It's just that the Third Hospital was the first to hit Tuya Hospital, which is a bit like a stupid rabbit picking on the grass on the edge of the nest.

Zhou Can began to study this rotten patient carefully.

The patient was diagnosed with a sternal tumor and underwent extensive sternalectomy and chest wall reconstruction.

At present, the patient has postoperative incision infection and sternal osteomyelitis, resulting in long-term non-healing of the wound.

The Third Hospital has tried many ways to treat patients, but unfortunately it has not been effective. The family feared that the patient would die in the Third Hospital if he continued to be treated. So he 'took the initiative' to ask for a transfer.

According to the family's introduction, the doctors and nurses at the Third Hospital, including the family members of the patients who shared the room, all said that the medical skills of Tuya Hospital were excellent.

Two days before the transfer, when the nurse gave the patient an infusion, she developed severe edema due to long-term infusion of the indwelling needle.

When the needle was pricked with the other hand, the nurse made a mistake and punctured the vein three times in a row.

The original bedside doctor asked for leave because of something at home, and changed to a new bedside doctor, who was frizzy and irresponsible. The family members and patients reported the problem to the doctor in charge of the bed, which was also perfunctory.

At this time, a patient's family member in the same ward secretly told them that they had heard that the Department of Cardiothoracic Surgery at Tuya Hospital had recently treated a number of difficult cases.

The family was moved.

Strong request for hospital transfer.

The corners of Zhou Can's mouth twitched, aren't these riotous operations of Xinxiang Hospital clearly persuading patients to transfer to the hospital? The family members don't understand the Tao, but he knows it.

Another interesting point is that Xinxiang Hospital desperately touted Tuya Hospital's medical skills, is this from the bottom of his heart, or has he received the kindness of Tuya Hospital and given Tuya Hospital some returns?

It's hard to say this kind of thing.

To say that it is a bit of nonsense to say that it is grateful.

At the beginning, Xinxiang Hospital followed the Provincial People's Hospital and the Third Hospital to encircle and plunder Tuya's cardiothoracic surgery business.

It may be that Tuya Hospital sent a team of experts to Xinxiang Hospital for consultation, which left an indelible impression on them.

Tuya's strength has been deeply rooted in the hearts of the medical staff of Xinxiang Hospital.

In addition, Tuya's cardiothoracic surgery has been very high-profile recently, and there are many difficult cases that have been successfully cured or obviously effective every once in a while. It is also a powerful impression to outsiders.

The patient's cause is clear, postoperative infection, accompanied by sternal osteomyelitis.

The difficulty lies in the treatment.

Xinxiang Hospital gave various anti-infective treatments to patients after they developed postoperative infections. It's a pity that I can't control it at all.

Sometimes, antibiotics are not a panacea.

In particular, some severe infections are a little weak with antibiotics alone.

To use the simplest analogy, a patient has an abscess in his body, which is infected and inflamed. In this case, antibiotics are used for intravenous infusion. As long as the abscess cavity exists, no amount of antibiotics can only suppress the disease, but it is difficult to cure.

The correct approach is to drain the pus from the abscess cavity and then remove the abscess cavity to ensure that there is no source of infection before giving antibiotics.

In this way, the goal of healing can be achieved.

In addition, the use of any kind of antibiotic comes at the cost of destroying the immune system.

Doctors with real level and experience are cautious when using antibiotics.

Some patients especially like to go to small clinics for intravenous drips, and if they have a little headache and brain fever, they go for infusion therapy. It often works quickly, and an infusion is quickly improved. But the next time you catch a cold, it's even more severe.

This is because the use of antibiotics weakens the immune system.

In recent years, many domestic pediatric experts have proposed that the vast majority of breastfeeding babies with colds and fevers can be cured with the help of antibodies in breast milk. Every time a baby heals itself through its own immunity, the body's immunity becomes stronger.

This is equivalent to the baby's immune system being naturally tempered again and again in order to adapt to the environment after the baby comes to this new world.

If some family members are too worried about the baby, they will take the baby to the hospital for injections and medicines at every turn, which will cause the baby's immune system to miss a good opportunity to exercise again and again.

The bodies of these children, after weaning, are significantly weaker.

Therefore, in recent years, the call for breastfeeding has become more and more popular.

It can not only prevent babies from drinking poisoned milk powder, but also enhance the baby's immunity with the help of natural antibodies carried by breast milk.

