Four hospitals, inpatient wards.

Gong Shuangjiang checked the patient's condition, and Zhang Gu and Xiaomao followed beside him.

Gong Shuangjiang saw Zhang Gu coming and introduced the patient to him by the way.

"This patient went to the horse farm a few days ago to ride a horse, was kicked by a horse, kicked in the upper abdomen, had a two-centimeter tear in the duodenum, and had a contusion and edema on the head of the pancreas. ”

"According to our estimates, it should be up to three days for the pus to go down. ”

"But the problem is that the recovery has not had obvious results, and the body temperature has been maintained at thirty-nine degrees for the past three days, so it's not a way to go on like this!"

Gong Shuangjiang wondered if the original exploratory operation was not thoroughly examined, and there were other hidden wounds that were not found?

Zhang Gu's heart moved, and he said, "Director Gong, do you want to inject Meilan to observe?"

Gong Shuangjiang weighed it and nodded: "You're right, use this method first, rule it out, and see if it's a duodenal fistula or a pancreatic fistula." ”

He instructed the doctor on duty next to him: "Go to the operating room, through the gastroduodenal decompression tube, inject Meilan into the patient for observation, and in addition, do a color ultrasound." ”

Soon after, the results came in.

The two looked at the ultrasound report and observations.

"Duodenal fistula and gastrojejunal anastomotic leakage should be ruled out. ”

Gong Shuangjiang nodded: "Color ultrasound shows that there is a liquid dark area in the liver and kidney space, most of which is still an abscess, and this part is ......."

Zhang Gu took over: "In this area, most of them are pancreatic fistulas, and they are also combined with abdominal abscesses. ”

Gong Shuangjiang smiled bitterly: "What we are most worried about is this situation, once the pancreatic fistula is combined with an abdominal abscess, it will be tricky!"

This situation is a bit up and down.

Drainage alone has no therapeutic effect, and it is not appropriate to operate again, which is a very embarrassing situation.

For a while, Gong Shuangjiang couldn't think of what to do. If it really doesn't work, you can only go under the knife again. But once the surgery is performed, there is a new risk of surgery.

It is important to know that this pancreatic fistula is a postoperative complication of the previous pancreatic head anastomosis, which is the consequence of the operation.

Zhang Gu's heart moved.

He had a better cure for it.

Then, I'll cure it!

It should be to alleviate the pain of the patient and reduce the risk of reoperation.

Moreover, treating patients in the outer hospital is also showing the superb medical skills of our three hospitals, and it is also giving face to the three hospitals, right?

If you go back to Director Xiang, you can also add some points to our evaluation, right?

In Zhang Gu's mind, he exchanged the last "appendectomy" with a skill replacement card for "abdominal abscess drainage tube irrigation treatment".

Zhang Gu opened his mouth and said, "Director Gong, have you tried anti-infection irrigation treatment?"

Gong Shuangjiang was visibly flustered.

If he had known, would he have considered another operation?

Zhang Gu said, "Our three hospitals will use anti-infection night irrigation methods for patients with pancreatic fistula combined with abdominal abscess. ”

Gong Shuangjiang was happy in his heart, the third hospital was of a higher grade than the fourth hospital, and there were many patients he usually encountered, so it was likely that there would be a better treatment.

"Okay, you come to treat, I will fully cooperate with you. ”

Zhang Gu said: "Intravenous cefoperazone first. ”

Gong Shuangjiang gave the side a look, and someone immediately ran errands to do it.

"Then use gentamicin and 0.9 percent normal saline to prepare anti-infection night. The ratio is 300,000 U gentamicin with 250 ml of normal saline, and it is taken after preparation. ”

Corey's people all moved with Zhang Gu's command.

Gong Shuangjiang secretly assessed and judged the principles and effects of Zhang Gu's operations in his heart.

After a moment, he pondered: "Is the anti-infective fluid to suppress the secretion of pancreatic juice?"

"At least this has the advantage of lowering the patient's temperature in a day or two. ”

Gong Shuangjiang nodded slightly, this method has at least a short-term effect.

At this time, Zhang Gu was already under the gaze of everyone and began to inject anti-infective liquid.

"Remember, at the beginning, you can only inject 10 to 15 milliliters at a time, too much of it will cause the abscess wall to burst and fall short. ”

"And the speed of the operation should be slow, if the bolus resistance is felt, the patient should be asked to adjust the position to facilitate the abscess to flow out and reduce the bolus resistance. ”

"You see, after the injection, it is immediately aspirated, and the purpose of the whole operation is to flush the thick cavity. ”

Everyone wrote down these key points one by one.

At this time, Zhang Gu found that the suction liquid in his hand could not be completely sucked out.

"What's going on?"

Everyone felt bad, and Gong Shuangjiang also came over.

"What is the reason for this?"

Zhang Gu thought for a moment and said, "It may be that there is a problem with the placement of the drainage tube." ”

Gong Shuangjiang's face darkened suddenly, and he glanced to the side.

A surgeon in charge of the surgeon was seen with a weak heart and a bowed head.

Zhang Gu said: "It should be that the drainage tube is placed in the wrong position, and the position is higher than the bottom of the thick cavity, so the depth and direction of the drainage tube must be readjusted." ”

After a burst of remedies for everyone.

Usually, Zhang Gu suctioned again, and sure enough, it was smooth.

Gong Shuangjiang was a little afraid, and cold sweat flowed down his forehead: "Doctor Zhang, thanks to you being here today, otherwise you wouldn't have found such a serious problem!"

When I did an abscess drainage operation, the drainage tube was placed in the wrong place!

How is this surgery done?

This kind of mistake is so undeserved!

Gong Shuangjiang was very heartbroken, and he was heartbroken because of the poor level of medical skills in the Fourth Hospital.

A doctor in the third hospital could tell that it was a drainage tube problem just by using the suction method.

However, a chief surgeon at the level of attending physician of the Fourth Hospital made such a low-level mistake during the operation.

Take a peek and see the whole leopard. No wonder outsiders say that the four courtyards are not as good as the three courtyards.

Gong Shuangjiang sighed in his heart, if he wants to improve the overall medical skills of the four hospitals, there is still a long way to go!

Feeling Gong Shuangjiang's disappointed gaze, the chief surgeon trembled in his heart.

At this time, Zhang Gu spoke, relieving the atmosphere.

"Rinse the thick cavity like this, once or twice a day. If the drainage flow is smooth, the amount of flushing fluid can be gradually increased. ”

At this point, the treatment methods are all clearly explained.

Gong Shuangjiang also basically figured out the principle of this treatment method.

He pondered, and couldn't help nodding: "While intravenous high nutrition supports recovery, plus inhibition of pancreatic juice to fight infection? This method is good, it should work." At the very least, it saves the risk of another operation. ”

Zhang Gu smiled: "Just follow this drainage for about two weeks, it should be about the same, if there is any problem in the process, call me, I will come over in time." ”

"It's not early, it's been delayed for a while, we have to rush back to the Third Hospital. ”

Zhang Gu and Gong Shuangjiang said goodbye.

Gong Shuangjiang shook Zhang Gu's hand tightly, thanked him for a while, and then personally sent Zhang Gu outside the hospital.

Xiao Mao felt that Director Gong's attitude towards Teacher Zhang now was closer than his attitude towards Zhou Dongfeng when he came.

Today's Zhang Gu's successive performances also opened Xiaomao's eyes.

It turns out that an excellent doctor like Mr. Zhang would be so respected?

This feeling......

It's really amazing.