After Fang Ziye left the banquet hall, he carefully thought about the status of the orthopedic department of Zhongnan Hospital in the country!

In recent years, the official comprehensive ranking has been ranked above 30 from the front, and even Tongji Hospital and Union Hospital have not been in the top 10.

The Sixth Hospital of the Demon Capital happens to be the top unit among the top three orthopedics in the country. It is rumored that the world's first limb replantation was born in the Sixth Courtyard of the Demon City......

The first case in the world, such fame?

Fang Ziye gradually calmed down.

A long time ago, Master Yuan Weihong and Professor Deng Yong led Fang Ziye to do psychological construction, this world is very big, the rivers and lakes are very wide, and it is also very exciting.

Jealousy does not make people progress, ignoring the gap, and forcibly saying that you are good will not make up for the difference in height of different steps.

It's a pity, today's Fang Ziye is far from the time when it is possible to consider increasing the status of the orthopedic department of Zhongnan Hospital in the country, Fang Ziye is only hospitalized, and during the total hospitalization, he has his own tasks.

……

After Fang Ziye went to the emergency department, he found that the situation of the patients transferred from Chishi was very tricky-

Don't die, but legs!

Classic post-traumatic long thrombosis of the lower limbs, the patient was referred to Zhongnan Hospital from Chishi for further diagnosis and treatment.

The reason why Zhongnan Hospital is preferred is because the patient himself knows someone in Zhongnan, and I heard that Zhongnan's orthopedic strength is not bad, and some acquaintances have called and asked other hospitals, but they have not received a positive reply for the time being.

I plan to come to Zhongnan Hospital first.

After seeing the patient, Fang Ziye's first thought was not how to rescue the lower limbs, but immediately yelled in the group: "I just encountered a very typical post-arterial thrombotic 5P syndrome, and I am interested in coming to the emergency department surgical clinic." ”

"I'm only going to give you ten minutes. @所有人. Fang Ziye directly called people in the large group of doctors in charge of the bed.

This time, there are a total of four doctors who graduated, and Professor Han Yuanxiao's group did not graduate this year, so the brothers and sisters in the group did not rush to the banquet hall to make do.

Fang Ziye's senior brothers, some of them were still drinking with their senior brothers in the banquet hall, and Fang Ziye didn't know who was free.

But this 5P syndrome is really typical, and it would be a pity not to call a junior brother to come and see it, so I just posted it.

Embolism or thrombosis of an artery in a limb is characterized by persistent pain accompanied by symptoms and signs of pallor, pulselessness, paresthesia, and paralysis of the affected limb. These 5 signs and symptoms begin with P, so they are called the 5P sign.

In addition, in private@Guo Ruodun, "Xiao Guo, you are in the emergency class today, and this opportunity for physical examination will be given to you first." Immediately come to the emergency department for the preoperative interview and signature procedure. ”

"The patient is currently willing to undergo surgery."

After doing this, Fang Ziye sent the results of the patient's lower limb CTA to Wu Xuanqi and Senior Brother Nie Mingxian.

And asked: "Senior Brother Wu, Senior Brother Nie, do you see the current CTA results of this patient, is there still a picture of the appearance, is there still a possibility of rescue?" ”

"The results of the current physical examination are ......"

Wu Xuanqi is only in the operation of vascular surgery, Fang Ziye is now in a similar state to Wu Xuanqi, and he has decided whether the operation can be operated, but whether it is suitable or not, whether it has conventional surgical indications, in fact, Nie Mingxian has a more thorough grasp.

As for things like asking people for advice will hang up the genius label, Fang Ziye has never taken it to heart, the more mature he is, the less important the so-called genius and face issues are.

As long as you can be good for the patient, bring a better experience to the patient, and make your work of higher quality, it doesn't matter if you put this face at the door.

Fang Ziye can actually add points, and add thousands of points to the theories related to vascular surgery and arterial thrombosis, but it can also reach Nie Mingxian's level.

It's just that the knowledge points are really not abundant, and the application is not much, so Fang Ziye is reluctant to add points for the time being, if there are knowledge points, Fang Ziye will definitely give more priority to the skills of trauma surgery such as bone transport......

Although Nie Mingxian has gone back to study for a doctorate, he has not broken the contact with Fang Ziye and Wu Xuanqi, especially after Fang Ziye returned to the position of general hospitalization, like Wu Xuanqi from Tongji Hospital, he often asked Nie Mingxian for remote consultation.

No, because if a similar arterial thrombosis is encountered in the general hospitalization of this hospital, the first suggestion is to intercept it!

"Senior Brother Fang, what is the surgical method?" Soon, Guo Ruodun rushed to the emergency department, first asked about the operation method, and then planned to write the risk entry on the informed consent form for surgery.

This is a kind of assessment of the ability of the doctor in charge of the bed, according to the surgical method, the test of the corresponding theoretical basic skills, the original Fang Ziye also came over like this, but at present, Fang Ziye will be such an assessment, more and more on the bright side.

Guo Ruodun is a master's student in charge of Zhang Zixi, and he is a classmate of Lin Yihuang, who has met in his previous sub-industry.

"Amputation prepares for arteriotomy and thrombectomy of the lower extremities."

