(Thanks to my friend zHL for his encouragement, and thanks to my friend BSBcool and Yilao monthly pass for encouragement)

"Let's suspend the operation first, the tumor base is too infiltrated, and it is difficult to preserve the anus, so I will communicate with the patient's family. Liu Banxia said.

The big guy stopped.

In fact, this kind of situation is the last thing that everyone likes to see, even if they have expected it before the operation, and they don't want to really develop on the bad side.

"Liu Feng's family. After coming outside, Liu Banxia greeted him.

Hearing his call, patient Liu Feng's wife, son, and daughter rushed over.

"It's messy here, come with me to the next room. Liu Banxia said.

"Dr. Liu, can't you save your anus?" asked the patient's son.

"The base of the tumor has infiltrated and spread in the direction of the anus. At present, the visual distance is enough, but according to my judgment, after the pathological examination, I am afraid that it is not enough to support it. Liu Banxia said.

"Now there are two options, one is to follow our original plan, I cut as little as possible and try to save the anus. However, after the pathology comes out, if it is not supported, a second operation is required. ”

"It's mainly about the cost, and going through two such surgeries in a short period of time will definitely have an impact on the body's recovery. However, there is no need to worry about cancer, after all, there is no chance of upward spread. ”

"Doctor Liu, what about your opinion? We came here for you. The patient's son asked.

"If you were to consult me personally, my choice would be to do the digging tank treatment. Liu Banxia thought for a while and said.

"This is the case with rectal cancer, which is often located close to the anus. It's not that we want to be doctors to save trouble, after all, we can at least have one more operation later after leaving the anus. ”

"You guys think about it for ten minutes, if you agree to dig the tank, sign it, the associated postoperative dangers and complications are similar to the whole operation, I won't tell you more, so as not to delay too much time." ”

"Dr. Liu, I can sign it now. Dean Xu recommended us to come over and believe you, and you said that it would not be bad. The patient's son said very simply.

Liu Banxia smiled and nodded, "Okay, then I'll go in and deal with it, and it will take about an hour or so to finish the operation." ”

"Don't worry too much, the five-year prognosis data for rectal cancer surgery is good. The only trouble is to change the ostomy bag and care, and our nurse will explain it to you later. ”

"Dr. Liu, I'm sorry for your trouble. The patient's son said gratefully.

"Cheng, I'll go in first. Liu Banxia nodded.

Liu Banxia is still very happy about the patient's son's simple choice, not because it reduces the time for communication and saves him from talking nonsense, but for the patient, the shorter the anesthesia time, the better.

In many cases, the more family members there are, the more difficult it is to communicate. Everyone has their own ideas, and the original intention is to think about the patient. However, in the process of consideration, there are too many personal emotions involved, and it is impossible to think calmly.

Similar patients like today? It's not that you haven't experienced it? Rather, it is experienced many times in patients with rectal cancer. I have also experienced the need for a second surgery to dig the tank, and the highest discussion time of the patient's family is nearly an hour.

What can you do? You can only wait for the patient's family to come up with an accurate opinion. Even if you have done a thorough communication before the surgery? The final choice is still in the hands of the patient's family.

"Teacher Liu? How is it?" asked Su Wenhao after Liu Banxia walked back to the operating room.

"Anal digging. You do the rest of the work, and I'll oversee it. Liu Banxia said.

There are also a lot of precautions for anal digging surgery? However, Su Wenhao and Liu Banxia have already undergone several similar surgeries, and it is no problem to do them.

But for a lot of surgeons? They don't have the courage of Liu Banxia? They will carefully consider it before they let their students participate more.

Where do they have Liu Banxia's fast reaction speed and adaptability, otherwise these interns would not follow him so desperately.

Ding! The surgery is complete

Gain 400 XP points, 200 Diagnostics skill proficiency points, and 200 Dressing Change skill proficiency points? 200 suture skill proficiency? Intestinal surgery skill proficiency is 500 points, and glory is 5 points

"Alright, let's take it to the ward. Liu Banxia shook his neck.

The day's surgery was also very hard, and he was still thinking about one thing, that is, the suspected tularemia patient. If not? The patient's condition may continue to deteriorate, delaying the best time to be saved.

"Super? What about Wang Huan?" asked Liu Banxia after returning to the emergency center.

"Upstairs in the ward, it seems that it doesn't get better after taking streptomycin. Wang Chao said.

