This time it didn't take long to empathize, but Ji Xiang was shocked far more than the time when the sea did the extension.

As for the pain, bleeding, infection, etc., after the circumcision, compared to this empathy, it is not enough to see.

So much so that Ji Xiang did not take stock of the harvest at the first time.

Probably because of the increased difficulty of empathy, this empathy gave Ji Xiang 30 surgical points.

But he was in a terrible mood, and his eyes were full of blood.

I don't know how things will develop after I leave, Ji Xiang thought silently.

"Teacher." Ji Xiang pursed his lips and did not agree with the statement of the system NPC.

"Doctor Xiaoji, tell me about your analysis of this matter." The system NPC looked at Ji Xiang and asked calmly.

Although he knew that it was just an illusion, or a program, Ji Xiang was still calm for a long time.

The system NPC handed him a bottle of 10% 250ml of glucose, and Ji Xiang gradually calmed down after drinking half a bottle.

Looking at Ji Xiang quietly, the system NPC did not interrupt his thoughts.

"The fault party for this incident is the surgeon who participated in the rescue three years ago, but the patient was emotional, and it was not right to hurt the innocent." Ji Xiang simply stated his judgment.

"The basics are still so weak that you have an error in your judgment of the whole thing." The system NPC shook his head.

"Huh?" Ji Xiang was stunned for a moment when he heard the system NPC say this.

The patient's right kidney is gone, this thing is a sure thing, how can the system NPC say that!

Could it be that his ass is sitting crooked? Even in the system space, his ass is still crooked?!

No wonder it is said that the ass decides the head, it turns out that it is true.

Ji Xiang felt a little disdain in his heart, and the young man's blood began to surge, even if he wanted to offend this system NPC who was profound and awesome to the extreme, he had to stand on the side of justice and justice.

The system NPC did not smile, but looked at Ji Xiang's expression very seriously.

He seemed to guess what Ji Xiang was thinking.

The young man was ready to challenge himself like a little beast, completely forgetting the real purpose of coming to the system space this time.

The old man and the young were silent, and the atmosphere in the operating room of the system was awkward and inexplicable.

After 3 seconds, the system NPC broke the suffocating silence.

"There is a type of disease called renal self-amputation, which is more common in tuberculosis patients." The system NPC waved his hand, and a light screen appeared in front of him, and he began to tell Ji Xiang.

Ji Xiang frowned, his kidney was amputated, and there was only a small amount of space to describe it in the diagnosis and other courses.

Although Ji Xiang has almost memorized all the textbooks of the same height with his superhuman memory, it is just a boring memory, and it is impossible to turn it into an ability.

"A large amount of calcium salt deposition in renal tuberculosis lesions causes extensive calcification of the entire kidney. The sonogram is characterized by varying degrees of kidney destruction and even calcification, when the kidney function is completely lost and the ureters are completely occluded.

This condition is clinically called renal self-amputation or putty nephrium. ”

"Teacher, the patient has no history of tuberculosis." Ji Xiang struggled to recall the memories of empathy, and argued.

The system NPC raised its deformed, chicken-paw-like right hand and pressed it.

"Renal self-amputation is a class of diseases, and there is another branch disease that we call traumatic renal self-amputation."

“……”

This sentence poured down like a basin of cold water, and the anger in Ji Xiang's heart was suddenly extinguished.

Traumatic kidney self-amputation, as the name suggests, can cause kidney problems.

Combined with all the empathy, Ji Xiang naturally thought of the words of the director of the Department of Urology, the purpose of his coming to the system space, and the patient's emotions after knowing that he had been choked.

The system NPC didn't care about Ji Xiang's feelings, and he continued to explain.

"The patient was diagnosed with liver rupture and kidney contusion and laceration 3 years ago."

"In renal contusions, CT scans may show uneven density, blurring of renal tissue, or fissures or intraparenchymal hematomas and subcapsular hematomas; Contrast-enhanced CT can be done to see more clearly. ”

"Kidney contusion and laceration lead to a series of complications such as hematuria, and the simplest way is to remove the kidney.

Due to the importance of the kidneys to people, of course, it is possible to avoid surgical removal. Preserve organs as much as possible, which is the clinical guideline.

Patients with persistent hematuria or outward bleeding can be identified by arteriography and treated with highly selective embolization, which blocks the bleeding branch blood vessels to stop the bleeding and preserve the kidneys. ”

The system NPC began to tell Ji Xiang about the kidney contusion and laceration, and then about the kidney rupture.

If it were usual, Ji Xiang would definitely think that the system NPCs were a little nagging and didn't go straight to the point.

But this time he listened carefully and cross-referenced what he had learned in school.

"The fifth type of injury is renal vascular injury, which is divided into two conditions.

The first is the rupture of the renal blood vessels, which can be one of the arteries and veins or at the same time, which can also be counted as renal rupture, or renal pedicle rupture, which is also a serious disease that will die from massive bleeding if it is not operated on quickly. ”

"The second type requires you to pay special attention."

The system NPC reminded Ji Xiang in an accentuated tone.

