"Come, lie down on the stage! The prone position is more convenient to operate! ”

Zhou Can guided the middle-aged uncle to lie down on the operating table.

The shape of the foreign object is conical.

It's puzzling how this thing could get into an adult's rectum.

And judging from the film filmed, the diameter of this foreign body is quite large. The possibility of eating it is almost none. If nothing else, this volume alone cannot pass through the narrow esophagus and small intestine.

So, it's definitely stuffed in.

"Doctor...... Do you need to inject anesthetics for this? ”

"If you need surgery to remove a foreign body from the anorectum, you will definitely need to take anesthetics. Spinal anesthesia is often used, which is often referred to as subarachnoid block anesthesia, also known as hemibody anesthesia. This surgery will be very difficult, and it will be necessary to open the abdomen and then cut the intestine to remove the foreign body. ”

Zhou Can patiently explained to the patient.

It is also to tell the other party the seriousness of the operation.

"Isn't it useless for you to defecate?" Zhou Can asked.

"It didn't work if I tried! I also deliberately drank half a bowl of cooking oil, but it didn't have any effect at all. The middle-aged uncle replied weakly. From the expression on his face, it must be painful at the moment.

The heart is full of fear.

"You must be careful in the future, this time it is more fortunate that the intestine did not rupture. If the intestine is punctured and the fecal fluid enters the abdominal cavity, the infection can be life-threatening. Intestinal tears and heavy bleeding are equally dangerous. ”

They are all adults, and Zhou Can can only remind each other like this.

There is a certain element of scare, but his intentions are good.

After intestinal rupture into the abdominal cavity, intestinal contents can cause serious bacterial infections and even sepsis, which can be life-threatening. Intestinal contents into the abdominal cavity can cause chemical peritonitis, severe pain, and even shock.

It can indeed be lethal.

Even with current medical conditions, the prognosis of intra-abdominal infection is still poor, and death occurs from time to time.

In the early years, there were many cases of abdominal surgery due to the accidental spillage of intestinal contents, which contaminated the abdominal cavity, and eventually led to the death of patients.

Zhou Can first used a dilator to expand the patient's anus, and then clamped the tail of the cone foreign body with a clamp.

Luckily, the cone is pointing inward, otherwise it would be much more difficult to get out.

"Qiao Yu, slowly inject some lubricant into it."

Zhou Can grabbed the foreign object and pulled it out with a slight force.

At the beginning, the card was very tight, and as long as he used a little force, the middle-aged uncle let out a miserable scream. Fortunately, after a slight loosening, the situation is much better under the action of the lubricant.

It took a lot of effort to finally pull the foreign object out.

Zhou Can checked it, and his intestines did not rupture, so he breathed a sigh of relief.

"What is this?"

Qiao Yu stared at him curiously.

"Don't ask too much about the children." Zhou Can found that Qiao Yu was as pure as a blank piece of paper.

He put on the middle-aged uncle's pants and prescribed a doctor's order, which was actually an opening box of anti-inflammatory drugs.

"When you go home, try to eat more vegetables and fruits to prevent colonization. If you feel unwell, seek medical attention promptly. ”

"Okay, thank you, doctor!"

The middle-aged uncle looked a little embarrassed, and under the leadership of Ma Xiaolan, he hurriedly left the operating room.

"Hey, you were talking too much just now! What a child's family, they are already twenty-five years old. Qiao Yu protested a little unhappily.

"Sorry! The next time I speak, I must pay attention to the words I use. Don't be stunned, Dr. Luo, hurry up and throw that thing in the trash! ”

Zhou Can apologized to Qiao Yu and instructed Luo Shishen to dispose of medical waste.

The first patient was processed, and the second was brought in.

The patient had an intestinal emergency, acute pyloric obstruction, and required emergency surgery.

The symptoms of pyloric obstruction are mainly nausea, belching, anorexia, stomach distention, etc.

Ordinary pyloric obstruction is usually treated with medication.

In acute pyloric obstruction like this, patients have serious adverse reactions, such as severe vomiting, dehydration, fatigue, oliguria, thirst and a series of symptoms. The internal medicine treatment in the hospital was ineffective, so he came to Tuya yesterday for emergency treatment.

After evaluation, it was indicated for surgery.

Emergency surgery is performed by the emergency department.

Surgeries like this are major surgeries and are generally elective surgeries.

This patient also has a stomach ulcer, and if it is delayed any longer, there is even a possibility of malignant transformation.

After the patient enters the operating room, the anesthesiologist follows in.

He is the director of Dongfang Luoxue in the Department of Anesthesiology.

Zhou Can doesn't need to go to cardiothoracic surgery to study with Director Hu Kan recently. Therefore, since Director Hu's death, he began to fulfill his promise, and at least three or four days a week, after getting off work, he went to the anesthesiology department to learn anesthesia techniques and knowledge from Director Xu.

There is little textbook knowledge in anesthesiology, and there is a high degree of overlap with the medical knowledge of clinical general practice.

