Ji Xiang chatted with Dr. Meng about speculation, went to the emergency department every four days, and accompanied Meng Qingfei on duty at night, helping to sew up wounds and see patients.

Time flies, and most of the months have passed.

"Xiao Ji!" Director Liu walked out of the office and stood at the door and shouted loudly.

"Yes, Director." Ji Xiang wore disposable gloves and opened the door with his elbow, and came out of the probe from the medicine change room, "What instructions director." ”

"Hurry up and change the dressing, let's go to the consultation."

"Okay." Ji Xiang responded, turned around quickly and explained the precautions to the patient after circumcision who had surgery on the weekend.

The circumcision he did was very good, there were almost no postoperative complications, and the explanation was detailed, and the patient's fear was light.

"Okay, just come back to me in three days to change the dressing." Ji Xiang took off his gloves and said to the patient.

"Doctor, do you want to go to the clinic or come to us?"

"It's okay to come here, you have to register when you go to the outpatient clinic, just change the dressing, it's not worth it." Ji Xiang Road.

Turning around and going out, Ji Xiang bowed down and smiled, "I'm sorry, director." ”

"What's embarrassing." Director Liu scolded with a smile, "Changing dressings is a serious job, don't be so hypocritical, learn more." ”

As he spoke, Director Liu glanced at Ji Xiang.

"Director." Ji Xiang was a little weak-hearted.

"Is there a forfeiture of the disposal fee for changing the patient's dressing?" Director Liu asked leisurely.

"......" Ji Xiang sighed in his heart, but he was still discovered by Director Liu.

"Your own patients, change their own medicines, if you don't accept it, you don't accept it, it doesn't matter." Director Liu suddenly smiled slyly, "But don't let the head nurse know, the housekeeper is verbose." ”

"Huh?"

"The performance of the department, hey! It's a joke to say, on the one hand, let the treatment save people, and on the other hand, the performance appraisal, don't you think it's very divisive? ”

"Sort of."

"Don't talk about this, it's hard to be a doctor now, mainly because of schizophrenia."

"Director, what kind of patient is being consulted?" Ji Xiang smiled and then asked.

"The patient was admitted to the hospital because of femoral vein thrombosis in the lower limbs, and the thrombolysis treatment was not good, so he was ready to intervene in catheter thrombolysis, and a CT was done before the operation, and a problem was found. I just watched the film on my computer and I always felt that something was wrong. Director Liu said as he walked.

"Something is wrong?"

"Well, I don't think it's a tumor, but I can't tell what it is." Director Liu said, "There is no kidney parenchyma, it is said that it should be a kidney cyst, but this thing is too big, I dare not admit it." ”

"How old?" Ji Xiang asked curiously.

"I estimate that there are 5,000 ml of water in it, and the physical layer is like a piece of paper." Director Liu said suspiciously, "It is said that no, kidney cysts are very common, I have seen them in more than ten centimeters or twenty centimeters, but the kidney parenchyma is pressed into a piece of paper......

Ji Xiang didn't speak, and continued to walk to the Department of Gastroenterology with Director Liu.

The kidneys are crushed into a piece of paper, which sounds weird. The reason why Ji Xiang didn't talk much was because he wanted to see the patient's information.

I haven't even watched the film, why should I talk so much.

When he came to the Department of Vascular Surgery, Director Liu arrived at the earliest, and he asked for the patient's image data to be inserted into the reader.

Although the system in the hospital is now all electronic, and you can watch the film with a computer, Director Liu is older and is more accustomed to watching the film on the reader.

Ji Xiang stood behind Director Liu and watched together.

The patient has a large mass on the left side of the abdomen, about 7 vertebral bodies in length and wider than the midline.

If it weren't for the density telling Ji Xiang that it was a "water bladder", anyone would suspect that it was a tumor.

But such a large "water bladder" does not look like a kidney cyst.

Ji Xiang's ability to read films is not high, just past the standard line, he went to see the medical records after reading them carefully.

The system NPC is not good, although he rarely tests himself, but once he asks a question, he can't answer it...... Ji Xiang felt too embarrassed.

It has to be said that the medical records written by the physician are detailed enough, and although the patient's admission time is short, the rewriting has also been written.

If you are a surgical patient, even if the patient is admitted to the ICU before discharge, the surgical record may not be written.

After writing it down, Ji Xiang came to the system space.

"Teacher, the cyst is very big." Ji Xiang said after reporting to the system NPC.

"It's not a cyst, or rather, it's not an ordinary cyst." System NPC said, "Consider it should be a huge hydronephrosis. ”

"Teacher, the water is all gone?"

"Yes." The system NPC nodded, "Generally, when hydronephrosis is found, there will be more or less kidneys remaining, maybe it is not functional, but it can be seen on the image." ”

"But giant hydronephrosis ......"

"Teacher, why is the name of this disease so strange?" Ji Xiang asked.

"It's just huge, there's nothing to describe." "It was first proposed in 1939 by Dr. Stirling that the concept of giant hydronephrosis was first proposed.

In other words, the water volume in the collecting system exceeds 1 000 ml, and the imaging shows that the fluid reaches or exceeds the midline of the abdomen, occupies half of the abdominal cavity, or the length of the fluid exceeds the length of 5 vertebrae. ”

"However, 1,000ml of stagnant water is not huge in clinical practice, and I have seen patients with more than 5,000ml."

"This one is at least 5000ml."

"Yes, but patients don't feel unwell and don't come to the clinic until they have complications, which is rare. Venous thrombosis of the lower extremities is caused by the compression of the inferior vena cava by massive hydronephrosis and the obstruction of the return flow and the reduction of blood flow rate. ”

"It's rare, and it's normal that your director hasn't seen it."

"The principle is the same as hydronephrosis, and the causes include ureteropelvic junction stenosis, vesicoureteral reflux, giant ureter, and posterior urethral valve, of which 80% of patients are caused by pelveropelvic junction stenosis."

"As for the treatment...... system NPC paused.

"Stenosis release surgery?"

"Ordinary hydronephrosis can do this, but the kidney on the side of the huge hydronephrosis is no longer functional, and if it is retained, the gains outweigh the losses, and it needs to be surgically removed."

Ji Xiang nodded.

"Don't underestimate this surgery." "Surgery for giant hydronephrosis is quite difficult to do. Although the concept was proposed in 1939, laparoscopic surgery was carried out in the last century, and laparoscopic treatment of giant hydronephrosis was not reported until 1991. ”

"Why, teacher."

"Because of the relatively long time, the dorsal membrane and peritoneum of the kidney are fused, and the local anatomical tissue is mutated, which makes it difficult to complete the operation with a laparoscope."

"If it's an open surgery, it's a little easier."

"Dr. Koji."

"Yes." Ji Xiang immediately responded.

He was a little sad, wondering if the system NPC was going to experience empathy himself.

"Let's train for surgery directly, you see me do one operation, and then try it a few times for myself." The system NPC said, "After you have done it yourself, you can understand why the surgery is so difficult." ”

"Don't empathize?" Ji Xiang asked.

"Patients don't feel anything until they find out about venous thrombosis, so there's nothing to try." The system NPC said, "If you fail the operation, you can give it a try." ”

Ji Xiang smacked his tongue and didn't dare to raise any more objections.

When you see the doctor of the healing department, remember the domain name for the first time: .w.8.2... m。 82 Chinese network mobile domain name: