In the operating room, anesthesiologist Qu Zi and the anesthetist nurse are doing general anesthesia for the patient.

Since the last time she spoke to Zhou Can, she has been appearing in the emergency department more and more frequently for surgery. When it is necessary to perform surgery on patients under general anesthesia and spinal anesthesia, Zhou Can will consult with her.

Sometimes, she felt that the surgery was too risky and did not agree to take the risk.

Zhou Can could only try his best to convince her.

Fortunately, she has a high degree of trust in Zhou Can's surgical ability, and the two have cooperated many times, and they have a certain trust foundation with each other. So in most cases, it was Zhou Can who successfully persuaded her.

After the patient was anesthetized, Zhou Can began to perform laparotomy on the patient.

Because the patient's physical condition was very weak, like a lamp that could go out at any time on a rainy night, Qu Zi was already nervous as soon as the operation was performed.

Fortunately, Zhou Can's surgery was not only fast, but also extremely stable.

At the time of laparotomy, there is a six-level incision, coupled with the blessing of the quick knife method and the stable knife method, it is really as smooth as flowing water.

Open the abdominal cavity and go straight to the ileocecal region where the source of the bleeding is located.

A large mass over 9 cm in diameter was found in the ileocecal region.

The walls of the lump are very thick.

"Good guy, why did you grow such a big lump?"

Dr. Xu stood next to him and fought for his apprentice, and was quite surprised to see such a big lump.

"It doesn't feel like a tumor, it's a lot of blood in it!"

Zhou Can's sixth-level debridement was not given for nothing.

Stared at the lump for a few moments, pressed it with his fingers slightly, and already had a number in his heart.

"Teacher, do you need to aspirate the fluid from the mass first?"

"It doesn't matter! This lump is also not very easy to suck, and it is estimated that it will break when touched. ”

Dr. Xu's surgical experience must have been many times richer than that of Zhou Can.

He said it was okay and basically didn't look away.

In terms of the caution of surgery, Dr. Xu called the second, and I am afraid that no one dares to call it the first.

After all, because he had an accident, he directly ruined his future and life. Once bitten by a snake, he was afraid of the well rope for ten years.

During the operation, Dr. Koh was not only strict with his doctors, but also with himself.

Even if he loves Zhou Can to the extreme, as long as Zhou Can dares to be careless during the operation, he will not be able to raise his head when he is scolded.

Zhou Can tried to move the mass with his hands in order to separate the adhesions between the mass and the surrounding tissues.

Crash!

I didn't expect it to break as soon as I moved it.

Blood flowed out immediately.

"Yang Zhi, suck up the accumulated blood!"

"Good!"

In fact, there is no need for Zhou Can to order, Yang Zhi is ready.

"If only you had one more handwashing nurse on your team, it would be more complete."

Nurse anesthetist Qin Yue said beside her.

She didn't talk much before, since the last time Qu Zi said that she wanted to be tied up with Zhou Can's team, she would always smile and nod when she saw Zhou Can. During the operation, she will take the initiative to point out some problems or deficiencies found.

"Alas, I would like to recruit another surgical nurse to help Qiao Yu share the pressure of work, but you also know that the surgeries I am currently doing are still mainly first- and second-level surgeries, and I can't support so many people!"

Zhou Can's statement is more modest.

With the horrific amount of surgery performed by his surgical team every day, it is completely possible to recruit a handwashing nurse.

However, this will definitely lead to a decrease in Qiao Yu and Ma Xiaolan's income.

Both of them are not in a good family situation, and they both want to make as much money as possible.

The work was a little tired, and the two had no complaints.

Zhou Can has no idea of recruiting another surgical nurse for the time being.

As he spoke, Yang Zhi had already sucked up the fluid in the mass.

"I feel that there is not only blood in this mass, but also rotten necrotic tissue, I'm afraid I have to cut off all of this intestine."

Zhou Can looked at the aspirated fluid and found that the patient's ileum was worse than he imagined.

It would have been nice if I had found it earlier, and maybe I could have cut a little less intestines.

It is even possible that it can be cured without surgery and with direct medical treatment.

After careful examination, he found that not only did the patient have signs of necrosis in the ileal segment where the mass was located, but also that the mesenteric lymph nodes were visibly enlarged and thickened.

"Cut!"

After seeing it, Dr. Xu agreed to remove the intestine and mesenteric lymph nodes.

After carefully cutting off this ileal and mesangial lymph node, Zhou Can only felt extremely comfortable in his heart. It's not that he has obsessive-compulsive disorder, but every time he helps a patient to cut out the lesion tissue, he feels a great sense of accomplishment.

[Quick knife experience +1, stable knife experience +1.] 】

At this moment, he sensed that there seemed to be a major breakthrough in his sword technique. I can't say how it broke through, it seems to be a matter of course.

