Liu Jie was a little surprised, but quickly adjusted his state and replied rigorously and seriously: "First of all, systemic support and symptomatic treatment, regulating water and electrolyte balance, and supplementing vitamins. Patients with obvious symptoms can be given a small amount of multiple blood transfusions, cooling, pain relief and other treatments. ”

"Second, adequate intravenous antibiotics are advised as early as possible in the acute phase, usually with two or more combinations, adjusted according to susceptibility testing. ”

"Cast cast, splint, skin traction, etc. are used again to elevate and immobilize the affected limb. ”

Finally, patients with high fever who persist after 48 hours of high-dose antibiotics or who have pus in subperiosteal should be treated surgically, including periosteal, drilling, or fenestration. If a subperiosteal abscess has formed, early incision and drainage should be done, and two silicone tubes should be placed in the medullary cavity for perfusion and irrigation of antibiotic solution. ”

Liu Jie's answer was exactly the same as the standard answer, and everyone present was in an uproar again.

In the absence of a range of answers, being able to grasp the knowledge points so solidly and memorize so skillfully, if it is not a fluke, it can only show that Liu Jie is really hard at studying on weekdays.

The impression of Liu Jie by the examiners deepened again, and the students secretly slandered themselves, they must have known the content in advance, otherwise how could they answer word for word, it is impossible.

The director of the orthopedic department smiled at Liu Jie and suddenly asked, "In addition to this treatment plan, do you have any other suggestions?"

Everyone was stunned, but several examiners collectively waited indifferently for Liu Jie's answer, it was obvious that they had already known that there would be this extension question.

It turns out that the previous question was just an examination of the knowledge points in passing, and now it is a formal on-the-spot play Q&A.

The examination room was already quiet, but it was even quieter at this time.

The examiners' attention was all focused on Liu Jie, and the students asked themselves in their hearts, what would they do if they were to solve this question?

In addition to the standard treatment plan, is there any other way to treat acute suppurative osteomyelitis of the right tibia?

However, without surgery, there is no way to drain the subperiosteal abscess, and the pus is not cleared, and the injury cannot be completely healed.

In addition to pus, necrotic tissue, granulation tissue, sinus tracts, and scar tissue are removed, and all dead bones are removed.

If these are not carried out, how can the disease be cured?

Without a basic treatment for chronic osteomyelitis such as lesion removal, subsequent flap or myoscutaneous flap tamponade or cancellous bone tamponade, or even antibiotic-containing cement filling, cannot be performed.

All the students present did not show it on their faces, and they were secretly glad in their hearts, but fortunately they did not have their turn to ask this question.

Liu Jie thought about it for a while and said: "In addition to surgery, there is also a conservative treatment, although the effect is slow, but as long as the treatment is properly recuperated, you can also fully recover." ”

Hearing this, the director of the Department of Orthopedics raised his eyebrows slightly and turned his head to look at Professor Shen.

Professor Shen smiled, didn't speak, only nodded to the director of the orthopedic department, and continued to wait intently for Liu Jie's next answer.

The director of the Department of Orthopedics took a look and looked at Liu Jie.

Liu Jie continued: "Acute suppurative osteomyelitis sometimes has a small number of bacteria in the blood of normal people, but it is eliminated due to the body's resistance, such as when the body's resistance is reduced and there are infectious lesions, bacteria can enter the bloodstream from the lesions, and the body fails to eliminate them all, and the bacteria can invade the bones with circulation. Therefore, theoretically, acute suppurative osteomyelitis is an external factor that combines a highly infectious bacterial invasion of the human body and an internal factor that reduces the antibacterial power of the whole body or local bones. ”

Everyone present silently echoed and nodded.

"So there is also a conservative treatment, which is acupuncture followed by medicated compresses. Liu Jie's voice was low and clear, but the short words fell into the hearts of everyone present like a spark, exploding with all kinds of sparks of shock, speechlessness, or surprise.

The director of the orthopedic department raised his eyebrows and asked, "Do you also know acupuncture?"

All the student materials present have already been sent to the examiners, and Liu Jie's identity is really special, and he can't pay attention to it.

Bachelor's degree, less than one year of work experience, less than a month in orthopedics, and previously worked in the emergency department.

Such a person was actually assigned by Director Sun to participate in the training and study, which in itself is enough to attract attention.

Liu Jie nodded: "My father is an old Chinese medicine doctor, and I have studied systematically with him since I was a child. ”

I see, the director of the orthopedic department nodded clearly, and suddenly said: "That's right, a volunteer in the field practice for a while is suffering from acute purulent osteomyelitis of the right tibia, you are responsible for treating him." ”

Is this just right? It was clearly arranged in advance.

Liu Jie looked at the director of the orthopedic department with some surprise, and saw the other party smiling at him.

Liu Jie had to nod with the other party, secretly surprised in his heart, this is to make a special assessment of him?

The thought turned in his heart, and Liu Jie glanced at Professor Shen, is this because his performance yesterday was too eye-catching?

Other people also played a side drum in their hearts, and said that they were not tired, and this step-by-step arrangement was too proper, from asking questions to on-site assessments, this was clearly the preparation of things.

But after thinking about it, everyone followed the examiner to the practical examination room on the fourth floor in turn.

While waiting for the elevator, Dr. Ban squeezed to Liu Jie's side and asked in a voice that could only be heard between the two of them, "Are you sure you want to use acupuncture to treat acute purulent osteomyelitis of the right tibia?"

Liu Jie nodded: "Hmm." ”

Dr. Ban immediately said, "It's impossible!"

After speaking, for fear that Liu Jie would not believe it, he said: "From an anatomical point of view, there are many terminal arterioles at the epiphysis of the long diaphysis, which have rich circulation and slower blood flow, which is conducive to bacterial reproduction. The more bacteria accumulate and the more virulent they are, the more difficult it is to destroy them, and the more likely they are to develop osteomyelitis. Some bacteria, such as staphylococcus, often accumulate into clumps, which can form embolism in small arteries, blocking the end of the blood vessel and causing local tissue necrosis, which is conducive to bacterial growth and infection. Clinically, the occurrence of osteomyelitis is often related to trauma (sprain, contusion, etc.), and local injury is often the trigger, which is conducive to bacterial growth. ”

What Dr. Ban said, Liu Jie also knows, these are the causes of acute purulent osteomyelitis.

Dr. Ban said: "Without surgery, there is no way to clear the pus, and without completely eliminating the breeding ground for bacterial growth, the disease will not be cured at all."

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