My Medical Skills Give Me Experiences

As Dr. Zou mentioned just now, domestic traditional Chinese medicine has declined and is squeezed by the market. Many developed countries in foreign countries have instead begun to vigorously develop Chinese medicine, recruit people, establish Chinese medicine planting bases, and conduct in-depth research on Chinese medicine.

This gave Zhou Can a sense of crisis.

The views on Chinese medicine have also changed a lot.

In the future, when his status becomes higher, his economic strength becomes stronger, his medical skills reach a certain level, and he has great influence, his attitude towards Chinese medicine will definitely bring great benefits to the development of Chinese medicine.

The operation went well, Director Wen was in a good mood.

He sat on a chair and chatted with everyone about the future development direction of medicine.

The atmosphere in the operating room is quite good.

At this moment, a graduate student exclaimed, "The patient's finger seems to have moved just now."

More than 15 minutes have passed since the patient stopped anesthesia administration.

Under normal circumstances, it is indeed possible for the patient to wake up.

However, the patient had been in a coma before the operation. If he really woke up at this moment, it would be great news for the doctor and the family.

All eyes are on the patient's hand.

Just at this time, the patient's right **** moved again.

"Wake up, really wake up!"

Director Wen had a happy smile on his face.

"Lin Lizhi, wake up! Lin Lizhi, wake up!"

The anesthetist patted the patient's shoulder and whispered in the patient's ear.

Human beings are in a coma, which is very similar to deep sleep. Calling the patient's name at this time has a high chance of waking them up.

If you can't wake up, you are usually in a severe coma, indicating that your condition is critical.

Now the patient's fingers can move, indicating that the brain is active.

This is a very good phenomenon.

Following the call of the anesthetist, the patient's eyelids trembled slightly, and then slowly opened his eyes.

It just looks like a lot of work.

His body is still very weak, and he has just recovered his life. To him, opening his eyelids may really weigh more than a thousand catties.

After opening the eyes, the patient's gaze was slightly dull.

Turning slowly, looking at the people around.

"Where am I?"

He spoke.

"Lin Lizhi, you had a car accident and are currently undergoing surgery in the hospital."

After Director Wen finished answering, he fixed his eyes on the patient's reaction.

Generally speaking, after the patient wakes up after the operation, there are some items that must be tested.

The first is whether you are sane.

Then check whether the limbs are paralyzed, and finally check whether the patient's various body functions are normal.

Lin Lizhi fell into a brief silence.

After a while, he seemed to remember the scene before the car accident.

"Doctor... is my girlfriend okay?"

He could remember that his girlfriend was also sitting in the car, indicating that the brain was not seriously damaged.

Memory and sanity are normal.

"I really don't know about this! After you recover, you can ask your family." Director Wen is a chief physician, and he has too many things to do every day.

He will not pay attention to these things that have nothing to do with the patient's condition.

Director Wen looked up at the anesthesiologist.

"Your point is right. Not only has he woke up, but he is also sane. There are indications that this operation was very successful." After speaking, he looked at the patient again. "Young man, cooperate well with the treatment. I believe you will be able to recover and be discharged from the hospital in a short time. Then you will be able to find your girlfriend."

"Good! Thank you!"

The patient still struggled to speak.

After waking up from anesthesia, he was observed for a few minutes, but there was nothing abnormal, and he was directly pushed out of the operating room.

Escorting such key patients is generally escorted by anesthesiologists and doctors in person. Because of the fear of making mistakes along the way. After being sent back to the ward, there is also a handover with the bed doctor in the ward.

"Everyone take a break, and we will continue with the second operation in half an hour."

Hospital operating rooms are actually a very scarce resource.

For example, the operation time of this patient was originally planned to take four to eight hours. It actually took less than two hours in total.

That means six hours of idle time.

At this time, if there is a patient who needs surgery but is postponed because there is no operating room, the patient can be arranged for surgery.

More often, it is some ultra-difficult operations, which are greatly delayed, resulting in no place for operations in the back row.

This vacant operating room can come in handy.

…

Half an hour later, Zhou Can and the others all returned to the operating room.

The patient is already lying on the operating table.

It was a fairly young female patient, probably in her twenties. The hair has been completely shaved, disinfected, and the scalpel site has been drawn.

Zhou Can has already read the information of this female patient.

At the age of twenty-four, he had a meningioma.

Generally speaking, meningiomas have a low chance of being malignant. Endothelial, fibrous, and vascular types are more common. There are also more mixed types.

Meningiomas are more common in older patients.

It is quite rare for her to have a meningioma at such a young age.

According to the patient's description, the head had been traumatized.

The medical community has long recognized head trauma as a risk factor for meningiomas. Because after head trauma, intracranial cells are prone to mutations in the process of repairing the damage.

She is currently experiencing three symptoms, diplopia, and she is always prone to double vision when looking at things. Left side of face felt numb. In daily life, many people even scolded her for facial paralysis in private.

