After the stitches were completed, Lu Cheng returned home after handing over to the operating team that came to wait for the patient to wake up.

I took a shower, lay on the bed and recalled what I had learned today, and I only felt very fulfilled and learned a lot.

First of all, comb the patients in the ward in their minds again, and then carefully recall today's surgical experience one by one, what is not good enough, and what can be improved?

If the patient is a young man, what will be done, if he is an elderly person, what can be done, etc.

This summary made Lu Cheng's experience a little deeper......

Following.

Lu Cheng came to the ward half an hour before the shift, he actually didn't come so early.

But Lu Cheng has a new patient, which is the 16 beds that were discharged from the hospital yesterday.

The new patient hadn't arrived in the room yesterday afternoon, so he needed to come in advance to get a detailed history of the patient.

The inpatients and their families were in the ward in the morning, and Lu Cheng finished the medical history and physical examination, and then read the films.

It must be too late to write the medical record, because after the morning shift, you have to go to the operating room, and after the operation, you can complete the template that has been built.

Friday's rounds, not too fast.

Because on Friday, in addition to clarifying the preoperative examination of the patient who operated on today, it is also necessary to determine and discharge the operation on next Monday.

Because of the heavy task of ward rounds and the need to go to the operating room early, Professor Min did not drag his feet too much and did not explain too much to many patients.

"13 beds, did you remove the tube yesterday afternoon?

"Today, after the operation of the bed, the doctor in charge of the bed should pay attention to guiding the patient to get out of bed, recheck a blood draw on Sunday, and prepare to be discharged from the hospital on Monday. ”

"14 beds, a new patient, can I schedule surgery next Monday?

"15 beds!"

……

After passing the more seriously ill prison 1 and prison 2 beds, he came to Lu Cheng's 16th bed.

Lu Cheng, as the doctor in charge of the bed, naturally stood on the side of the report, that is, on the left side of the patient.

The professor stands on the patient's right side to facilitate the supplemental examination.

Lu Cheng said briefly: "Professor Min, the new 16th bed is a patient with osteoarthritis in the right knee joint, complaining of difficulty in standing up and squatting, and the pain in going up and down the stairs is aggravated. ”

"In addition to knee hyperextension and hyperflexion pain and obvious medial tenderness, the physical examination also includes misalignment of the patella and trochlea, tenderness at the inner and outer borders of the patella, patellar abrasion test (+), and positive quadriceps resistance test. ”

"Additional diagnosis, there is high patella and patellofemoral arthritis. ”

"There is a history of hypertension in the past, up to 175mmHg, and it can be controlled at present. ”

"At present, I have done an X-ray of the right knee in a standing position, and the film is here. ”

After Lu Cheng briefly explained the basic situation of the patient, he took out the patient's film bag from under the bed and held it to Professor Min.

Because Lu Cheng also knew that today's time was tight, the task was heavy, and the surgery scheduled today would not be discussed before the operation, so there was no time and opportunity for him, and everything was based on time.

But who knows, Professor Min took the film for almost ten seconds, and after scanning it up and down, he looked at Lu Cheng: "Xiao Lu, this patient is yours, right?"

"What do you think of this film?"

Professor Min was deliberately considering Lu Cheng to see if he had read the diagnosis on the hospitalization certificate, and then recited it to him.

A doctor who can endorse must have solid basic skills, but he wants to see something else from Lu Cheng.

Lu Cheng took the film and carefully and quickly made a gesture on the patella of the film with a pen.

