that surgery can be done, can not deliberately block the ears.
"Zhou, do you cross the door, or open the door and see the world of Truman? A K-wire is free at the far end, and it scares it like this?" Su Yun's voice is full of infinite contempt.
"It’s just a Kirschner needle. If you have a cervical spine surgery in a hospital in Bengbu, you can’t sleep in it.
"Homesick, come back and see." Zheng Ren, a serious nonsense, "Zhou, trouble to brush your hand."
"Ah?" Zhou was dying, and he snorted.
"The surgery is almost done, you come up to take the Kirschner wire, we close the chest." Zheng Ren looked around and had to accept the fact that he left the chest.
It is still convenient for 912. After the operation is finished, you can walk with your own hands. You don't have to worry about closing your chest or closing your abdomen.
Unconsciously, Zheng Ren’s thinking has become the thinking of professors and directors.
Close your chest and close your abdomen? That is the life of a small doctor, and what does it have to do with me.
Zheng Ren stripped the pericardium in order.
Try to remove the piece as much as possible. If myocardial rupture occurs, use the exfoliated pericardium to repair hemostasis.
Of course, this is only a precautionary measure. Zheng Ren only did it subconsciously. He did not even think that this problem would occur with his master-level cardiothoracic surgery skills.
The pericardial piece on the right side is separated to the atrioventricular sulcus on the left side, and the upper boundary is below the thymus. The upper left margin of the pericardium is separated into the main pulmonary artery trunk, and the narrowing ring is cut off to avoid severe postoperative right ventricular pressure.
The lower boundary completely dissociates or excises the thickened pericardium other than the diaphragmatic muscle; the posterior border completely dissociates the pericardium of the left ventricle.
When separating the inter-chamber ditch, Zheng Ren's hand speed is slower, so pay special attention not to damage the coronary artery branch.
But only the heart of the big fist, in order, separated step by step, and separated in a blink of an eye.
At the end of the operation, Zheng Ren asked for warm saline gauze and covered the incision.
Open the chest and keep it the best.
Otherwise, if the orthodox operation of orthopedics is really blind, Zheng Ren is afraid that Zhou will suddenly pierce the patient's aorta.
Change the incision, pay attention to the sterile area, Zheng Ren took a look at ECG monitoring.
The patient's vital signs are stable, and this difficulty should be over.
"Zheng boss, you said that this heart disease, how can the first symptoms in the abdomen?" Wang recalled the patient's medical history, although he did not know the details, but if he was diagnosed, he was afraid that he could not think of chest disease.
Asking the boss of Zheng, the future is also a reference.
"When you didn't see the surgery, what did the left iliac artery squeeze into?" Su Yundao "Long-term chronic injury, the patient has gradually become accustomed, so it is only said that there is chest tightness. But the abdominal digestive tract ulcer, bleeding, causing nausea Vomiting, the symptoms are more typical, it is particularly easy to be missed."
"Zheng Boss, Yun Geer, how did you discover the two?" Wang said admiringly ~EbookFREE.me~ The patient complained of chest tightness, shortness of breath, and auscultation of breathing sounds is normal. "Zheng Ren casually said, "Wang, normal physical examination, some simple big items still have to be done, can not be sloppy.
Wang always stunned and then smiled.
According to the regulations, physical examination is a must, and it is a complete set.
But clinical things are not that simple.
A set of checks is done, and not half an hour is not enough. The emergency department is so busy, how can I have time to check it in detail?
Besides, the situation is definitely not that simple.
A female patient has come to diagnose appendicitis. I have to give a chest and a to check the body. Isn't that a rogue? !
Many doctors who have just entered the clinic are planted in this pit.
Mr. Wang’s statement to Zheng Ren can only be reported with a smile. However, the patient complained of chest tightness, he should have auscultation, it should be.
Zhou Zong, with the first-line doctor of orthopedics, disinfected and laid out the list and started surgery.
Taking Kirschner wire is one of the smallest operations in orthopedics. It should have been completely difficult for Zhou.
But this surgery is very awkward today.
He was cautious and hardly used violence.
However, the Kirschner wire has been deeply buried in the skeleton, and it cannot be taken without violence.
In the past, when the scope of the orthopedics did not include the cervical vertebrae, it was called a "carpenter."
锛 chisel axe saw, everything.
The surgery is also heroic, and the smashing of the knot is over.
Zheng Ren saw that Zhou Zong couldn’t open his hands and feet and sighed.
I had to do adequate protection for Zhou in the chest, protect it with a large gauze pad, and then block the Kirschner wire with the iron of the big hook. In this case, the Kirschner wire will not cause too much damage even if it is moved under violent conditions.
.