In fact, people can only work hard for a few years. The years before you get married or have children are the best time to lay the foundation. Once you have the foundation, you may be able to improve over time. Once the sway has passed, it will be extremely difficult to struggle again.
Only Zhang Fan has a system. After eating and drinking, when he wakes up, the battery is full again! In hospitals, especially in the surgical system, due to the excessive workload, older doctors are really gritting their teeth and persisting, and even married life has become a luxury.
In the early morning session of the general surgery department, a group of attending doctors looked depressed. Hospitalization hanging high is like a carrot hanging in front of a donkey. If you don't work hard, it will belong to others.
After arranging tomorrow's surgery and explaining some department work, Director of General Surgery Zhao Pingquan said to the doctor: "Now, let Zhang Yuan say a few words."
"Our surgery today is to remove gastrolithiasis for patients with gastrolithiasis. Are you ready for the surgery?" After a period of confusion, Zhang Fan is now accustomed to this position.
"Zhang Yuan, get ready. Gastrointestinal decompression has been prepared since the day before yesterday. I have been fasting since yesterday, and all nutrition is parenteral." The doctor in charge of the bed reported.
"Director, will you perform this surgery?" Zhang Fan still respected Lao Zhao.
"Okay, I'll help you." Lao Zhao liked to perform surgery with Zhang Fan. Apart from the fact that he couldn't talk casually on the table, performing surgery with Zhang Fan really seemed to be an artistic enjoyment.
"Okay, let's call the operating room to pick up the patient."
Zhang Fan and Director Zhao walked to the operating room together. The two of them chatted while walking, "Recently, the doctors in the department are all screaming and rushing to collect patient numbers."
"It's all because of your support, director. General surgery is not like other surgeries. The maturation period for doctors is too long."
The two chatted and entered the operating room from the special elevator. When the building was first built, Huang was stingy and bought four elevators in the hospital. At that time, he felt that these four elevators were a bit wasteful.
As a result, there are not enough elevators in the surgical building now, and someone has to organize queues in the morning. Otherwise, people would argue about taking the elevator every day.
Ouyang is more generous than Lao Huang in this regard. There are eight elevators in the emergency center, one in the operating room is dedicated to emergency patients, one is dedicated to doctors and nurses, and the remaining six are reserved for patients and their families.
Entering the operating room, Uncle Jinya saw Zhang Fan, smiled at Zhang Fan in a flattering way, and wanted to talk, but the attitude of the little nurse who followed him was not as good as Zhang Fan, and he did not dare to run over and talk to Zhang Fan.
The gold tooth has long been placed with the family. Disinfect, brush hands, spread drapes, and perform surgery. The stomach, the human stomach, is too boring to describe using professional terms.
When Zhang Fan was taking classes, he really didn't like the courses on abdominal organs and nerves. Orthopedics was just a simple course. The anatomy of abdominal organs is too complicated. There are different forms, and if you don’t work hard, you will get confused.
As for neuroanatomy, it is almost the same as listening to heavenly books. It is too abstract. Sometimes it is electrical conduction, sometimes body fluid conduction, and from time to time there will be jump conduction. If you don’t understand something in class, if you don’t review it after class, the exam will be a mess.
That is to say, the system came into being later, and Zhang Fan had to understand the anatomy of these two systems countless times.
The esophagus and stomach can be described as cables in layman's terms. When it is derived from the esophagus to the stomach, this cable becomes larger, thicker and thicker.
The outer skin is a wear-resistant protective layer, and the inner layer carries blood vessels and nerves.
The structure of the stomach can be divided into four layers, from the inside to the outside, it is divided into mucosal layer, submucosal layer, muscular layer, and serosal layer. The muscle layer can be divided into three parts.
It's so complicated. The shape of this muscle layer is not the same. The innermost muscle is oblique, starting from the contact between the esophagus and the stomach and continuing to the duodenum.
This shape makes sense. The oblique shape of the muscles is conducive to the downward movement of food. If you make a circular muscle, the food may get stuck in the stomach.
The middle layer is the circular muscle, which wraps the stomach in circles to increase the firmness of the stomach. The outermost layer is longitudinal to reduce friction with other organs. Because the stomach is always active.
Circles and circles, really like a ball of wool.
The stomach can secrete many things, no less than a dozen. In the early years, the medical community only believed that the stomach only had the function of digestion and grinding. Later, it was discovered that the stomach also had the function of secretion.
The main secretion is HCL and some special enzymes. Its PH is about 0.5 to 1. This concentration of hydrochloric acid may be able to be dissolved by throwing in an iron tablet.
But stomach, won't it be corroded by HCL? Yes, it will be corroded, but it is because there is a weakly alkaline protective layer on the inner surface of the stomach. There is a bicarbonate barrier with a thickness of about 0.5mm. This is the most important protective layer of the stomach.
Without this protective layer, even if the stomach muscles are ten meters long, gastric acid can still penetrate. If you eat chili pepper, drink wine, or get craving for chocolate, and then have stomach pain, it means you have an ulcer in your stomach.
Angry, especially in young women, because the body's secretion function is strong, the various hormones produced after anger will also cause the reduction of this mucous membrane, so this is also the reason for stomach pain after anger. A person with a bad temper may perforate his stomach due to anger, but that's not the case.
Ulcers are caused when the protective layer of bicarbonate is penetrated by gastric acid. I have been angry all the time, and have been corroded by stomach acid, corroding and corroding. If my stomach is open, it is a perforation. The treatment method for perforation is very simple. If the area is small, suture is performed. If the area is large, gastric incision is performed.
Moreover, once the area of the ulcer is too large and reaches a certain depth, well, even if it is not perforated, cancer will appear over time, and it will not escape at all.
Therefore, eating three meals on time, drinking less alcohol, eating spicy food, and being less angry are the best ways to protect your stomach.
After anesthesia, the surgery begins. "This is a typical example of a small lesion leading to a serious disease. With such a large stone, the gastric incision will not be small, and the patient may suffer from long-term and chronic pain in the future."
While Zhang Fan was preparing for the operation, he said something to the others. In fact, Zhang Fan said this because he wanted to see if other people had any other ideas.
The result was no! Others just said: "That's right, make a big incision!"
Zhang Fan smiled and said nothing. "Alcohol cotton ball!" Zhang Fan took the cotton ball and began to disinfect the skin for the last time, and then opened a very small opening in the middle.
It is about the same size as an ordinary appendix incision. "Zhang Yuan, the opening is a bit small. How can we remove the stone from this opening?" The director in charge of the bed was puzzled. "What is this for!" He was confused and couldn't understand!
Lao Zhao understood. But he didn't say anything. Zhang Fan turned to look at several doctors and said, "There is no fixed formula for surgery!"
"MMP! I haven't even finished learning the fixed-style surgeries, and you, a resident doctor, have started to perform unfixed surgeries. What a worldly thing!" Several doctors who listened to Zhang Fan's pretense collapsed.
It’s not the doctor’s fault either. Not to mention other things, there are no fewer than six surgical methods for gastric ulcers in textbooks, and there are some that are not in textbooks. Now, there is a saying that there is no fixed method for surgery, which makes people unable to live. Only by learning a lot of surgeries can one be sublimated or have super talents.
There are more and more diseases, and doctors are divided into more and more disciplines. This is something that cannot be helped, but people are a whole, so it is very contradictory. This is also a problem for the future development of medicine.
The abdominal cavity was opened, the bleeding was stopped, the omentum was pulled open, and the stomach was finally seen. Because of the stone, the patient's stomach was full even though he had not eaten for two days.
It's really like being a pregnant woman about to give birth. "Sharp knife!" After Zhang Fan took the scalpel, he opened a small opening in the stomach, a very small opening.
At this time, the talent has opened up a distance. Some doctors understand it, while others are still confused.
The doctor who understood suddenly realized, "Damn! I never thought that this is so simple and the damage is much smaller."
The doctor who couldn't understand was still confused, "What is this going to do! What can be done by opening the hole that can only fit a finger!"
"Pliers, hold both sides of the incision." Muscle is different from skin and fat. A small incision is made between the skin and fat. If you don't use strong force, the incision will not be extended.
But the muscles are not good. As long as they crack, the incision will automatically become larger. Zhang Fan used pliers to hold the incision to prevent the incision from getting larger.
Surgical forceps, in the hands of doctors, click! Click! Click! of closed incision. "Gauze! Alice forceps hold one end of the gauze." Zhang Fan explained to the nurse.
The nurse had never encountered this kind of surgery before, so Zhang Fan had to explain it clearly to the nurse. Otherwise, the nurse would not know the procedure.
Surgery requires a lot of hard work and talent on the part of the doctor. The confused doctors continue to be confused, but the doctors who understand have begun to actively cooperate.
The long Alice forceps used the gauze to enter the stomach along the small hole in the stomach.
"Gently push the stone toward the spray door." Zhang Fan said to the third assistant. The third assistant is a resident doctor. Although he has not been working for a long time, he is very talented. He has already understood the meaning of Zhang Fan's surgery.
In conjunction with Zhang Fan's Alice Pliers, if Zhang Fan's Alice Pliers were turned to the left, he would gently push the stone to the right; if Zhang Fan turned to the right, he would push the stone to the left.
