"Put the thread on the small round needle and make the thread longer. Secretary Ren, I'll leave the patient's vital signs to you.
Dr. Chen, extend the anesthesia time!
Dr. Wang, please negotiate with the patient's family, and we must be prepared.
Once spleen preservation fails, splenectomy surgery is necessary, and the risks of the surgery must be clearly explained to the patient's family. "
"good!"
"yes!"
Ren Li agreed. After hearing what Zhang Fan said, Dr. Wang immediately agreed and left the operating room with a thick stack of consent forms for the operation.
The instrument nurse took great pains to hang an absorbable thread on the smallest round needle.
Needles, various skin needles, circular needles, and special absorbable threads with their own needles, there are many types in medical treatment.
The round needle is actually the needle used to sew clothes at home, bent into a full moon shape, like a full moon scimitar.
The shape of leather needles is actually exactly the same as that of circular needles, the difference is in the needle heads.
The head of a round needle is pointed, while the head of a leather needle is like a triangular thorn.
Skin needles are used to suture skin and cartilage, while circular needles are used to suture soft tissues and organs under the skin.
Because of the difference in needles, suturing the soft tissue under the skin with skin needles often results in the tissue being split.
Regardless of the small needle, there are also three, six or nine grades in the hospital. For example, the circular needle that comes with the absorbable suture in a certain country is quite easy to use.
It is sharp, as if the material has its own smooth oil, and there is no dryness when inserted into the tissue.
Moreover, the most awesome thing is that its material is easy to use as a skin needle. Doctors with good skills can use it to penetrate flat bones, such as ribs.
But the price is also good, one thread and one needle cost more than 400! This is the hospital price. If you go to a beauty salon, this thing will cost several thousand.
In order to prevent repeated use in the hospital, there is no threading hole at the end of the needle, making it a completely disposable product.
To be honest, if the price were not a problem, doctors would prefer to use this kind of foreign needles and threads.
I guess it’s because small needles don’t make money, and domestic manufacturers don’t bother to make them. As a result, domestically produced needles are really not very easy to use.
Especially for doctors with slightly less technical skills, when suturing tougher tissues, the needle will be bent first if the force is not appropriate.
The nurses complained, the anesthesiologists urged, and the superior doctors criticized. Really, even young doctors could be bullied into tears by the needle.
Although Zhang Fan doesn't have any requirements for needles, he also likes to use needles that are not dry at all. When inserted, they are particularly slippery, just like popsicles, very smooth.
After taking the needle, Zhang Fan raised his head and looked at the anesthesiologist. The anesthesiologist nodded gently to Zhang Fan and said, "Yuan Zhang, you can start."
"good!"
The abdominal cavity tissues include the gastrointestinal tract, liver, pancreas, spleen and kidneys. People have a lot of autonomy in these abdominal organs, and they don’t pee their brains very much.
For example, intestinal peristalsis is managed by the intestines by itself. If you eat too much, eat irritating food, or use something to tease you from the back door, the peristalsis will speed up.
But when it comes to other stimuli, they are also very lazy, and don't give much feedback to the brain when something happens.
For example, if the intestine is perforated, it will only cause the person to roll around in pain after the intestinal juice flows out.
What is intestinal juice? It is a strong base. Even so, the pain point in the abdomen is not very clear.
The abdominal organs are not very sensitive to temperature, cutting, and acupuncture.
However, the abdominal organs are the most sensitive to pulling force. This is why the second brother from the grassland will kill any prey he sees.
Once you bite the head of the cecum and pull it back, no matter you are a two-ton rhinoceros or a giant lion with sharp teeth, you will lie on the ground in pain and call daddy.
Therefore, when doing abdominal surgery, when the old doctor leads the young doctor, he will definitely say, "Slow down, slow down, be gentle, don't pull!"
If the patient is stretched frequently, even if the patient is anesthetized, the patient may become agitated or even suffer from painful shock.
And when you have abdominal pain, you must not take painkillers at home, such as ibuprofen or diclofenac sodium sustained-release tablets.
You must not eat it. This thing is not very good at urinating the brain. Once you take painkillers, it will cover up your condition.
Seeing the anesthetist nodding, Zhang Fan calmed down his emotions and collected himself.
"start!"
Lao Zhao held the forceps with one hand, gently fixed the spleen in his hand with the other, and then firmly showed Zhang Fan the surgical field.
Suturing, among organs, the stomach is the best to suture, it has a three- to four-layer structure, and the texture is tight, just like a bag.
The spleen is the most difficult to sew. How can I put it? It's like a crisp radish or a green apple rich in moisture.
You will know how difficult this operation is if you sew up a green apple with a needle.
Once this thing rips, it is quite difficult to maintain. The entry angle of the needle is a bit off. Not to mention sewing, it can continue to rip several flaps for you.
This kind of injection, every injection is a gamble. You don’t know whether your injection will cause the spleen tissue to split.
Moreover, when the suture opening becomes smaller and smaller, it becomes more difficult to sew, because the closer to the edge, the greater the chance of it cracking.