He also said that she has a yin and yang face.

When laughing, there is expression on one side and no expression on the other side, which looks very weird.

Recently, a new symptom appeared. It is always easy to choke when eating, and it is difficult to swallow food and even drink water.

From her self-reported symptoms, it can basically be judged that it is a meningioma.

Later, after a CT scan, it was found that there was a tumor foreign body at the base of the skull.

This time surgical removal was required.

Among the many meningioma surgeries, skull base meningioma should be the most difficult one to operate.

Because skull base meningioma is closely related to normal brain nerves and blood vessels, and it is difficult to reveal during surgical resection, the operation is extremely difficult.

In fact, none of the operations that the chief physician can perform is simple.

Director Wen is the chief physician of Shenwai, and he faces many difficult and critical cases every day. The pressure is also far more than that of ordinary doctors.

Surgery began shortly thereafter.

Zhou Can's surgical status in the group has been preliminarily established, and now he can stand behind the two attending doctors as the third assistant to observe.

Several residents and three postgraduates were all squeezed to the back by him.

Zhou Can stood in Sansuke's seat, and they were all convinced.

Because Zhou Can's surgical ability is indeed far above them.

"You must have seen the films and examination reports. The patient's meningioma belongs to the sphenoid ridge meningioma. It is the most difficult type of skull base meningioma. I want to cut it all out without damaging the patient's neurological function. , extremely difficult."

Director Wen is teaching patients while operating on patients.

This operation should be between the third and fourth levels, and it is extremely difficult, even surpassing many fourth-level operations.

"The incision is generally centered on the pterional point, and the approach is from the frontotemporal. Stop the bleeding!"

After the incision was made, blood gushed out.

Dr. Zou acted as the first assistant. His hemostatic ability is not bad, close to the middle level of the attending physician, after all, he is a 40-year-old attending physician.

It is weaker than Zhou Can's ability to stop bleeding.

But it's okay.

He steadily manipulated the electric coagulation knife to stop the patient's bleeding, while Tang Li cooperated tacitly to **** up the gushing blood in time.

"Do you know why I emphasize that the patient's tumor diameter should not exceed 2cm?"

Director Wen looked at the two attending physicians under him.

"Too big to cut."

Tang Li's answer was a bit of a panacea.

"I'm afraid of hurting the nerves and blood vessels." Dr. Zou answered more precisely because he was older.

"Dr. Zou is right. The diameter of the tumor is too large, and it is almost impossible to completely remove it. Because it is very easy to damage important blood vessels and nerve tissues. So when you go to the clinic in the future, as long as you find a suspected meningioma, you must ask the patient to diagnose it early. Early treatment. When the tumor grows to a larger diameter, the difficulty of sweeping will increase geometrically."

Director Wen gave an explanation.

Zhou Can secretly wrote it down.

These are very valuable surgical experiences, which are difficult to learn in books.

Old doctors spread word of mouth and shared it with young doctors.

"Teacher, this patient's tumor has reached 2.1cm, so why do you still need to operate on her?" A graduate student asked.

"Because she is still young. If we don't operate on her, her life is likely to die. And her tumor is growing rapidly, which is a very bad phenomenon. Usually, only malignant tumors are prone to rapid growth." Growth. Benign tumors tend to grow more slowly."

Although Director Wen wants to save face, he likes to do some superficial work.

But from his behavior and willingness to operate on this female patient, it is enough to prove that there is a bright spot in his thinking.

Is a respectable doctor.

As the epidermis and subcutaneous tissue are cut layer by layer, the tumor can already be seen at this time.

The tumor was more than 2cm in diameter.

Zhou Can's hands itch when he saw it.

His separation and incision are already at the fourth level, and all of them have reached the level of attending.

He is not sure about this big tumor, but he can try to challenge it.

Director Wen has already begun to separate the tumor from the middle cerebral artery. He appears to be extremely careful, walking on thin ice with every cut. It was only at the end of the separation that he stopped.

"This tumor is too tightly adhered to the artery wall. If it is forcibly separated, the blood vessel will definitely be broken. Even if it is not broken now, there will be serious problems after the operation. If it is not possible, I am afraid that only a small part of the tumor wall will be left."

Director Wen hesitated again and again, and finally gave up the forced surgical separation.

"Immediately take this excised tumor and send it to the pathology testing room, and let the pathology testing room expedite it. I will wait here for 20 minutes, and after the pathology results come out, I will decide whether to remove the tumor wall."

After the arrangement, Director Wen checked around the lesion to see if there were other tumors?

Looking at the excised tumor, Zhou Can instinctively had an ominous premonition.

He has seen some benign tumors, and they usually look more pleasing to the eye.

Just like us human beings, each other is born from the heart. Kind-hearted people are mostly honest and kind-hearted. Those who are vicious and savage, are mostly vicious and vicious.