The postoperative treatment of this patient at Xinxiang Hospital is mainly anti-infection.

This is somewhat similar to the abscess treatment described above, where the abscess cavity is not cleared, only antibiotics are given.

The source of the infection must first be found and eliminated, and then antibiotics must be administered to make it possible.

From this point of view, it can be seen that the foundation of Xinxiang Hospital is insufficient.

Sternal resection and chest wall reconstruction failed to stump the surgeons at Xinxiang Hospital. However, there was a problem with postoperative management, and the retreatment of postoperative infection directly stumped them.

Zhou Can began to carefully sort out each surgical link, as well as the various examinations that the patient did after surgery.

The surgery is not complicated, the basic steps are general anesthesia, endotracheal intubation, and then the location of the sternal malignancy is determined and the incision is selected.

The skin and subcutaneous tissue are incised, the sternal lesion is exposed, and the muscles attached to the sternum are severed.

The lesion and some of the surrounding normal tissue are then removed.

For the resection of this malignant tumor, as long as the surgeon with a little experience will choose to make multiple incisions, and will not be soft.

Because some adjacent tissues that seem normal are likely to have metastasized tumor cells.

The harm of incomplete surgery is very great.

Patients will soon relapse again.

The vast majority of malignant tumors grow the more they are stimulated.

The typical road is one foot high, and the magic is one foot high.

Resection of the lesion is standard and there are no problems.

Zhou Can locked his eyes on the chest wall reconstruction surgery in the back.

Because the patient did not develop an infection before surgery, an artificial material was chosen to reconstruct the chest wall.

They chose plexiglass plates.

After the reconstruction of the chest wall, Xinxiang Hospital placed a drainage tube when the incision was sutured according to the surgical requirements.

If the postoperative defect is large like this, it will definitely require a drain.

Only if the chest wall defect is small, the incision can be sutured directly without drainage.

"Is there a problem with artificial materials?"

Zhou Can has rich experience in surgery and is well-informed, and has been taught by Director Hu Kan.

After some combing, combined with the patient's symptoms, he quickly identified the most likely cause of postoperative infection.

The working attitude of the medical staff of Xinxiang Hospital is a little perfunctory, but Zhou Can has seen it.

The possibility of infection caused by non-standard postoperative care cannot be ruled out.

He decided to visit the patient in the ward for further diagnosis.

Coming to the ward, he saw the patient, male, in his forties.

The patient's medical record information shows that he is 48 years old.

Fifty knows the destiny of heaven.

48 years old is already an age that is not old, and the body's metabolic level and recovery ability at this time are not as good as those of young men.

The incision on the patient's chest is clearly infected.

Because of the continuous use of antibiotics, there is redness and swelling, but there is no obvious suppuration.

The situation is quite ideal.

It is estimated that when the cardiothoracic surgery department received the patient, it had already passed the check. It is really very serious, and the patients who have a high chance of dying will naturally not be accepted.

"How are you feeling now?"

Zhou Can finished checking and asked the patient.

Since ancient times, diagnosis has been expected to be inquisitive. Asking the patient how they are feeling can help the doctor better understand the patient's condition.

Why is pediatrics refractory?

Many children under the age of three do not clearly express the location of pain or where they are uncomfortable.

I just know that it is uncomfortable.

Looking at this kind of 'dumb medicine', the doctor will be more laborious and laborious.

"It hurts! Fever, can't eat......"

The patient struggles to speak, with a pained expression on his face.

When speaking, the wound that pulls into the chest causes pain.

If the wound is not infected and heals gradually, this problem will not occur.

"Doctor, I can accompany you to the office to talk if you have any questions, my dad is very uncomfortable now, and he has already expressed any symptoms to your doctor in charge and Director Xue. Please understand and try not to ask the same questions over and over again. ”

The patient's daughter was wearing a fur, high heels, and black leggings.

Even when I was accompanying the nurse in the ward, I painted my eyebrows and wore bright lipstick.

He is not very old, only about twenty-four or five years old.

The melon seeds have a pointed face and chin, delicate facial features, big eyes, and they look quite beautiful and smart.

It's just that the words are not polite at all, and they seem very strong.

"The patient's condition is constantly progressing and changing, and the symptoms will be different. We ask our patients every day about their latest feelings, and it seems to be repeating the same questions, but we are responsible for them. If there are any new changes, we can also find out in time. ”

Zhou Can can deal with this kind of sharp-mouthed family member, and he can already be calm and calm.