In the past, when he performed the steady knife technique, the scalpel seemed to press against a mountain.

At this moment, there is a new understanding and breakthrough in the knife stabilization method.

When he holds the scalpel and lands on any part of the patient's body, there is a subtle sensation of landing.

The tip or blade of a knife is extremely sharp, and when it hits the skin or organs of the body, it will immediately cut the part where the blade is located.

Treating a scalpel as a 'foothold' is a madman's idea.

I'm afraid that no doctor dares to use the scalpel as a physical fulcrum when performing surgery.

Even a force of just 0.1 kilograms is enough to cause fatal injuries to the patient.

To regard the scalpel as a foothold, the surgeon's strength and use of the knife are required to reach a height that is difficult for ordinary people to achieve.

Zhou Can couldn't wait to check the medical attributes.

[Steady knife method, current experience value: proficiency level 1/100000, steady as a mountain, dexterous as a swallow, with a knife and feet as the fulcrum, like a three-legged tripod. It can be integrated into all surgical procedures with a knife. 】

As long as the effort is deep, the iron pestle is sharpened into a needle.

After years of practice, his sword stabilization technique was finally promoted to the second realm, the proficiency level.

When the knife is operated, the knife is a fulcrum of the body, forming a three-legged stand with the feet.

According to the laws of physics, triangles can form the most stable physical structure.

The wisdom of the ancients was extremely advanced, and the three-legged giant tripod had been cast in the Yu period to suppress the flood beasts.

The famous Kyushu Ding, a total of nine, all three-legged.

Zhou Can didn't expect that the second realm of the knife stabilization method turned out to be a three-legged momentum with the knife as a foot, and the feet formed a three-legged momentum. This kind of high-level comprehension of knife techniques is not something that the brain can imagine at all.

You can only practice it over and over again, practice makes perfect, and you can naturally understand the skills in practice.

It is also a profound understanding of the use of power.

I don't know if Director Hu Kan's second realm of stable knife method is also a three-legged stand?

Director Hu Kan has already done the past, I'm afraid there is no way to verify it.

The steady knife method and the fast knife method are the knife techniques that Zhou Can values the most, and each has its own merits.

Now that the Steady Knife Method has been promoted to the proficiency level, and the Quick Knife Method is also a proficient level, will it cause an imbalance of power between the two Sword Techniques, and affect his unique knife technique after the fusion of the Quick Knife Method and the Stable Knife Method?

After testing, he found that there was no effect.

On the contrary, because of the successful promotion of the stable knife method, the self-created knife method has become more stable and flexible.

After cutting out the diseased intestinal segment and enlarged mesenteric lymph nodes, Zhou Can performed debridement of the surrounding tissues and removal of suspicious secondary lesions.

Cancer doesn't have to spread.

If the ulcer is not treated promptly, it can also lead to the rapid spread of the germ.

For example, the most common gastric ulcer is usually self-limited. However, if the patient's physical condition is poor, or if it is not treated correctly in time, it may lead to an increase in the size of the ulcer.

The patient's ileal segment was cut off, and the lining of the intestine was 100% decayed.

It's not cancer, but it's not inferior to cancer.

This time, if it weren't for the shock caused by blood loss, the patient would have been delayed for a while, and the intestines would have broken directly.

When the time comes, just one intestinal perforation will be enough to kill him.

After intestinal perforation, intestinal contents enter the abdominal cavity, and peritonitis will definitely occur.

Zhou Can helped him operate, which is definitely equivalent to saving the patient's life.

In the process of debridement, the newly promoted knife stabilization method should naturally be used well in actual combat, and it will be addictive.

The biggest feeling is that debridement is easier, faster, safer and more perfect.

In the past, even if his debridement was promoted to level 6 and debrided a patient, he never dared to use the word perfect.

At best, it's just right, and debridement is excellent.

At this moment, he used the word perfection for the first time.

Don't look at the current just cleaning the ordinary surgical wound, if it is used to sweep away the dense lymph node tumor group, I believe he is also competent.

I believe that whether it is dissecting difficult body parts, or removing extremely difficult lesions, or separating extremely difficult adhesion tissues, etc., the stable knife method can help his surgical ability to reach a higher level.

By the time Zhou Can completed the operation and the cavity was closed, the patient's vital signs had been stabilized. Doctor Xu stared at Zhou Can in surprise and said, "Xiao Zhou, I saw your debridement just now, and your surgical ability has obviously gone to a new level." The knife is not only dexterous as a tongue, but also as stable as a mountain, it seems that there has been no less hard work in the past two years! ”

"Hehe, it's still the teacher's eyes that are vicious, and I can't hide anything from you. The level of knife technique has indeed made a breakthrough in the operation. ”

Zhou Can's strength has reached a higher level, and his mood is also excellent.

The removal of part of the ileal and mesenteric lymph nodes is nothing.