"I'll go up and have another look. Liu Banxia nodded.

Feeling a little bad today? I wanted to save the patient's anus but didn't keep it, thinking it was tularemia, and now it seems that there is some unsupport.

"Surgery? It shouldn't be tularemia. I'm thinking about whether to have an MRI of my head? Recheck the serum. Wang Huan said.

"I also thought about it when I had the surgery just now. What if the symptoms of drowsiness are the main manifestation of the disease? Concurrent drowsiness. Liu Banxia hesitated a little and said.

"But for narcolepsy? There's something wrong with that, too. Wang Huan said with a wry smile.

Liu Banxia shook his head, "What if it's sleeping sickness?

Wang Huan frowned, "I have considered this matter, and I was the first to consider it after the results of the examination came out, but after asking the patient's husband, I directly denied it." ”

"They have been living in Binhai City, let alone going to Africa, and they haven't even been out of Binhai City for nearly a year. Both parents are also in the city, and their son is also studying at Marina Polytechnic. Unless ......"

"Anyway, I've been thinking about it for a long time, and after ruling out tularemia, I think it's only sleeping sickness. All the symptoms match, and if diagnosed, the second stage has been reached. Liu Banxia said.

"Hey...... I should ask them separately about the patients I treat. Wang Huan said with a wry smile.

Sleeping sickness is very common in African countries, and the main manifestation symptom is lethargy.

It is also a parasite, specifically trypanosomes, which is difficult to diagnose on the test, and can only be judged by these current symptoms and experiences.

The mortality rate of this disease is very high, because once it is discovered, it is the advanced stage, that is, the second stage, the parasite has affected the central nervous system, so the patient will often fall asleep, and the final result is that he can never wake up again.

The parasite is often hidden under the skin, and in the case of Trypanosoma brucei gambiense, the incubation period is much longer, perhaps months or even years.

And the main way of transmission of this disease is bodily fluids, so Liu Banxia had such a question just now. Since neither of them had ever been out of Marina City, there would be carriers returning from Africa.

It may be that one of them has had an affair with the carrier, and judging by the current situation, the patient's wife is more likely.

However, judging from the introduction of the patient's husband now, their life is very happy, and the chance of the wife having an affair is very low.

However, no one can guarantee these things 100% of the time, and if this is the case, it may affect the whole family.

"Why can't Mr. Liu ask right away?" asked Su Wenhao curiously after coming down.

"You haven't learned about this disease yet, have you? If I tell you, it's not as good as what you did when you looked it up yourself. Liu Banxia said with a smile.

"However, this case also reminds us that we cannot deny it without clear examination and indications. Dr. Wang and I both made this mistake and thought about it, but we both denied it in our hearts. ”

"This is also our mistake, I hope this will not affect the treatment. Now it is the second stage of affecting the central nervous system, and the effect of medication varies from person to person. ”

"Anyway, in Africa, the mortality rate is close to 100%. It was found that it was the late stage, and there were not so many medicines, and the rest was to wait for death. ”

"In fact, even the second stage of the drug is very dangerous, there are many side effects and complications, and the prognosis is very poor. So, this family is going to go through a test. ”

"Teacher Liu, how do you know so much? Su Wenhao sighed.

"Yo, it's not easy to hear a compliment in your mouth. Liu Banxia quipped.

"Actually, it's not that I know a lot, it's that I read a lot of books. You usually have to look at it, the earth has become a village, and the disease that you love in the east of the village may also spread in the west of the village. ”

"So we have to keep up with the times now, not only to pay attention to the common cases in China, but also to pay attention to some rare cases abroad. ”

"Especially for areas with a large foreign population like our Binhai City, they will have a long contagion connection with each other when they transfer planes. One negligence can spread a terrible infectious disease. ”

"For today's patient, if she were to change her occupation, the incubation period of the disease would have been more than half a year. Can you imagine how many people will be recruited?"

Hearing Liu Banxia's words shocked these interns, some things are not advocated, but it doesn't mean that they don't exist. If this is really according to Liu Banxia's description, it will be light to spread 180 people in half a year.

Because this kind of diffusion is not one-way, there will be many branches, and the incubation period is very long, that result is really unimaginable.

But this also made them admire Liu Banxia even more, after all, not everyone has so much energy to pay attention to so many diseases. There are so many infectious diseases in the world that you can learn about every single one of them.