He knew the surgery well and was good at assisting. Zhang Fan did it very smoothly. Old Zhao looked at the young resident in surprise. "Ma Yichen, it's okay. Have you ever had this kind of surgery before?" Lao Zhao said.
The second assistant is the attending surgeon. He is not confused yet. Unexpectedly, this boy has already understood the operation. One has only been working for half a year, while the other has been working for ten years. This is the difference in talent.
"Director, I have never had this kind of surgery." Ma Yichen said to Director Zhao Quanping with a smile.
Ma Yichen is a graduate student at Sanchuanbei Medical College. Because his father is doing business in the frontier, he is a graduate student from Sichuanbei General School of Gastroenterology. If you want to stay at Xihua, graduate school is not enough.
After graduation, he simply came to Frontier Tea. I originally planned to take classes for a few years and then take the Ph.D. exam to continue my studies. I didn’t expect that a small hospital in this small place would be so powerful.
Zhang Fan also raised his head and glanced at the young man. Although wearing a mask, it can be seen that the young man must be very handsome and in great shape.
Zhang Fan used Alice pliers to hold the gauze and slowly change its direction. The previous operation was very fast, but now it has slowed down. This is a job that relies on patience. You can't be anxious. If you are anxious, you have to start all over again.
Ma Yichen cooperated very well, and Lao Zhao was tempted. Zhang Fan is the best example of the hospital. With Zhang Fan's prominence, he and Lao Gao suppressed several orthopedic directors. This is how the apprentice is awesome, and the master is starting to become awesome as well.
"What direction do you want to pursue in the future?" Before Old Zhao could speak, Zhang Fan spoke first.
"Keep doing gastrointestinal work, I really like gastrointestinal." Ma Yichen said with a smile.
"You..." Old Zhao just spoke, and Zhang Fan immediately said: "Don't limit yourself to gastroenterology. Although you are a master of gastroenterology, it is best to broaden your horizons. I have several cases of liver tumors at the Bird City Affiliated Hospital over the weekend. Come and have a look at the surgery."
"Okay, Zhang Yuan." Ma Yichen probably started smiling.
This is not a question, but an affirmative. Zhang Fan is also tempted. He has good talent and is young. This is Miaozi. If Zhang Fan and Xue Fei were doing surgery together, he would make Zhang Fan almost mad to death.
It's not that Xue Fei's skills are not good, but his talent. He doesn't think through many things. But this young man can figure out Zhang Fan's intention in such a short period of time. This is talent.
"Zhang Yuan, it's not appropriate!" Lao Zhao was unhappy. "MMP, I won't say anything about my overbearing surgery. Now I have begun to attract my apprentice's attention." In the past, Lao Zhao had not realized that Ma Yichen's talent was so good.
"It will be good for him to be more knowledgeable. After all, there are still few patients in our place. The director pulled the hook and quickly used the suction device to suck blood, and the blood came out." Old Zhao was angry when the first-level official of the Guanda University crushed someone to death. It's crooked, what can I do?
Little by little, Zhang Fan finally wrapped the stone with gauze. "Oh. I understand!" The doctor in charge of the bed now understood Zhang Fan's intention.
He is Lao Zhao's apprentice. "Only you understand!" Lao Zhao was so angry that his liver hurt.
"Haha!" The doctor in charge of the bed smiled slightly sheepishly. I have already scolded my mother in my heart, "I can't tell you clearly, who wants to know what you are going to do!"
"Electric drill! Wide retractor!" The incisions have been made on all sides of the gauze. At this time, it is equivalent to Zhang Fan using the gauze to pull up the stone in Uncle Jinya's stomach.
The electric drill is to break down the stones in the stomach, and the wide retractor is to protect the incision from being damaged by the electric drill.
Picking up the electric drill, Zhang Fan began to drill along the small incision toward the stone in his stomach. Protein mixed with calcium and hair makes it very strong.
After the drill bit drilled down, it spattered like gypsum powder. Because there were hairs, the high temperature of the drill bit directly produced a smell of burning hair. Drill up, drill down, drill to the left, drill to the right. Several assistants pulled hard on the gauze.
You have to use a lot of force to remove the gauze. If your hands slip, the drill may enter your body. Finally, there was a click and the stone cracked.
"Awesome! It's awesome. The method is great. The damage is small and it's simple. It's a minimally invasive surgery." The attending doctor said with envy. He also had a feeling of MMP in his heart, "How could I not have thought of it? This way, the operation would be too simple."
Then drill, take the larger stones, and continue to drill smaller ones. It was no longer easy to drill at this time. "Bring it up a little more!" Zhang Fan said.
Several other doctors were holding the gauze vigorously.