The improvement of anesthesia technology mainly depends on practice and is obtained from clinical experience.

Each of the surgeries in which Director Yu participated was a third- or fourth-level high-risk major surgery. His strength is undoubted, and he belongs to the top anesthesiologists in Tuya Hospital.

Senior, experienced and skilled.

Many people find him an eccentric personality, difficult to get along with, and afraid to deal with him. Zhou Can felt that Director Yu had an extremely passionate heart for anesthesiology, and devoted his whole life to the study, accumulation, and improvement of anesthesiology.

In ancient times, it was described as a martial idiot who devoted himself to martial arts and did not ask about mundane things.

Director Yu is a 'medical idiot' in anesthesia.

In this world, the most terrible thing is that a person concentrates on one thing all his life. Ten years, decades of accumulation, that's very terrifying, and they are often able to achieve extremely high levels of achievement in the field they delve into.

Zhou Can's enthusiasm for anesthesiology was not high at first, and he simply felt that he was not overwhelmed by his skills, so he followed Director Yu to learn.

Later, after learning a lot, especially after following Director Hu Kan to learn the surgical knowledge and diagnosis and treatment knowledge of cardiothoracic surgery, he gradually discovered that anesthesiology is good.

First of all, anesthesiology has a thorough understanding and study of the three major cycles of the human body, as well as the internal and external circulation. Secondly, it has in-depth research and practical accumulation of the nine major systems of the human body, especially the research of the nervous system, respiratory system, circulatory system and locomotor system, which is extremely in-depth.

It can be said that internal medicine is the group of people who understand the mechanism and pharmacology of the human body the most.

But anesthesiologists are the group of people who know life best.

How to support life and ensure the maintenance of life, anesthesiologists call it second, and no one dares to call it first.

After learning anesthesia knowledge, Zhou Can can clearly feel the great benefits in clinical practice. Even the idea of surgery can change because of anesthesia.

He also found that there was a certain degree of interoperability among the various disciplines of medicine.

Medicine is somewhat like a circle, and without any of these sections, the circle is no longer coherent.

Studying anesthesiology well can greatly improve the depth and coherence of overall medical understanding.

For ordinary people, it is very good to learn a medical field well in a lifetime.

Because Zhou Can has an experience value system, he has a great advantage in this regard. The road that others can only complete in ten years, he may be able to accumulate experience points in two or three years, or even less, from quantitative change to qualitative change.

With this huge advantage, it is destined to give him the time and energy to study more medical fields.

It is impossible to study all areas of medicine thoroughly.

But it shouldn't be difficult for him to reach a certain level in multiple medical fields.

At least he has now reached a fairly high level in most fields such as general surgery, intensive care medicine, cardiothoracic surgery, nephrology, gastroenterology, etc.

Now in the emergency department, he leads the surgical team to perform crazy surgeries, and almost all surgeries can be accessed.

I believe that as long as he continues to accumulate, he will continue to climb to new heights in more fields of medicine.

The snow in the east is as cold as ever, like the legendary iceberg beauty.

Because she is over forty years old, her age is there, and at most she still has charm.

"Want to help?"

Zhou Can greeted her with a smile.

"Good!"

She only replied with one word, and at the same time, she tried to squeeze out a smile on her face to respond to Zhou Can.

Maybe it's because I'm used to having a cold face, so the smile I squeeze out is extremely stiff.

But for her, it was not easy.

"Director Dongfang still looks better when he smiles, looks more cordial and beautiful!"

Zhou Can did not hesitate to praise her.

In the past year, before Director Hu Kan passed away, he would go to the anesthesiology department at least once a week to study with Director Yu. Gradually, I got acquainted with the doctors in the anesthesiology department.

The doctors in the anesthesiology department treated him as half of their own.

Dongfang Luoxue's attitude towards Zhou Can is so friendly, she is obviously a chief physician, but she treats a resident doctor with a level attitude, it is because she has seen Zhou Can's strength.

If you don't accept it, you can't.

got Zhou Can's praise, and there was no expression on her face. But the eyes betrayed her, at least she could see that her heart was happy.

Zhou Can helped to administer general anesthesia to the patient while understanding the patient's condition.

Before Dongfang Luoxue signed the anesthesia consent form with the patient, he must have had an in-depth understanding of the patient's situation. Zhou Can learned again because of his own need to learn.

It is also to ensure that there will be no major mistakes in the operation and eliminate potential safety hazards.

"Come, lie flat! When you are given surgery, it is in a supine position. Relax is the equivalent of a good night's sleep, and when you wake up, your illness has been solved. ”

Zhou Can comforted the patient and guided the other party to lie flat.

Pyloric obstruction surgery is usually performed in a supine position, with an incision from the middle of the upper abdomen or an incision from the left upper rectus abdominis muscle.

Patients sometimes prefer to lie on their side because of the pain.

The whole process of general anesthesia went smoothly, and the patient was soon in a comatose state with normal signs.

