As the attending officer, Lin You's biggest task is to assist Professor Min and Professor Zhu in managing patients and wards, as well as guiding the work of junior doctors, which is also a kind of experience for him.

Lin You said without thinking:

"Joint replacement, from the preoperative analgesia and functional exercises. On the day of admission, the patient was given non-steroidal drugs, and it has been three days so far, and functional exercises have been carried out for three days before surgery, and 200 straight leg raises have been completed so far. ”

"If there is a cap during the operation, depending on whether it is necessary to add a titanium mesh, if there is a titanium mesh, then it needs to be observed for one week after the operation, and if the titanium mesh is not used, the third day after the operation. ”

"For example, without titanium mesh, the drain was removed on the first postoperative day, and low molecular weight heparin sodium was prophylactically anticoagulation. At the same time, physical anticoagulation such as ankle pump exercise is strengthened. ”

"On the second day after surgery, with the assistance of the doctor in charge of the bed, I can get out of bed with crutches and walkers to assist in walking, and the pelvic plain radiograph will be rechecked on the same day. ”

"Blood is drawn on the first and third days after surgery, and the inflammatory indicators of patients who are drawn on the first day after surgery will definitely have an increase in stress, mainly depending on electrolytes and albumin, and whether they need to be supplemented. ”

"On the third day, blood was drawn to check the inflammatory indicators, and if the white blood cells and inflammatory indicators improved, the discharge procedures could be handled at noon on the third day. ”

"Cefuroxime can be used up to 24 hours after surgery. Drugs for pain relief and stomach protection can be used once on the day after surgery, because considering that the patient has been given advanced analgesia, oral non-steroidal drugs and Maizhiling assist in reducing swelling on the first day after surgery, which will last until half a month after surgery, and if the pain still exists after half a month, it can be extended to one month. ”

At the same time, the patient has strengthened the straight leg raise exercise before the operation, and the leg can be lifted within two days after the operation. After discharge, continue to strengthen the current exercise method until one month after surgery. ”

"After discharge, continue aspirin or rivaroxaban anticoagulation, and recommend aspirin anticoagulation, although a large number of studies in previous years have shown that rivaroxaban has a smaller chance of complications than aspirin, but in recent years, studies at home and abroad have pointed to aspirin. And aspirin costs less. ”

"Walking on crutches or walkers until one month after surgery, the follow-up examination is based on the patient's muscle strength recovery, and the decision is made whether to lose crutches. ”

There is no doubt that Lin You is professional, he has been professional enough to arrange everything clearly from the patient's admission to discharge, and at the same time, he will also adjust the treatment methods in combination with the latest theories.

Of course, how to make the final decision depends on Professor Min.

He is the one who ultimately decides on the treatment plan.

Professor Min knew who Lin You was talking about so much nonsense today, and he said, "Oh, is there any research that has started to notice aspirin now?"

"Aspirin is a good medicine. ”

Lin You nodded and replied, "Well, if nothing else, it is estimated that in one to two years, the guide will be changed." Professor Min, which one do you decide? ”

Professor Min smiled and said, "If that's the case, then I'd really like to see what it was like at that time." ”

"Of course, the patient is going to take rivaroxaban. Just follow the guidelines, and as long as the guidelines don't change, we won't change them. ”

With that, Professor Min was ready to move on to the next bed.

But at this time, the old lady was reluctant, and she asked with a wary face: "Professor Min, didn't you just say that aspirin should be cheaper? Why don't you use the cheap one for me, and use the expensive one?"

The family also means that they want to speak and stop.

Professor Min didn't look back, but just said: "At present, our country is more recognized as rivaroxaban, whether aspirin is good or not, and it is just an experiment, do you want to do an experiment?"

"If you want to use it, sign it, and I'll write it to you. ”

Before the old man could make a decision, the family member said directly: "Professor Min, look at what you said, we came to the hospital, of course, everything is at your disposal." ”

"You say you will use whatever you say, you are an expert, we don't understand any of this. ”

……

Professor Min didn't have too many fluctuations in his heart, but he recorded this scene.

Professor Min is a professor, who is not only very professional, but also understands people's hearts.

With the cognitive nature of the Chinese people about experiments, as long as you say that you will use him as an experiment, there is a chance that you will not dare. This kind of conversation routine is very suitable for difficult patients who have consulted Baidu doctors.

To write it down in a small notebook, this is also the art of conversation.

Beds 14 and 15 are all postoperative patients, and Professor Min looked at the wounds of the two patients, and after listening to the blood draw results of the reexamination, he was ready to arrange for discharge today.

Both of them were patients who had surgery on Friday, and they were originally going to be discharged from the hospital on Monday, but neither of them seemed to be at ease with early discharge, so they dragged on to occupy a day's bed.

Then Professor Min said that he could be discharged from the hospital, but could he not be discharged from the hospital?

Compared to limping when I entered the hospital, I was now able to walk around the ward three or four times, and they and their families were relieved and happily accepted the proposal to be discharged.

Immediately after that, I came to Prison 1 and Prison 2.

The prison bed 1 is an eighty-eight-year-old man.

The patient is still Brother Zhuoyuan's.

The patient was in very serious condition.

I fell while taking a shower, fractured my femoral neck, and was dragged into the operating room before surgery on the second day of admission, when I suddenly suffered a pulmonary infarction.

It took 3 days to be transferred to the ICU before being transferred back to the general ward.

After Senior Brother Zhuo Yuan finished his report, Lin You took the initiative to stand up and say: "Professor Min, this patient is a common complication after a femoral neck fracture, pulmonary infarction, although the vital signs are stable, but the risk of tolerating the operation is extremely great. ”

"And even if you have an intramedullary nail, you may not be able to undergo surgery. ”

Lu Cheng's eyes immediately stood up.

This is one of the most difficult orthopedic magazines in textbooks.

It stands to reason that he should be discharged from the hospital now to treat his pulmonary infarction, which is the best choice, but Professor Min has never let him be discharged.

The patient's family members have obviously also checked Baidu, and at this time they are looking at Professor Min with blank eyes, in fact, they are all clear about the patient's situation, but after the pulmonary infarction, they want to drag the patient back, what can they do?

There is no shortage of money at home, and they always tell Senior Brother Zhuoyuan not to rush them to the hospital, just cure the pulmonary infarction here and find a way, they are willing to spend money.

The main thing is the situation on the day of the pulmonary infarction, which is so scary that they simply can't afford to have a similar situation happen again.

Professor Min glanced at everyone and asked, "Do you think anyone is willing to accept such a patient after he is discharged from the hospital?"

No one answered this question.

The answer is self-evident.

"There will definitely be no one who will accept it, even if it is transferred to a few hospitals in Jishuitan and Modu, no one will necessarily be willing to accept it. ”

"Then send the patient out like this, and it can only be seen if the patient can grow on his own. ”

"Moreover, as doctors, we must strictly grasp the contraindications and indications. ”

"The acute phase of pulmonary infarction is indeed a contraindication to surgery, and anesthesia cannot be tolerated, but it does not mean that pulmonary infarction itself is a contraindication to surgery. ”

"There are at least two sets of blood supply to the lungs, and simple pulmonary infarction will not cause lung necrosis. ”

"Wait until he's done and then have surgery. ”

Then, he looked at the patient's family and said, "I also said these words to you, are you willing to wait at my place, or do you want to be discharged directly to the respiratory medicine department?" ”

The family members glanced at each other, looking at each other and couldn't make a decision, and when he wanted to look at Professor Min's expression again, everyone had already walked to the second bed in prison.