In the surprised and surprised gaze of Dr. Zhang Qi outside the door, Xu Ze naturally held down the part ready for puncture with one hand, held the syringe in the other hand, and took five milliliters of lidocaine from the small medicine bottle in Director Qu's hand very steadily and accurately, ready to start local anesthesia.

In Xu Ze's view, since Director Qu said to let himself do it, then in the case of only two people, Director Qu will of course be an assistant to assist him in doing a good job of this lumbar puncture, but there is no need to be too taboo about any identity issues, and Zhang Qi was shocked that Director Qu did not do it himself, but also acted as an assistant, which in their opinion, this is almost impossible, as a busy director of the department, and a well-known expert in the country, in addition to weekly rounds; Generally speaking, patients have to be applied for by the general doctor in charge of the patient, and they will only take the time to come out for consultation.

It is impossible to waste time to do such a minor operation in person, but now Director Qu not only came to do it, but also turned out to be an assistant to a new doctor, which is strange.

At that moment, Zhang Qi hurriedly put on a mask and hat and walked in, and smiled at Director Qu: "Director, why don't you rest, I'll be Dr. Xu's assistant." ”

Director Qu knew what Zhang Qi meant, chuckled and shook his head, and then continued to watch Xu Ze do it, he was not an assistant for anything else, just to see Xu Ze's true ability, of course he would not let others replace him.

Xu Ze didn't think so much at this time, he was doing his own surgery wholeheartedly, carefully piercing the syringe obliquely into the puncture point, injecting some anesthetic into the bottom layer of the skin, and then changing to vertical needle insertion, from the skin to the intervertebral ligaments, layer by layer carefully for local infiltration anesthesia.

When the lidocaine had been completely injected into the ligament, Xu Ze took a light breath, calmed down, picked up the puncture needle about ten centimeters long, carefully fixed the skin of the puncture point with the thumb and two fingers of the left hand, and held the puncture needle in the right hand in the direction of the vertical back, starting from the 3rd and 4th lumbar vertebrae to slowly puncture, and officially began to perform the lumbar puncture.

Seeing that Xu Ze began to be officially pierced, a trace of curiosity flashed in Director Qu's eyes, he basically didn't doubt Xu Ze's ability at this time, but he was wondering if Xu Ze could succeed at one time, if this could also be successful at one time, then it means that Xu Ze must have very rich experience in clinical practice, and his theoretical and practical ability is extremely strong, and he can let Xu Ze do things in the future.

And Zhang Qi saw Director Qu's refusal at this time, so he also watched cautiously from the side, looking at Xu Ze, who can make Director Qu pay so much attention, what kind of hand is at hand, it shouldn't be a silver-like wax head gun... At this time, Xu Ze was also a little nervous, although it was said that this lumbar puncture was unsuccessful once, and there were many cases of doing it once or twice; But Xu Ze still wants to be perfect, when he was in the virtual space, but after doing it many times, he can only succeed once after being familiar with the feel, but this time in reality, he can't help but feel a little nervous.

Xu Ze recalled the feeling when he was working in the virtual space, and slowly pushed the puncture needle forward with his feelings, so when he pierced about 3 or 4 cm, Xu Ze's hand was slightly sluggish, and he felt a little resistance, when he gently pushed forward, he quickly broke through, and couldn't help but twist his eyebrows at the moment, this should be the breakthrough of the first ligament, and the next thing is the most critical, whether it is successful or not depends on the situation later.

Continued to puncture two centimeters, Xu Ze really felt the resistance again, this time the resistance was much greater, Xu Ze raised his eyebrows lightly, then took a light breath, held the puncture needle tightly, pushed forward, felt that with this push, and then his hand was empty, the resistance to the needle disappeared obviously, Xu Ze breathed a sigh of relief, knowing that the puncture needle had successfully passed through the ligament and dura, and successfully reached the spinal canal.

Although it is estimated that it has reached the spinal canal, it is still not completely certain that the puncture will be successful, and this must be seen cerebrospinal fluid to count.

Xu Ze exhaled lightly, pulled out the needles slowly, and the success or failure was once again in one fell swoop, if the cerebrospinal fluid was still not seen, then it had to be re-punctured again.

However, it was obvious that Xu Ze's training in the virtual space had a very good effect, and as the needle slowly withdrew, a drop of colorless transparent liquid gently dripped out in the expectant gaze of the three of them.

Seeing this drop of transparent cerebrospinal fluid dripping out, Xu Ze couldn't help but breathe a sigh of relief, but Director Qu and Zhang Qi on the side had a hint of approval on their faces, this Xu Ze is really good... Xu Ze slowly pushed the needle back, temporarily stopped the cerebrospinal fluid from flowing out of the needle, and then felt out a manometry tube from the lumbar puncture bag, carefully inserted the lower end of the manometry tube into the needle, and began to measure the intracranial pressure, which is also an important diagnostic method for lumbar puncture.