"Dr. Luo, the incision of this kind of pyloric surgery must be combined with the actual situation of the patient. Don't do it. You only need to remember the principle of which incision method is more conducive to the convenience of surgery and the prognosis of the patient. When the two can't be taken into account, weigh the pros and cons and choose carefully. If the technique is not available, then choose an incision that is more convenient for surgery. ”

Zhou Can was quite careful about the cultivation and teaching of the Luo gentry.

It's basically an ear-to-ear life.

As for how much he can comprehend and remember, that's his own business.

Dr. Xu stood next to him and didn't speak, giving Zhou Can a check and a seat.

Now, he basically belongs to the release stage for Zhou Can.

As long as Zhou Can can do it himself, he will not interfere. It is this kind of bold delegation of power that allows Zhou Can to get a very valuable opportunity to exercise and improve alone.

"Stop the bleeding!"

After Zhou Can cut open the patient's abdominal wall, blood gushed out.

In fact, he had avoided the larger blood vessels.

As long as it is surgery, bleeding is inevitable. In particular, the potential risk of major bleeding is extremely high.

Surgeons who are not experienced enough and cannot reach a certain level of surgical skills do not dare to operate on the patient's chest, abdomen and other vital parts.

If you don't have that certainty, if you forcibly operate, there is a high probability that something will happen.

Luo Shishen hurriedly electrocoagulated the patient's wound site to stop bleeding.

"Xiao Luo, I have to practice more when I go home. I'll do it! ”

Dr. Xu couldn't stand it anymore.

With his strict requirements for junior doctors, this frizzy operation is simply a challenge to his bottom line.

That's why interns aren't qualified to be a helper at all.

If it is only a first- or second-level operation, the intern may be barely competent as a medical assistant.

Level 3 and 4 surgeries, let alone interns, or senior residents, may not be able to do it.

Zhou Can's demon is still a minority after all.

Even a returnee doctoral student like Du Leng is far inferior to Zhou Can in the field of surgery. To put it mildly, he doesn't even deserve to lift his shoes.

It's not hubris, it's really unworthy.

When Du Leng entered surgery, he was actually not wise.

With his profound medical knowledge, he should go to internal medicine, and his development may be better.

The path is all chosen by oneself, and sometimes it depends on a little luck.

Now, more than three years have passed. Du Leng was already the attending physician outside the gods, and I heard that he had been exercising in the general outside for nine months. How is the development now, Zhou Can really doesn't know.

It's not as high-profile as it used to be, it's true.

Without that strength, the department and the doctor would not give him a high-profile opportunity.

Several geniuses who entered Tuya Hospital at the same time as Zhou Can are basically working hard to improve silently. Including Gao Jian, who entered the Department of Internal Medicine, I heard that the outpatient number had been opened not long ago, and I began to sit for consultation.

However, compared with Zhou Can, it is definitely not a level.

Zhou Can has been in the pediatric clinic for more than a year.

The accumulation of popularity and experience is not comparable to high insight. The level of diagnosis, medication, treatment plan, prognosis evaluation, etc., even if Zhou Can is lying down and no longer progresses, it will take at least ten years for Gao Jian to catch up with him.

Not bragging.

It is only the level of pathological diagnosis and pharmacological syndrome differentiation at the level of deputy director, which many doctors cannot reach in a lifetime.

Most good doctors, who have a bit of talent, want to reach this level and go up for at least twenty years.

Tuya Hospital included Zhou Can, an undergraduate, in the reserve quota of the Famous Medical Hall, and Zhou Can was still in the stage of regular training at that time, and he had not even obtained the certificate of completion of regular training. It is enough to show that he is extraordinary.

The hospital's decision-making in this kind of matter has an extremely strict review mechanism.

Du Leng has such a dazzling academic background, and now he has entered the reserve quota of the famous medical hall, and he has not even seen a shadow.

You can know how difficult it is to enter the reserve army of the famous doctor's hall.

……

The surgery went smoothly and was completed in less than two hours.

However, because of the two most powerful knives in the emergency operating room, Zhou Can and Dr. Xu are both operating on this patient, resulting in a backlog of other emergency surgery patients.

In another operating room, Dr. Cui, who is actively seeking a contract with the attending physician, is working hard to perform the operation.

His surgical level has been able to reach the level of the indicator.

In terms of speed, it is far worse than Zhou Canke.

It is worth mentioning that Dr. Xu did not perform the surgery very quickly. On the one hand, he was afraid that something would happen again, and the operation became cautious. No longer blindly pursue the speed of surgery. On the other hand, Dr. Xu is old after all, and his physical strength and energy cannot keep up.

After the age of thirty-five, the physical strength and energy of a man will be significantly inferior to that of a young man in his twenties.

Men over the age of fifty, called old men, will have worse physical strength.

Therefore, the absolute main force in the emergency operating room is Zhou Can.

The surgery was done quickly and well done.

Moreover, meat and vegetables are not taboo, and almost all kinds of surgeries can be done.

(End of chapter)