Tumors can also be distinguished through vision and touch.

Experienced old doctors, breast cancer, lymphatic cancer and the like can be touched with their hands, and they can basically judge whether it is good or bad just by touching it.

However, the final result is subject to pathological examination.

Intraoperative pathological detection is the fastest one.

Results can be obtained in twenty minutes.

Ordinary pathological tests require queuing, and the results often take the next day.

After about twenty-four or five minutes, the pathological test results came out.

Vicious!

Everyone was stunned by this result.

This is the last outcome doctors want to face.

Such a young girl actually got a malignant tumor.

"However, there is good news. The pathological examination found that the tumor has clear margins, and it should not have spread to other surrounding tissues. As long as the resection is clean, the patient should be able to recover."

Looking at the pathological test results, Director Wen made a difficult mistake.

The remaining last layer of tumor wall is too difficult to remove.

"Let's all work together to see if there is a better way to solve it?"

Director Wen asked everyone.

Any situation encountered during the operation is possible and ever-changing.

Before the operation, there is no way to do a pathological test, and no one knows whether it is benign or malignant.

Now the result is out, and it is a very cruel result for the patient.

If the operation is not done cleanly, the cancer cells will surely spread in her body very quickly.

At that time, it is almost certain to die.

Director Wen hesitated because it was about the life and death of this little girl.

Save, definitely want to save.

But how?

Several doctors offered suggestions one after another, but Director Wen rejected them one by one.

None of these solutions are practical.

"Can you prepare with both hands, take a piece of venous blood vessel and prepare it for vascular anastomosis at any time. Then try to surgically separate the remaining tumor wall."

Zhou Can has learned a lot of similar surgical knowledge from Dr. Xu.

The solution given by a famous teacher should be one of the more feasible solutions.

He did not propose the use of artificial blood vessels of eucalyptus. That's because the patient is only 24 years old. Although the artificial blood vessel technology is already very good, no one knows how long it will last.

Even if its lifespan is thirty years, it is still a huge hidden danger for this female patient.

It is troublesome to take venous blood vessels from other parts of the patient's body to repair the blood vessels here, but the autologous blood vessels will not have any rejection reaction. The success rate of the operation is high.

There is no danger in the future.

"There are many difficulties in repairing this segment of blood vessels with venous blood vessels. First, the two end surfaces need to be anastomosed, and the anastomosis time will be quite long. The ischemic tolerance time of the brain is about three minutes. Even with my anastomosis level, It takes at least 20 minutes just to anastomose the two end faces. This is still the case when the veins are prepared in advance. Secondly, there is a wealth of nerve tissue around the central cerebral artery. If you want to anastomose it, you need to separate it first. At least 3cm separation is required. The risk in this process is also extremely high.”

Skull base meningioma surgery is known as one of the most difficult operations in meningioma.

Sphenoid ridge meningioma resection is the most difficult operation in skull base meningioma surgery.

Difficulty is not in vain.

The entire operation is full of unpredictable and huge risks.

"If you want to solve the blood supply problem during the period of arterial anastomosis, there is a way to solve it. That is bypass."

Zhou Can gave another solution~www.wuxiax.com~Aren't you making trouble yourself? "

Director Wen had a wry smile on his face, but he admired this kid's audacity.

"I have researched that the blood supply of this branch blood vessel is also intracranial. But it is more of a blood supply to the scalp. It is shunted from here and connected to this blood vessel. Even if the cerebral central artery is cut off for one or two hours It won't be a big problem."

The solution proposed by Zhou Can is to solve the problem of blood supply to the important tissues of the brain during the time period that coincides with the cardiovascular system in the brain.

Drainage from the branch of that artery, although insufficiency may occur.

But it is only for the operation time to anastomose the central artery. So as long as the brain tissue is not necrotic due to ischemia.

Director Wen fell into deep thought.

"Although the plan proposed by Dr. Zhou is troublesome and risky, it is feasible to a certain extent. It gives me the feeling that various layouts should be carried out first, and finally everything is ready before starting the siege battle."

For the first time, Dr. Zou supported Zhou Can's surgical plan.

To be honest, he admired Zhou Can a lot.

For a Gui Peisheng to have such a clear and precise surgical thinking, there is probably only one in Tuya.

If he had been told that Zhou Can's teacher was Xu Yidao, a famous "quick knife" at home and abroad, he might not think so.

Famous teachers produce outstanding apprentices.

Can the apprentices taught by Xu Yidao be bad?

Dr. Xu really taught Zhou Can everything he could.

The treatment Jin Mingxi enjoys is much worse.

"This plan is indeed feasible. Talk to the family members. If the family members are willing to accept it, we will implement it according to this plan. If not, that's the only way to go. When the time comes, the surgical wound will be cleaned up and sutured directly."

Director Wen made a decision.