Lu Cheng didn't delay time, and said directly and quickly: "Professor Min, the patient's knee joint space is first narrowed and then osteophytes, and it can be seen that his medial space is extremely narrow, which is in line with the diagnosis of knee arthritis stage 4. ”

"In addition, we can see from the lateral view that the patient's patellar joint alignment is extremely poor, and there is a large number of osteophytes on the upper and lower sides of the patella, and the patellar joint space narrowing leads to entrapment, which is consistent with the misalignment of the patella and trochlea, the inner and outer edges of the patella are tender, the patella abrasion test (+), and the quadriceps resistance test is positive. Consider patellar osteoarthritis. ”

"Of course, we can also see from the lateral view that the patellar height, that is, the Insall-Sasati ratio, is greater than 2., which is consistent with the diagnosis of high patella. ”

In Lu Cheng's words, there is not a single nonsense, and the physical signs and the results of reading the film are also extremely fitting, and there is not a word of nonsense.

And there's also very technical jargon.

The Insall-Savati value is the ratio of the distance from the lower border of the patella to the tibial tuberosity to the longitudinal diameter of the patella, which is one of the best and most commonly used indicators for diagnosing high patella.

Professor Min listened, nodded slightly, and looked at the others around him.

"I think Xiao Lu summed it up very well. Do you have any other different opinions about this patient's diagnosis?"

No one spoke.

Only Suzaku said jokingly: "Professor Min, if you let us express our opinions, we have to ask Xiao Lu to leave something for us first!"

"What's the point of adding osteoporosis and osteoporosis at most?"

"Xiao Lu manages the patient very well, he first said the indication for surgery, that is, stage 4 of knee arthritis, and then the additional diagnosis, but also to explain the surgical method in detail, if Xiao Lu can push out the detailed way of surgery, then our superiors can completely take a holiday on non-operative days. ”

Although Zhu Queguang's words were joking, they were indeed the greatest affirmation of Lu Cheng.

Hearing Zhu Queguang's words, Lin You also felt that there was light on his face, and he took the words with a smile on the corner of his mouth: "Brother Guang just wants to be lazy, so he doesn't check the room." ”

Suzaku Light has a hobby, even a hobby, which is powder.

As long as the newly opened powder shop, no matter where it is, as long as it doesn't go out of the city, someone recommends it, and he will inevitably go to check in.

In his words, if you don't talk about it for a day, you don't feel good for a day, as if something is missing.

Professor Min said directly as he walked: "In that case, call Professor Zhu to invite us to eat a meal, who hasn't had breakfast? ”

"Also, this patient is scheduled for surgery on Monday. Pay attention to follow his preoperative examination and rule out contraindications to surgery. ”

was praised again, Lu Cheng's face could only smile, looking harmless to humans and animals.

He knew that the main reason for getting these superiors today was that Lin You had Lin You in his hands for many things, so his superiors gave him the opportunity to speak, and such an opportunity changed from one to two, two to three, and that's it.

Only in this way can we gradually gain the trust of their superiors, let them gradually let go, and let themselves accumulate rich clinical experience.

"17 beds, you should be able to be discharged today, 18 beds, the white blood cells after the operation are slightly higher, they are all eighteen, you can wait until next Monday to recheck and draw blood before being discharged. ”

“……”

Professor Min walked all the way down and didn't listen to it anymore.

After checking the room, Liu Zhicai said to Lu Cheng with some envy: "Brother Xiaocheng, it can be seen that Professor Min likes and admires you very much, the five new patients this morning, only your patients, let you make your own diagnosis." ”

"The patient information we prepared in advance yesterday afternoon didn't have any chance to perform. ”

Brother Kuang also patted Lu Cheng on the shoulder and said: "Brother Xiaocheng, I have to say, your basic skills are really solid, I feel that it is a bit of a waste to call you to manage patients for three years." ”

Liu Zhi's words, Lu Cheng could be proud in his heart, but Brother Kuang's words, Lu Cheng did not dare to agree.

Three-year residency is a national policy, which allows us to manage patients unconditionally and without responsibility for three years to accumulate rich clinical experience.

Do your best.

Lu Cheng simply ignored it, and said to the mud: "Brother Zhi, Brother Kuang, I'm sent for surgery, go to the operating room, and learn more from you." ”