At least many deputy directors and chief physicians of surgery have this surgical ability.

But to find out the cause of this patient, and quickly complete the operation, successfully save the patient's life, all combined, it is quite good.

"What broke through was Lao Hu's steady knife technique, right? You have to work harder on the fast knife technique I taught you! ”

There was a sour taste in Dr. Xu's tone.

Seeing that Ai Disciple had made a major breakthrough in the steady knife technique, but the fast knife technique had been tepid, he was obviously a little surprised.

"The fast knife technique has not been left behind, and I have been practicing! I just want to make a breakthrough, in addition to hard training, chance is also very important. I don't know when I will break through, and I will make you happy and happy when the time comes. ”

Zhou Can's fast knife technique has already been promoted to the proficiency level, and if he wants to be promoted to the next realm, the experience points required will increase tenfold, how can it be so easy?

"By the way, has the cut intestine been sent for testing?"

Zhou Can asked Dr. Pu.

At present, he can only run errands for this kind of chores for inspection.

"It has been sent for pathology. It is estimated that the report will be released a little later. ”

Dr. Pu replied.

……

Towards the end of the afternoon, the patient's pathology report came out.

The intestinal wall of the intestinal segment sent for examination is thickened, and the incision is soft, fishy-like, and necrotic. Microscopically, a large number of reticuloendothelial cells proliferate in the intestinal lymphoid tissue, forming macrophages, phagocytes, red blood cells, and nuclear fragments can be seen in the cytoplasm, and some intestinal wall ulcers are formed and necrosis.

Seeing this, Zhou Can couldn't help but secretly admire Director Shang of the Department of Gastroenterology, the patient was indeed enteric typhoid fever.

As long as macrophages are formed, the diagnosis of enteric typhoid fever is basically 100%.

He then looked down and sent for swollen lymph nodes, and typhoid cells were visible under the microscope.

These changes are consistent with typhoid fever.

Now, the cause of the patient's high fever has finally been solved, the maximum source of bleeding has been successfully found, and the bleeding has been successfully stopped by surgery.

Necrotic bowel segments were also removed.

As long as the lesion progresses to the typhoid stage, it means that the lesion site has entered the necrotic stage.

From this case, Zhou Can learned a lot.

It is also a rare cause among the many difficult cases he has encountered.

Typhoid fever has been incurable since ancient times.

Traditional Chinese medicine even developed a typhoid faction based on typhoid fever.

He summed up the diagnosis experience and decided to write a diagnosis experience after work, believing that the next time he encounters a similar case, he can avoid many detours.

Now that it has been clearly diagnosed that the patient has enteric typhoid fever, it is easy to do.

The bleeding has stopped, and only anti-infection, anti-typhoid treatment is required.

On the third day, the patient's body temperature had returned to normal. Vital signs have also leveled off. There were no more symptoms such as continuous drop in blood pressure and shock.

In view of the fact that this patient also has gastric ulcers and old bleeding, it means that the patient's usual diet and work and rest rules are very poor.

A 20-year-old man is the golden age of the best body.

The entire digestive tract has become dangerous, even to the point of enteric typhoid fever.

Zhou Can felt that it was necessary to talk to the patient's family.

Unexpectedly, the child's father saw that his son's condition was improving and had already gone back to work. A father's love for his children is as thick as a mountain, but it is extremely silent.

He is the breadwinner of the family, and his son has spent a lot of money on his treatment, and he has to work hard to earn money to support the family.

The child's mother obviously can't control her son, and she is almost obedient to her son, and treats her son like an emperor.

Seeing this scene, Zhou Can couldn't help but fall silent.

Doctors can cure patients' diseases, but they can't change the patient's family education environment, let alone change the patient's bad habits.

Out of the doctor's sense of responsibility, Zhou Can still decided to talk to the patient himself.

In terms of age, Zhou Can is not a few years older than the patient.

After work, after checking the ward, Zhou Can sat down in front of the patient's bed.

The patient's mother was very polite to him.

After all, it was Zhou Can who cured her son's illness.

Seeing her son's condition improve day by day and be pulled back from the ghost gate by the doctor, she is full of gratitude to everyone who has participated in the treatment of her son.

"How old are you now?"

Zhou Can didn't know how to get close to people, because usually others took the initiative to get close to him.

I can only find something to say, so I talk to the patient first.

"Freshman!"

"The freshman year is good, I have just been freed from the bitterness of the college entrance examination and entered the university campus, and I can live a very relaxed and comfortable life. If you're lucky, you might even get a beautiful girlfriend. ”

"Hehe, that's not it! Compared to my previous high school life, I also feel that college life is simply heaven. ”

Patients were resonated by his words.

"Have you talked about girls?"

Zhou Can asked.

The patient subconsciously glanced at his mother, who was standing next to him, but did not speak.

This kind of thing, both men and women, will avoid their parents.

(End of chapter)