Just like a piece of ceramic, this thing breaks not only at one point, but sometimes, due to torque issues, this thing can crack your entire spleen.
Therefore, the older the doctor, the less he dares to operate the spleen, because if he is not careful, the operation will be in vain.
However, precision and stability are no problem at all for Zhang Fan.
Zhang Fan took a long breath and saw the full moon-like needle piercing the spleen wound at a 90-degree angle.
At the edge of the spleen tissue where the wound was like petals, Zhang Fan held the needle holder in his hand and stabbed the round needle steadily into the tissue.
The strength of the wrist must be used when suturing cartilage or even penetrating flat bones or fascia.
And this kind of fragile tissue requires the power of fingers, which not only has clean penetration, but also impartial stability.
Suturing the human body is not sewing clothes. You can do whatever you want with a needle in your hand.
When suturing the human body, a needle holder is used to hold a circular needle, so the force is transmitted to the needle through the needle holder.
Just like when you hold a nail with pliers and push it into the wood, if you use improper force, the held nail will walk crookedly like a person who is not used to wearing high heels.
If this situation occurs after this time, don't even think about it. The spleen will definitely become spleen flowers, and the only option is to cut it off.
With Zhang Fan holding his breath, every time he penetrated, Zhang Fan would penetrate at the most stable moment with his breathing, and then seize the time to come out.
This thing doesn't require force. Anyway, the spleen is right there. If I push it in hard, I can get in no matter what.
Every time it was penetrated, not only Zhang Fan, but also Zhao Quanping, the director of the general surgery department who was working as the first assistant, held his breath involuntarily.
It was as if he was deeply afraid that his breathing would affect Zhang Fan's penetration.
One shot, two shots. The distance between the stitches is as measured with a ruler, and they are arranged neatly.
The profession of surgery is slightly similar to that of chefs. In the profession of chefs, the best performers are men, while in surgery, the best performers are also men.
Not to mention high-end, let’s talk about this stitching.
When Zhang Fan and the others were taking surgery classes at the university, the teacher anesthetized the students and tied the skinned rabbits to the operating table.
Then have students practice stitching.
At that time, to be honest, everyone was the first brother and the first sister. Who had ever done this job?
The overall result of sewing is that boys can sew better than girls.
The spleen was as crispy as an apple, and as the stitches slowly oozed out traces of blood, Old Zhao glanced at Zhang Fan, who didn't even dare to wipe away the blood.
Zhang Fan's sewing was not only stable, but also fast. Seeing the dense sweat on Zhang Fan's forehead, the circulating nurse did not dare to step forward to wipe it away.
This time is so critical. The wound on the spleen slowly closes and closes like the mouth of a crying child.
For this kind of suture, stability is the foundation and speed is the key. In trauma medicine, there is a saying called the golden hour.
For example, the spleen is full of tissues made up of various small bubbles. It can hold food and eat, but it has very few blood vessels.
Once ischemia is caused for a long time, even if it is sutured, it will cause avascular necrosis.
Zhang Fan stitched quickly, like a clairvoyant eye. Every time the needle went down, it would avoid the blood vessels in the spleen.
There was only a faint layer of superficial blood oozing on the surface of the spleen, and there was absolutely nothing like blood splattering.
Doctors, although most doctors have similar education, the skills they display during surgery vary widely.
Some doctors perform operations just like killing a pig, with blood spilling all over the surgical field.
And like a lone knight, he rushed forward with his head lowered in the blood, cut an appendix, and then the patient had to have a blood transfusion of 400cc.
On the operating table, for such a crappy doctor, the only weapon of resistance for an anesthetized patient is bleeding.
Therefore, a good surgeon is not only good at stopping bleeding, but also good at avoiding bleeding in advance.
On the operating table, it can be said that 1g of bleeding requires 10g of treatment.
"Boost!" After Zhang Fan completed the last stitch, he gently released the curved forceps holding the spleen hilum with his left hand. This kind of loosening was not a complete loosening.
Instead, the mouth of the curved forceps has just left the blood vessel, but if necessary, it can immediately clamp the blood vessel again.
The left hand supports, and the right hand gently presses on the sutured wound of the spleen.
This particularly fragile tissue sometimes contracts the body due to suturing, and then breaks apart after re-perfusion.
Therefore, the suturing of this kind of tissue is so weird that sometimes after failure, even the doctor himself cannot find out what went wrong.
Zhang Fan is confident in his skills, but he can't protect himself just in case.
Therefore, you must not be careless until your spleen is filled with blood.
Carelessness at this time means a life.
Ren Li administered the medicine herself, and little by little the vasopressor drug entered the medicine pot. Slowly, the discolored spleen began to turn darker and darker.
The bleeding from the suture stitches also increased significantly.
"What's your blood pressure?"
"High pressure is 120 mm Hg, low pressure is 90 mm Hg!"
Zhang Fan pressed his hand on the spleen and began to feel the swelling of the spleen slightly.
