Next, until 11 o'clock in the evening, the patients who did not come for surgery were basically those who had a fever and cold.

Finally, there was a gap period, and the doctors and nurses had to take a break.

Seeing that Jiang Yan's mood was still a little low, Hou Quanhai asked, "Director, do you want to drink coffee?" ”

In fact, as an emergency doctor, especially the chief surgeon, I can't save a life, and I feel very lost. Sometimes it's often just a little bit close to being saved, but unfortunately God still doesn't give it a chance.

"Hmm." Jiang Yan nodded.

Yang Xuan next to him also found that Jiang Yan was in a low mood, so he smiled and said, "Director, are you hungry?" I know there's a very good-tasting Malatang nearby, can I order you a takeout? ”

Yang Xuan thinks that now is the best time to care about beauties, and beauties are in a bad mood? Let the food heal!

"It's working hours, what to eat? What if you eat this junk food and have diarrhea, you will be responsible for the operation when the time comes? If you have time, learn more about basic surgery with Dr. Hou. Jiang Yan didn't like Yang Xuan's behavior of ordering takeout during work hours! Especially when I had surgery before, I asked the other party to have tracheal intubation, but the other party didn't dare. It's really terrible for the dish.

"Uh...... Yes, yes......" Yang Xuan's glass heart shattered instantly. What is said on the Internet is wrong, what kind of food can cure the girl's mood!

"Director, your coffee." At this time, Hou Quanhai came back with two cups of coffee, and handed one to Jiang Yan.

"Thank you."

As soon as the coffee was finished, there was a noise outside the emergency department.

It didn't take long to see a family hurriedly send an old man in his 80s in.

"Doctor, doctor, save my grandpa, save my grandpa!" The young man rushed in with the eighty-year-old man in his arms, gasping for breath and saying sadly.

Hou Quanhai saw that the old man had fainted and didn't know what the situation was.

"Send it to the operating room first!" Hou Quanhai helped to carry people.

"How did your grandfather get unconscious?" Jiang Yan asked.

"My grandfather said he had upper abdominal pain and vomited! By the way, he had a very high temperature, as if he had a fever. He fainted on the way to it. The man said hurriedly.

In fact, it is difficult for ordinary doctors to determine what the disease is.

Maybe acute pancreatitis, acute ulcer perforation, high acute appendicitis, right kidney stones, etc.

"Let's do a B-ultrasound now!" Jiang Yan said.

Soon, Yang Xuan and the nurses sent them for B-ultrasound.

"You are a family member of the patient, right, what is the name of the patient, and are there any other diseases?" Jiang Yan asked.

The man said: "My grandfather's name is Wang Xinhua, and he has a heart attack!" ”

Brush brush, Jiang Yan recorded on the side.

"Okay, you register to pay the fee first, your grandfather needs a B ultrasound to know what the disease is."

In less than ten minutes, the results were in.

Jiang Yan's brows furrowed after reading the B-ultrasound results!

According to her years of experience, judging from the above, this Wang Xinhua has acute cholecystitis, and it is also a very serious purulent cholecystitis. And even worse - the gallbladder is perforated!

"How?" Hou Quanhai and Yang Xuan both looked at Jiang Yan.

"Purulent cholecystitis, and the gallbladder is perforated, so I have to operate immediately!"

"Huh? So serious? But this old man also has heart disease, if the gallbladder is surgically removed, anesthesia and infection are the most difficult problems in front of us! Hou Quanhai said solemnly.

It is very troublesome to administer anesthesia to patients with a history of heart disease. The premise of using anesthesia is to grasp the indications of anesthesia and control heart disease. It depends on the severity of the disease and the anesthetic used. How much to dose! In particular, this heart patient is still in his 80s.

Once the anesthetic lasts too long, you may not be able to wake up! However, major surgery requires the use of long-term anesthetics......

The second is infection, purulent cholecystitis, and the gallbladder is perforated, which is a big problem.

In other words, the operation is not difficult, but how to choose is a difficult problem!

At this moment, Jiang Yan was also hesitating. If the patient is given a cholecystectomy, it may be successfully removed, but the patient may not wake up due to heart disease or anesthetics. Even if I wake up, what should I do if I have an infection?

But without cholecystectomy, the patient will definitely die!

Dilemma!

The young man on the side saw that the two doctors were silent, and they were all sweating profusely: "Two doctors, you have something to say!" My grandfather was in a coma for more than ten minutes. ”

"Director, our emergency department has always been to save lives first and then treat patients! Why don't you alleviate the patient's condition first, and then perform cholecystectomy when the condition is not so serious? Hou Quanhai suggested.

Jiang Yan's eyes lit up after listening to Hou Quanhai's words: "Okay, you're right, in the face of this situation, we can't blindly think about directly curing the patient's disease, but first save the patient's life!" ”

"I'm going to do a liver and gallbladder puncture and catheter drainage for the patient! Prepare things, Hou Quanhai, Yang Xuan, learn well. After Jiang Yan got Hou Quanhai's inspiration, he instantly thought of a treatment plan in his heart, so he was in a good mood.

While being sent to the operating room, Yang Xuan asked curiously, "Director, how can you save your life first?" ”

As a rookie, his brain is a little dead at this time!

"I think the director gave the patient a liver and gallbladder puncture and catheter drainage first, so that the patient could get better and wake up significantly. In the next few days, it is estimated that percutaneous puncture drainage of abdominal pus and ERCP (endoscopic retrograde cholangiopancreatography) will be done according to the situation, and an intrabiliary stent drainage tube will be placed to reduce the pressure on the biliary tract! Finally, wait for the patient's condition to stabilize before cholecystectomy! Hou Quanhai guessed.

After all, he also has a director-level cholecystectomy, and when Jiang Yan said that he was going to do hepatic gallbladder puncture catheterization and drainage just now, he thought of the second and third steps.

"Haha, that's right! The patient cannot withstand a major surgery that takes a long time under anesthesia. Abdominal emergencies are menacing, but the more critical they are, the more they cannot "solve the problem with one cut", and it is necessary to reduce the risk of surgery step by step. When the patient is well adjusted and the gallbladder is not severely adherent to the surrounding tissues, laparoscopic cholecystectomy can be resolved. Jiang Yan glanced at Hou Quanhai in surprise and said with a smile. Because the other party's thoughts coincide with their own. Just now, the other party reminded her to save people first and then treat the disease, which made her think of this method in a whim.

Suddenly, she found that Hou Quanhai really had two hits! It's not like a resident doctor coming out of a county hospital.