"Remember, talk to the patient about the options and risks of amputation, limb salvage is only an option, and if the patient does not agree, it is recommended that the patient find another hospital." Fang Ziye got the positive news from Nie Mingxian on the one hand, and at the same time explained to Guo Ruodun.

At the master's level, there are not many opportunities to get, and you need to fight for them in their own practice rooms.

As the general hospitalist, Fang Ziye has gone through thorns in the past, but now he is relatively generous, and the delegation of authority will be a little lax, but when Fang Ziye checks the corresponding risk provisions later, it will be more strict.

"Okay, Senior Brother Fang, I'll give you a purpose later. I type fast. Guo Ruodun's wife boasted about selling melons.

Fang Ziye put away his mobile phone, and then went outside the clinic to explain in detail to the patient's family: "In your situation, I also consulted the teacher of vascular surgery, and the teacher there has a slightly different opinion from Dr. Liu, the general resident of the Department of Vascular Surgery. ”

"There is such a small opportunity, you can try to remove the thrombectomy, if you can't take it out, and then amputation, it won't add any cost."

"But if you don't want to toss, the only option in our hospital is amputation, if you want to save your limb and get more affirmation before the operation, then you may have to go to other hospitals to investigate."

The patient and his family were already seeing some new information on their mobile phones at the moment, and their faces were even more ugly.

The family put away their mobile phones and asked, "Doctor Fang, are you sure that we can have a chance to salvage our limbs?" ”

"There is one thing, I can only say that I can look forward to it, fight for it."

"If you can fight for it, you can save your limbs, and if you can't fight for it, you will save your life, otherwise once the limbs die, infection or reperfusion damage will occur at that time, it will be very troublesome......," Fang Ziye explained.

I guessed in my heart that this patient and his family might not be very good to inquire about.

Of course it won't be good, who wants to make a fuss for no reason?

If it weren't for Fang Ziye's acquaintance with Nie Mingxian and his friendship with Wu Xuanqi, the general trauma surgery boss and vascular surgery boss would recommend amputation after consultation.

After there is an indication for amputation, no one will easily bring out a few professors to do your limb salvage, and the professor of vascular surgery may not have a spare schedule.

"Okay, Doctor Fang, then we're willing to give it a try." The family member is the patient's husband.

After he finished replying, he looked at his wife and repeated: "Let's try, Doctor Fang dares to say this, he must have at least some confidence......

The despair in the patient's wife's expression eased slightly, and she nodded slightly......

……

After obtaining the permission of the patient and family, all that remains is to prepare for the operation and arrange the operating room.

If a patient is new to the hospital, it is not an absolute super-emergency rescue indication such as hemorrhagic shock, so it is impossible to arrange the operating room immediately and desperately, and it is still necessary to make emergency preoperative preparations, which takes a certain amount of time.

Although this will also waste a little time and increase the risk of limb necrosis, from the doctor's point of view, a safer surgery will be of higher quality than a single operation, and it will be more important.

Fang Ziye sent another message to the two juniors to ask what the atmosphere in the banquet hall was like at the moment, and the answer was positive.

Fang Ziye was also relieved.

In fact, Fang Ziye is a little worried, after the arrival of so many bigwigs, where do you need him to take care of a fresh doctor?

Even when Fang Ziye defended, the topic given was a bit amazing, and the animal experimental model was of great clinical significance, and the unprecedented HK2 knockout animal model even aroused the interest of several professors.

But after all, he is a junior, in their opinion, Fang Ziye may be a middle school student with relatively good grades, and now he has been admitted to the best high school with excellent results.

But in fact, for adults, if they are not admitted to college, they are not considered graduates.

For top professors, they have not crossed the threshold from associate professor to professor, and they are still below the marking......

When Fang Ziye took Guo Ruodun to go for an arteriotomy thrombosis, he didn't expect to be caught by Yuan Weihong.

The phone quickly called: "Ziye, I heard Jiehan say, you plan to take someone to have thrombus removal to save your limbs?" ”

"You can't mess around with this, huh?" Yuan Weihong's voice was obviously drunk, and his tone was admonishing.

When Fang Ziye heard this, he frowned slightly, and asked, "Master, I have carefully talked to the patient about the risk of amputation, is it not possible to prepare for surgery with thrombus removal?" ”

"In our hospital, thrombectomy can only be performed by vascular surgery, and no one else can perform it?"

It's a leg, after all.

It's not that Fang Ziye hasn't had an amputation, but that kind of amputation is mostly caused by damage and injury. Without the participation of the big guy, Fang Ziye could only amputate his limbs, and he did not dare to look forward to limb reconstruction and limb salvage.

But this is only a 'necrotic limb' after thrombosis, and it is easily amputated, which is really a pity from Fang Ziye's point of view.

"There's no such rule, but? It is okay for a sub-industry to be bold and bold. ”

"But if you don't do it well, you're going to be talked about. Although vasotomy belongs to the intervascular discipline of orthopedic and vascular surgery, it is hand surgery and vascular surgery. ”

"The failure of interdisciplinary operations will be mistaken for pretending to fail...... Yuan Weihong explained the key points to Fang Ziye.

"Master, I didn't think about pretending to be a coerc?" Fang Ziye corrected.

"But that's what you're doing?" Yuan Weihong corrected again.

(End of chapter)