If it weren't for Zhou Can's insistence on exploring the pancreas, this small tumor would not have been found at all.

Why is pancreatic cancer scary?

Because the clinical manifestations of pancreatic cancer are not specific, and there is a lack of accurate direct examination methods, early diagnosis is extremely difficult. Most people diagnosed with pancreatic cancer have advanced stage and have lost the opportunity for radical surgery.

It has a high mortality rate, with a 5-year survival time of less than 5%, which is why it is called the king of cancer.

Although other chief physicians also found out that there may be injuries to the pancreas through films, they did not take it seriously. Because the bleeding is not serious and has stopped. Considering that the patient's body is extremely weak, we try not to do surgery if we can do it as much as possible.

Including the patient's current fractures of both legs and right arm, it will not be treated for the time being.

This is also the basic procedure of first aid.

Fatal injuries are treated first, followed by general trauma.

This type of limb fracture is usually less life-threatening. It's completely post-processed.

Unless the femoral artery is punctured or a deep vein thrombosis of the lower extremities develops, the condition must be treated immediately.

Other chief physicians thought that the pancreatic injury could be done without surgery, indicating that they must not have noticed a major problem with the pancreas. But Zhou Can insisted on investigating the situation of the pancreas, is this a coincidence, or has Zhou Can already discovered something?

Director Gou Qian couldn't help but start thinking about this matter secretly.

If Zhou Can could find out in advance that there was a tumor in the pancreas just by looking at the film and auxiliary test results, it would be too powerful.

With such a powerful level of diagnosis, even the director of Gou Poor does not have it.

"Director Gou, do you think you can remove the laparoscope?"

Zhou Can asked.

With almost magical top-level technology to remove pancreatic tumors, Zhou Can's surgical strength has been deeply rooted in the hearts of every doctor present.

Including the itinerant nurses who don't look down on him very much, their attitudes towards him are also quietly changing.

When she discovered that there was a tumor in her pancreas, the traveling nurse was shocked.

She had to be impressed by this young doctor from Tuya.

"The operation is very well done, let's remove the lens!"

After the endoscope was removed one after another, a catheter was needed because of the presence of fluid in the abdominal cavity. One is drainage, draining new fluid that may have formed. The other can also be used to observe bleeding in the abdominal cavity.

If the repaired blood vessel ruptures again, the amount of fluid that drains out will increase, and the color may be red blood.

It seems to be a simple drainage tube, but it also has a lot of exquisiteness.

It is necessary to avoid the drainage tube becoming an introduction tube for bacteria and viruses.

It will bring certain difficulties to nursing and postoperative management.

The laparoscopic surgery was successfully completed, and then the most difficult intracranial hemostasis surgery was performed.

The amount of bleeding in the skull is not particularly violent, but there is no way to stop the bleeding on its own, it is fatal.

"Director Ming, can the patient's condition still withstand a craniotomy?"

Director Wu Yongming, whether he wants to or not, must gnaw this hard bone.

Intracranial hemostasis must be done in patients.

"The patient's signs are now stable and his breathing is a little stronger. I don't think it would be too much of a problem to endure endoscopic surgery. ”

Director Mingxin made a comprehensive assessment of the patient's condition.

Not bad.

Many signs improved.

And important signs such as blood pressure and heart rate have become more stable, even more stable than before surgery. That's pretty good.

It also provides the basis for the subsequent intracranial endoscopic surgery.

"Okay, then I'll get to work. Director Gou, Dr. Zhou and others have put in so much effort and won the first battle, I have no reason to drop the chain. After Wu Yongming finished speaking, he had already begun to cut the scalp layer at the predetermined position of the patient's head and make a cross incision......

Soon it was the turn to drill the patient's skull.

The human skull is like a hard turtle shell, which protects the nerves, brainstem, cerebellum and other important tissues of the entire brain and head.

To have intracranial surgery, the skull must be sawed open.

Traditionally, the skull is removed, which is a major project. Now, with the advancement of science and technology, doctors can directly drill a small hole in the skull and insert the endoscope into the cranial cavity for surgery.

Not long after the drilling was underway, the life monitoring equipment emitted a screeching alarm.

The patient's blood pressure plummets, and the heartbeat plummets, which means bradycardia.

Frightened, Director Wu Yongming hurriedly stopped drilling.

"Is this a hole that hurts brain tissue?"

Director Mingxin asked anxiously.

Others are also somewhat skeptical of Wu Yongming's operation. Skull drilling is inherently a very dangerous operation and requires a high level of skill from the doctor.

"No, the skull hasn't been pierced yet!"

Wu Yongming also looked aggrieved.