"Okay, okay, I can't beat you. If my dad has any new situation in the future, I will find the doctor in charge of the bed in time, or report to her during Director Xue's rounds. Please try not to disturb my dad's rest again. Feel free to ask me any questions. ”

The woman said impatiently.

She obviously regarded Zhou Can as an ordinary doctor, but she didn't know that the person in front of her was even better than Director Xue.

"Got it!"

Zhou Can nodded and walked out of the ward.

It is extremely unwise to quarrel with family members.

Some family members think they know a little about the hierarchy of hospitals, and during the hospitalization of their loved ones, the person who dare not offend them is the chief physician. Secondly, for the bed, the doctor will also try his best to curry favor.

As for the nurses and other doctors, they didn't bother to wait.

Anyway, it doesn't affect the patient's treatment.

Of course, when encountering such snobbish family members, nurses and other ordinary doctors often feel particularly aggrieved and suffer from some idleness. But few people care.

In these years, it is the uncle who does not simply owe money, but the grandson who asks for the account.

In the hospital, some patients and their families hold the trump card of complaint, and they are really in front of the hospital.

Because they believe that the consumer is God.

They spend money on medical treatment, and naturally they want to enjoy God-like treatment.

It can only be said that medical care should never be a service industry, but a resource. A valuable resource that can save lives when it matters most, heal when sick, and restore patients.

Really let the medical staff smile and grovel to the patients and family members like hotel waiters, which is absolutely the sadness of all patients.

In developed countries, a whole new kind of medical industry is now emerging, the private medical team.

When a patient is sick, as long as they can afford to pay for it, this team can provide the highest quality care and absolutely professional. The only drawback is that the price is a little expensive, even in a beautiful country, a single treatment may directly bankrupt a medium-sized family.

Many people are sick and would rather stay at home and die than be dragged for treatment.

Because it's too expensive, I can't afford to treat it.

Zhou Can returned to the office and continued to think about the cause of the postoperative infection in this surgical patient.

"If the assumption is correct, it is the patient who used artificial materials for chest wall reconstruction, and this non-vascular reconstruction material caused difficulty in healing, coupled with inadequate care, which led to postoperative infection."

[Pathological Diagnosis Experience +1, Reward Pathological Diagnosis Experience +100.]

And so it was.

His gaze brightened.

At this time, Director Xue heard that Zhou Can was coming after the operation, and took the initiative to look for him in the big office.

"Zhou Can, I heard that you just went to the ward to learn about the situation of the 73-bed patient. The patient was a refractory patient who had undergone surgery at Xinxiang Hospital and had a postoperative infection. Is there any progress on you? ”

After she divorced her husband, she focused on work, but she used the high-intensity work pressure to get through the saddest days.

Zhou Can and Director Le knew that she was divorced, and they also gave her a lot of extra care.

It's just that I heard that her husband is really not a thing, and after the divorce, the competition for property is particularly powerful. Even the only housing has to be occupied, so Director Xueyan can only rent a house now.

In the process of confrontation between women and men, they are ultimately in a weak position.

The man occupies the house, and the woman's maiden family does not have a few men, so it is difficult to get it back.

If a woman dares to rob it, most of them will be beaten.

The only way is to resolve it through the law, but this will take time.

Director Xueyan told Zhou Can about this, and her idea was to give up the fight for the house, as long as she could really break off with the man, and stop pestering her in the future. In addition, she gave up the house in exchange for custody of her children.

This is someone's family matter, and in addition to respect, Zhou Can is to give some help within his ability.

"There has been some progress. I suspect that the patient developed a postoperative infection, most likely due to the artificial materials used to reconstruct the chest wall, which made it more difficult for the wound to heal, and improper postoperative care. ”

In fact, it is not a good thing for any wound to have difficulty healing.

Even with proper care, the risk of infection can increase exponentially.

"I also suspect it's caused by artificial materials. I was worried about the instability of the patient's chest cage by removing the artificial material and performing a simple soft tissue reconstruction. Do you have any good solutions to solve it? ”

Director Xue Yan and Zhou Can are both senior apprentices of Director Hu Kan, and her level in the diagnosis of cardiothoracic surgery is also very high.

"There is a way, anyway, you need a second operation, it is better to do a larger operation again. This time it can be taken from the reconstruction of the body bone. Ribs are actually an ideal material. ”

Zhou Can proposed a surgical plan.

(End of chapter)