Next, until 11 o'clock in the evening, the patients who did not come for surgery were basically those who had a fever and cold.

Finally, there was a gap period, and the doctors and nurses had to take a break.

Seeing that Jiang Yurong's mood was still a little low, Ruan Bin asked, "Director, do you want coffee?"

In fact, as an emergency doctor, especially the chief surgeon, I can't save a life, and I feel very lost. Sometimes it's often just a little bit close to being saved, but unfortunately God still doesn't give it a chance.

"Hmm. Jiang Yurong nodded.

Zhou Tianlei next to him also found that Jiang Yurong was in a low mood, so he smiled and said, "Director, are you hungry?" I know that there is a very good-tasting Malatang nearby, can I order you a takeaway?"

Zhou Tianlei thinks that now is the best time to care about beauties, and beauties are in a bad mood?

"It's working time, what to eat? What if you eat this junk food and have diarrhea, you will be responsible for the operation when the time comes? If you have time, learn more about basic surgery with Dr. Ruan." Jiang Yurong didn't like Zhou Tianlei's behavior of ordering takeout during work hours, especially when he had surgery before, he didn't dare to let the other party perform tracheal intubation. It's really terrible for the dish.

"Uh...... Yes, yes......" Zhou Tianlei's glass heart shattered instantly. What is said on the Internet is wrong, what kind of food can cure the girl's mood!

"Director, your coffee. At this time, Ruan Bin came back with two cups of coffee, and handed one to Jiang Yurong.

"Thank you. ”

As soon as the coffee was finished, there was a noise outside the emergency department.

It didn't take long to see a family hurriedly send an old man in his 80s in.

"Doctor, doctor, save my grandfather, save my grandfather!" the young man gasped and said sadly as he rushed in with the eighty-year-old man in his arms.

Ruan Bin saw that the old man of the patient had fainted and did not know what the situation was.

"Send it to the operating room first!" Ruan Bin helped carry people.

"How did your grandfather get unconscious?" Jiang Yurong asked.

"My grandfather said he had abdominal pain and vomited! By the way, he had a very high temperature, as if he had a fever. He fainted on the way to it. The man said hurriedly.

In fact, it is difficult for ordinary doctors to determine what the disease is.

Maybe acute pancreatitis, acute ulcer perforation, high acute appendicitis, right kidney stones, etc.

"Let's do a B-ultrasound and take a look!" Jiang Yurong said.

Soon, Zhou Tianlei and the nurses sent him to do B ultrasound.

"You are a family member of the patient, right, what is the name of the patient, and are there any other diseases?" Jiang Yurong asked.

The man said: "My grandfather's name is Wang Deming, and he has a heart attack!"

Brushing brush, Jiang Yurong recorded on the side.

"Okay, you register and pay the fee first, your grandfather needs a B ultrasound to know what the disease is. ”

In less than ten minutes, the results were in.

Jiang Yurong's brows furrowed after reading the B-ultrasound results!

According to her years of experience, judging from the above, this Wang Deming has acute cholecystitis, and it is also a very serious purulent cholecystitis. And even worse - the gallbladder is perforated!

"How is it?" Ruan Bin and Zhou Tianlei both looked at Jiang Yurong.

"Purulent cholecystitis, and the gallbladder is perforated, so I have to operate immediately!"

"Ah, so serious, but this old man still has heart disease, if the gallbladder is surgically removed, anesthesia and infection are the most difficult problems in front of us!" Ruan Bin said solemnly.

It is very troublesome to administer anesthesia to patients with a history of heart disease. The premise of using anesthesia is to grasp the indications of anesthesia and control heart disease. It depends on the severity of the disease and the anesthetic used. How much to dose! Especially since this heart patient is still in his 80s.

If the anesthetic takes too long, you may not be able to wake up! However, major surgery requires a long period of anesthetic......

The second is infection, purulent cholecystitis, and the gallbladder is perforated, which is a big problem.

In other words, the operation is not difficult, but how to choose is a difficult problem!

At this moment, Jiang Yurong was also hesitating. If the patient is given a cholecystectomy, it may be successfully removed, but the patient may not wake up due to heart disease or anesthetics. Even if I wake up, what should I do if I have an infection?

But without cholecystectomy, the patient will definitely die!

Dilemma!

The young man on the side saw that the two doctors were silent, and they were all sweating profusely: "Two doctors, you have something to say! My grandfather has been in a coma for more than ten minutes." ”

"Director, our emergency department has always been to save lives first and then treat the disease! Why don't you alleviate the patient's condition first, and then perform a cholecystectomy when the condition is not so serious?" Ruan Bin suggested.

Jiang Yurong's eyes lit up after listening to Ruan Bin's words: "Okay, you're right, in the face of this situation, we can't blindly think about directly curing the patient's disease, but first save the patient's life!"

"I'm going to do hepatogallbladder puncture and catheterization and drainage for the patient! Prepare things, Ruan Bin, Zhou Tianlei, learn well. After Jiang Yurong got Ruan Bin's inspiration, she instantly thought of the treatment plan in her heart, so she was in a good mood.

While being sent to the operating room, Zhou Tianlei asked curiously: "Director, how can you save your life first?"

As a rookie, his brain is a little dead at this time!

"I think the director gave the patient a liver and gallbladder puncture and catheter drainage first, so that the patient could get better and wake up significantly. In the next few days, it is estimated that percutaneous drainage of abdominal pus and ERCP (endoscopic retrograde cholangiopancreatography) will be done depending on the situation, and an intrabiliary stent drainage tube will be placed to reduce the pressure on the biliary tract! Finally, when the patient's condition is stabilized, cholecystectomy will be performed!" Ruan Bin guessed.

After all, he also has a director-level cholecystectomy, and when Jiang Yurong said that he was going to do hepatic gallbladder puncture catheterization and drainage just now, he thought of the second and third steps.

"Haha, that's right! The patient can't afford a major operation that takes a long time under anesthesia. Abdominal emergencies are menacing, but the more critical they are, the more they cannot "solve the problem with one cut", and it is necessary to reduce the risk of surgery step by step. When the patient is well adjusted and the gallbladder is not severely adherent to the surrounding tissues, laparoscopic cholecystectomy can be resolved. Jiang Yurong glanced at Ruan Bin in surprise and said with a smile. Because the other party's thoughts coincide with their own. Just now, the other party reminded her to save people first and then treat the disease, which made her think of this method in a whim.

Suddenly, she realized that Ruan Bin really had two hits! Not like a resident doctor who came out of the county hospital.