It is not the first time that a patient has undergone cranial endoscopic surgery, and the operation has been decent.

Sometimes, this is the most feared thing about surgery.

And I don't know what the problem is.

"The drop in heart rate should be bradycardia caused by hypotension, and you can try an intravenous bolus of 0.5mg of atropine to see the effect." After Zhou Can looked at the patient's indicators, he combined them with his condition and made a diagnosis.

He may not have as much experience in diagnosis and rescue as Director Xiang Fei, let alone Director Ming Xin, an anesthesiologist.

But he had an advantage that other doctors might not be able to achieve in their lifetime, and many of his medical skills were promoted to level six. It is equivalent to both internal and external training, and all of them are of a high level.

In addition, there is also the blessing of the special medical skill of first aid and wisdom.

Let him be even more powerful than the chief physician in the rescue work.

In Tuya Hospital, whether it is the operating room, the emergency department, or the intensive care ward, as long as Zhou Can is there, it is equivalent to giving the patient an extra life amulet.

In the past two years, the Department of Cardiothoracic Surgery has done many difficult and high-risk surgeries, and since Zhou Can participated, there have been no accidents.

In fact, it is not that there was no accident during the operation, but after the accident, Zhou Can tried to treat it as soon as possible, and worked together with all the medical staff to finally turn the patient around.

As his rescue experience has become more and more abundant, the level of various medical skills has become higher and higher, and the rescue success rate has reached more than 99%.

At the moment, he only checked the patient's condition a little and quickly diagnosed the cause.

"Isn't it okay to push the accessory kidney to strengthen the heart?"

Ru Yaji, who was behind Director Xiang Fei, couldn't help but ask.

During first aid, for heart failure, cardiac arrest and the like. The scene with the accessory kidney is a little bit more.

"Epinephrine is a drug that constricts blood vessels, and it can indeed raise blood pressure and increase the contractility of the heart. However, it can also constrict the blood vessels of the heart, liver and musculoskeletal muscles, and selectively shrink the blood vessels of the skin and mucous membranes and the blood vessels of the limbs, which is more suitable for rescuing patients in shock and is widely used in the rescue of critical patients in clinical practice. However, it should be used with caution in patients with too fragile blood vessels. ”

Zhou Can glanced at her and gave an explanation.

"The patient has just finished repairing and anastomosis of the splenic artery, and his blood vessels are already fragile, and the use of epinephrine can easily cause secondary rupture of blood vessels."

Director Xiang Fei also pointed out the beloved disciples in a timely manner.

The most feared thing about studying medicine is dogmatism, which is the same. This is extremely harmful to patients.

Thousands of people and thousands of diseases, one disease and one party, this is the experience that has been summed up in ancient Chinese medicine.

It seems that all patients are critical, and the methods of rescue may be completely different.

Even if they are all using the same drug, there may be a big difference in dosage. Some patients need to push sharply, while others need to be slowly instilled. Some patients may only need 0.5ml to be sufficient, while others may push it to no effect at all.

For example, people who are overweight often need to increase the dose.

In addition, it is necessary to consider whether the patient has an allergy to these drugs, non-absorption, whether there are contraindicated underlying diseases, etc.

For example, patients who have undergone stent surgery should be especially cautious when using hemostatic drugs.

Normally, these patients will need to take anticoagulants for life to prevent recurrence of blockages.

"Got it!"

Ru Yaji nodded teachable and glanced at Zhou Can gratefully.

For Zhou Can's clinical rescue ability, she couldn't help but admire it even more. I deeply felt the gap in strength between the two.

I thought that there was only a huge gap between Zhou Can and Zhou Can in terms of surgery.

Unexpectedly, rescuing critically ill patients, whether it was diagnosis or medication, Zhou Can was far above her.

This time, she was completely convinced.

Pang Houzhong next to him was even more wizened, looking like he was not lightly hit.

After the patient was given 0.5 mg of atropine intravenously, the patient's condition improved.

However, the situation remains worrying.

"Director Ming, do you think it will be risky to transfuse about 150ml of blood to patients now?"

Zhou Can asked.

There are only two people with high-level rescue capabilities at the scene, one is Director Mingxin and the other is Director Xiang Fei.

If you want to discuss it, you must consult with the anesthesiologist in charge.

After all, during the operation, she is responsible for the patient's life safety.

"Why is it 150 ml of blood transfusion and not more than 200 ml?"

She asked rhetorically.

"Maybe I've always been too cautious. Just now I calculated according to the patient's heart rate and blood pressure, and 150ml of blood transfusion should be barely enough, just enough to stabilize his vital signs. Supporting the completion of intracranial surgery. If I lose too much, I'm worried about other unpredictable consequences. It also increases the difficulty of intracranial hemostasis. ”

Zhou Can gave his own answer.

