"Doctor Hou, I heard that you are working as a doctor in a county hospital?" Lu Lei asked a little curiously.

"Yes, Tiannan County Hospital." Hou Quanhai nodded.

"It's a pity to stay in the county hospital like you, have you ever wanted to come to Wuzhou to be a doctor? The cosmopolitan city has great opportunities for your future career and life planning. Lu Lei asked with a smile.

"Of course, I aspire to develop in a big city, but I am only a resident doctor, with an average level, and I also graduated from a third-rate medical school, which is more difficult." Hou Quanhai said modestly.

"You're average, huh? I think your clinical experience is good, and you have made the first REBOA in China. If you want, I can help you ask our hospital to see if it still accepts people! Lu Lei said with a smile.

"This ...... Let's talk about it. "Hou Quanhai can be heard that this guy wants to dig him up openly and secretly?

However, if he wants to stay, he still wants to stay in Wuzhou First People's Hospital, and first of all, he knows the senior doctors of this hospital. And Xia Yu's plastic surgery hospital is diagonally opposite.

When the time comes, it's convenient to make extra money!

If you go to work in the other party's hospital, don't talk about anything else, it will be too troublesome to make extra money at that time, and it will be more than half an hour's drive from Xia Yu.

Seeing Hou Quanhai's somewhat euphemistic refusal, Lu Lei was slightly disappointed.

If the doctors in other county hospitals heard that they could work in one of the top hospitals in Wuzhou, they would probably be in ruin.

Even the doctors in the city hospitals are probably eager to squeeze in.

But Hou Quanhai doesn't care much.

But think about it, people are so talented, and they also made the first REBOA in China, it is estimated that the First People's Hospital of Wuzhou will not let Hou Quanhai go.

Even if Hou Quanhai's surgery is not good and his clinical experience is not good, it will be very useful for him to do pre-hospital emergency treatment alone.

…………

The next day, go to work as usual.

Today is Wednesday, and there are not many patients early in the morning.

At about ten o'clock, an operation finally came.

It was sent by a lower-level hospital.

Jiang Yan took Hou Quanhai to take over.

The patient, a 96-year-old female, went to a hospital in the following city for treatment of 'epigastric pain and vomiting blood. The local hospital recommended conservative treatment, and the surgery was too risky to do. In fact, it is to prescribe some medicine to go home and wait for death, many children can't bear to watch the old mother wait for death, and then directly ask for a transfer!

Hou Quanhai looked at the patient's medical records: there was a history of gastrointestinal perforation and gastrointestinal bleeding.

In the examination report of the lower level hospital, the physical examination: T36.8°C, P90 times/min, R18 times/min, blood pressure 132/78mmHg, pain score 2 points.

Specialist examination: clear, no pallor, yellow staining. Breath sounds in both lungs are clear, and there are no rales. HR90 times/min, rhythmic, no noise. Flat abdomen, tight abdominal muscles, subxiphoid tenderness, no rebound tenderness, no palpable subcostal liver and spleen, negative Murphy.

CT scan shows a perforated gastrointestinal tract, which is a duodenal ulcer and perforated.

Diagnosis: 1. Acute diffuse peritonitis 2. Duodenal ulcer with perforation and bleeding 3. Acute coronary syndrome to be ruled out.

After Hou Quanhai read it, it is no wonder that the lower level hospital suggested that the patient should go home and take 'conservative treatment'.

Duodenal ulcer disease is perforated and bleeding, although only a secondary surgery is required - gastric or duodenal ulcer perforation repair can be cured.

But the problem is that the patient is 96 years old!

What is the concept of 96 years old?

I don't know to what extent the body's organs have failed, and how far the body's functions have declined.

This kind of patient is on the operating table, and there is a very high chance that he will not be able to get down!

The bottom line set by general hospitals for this kind of surgery is within 75 years old, and basically appendicitis and gallstones cholecystitis older than 75 years old are mainly treated conservatively.

Of course, there are many big hospitals that put the bottom line at 80 years old, and even top hospitals even put 85 years old!

But the one in front of me is 91 years old!

This is definitely a no-go area for surgery.

Because the older you are, the higher the risk of surgery and the more complications there are. Even if you have a successful surgery, you often won't survive in the end.

This is why age is definitely at the forefront of the forbidden area for surgery.

Jiang Yan also understood the patient's situation, and said with a slight frown: "Your mother's age is relatively old, if she takes the risk of surgery, it is very likely that she will not be able to get off the operating table, and even if she does, she may not be able to resist it in the follow-up rehabilitation." ”

Since the other party asked to be transferred to the hospital for treatment, I believe that the other party is also mentally prepared.

"This doctor, after discussing with our family, unanimously asked to operate on my grandmother, because we didn't operate on her, and we would go home and wait for death. It's better to give it a go! A man in his fifties said with reddish eyes.

"Doctor, don't have a psychological burden, let's sign, you can do it with confidence." Another young man also spoke. It is estimated that they are all the sons of the patient's grandson.

Hou Quanhai looked at it, this family is reasonable.

In fact, at the age of 96, it is worth the risk of surgery, or waiting for death at home, this choice is basically the choice of the family.

If you wait to die at home, you will definitely die.

If you take the risk of surgery, you may end up paying a lot of money for treatment, but in the end, there will be no one left.

But overall, it's up to your conscience.

"Okay, then go through the hospitalization procedures first, and we have to have a consultation." Jiang Yan said.

Soon, Jiang Yan summoned Deputy Director Liu, Dr. Li, and Hou Quanhai for a consultation.

As for the director of the door, he is not available for surgery.

"This is the case with the patient, and the family is asking for surgery, whether it is successful or not." Jiang Yan said.

"At 96 years old, the risk of having a gastric or duodenal ulcer perforation repair is too high!" Liu Zhenyang shook his head slightly. According to statistics and surveys, surgery at the age of 80 is a watershed moment in difficulty!

90 years old is another watershed of death!

Currently, the maximum age for stomach cancer surgery is 92 years old!

Of course, gastric or duodenal ulcer perforation repair is much simpler than stomach cancer surgery.

"However, I think that although the patient's cardiac enzyme profile is significantly elevated, the patient's heart rate is normal and there is no chest pain, so I think surgery can be tried!" Jiang Yan judged.

"Well, the family members have agreed, we can only go to this operation, the patients are 96 years old, and the traditional laparotomy is definitely not recommended. The trauma is too great! Let's consider laparoscopy! If laparoscopy really can't be done at that time, turn the abdomen immediately. Liu Zhenyang also agreed with Jiang Yan's opinion.

"So, who should be on this operation?" Saying that, Liu Zhenyang and Jiang Yan both looked at Hou Quanhai one after another.