Just like a cat testing, it first licked lightly, then licked deeply, and finally put its tongue directly on Zhang Fan's hand.
Swelling is inevitable, let alone this kind of injury. Even if you slap someone, your face will swell, let alone this kind of injury.
When the blood pressure rose to normal and the spleen was lying firmly, I heard Old Zhao let out a long sigh of relief.
"Quickly, wipe Zhang Yuan's sweat, and wipe it for me too, I'm almost sweaty!"
Can you not be nervous? It's like a time bomb that can explode in your hand at any time!
"Close the abdomen, go out alone, and inform the patient's family that the patient's spleen is wrapped!"
When the head nurse heard this, she immediately ran out quickly, and the young doctors on the side had not yet reacted.
"Stop crying, okay, okay, wipe the tears clean, the patient was rescued and the spleen was saved!"
The head nurse, who pulled down her mask and exposed her face, stood at the door and informed the family of the patient's condition.
After saying that, the head nurse proudly turned her head and entered the operating room.
The head held high and the chest puffed out seemed so arrogant. She liked this feeling and being surrounded by people's grateful and adoring eyes.
Before the operation, the doctor told the patient that he was in critical condition and might die on the operating table. The family members felt as if they had been crushed by a steamroller, and there was black mist in front of their eyes.
During the operation, the doctor came out of the operation and told me that the spleen might need to be removed. Although an organ needs to be cut off, as long as the person can be saved, the family is willing to do anything.
When the patient's family members only had a little hope that they could just save the patient, the beautiful and plump nurse proudly told them that the patient was alive.
The family members were really pulled from the abyss to the top of the mountain in one fell swoop. This feeling of joy is really exciting.
The gray-haired old man held his little granddaughter and cried heartily.
One month after the operation, I heard that the female owner of the hardware store sold her shop and gave the money to the female owner of the optical shop, and then she got the optical shop owner’s forgiveness.
This was what Zhang Fan heard occasionally when the nurses in the hospital were gossiping.
After the beginning of spring, registration for the annual medical practitioner examination began again.
The hospital is now at the forefront of technology, but Ouyang still feels that it is not enough. It not only needs to be at the forefront of technology, but also needs to be at the forefront of exams.
Na Duo, Xu Xian, Xue Xiaoqiao, all top academics with test scores above 500, and directors of various subjects were pulled by Ouyang to set up an exam tutoring class.
Of course, Ouyang certainly didn't let Zhang Fan go, as Zhang Fan was the main person in charge of the tutoring class.
Ouyang's current governing philosophy is to come up with one thing at a time. When quarreling with the government, she will send Lao Gao first. If Lao Gao fails, she will take action.
Almost all the internal affairs of the hospital fell on Zhang Fan and Ren Li.
Ren Li is hard-working and uncomplaining, Zhang Fan can't afford to be a swindler even if he occasionally wants to, and Ouyang is becoming more and more thief.
As soon as Zhang Fan opened her mouth, she said that she had been working all her life and either had a backache or a headache, or a headache or an upset. Now she couldn't even feed the cactus, and asked Zhang Fan to be considerate and considerate to her.
Zhang Fan has nothing to say!
Anyway, just one sentence, if I don’t work, you can take care of it yourself.
For the junior doctors who are taking the exams to become licensed physicians this year, even though they have the guidance of academic masters like Zhang Fan, the bad news also frightens them.
Ouyang has already announced that those who have passed the exam with a score of 500 will receive an extra half-year bonus and performance, while doctors who have not reached 500 but have passed the exam will receive an extra month of bonus and performance.
For doctors who fail to pass the exam for the first time, all performance benefits will be suspended from the day the results come out and they will only be given a monthly living allowance of 600 yuan. Those who fail to pass the exam for the second time will be directly terminated from the labor contract.
As soon as the hospital's red-headed documents came out, there was a cry. As the reputation of the Municipal People's Hospital continues to increase, now I want to enter this unit. To be honest, some undergraduates have spent a lot of thought. If they are dismissed because of the exam, really, in Cha How can I live a normal life and how can I get along in the medical circle of Qiansu?
On the day when the auxiliary class started, not only the candidates from the Municipal People's Hospital but also young doctors from other hospitals who were going to take the exam came to observe.
The deputy director of the medical department originally wanted to kick out these doctors from other hospitals. Isn't this taking advantage of our hospital?
As a result, he was stopped by the director of the medical department. Chen Sheng understood Ouyang so well, and as expected, when Ouyang found that the auditorium was full of unfamiliar doctors, the wrinkles on his face blossomed with laughter.
Why does a hospital become famous? It relies on the support of peers, the envy and jealousy of peers!
If these doctors were really kicked out, Ouyang would definitely be furious.
Besides, if he can find a few good talents in the study class, Ouyang is absolutely confident to recruit them, and the old lady's calculations are very good.
Zhang Fan is the first teacher to take the stage in the tutoring class.
When Zhang Fan stepped onto the podium, there was an instant buzz below.