Suddenly, everyone once again cast envious, jealous and hateful eyes.

Calculating the amount of blood transfusion is not a particularly clever skill. Basically, many doctors can calculate the amount of blood lost based on the patient's hemoglobin level and then prescribe the amount of fluid transfusion.

However, in this kind of clinical first aid, it is necessary to accurately calculate the amount of blood transfusion in a very short period of time, just according to the patient's heart rate, blood pressure and other parameters.

150 and 200 seem to be only 50ml different, but after being infused into the patient's body, it may break a certain balance and cause a series of adverse consequences.

The precise control of the amount of blood transfusion is a real high-level reflection.

"Take 150ml of plasma and give the patient a blood transfusion immediately."

Director Mingxin gave instructions.

In the process of transfusing blood to the patient, Wu Yongming never drilled the patient's skull again.

It really scared him a lot just now.

"Dr. Zhou's ability to rescue critically ill patients is outstanding! Which doctor in Tuya did you study with? Is it Liu Xiangqing, the director of the Department of Critical Care Medicine? ”

Director Mingxin really inquired about Zhou Can's origin during this gap in blood transfusion.

Because this kid is so good.

"I didn't expect you to know Director Liu, I did study with him for a while." Zhou Can still misses the days when he was trained in the intensive care medicine department. I am full of gratitude to Director Liu Xiangqing.

It is enough to be glad to meet a chief physician who has cultivated you with all his strength in your medical career.

And as long as you work hard, the talent is not too bad, and it is easy to mix up.

Zhou Can is luckier than others, because there are too many chief physicians who appreciate him. They did their best to cultivate Zhou Can and teach each other, which finally created such a demon-level young doctor.

Even in a provincial tertiary compound like the Provincial People's Hospital, it amazed everyone everywhere.

Let them see the style of the Tuya people.

"Famous teachers make high apprentices, no wonder you are so powerful. Who did you learn your surgical skills from? I watched you have surgery just now, and I saw the shadow of Tuya's two famous knives. has both the shadow of the most stable scalpel and the shadow of Xu Yidao, who once set a world record, you can be taught by so many top chief physicians, it shouldn't be the second generation of officials, right? ”

Director Mingxin's attitude towards him was obviously a lot more friendly.

This question is a bit of a joke.

"What are you doing? Check your account! Zhou Can responded with a smile, just like that, he didn't want to be turned out. You see, the patient's signs are now stable and he should be able to do it again. The patient's blood pressure plummeted and bradycardia just now, but in fact, it was just a kind of stress from the trauma caused by the opening of the head. It's like a house that is about to collapse, and it was about to collapse, and it shook slightly, triggering its collapse. ”

Zhou Can quickly changed the topic.

He's smart enough to bring everyone's attention directly back to the patient.

In this way, it also prevents these people from being overly curious and inquiring into his origin and details.

"Then let's finish the surgery first. When the surgery is done, you'll have to talk to us for a few words. If many of Tuya's young doctors are as good as you, our Provincial People's Hospital might as well directly incorporate you. ”

She was joking again.

But it's also true.

It would be terrifying if Tuya could have ten young doctors of Zhou Can's level.

As long as it grows up, it can easily crush almost all the hospitals in the province.

That's really the kind of invincible opponent in the province.

Zhou Can smiled bitterly and didn't speak, silence is golden.

At this point, it's smarter to keep quiet.

The operation continues.

Wu Yongming tried to drill the patient's skull again, and this time there were no more problems.

Next, the dura mater was incised, and Director Wu also showed superb surgical ability.

The chief physicians of these provincial people's hospitals are very strong.

"Doctor Zhou, how about you come and help me?"

Unexpectedly, after opening the cerebral dura, Wu Yongming changed generals on the spot and directly sent an invitation to Zhou Can.

It made his doctor quite unhappy.

It's something that can't be helped.

The patient's condition is extremely dangerous, and the subsequent hemostatic surgery will be hellish and difficult. More likely to have another accident.

After seeing Zhou Can's outstanding performance in laparoscopic surgery, Wu Yongming finally made the decision to change generals on the spot after the battle between heaven and man. Having Zhou Can as an assistant for him has multiple benefits.

It is more reliable than the existing medical assistants and gives him a greater sense of security.

Even if the patient really has an accident again, he doesn't need to speak, Zhou Can will directly help try to save him.

Also, Zhou Can's vascular anastomosis ability is super strong, fast and good. The hemorrhage point is close to the brainstem, and Zhou Can may be needed to repair the blood vessels.

(End of chapter)