With the sleeve of the manometer, the cerebrospinal fluid scale displayed in the manometer rose slowly, and gradually stopped at the 150 mm water column, Xu Ze also relieved himself, the normal value is 180, and now it is only 150, it seems that the intracranial pressure has not increased, there should be no other intracranial or cerebrospinal fluid lesions, and the diagnosis of Guillain-Barré syndrome is a little more certain.

After the pressure measurement, Xu Ze carefully removed the manometer, and then inserted the needle into the needle to block the cerebrospinal fluid so that it no longer flowed out; Then he reached out and took out three test tubes from his waist bag and prepared to keep a cerebrospinal fluid sample for testing.

Carefully arrange the test tubes in his hand in a row in his right hand and place them below the needle in the patient's spine, then gently hold the needle with his left hand, and carefully pull it out at a slow speed, as the needle is withdrawn from the needle, the colorless and transparent cerebrospinal fluid slowly drops from the needle into the test tube in Xu Ze's hand drop by drop.

When the three test tubes in his hand were all dripping with a small half tube of cerebrospinal fluid, Xu Ze hurriedly pressed the fingers of his left hand against the needle to stop the cerebrospinal fluid from flowing out temporarily, and then put the test tube in his hand into the treatment tray on the side. The needle is then inserted into the needle to block the cerebrospinal fluid so that it does not flow out.

Everything was already in place, Xu Ze reached out and quickly pulled out the puncture needle, sealed the needle hole with a piece of gauze, and then changed the patient's position from the side decubitus position to lying flat, and then asked the patient if he was not particularly unwell, and then explained that he went to lie flat on the pillow for four hours before he was allowed to sit up, then packed up the surgical instruments, took three test tubes filled with cerebrospinal fluid, and went out of the ward with Director Qu.

Back in the office, Director Qu quickly opened the test sheet, took three test tubes and handed them to the nurses, asking them to send them to the laboratory for testing immediately.

Zhang Qi looked at Director Qu so cautious, and couldn't help but ask curiously, "Director, is there anything wrong with this patient?" ”

"Hmm... After a detailed analysis, we considered that this patient may not be a simple myasthenia gravis, but may be a newly discovered disease, so it must be diagnosed as soon as possible so as not to delay the treatment of the patient! Director Qu nodded and looked at Zhang Qidao.

"A newly discovered disease? Xu Ze can see it? Hearing Director Qu's words, Zhang Qi couldn't help but be stunned.

"Yes... Xu Ze, this young man is very good, he has a wide range of knowledge, and he has also studied some new diseases in depth, if he hadn't discovered the abnormality this time, I wouldn't have thought of this! Director Qu said with a smile.

It was almost twelve o'clock, Qian Xuebin pushed open the door and walked in, and smiled at Director Qu: "Director, you should get off work... I've eaten! ”

Seeing Qian Xuebin come in, Director Qu beckoned, and then said, "Xiao Qian, come here!" ”

Seeing Director Qu's solemn face, Qian Xuebin's heart couldn't help jumping, and then he walked over with a smile and said, "Director, what's the matter?" ”

Director Qu nodded and motioned for him to sit down, then handed the medical record in hand to Qian Xuebin, and said, "Xiao Qian, this medical record of yours needs to be rewritten, I went to see this patient just now and found that there is something abnormal, it may not be myasthenia gravis with a simple surname, it may be a newly discovered disease called Guillain-Barré syndrome!" ”

"I'll find out the information and show it to you later, you first re-ask the patient's medical history, and then do a careful physical examination, and then write the medical history and some subtle physical examinations in detail, don't have any more problems, understand?" Director Qu explained cautiously and somewhat harshly.

Hearing Director Qu's critical words, Qian Xuebin's face turned gloomy, although it was not too embarrassing to be criticized by the director, but being criticized in front of other doctors, Qian Xuebin still felt that his face was hot.

Although he didn't know what was wrong with his medical records, Qian Xuebin still nodded hurriedly and humbly, and said seriously: "Okay, director, I will re-conduct a comprehensive examination and physical examination of the patient, and there will be no more omissions!" ”

"Hmm... Let's go now, Xu Ze and I have already done a lumbar puncture for the patient, and we are waiting for the test results to come out; After you ask about your medical history and do a physical examination, I will find the information for you! Director Qu nodded, then got up and went to his director's office.

After Director Qu left, Qian Xuebin began to analyze this matter, his physical examination should have been good, and there is generally not much problem in asking about medical history, so where will the problem be?

Qian Xuebin thought about it, and suddenly remembered the strange and seemingly unrelated medical history that Xu Ze asked when he went to see this patient two hours earlier, and his heart jumped at the moment, and he secretly said that something was wrong, but he was afraid that something was wrong here.

Xu Ze was afraid that he saw some problems, but he didn't make a sound, but told the director directly, allowing himself to be criticized by the director... Thinking of this, Qian Xuebin's eyes couldn't help but show a hint of resentment