Ji Xiang nodded, his eyes looking at the light screen. His brain splits into several different threads, thinking about empathizing with the emotions of the patient, himself, and the CT room doctor, and listening to the teachings of the system NPCs.

"In renal artery contusion, the main problem will be on the blood vessels. The patient was sent to the operating table during emergency treatment and laparotomy, and the kidney morphology did not change, and there was no indication for surgery. ”

"Even if I did a CT scan in the emergency department at that time, I wouldn't have found any problems."

"Teacher, if you do a 64-slice CT, it's the kind of medicine you do." Ji Xiang asked.

"Regardless of whether the emergency patient can give you time to do this kind of examination, even if it does, there is a high probability that there will not be any diagnosis."

"......" Ji Xiang was speechless.

"Renal artery injury causes the lining of the blood vessels to become unsmooth, hydrodynamics to change, and it is easy to form blood clots.

from incomplete final to complete blockage of the renal artery; The fast ones are a few hours after the injury, and the slow ones are more than ten days after the injury, and even dozens of days have changed. ”

"I ask you." The system NPC looked into Ji Xiang's eyes.

Ji Xiang was a little panicked by those bright and transparent eyes.

He already understood what the system NPC meant, and although it wasn't very clear, he knew that he had made a huge mistake in the process of empathy.

"How long will it take for a traumatic patient to be discharged from the hospital if the rescue goes well."

"10-14 days, no infections and other accidents." Ji Xiang replied.

"Hmm." The system NPC nodded, "It's okay for the patient to have a simple follow-up after surgery, will you prescribe a more expensive imaging examination for the patient?" ”

"No, it won't."

Ji Xiang replied seriously.

"Yes." "This is a secondary disease, and the doctor has experience and advises the patient to go to the outpatient clinic for examination 1 month after discharge to see if there are any changes in the kidneys.

However, the recovery is almost complete, and the vast majority of patients will forget about it after they are discharged from the hospital. ”

Ji Xiang exhaled softly, as for his complicated feelings, even he couldn't tell himself.

"After a renal artery contusion, the most serious case is the complete loss of blood supply to the kidney on the injured side, and of course the gradual ischemic atrophy.

It has also been called "aseptic necrosis".

The tissue of the normal kidney structure gradually disappears under ischemia and necrosis, and is replaced by connective tissue similar to the surrounding tissue, which cannot be seen on CT at all. ”

"In other words, the patient's right kidney was not cut off, but because of an extremely rare renal artery contusion that led to traumatic renal self-amputation, and he died of necrosis?" Ji Xiang found this logic difficult to accept.

The system NPC nodded.

Ji Xiang was silent.

He had something to say in his heart, but he didn't say it.

"You're saying that doctors are still responsible." As if they were gods, the system NPC saw through Ji Xiang's heart and asked lightly.

"Yes." Ji Xiang didn't hide it, nodded and replied.

"I'll give you an example." The system NPC said solemnly, "The neurosurgery department of our hospital once received such a patient - a car accident injury, a very slight scratch, and the patient was wearing a seat belt. ”

"You know about the trauma."

Ji Xiang was stunned, the system NPC said it simply, but he only knew a little bit, and he didn't understand any more.

If the trauma patient has insurance or the other party is fully responsible, he will basically choose to be hospitalized.

One is just in case, and the other is that it is good to have a full body check-up by the way.

"The patient is a young woman who has been hospitalized for 6 days and is ready to be discharged the next day. After the doctor on duty stepped down from the emergency surgery that day, he also saw the patient get up at night to go to the bathroom, and everything was normal. ”

"But less than an hour later, the nurse took over the shift at night and found that the patient was incontinent and did not respond to his calls."

“！！！” Ji Xiang was stunned.

"At this time, it's too late to bring the doctor over." The system NPC sighed, "There is a probability of 1 in 50,000 carotid artery intimal avulsion, resulting in a large number of embolus in the patient's head blood vessels, and finally blocking the brainstem, and he died 19 days later." ”

“！！！”

"The two cases are somewhat similar." The system NPC brought the topic back, "You think that if the doctor is of a high level, the idea that you can prevent it early is true, but that requires a doctor of my level." ”

Speaking of this, the system NPC paused.

"With a 1 in 50,000 probability, how many similar patients can you say there can be in the country?"

Ji Xiang no longer paid attention to the words of the system NPC "Versailles", he frowned and asked, "Teacher, if you find it early, is there a cure?" ”

"That's something you didn't think about until you reached level 9 in your urology skills." "Now let me ask you, do you know the mystery of the director of urology's concern?" ”

The reason for not paying attention to patients with extremely difficult and many postoperative complications such as partial nephrectomy and special instructions to pay attention to a patient with kidney contusion emerged in front of Ji Xiang.

He knew that the director of the Department of Urology would definitely not pay attention to all kidney contusions, but vaguely guessed that this patient might have a problem based on his difficult clinical experience, and needed to observe and communicate more with the patient and his family to avoid accidents.

It's a lot of clinical experience.

Ji Xiang didn't nod, but began to ask some questions that the system NPCs didn't understand yet.

This doesn't need surgery points, and the system NPC belongs to the kind of best teacher, Ji Xiang must hold on, and he must study it thoroughly.