My Medical Skills Give Me Experiences Chapter 143

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Zhou Can curled his lips, now Cheng Gang can still scold him.

When he showed his face a few more times in the operating room and his status improved, Cheng Gang might have to treat him differently.

Follow Dr. Ou to talk to the family members.

The patient and his wife are waiting anxiously.

After the rupture of the cerebral aneurysm was found, the patient and his family members were already distraught. The rapid deterioration of the condition is full of fear.

"Doctor Ou, when will the hospital treat my husband?"

The patient's wife was so anxious that tears rolled in her eyes.

From yesterday to now, she has been accompanying her for a whole day with her clothes untied, her hair is a little messy, and she doesn't care about combing it at all.

"You must have known the results of the examination. I really didn't expect his disease to develop so quickly. The rupture of the aneurysm may threaten his life at any time. Therefore, early treatment is necessary."

When almost all doctors talk to family members, they will first talk about the serious consequences.

It is not simply to scare family members and patients.

Instead, prepare for the worst.

Let the family members have a psychological preparation in advance.

After being cured, the patient will feel that the doctor has excellent medical skills and saved my life. If it is not cured, we have already said hello, and the family members can reluctantly accept it. Not too much psychological gap.

Also, if the consequences are more serious, when discussing the treatment plan with the family members, the family members are more likely to accept it.

Many family members and patients are particularly afraid of surgery and often hesitate to decide.

The patient's condition can't be delayed any longer. To frighten them appropriately can avoid unnecessary evil consequences caused by the hesitation of the family members.

"Doctor, please, please save my husband!"

The woman said that she was about to kneel down.

"Don't do this, don't do this!"

Doctor Ou supported the woman.

"It's our doctor's duty to save the dying and heal the wounded. We will definitely find a way to treat your husband. After discussion, the doctors in our hospital just now drew up two sets of surgical plans. You can listen to them and choose one of them."

Dr. Ou's conversations with his family members are very skillful, and Zhou Can can learn a lot.

For example, it was Wu Baihe who told him two surgical options in advance, but he told his family members that they were discussed by the doctors in the hospital after the patient's cerebral hemorrhage was detected.

This makes it easier for patients to accept.

"The first solution is to do a craniotomy. Cut the scalp, dig out a piece of the skull, and then use the gap in the brain tissue to find the aneurysm and clamp it with a special clip to prevent blood from flowing into the aneurysm. The bleeding eventually stopped and the aneurysm was unharmed. The risk of this craniotomy is extremely high and the recovery period is long."

"The second solution is to do a new type of aneurysm interventional surgery. A guide wire is threaded through the femoral artery and travels all the way upstream to enter the location of the cerebral aneurysm. Then the spring ring is inserted to fill the aneurysm space, and the aneurysm space is filled. A thrombus forms around the elastic circle, which eventually seals the bleeding and removes the threat of the aneurysm. The cost of this solution is slightly more expensive than craniotomy.”

"But the harm to the patient is small, and the postoperative recovery is fast. If the situation is ideal, you can leave the hospital in about three days. Compared with the hospitalization period of traditional craniotomy, it will save more than ten days. The hospitalization fee saved, It should be enough to even out the difference in the treatment cost of traditional craniotomy."

There are two surgical treatment options, the second one has only been developed in recent years.

Domestic technology in this area is far behind foreign countries.

Compared with traditional surgery, emerging interventional surgery and robotic surgery do have advantages.

The trauma of interventional surgery is small and the recovery is fast, which is of great benefit to some patients with weak surgical tolerance.

For example, if the patient is too old or too weak, doctors dare not perform craniotomy. In the past, when encountering this kind of situation, patients could only accept conservative treatment.

It's almost like waiting to die.

But now he can choose to do interventional surgery, maybe he can save his life.

"Doctor Ou, how much does my husband cost for the interventional surgery?"

For ordinary people, treatment costs are a common concern.

"His aneurysm is relatively large, but fortunately there is only one, and the cost is conservatively estimated to be around 120,000. But you also know that the situation changes rapidly during the operation. Once on the operating table, our doctor will consider It is how to save the patient's life, how to cure the patient's disease, the cost can only be calculated by the financial department after the operation is completed."

Dr. Ou's quotation is only an estimate based on previous similar surgery patients.

"What about the cost of traditional surgery?"

asked the patient's wife again.

"About six to eighty thousand."

The price of traditional surgery is indeed much cheaper than interventional surgery.

Only considering the long hospitalization period and the high risk of surgery, interventional surgery is obviously more beneficial if economic conditions permit.

The woman discusses with her husband in a low voice.

Their family background should belong to the kind that is neither high nor low.

Because the husband and wife seem to have a low level of education. She dresses like a white-collar beauty in the city.

Hundreds of thousands, definitely can be taken out.

Medicare should cover some of it.

"We do interventional surgery."

She has negotiated the outcome.

"Okay, I'll start arranging for you right away. Before the operation, you need to deposit the money into the account you opened at the hospital. When will it be in place?"

Doctor O asked.

If the patient does not hand in the money, the hospital will generally not arrange for surgery.

"I'll go get it now."

The woman really has some family background, and she can withdraw hundreds of thousands of deposits as she pleases.

Half an hour later, the woman had already paid 120,000 yuan for the surgery.

The money was already in place, and Dr. Ou called Wu Baihe, who was undergoing surgery. Moreover, it is a major operation that takes at least six to eight hours.

I have no choice but to find Director Wen.

After some communication, Director Wen finally agreed to do an urgent interventional operation for this patient.

On the one hand, the condition is indeed critical, on the other hand, the time for interventional surgery is relatively short.

For uncomplicated cases, it usually takes only one to two hours to complete.

The next step is simple, arrange for the anesthetist to come to talk before the operation, and sign the anesthesia consent form. Dr. Ou asked the family members to sign the consent form for the operation.

The hospital temporarily arranged an operating room.

The entire operation proceeded in an orderly manner.

Zhou Can was very lucky, and got a chance to observe and study with Dr. Ou in the operating room.

In the operating room, he finally met the mysterious Director Wen.

An old man in his fifties, probably in his fifties or sixties. The hair is actually black, black and shiny like a young man.

But age spots can already be seen on the face, back of hands, etc.

The wrinkles on the forehead and the corners of the eyes are also very obvious.

Time is merciless, this director Wen's hair is probably dyed black.

The whole person looks quite elegant, wears glasses, speaks unhurriedly, and is full of the charm of a mature man.

It is not easy to be awarded the title of director in Tuya Hospital at the age of fifty-six.

Look at Dr. Ou, who is in his early fifties and is still only an attending physician.

It is conceivable how difficult it is to evaluate a high professional title.

Let alone a senior professional title, even a deputy senior professional title is equally difficult.

Many excellent doctors can only spend their whole lives until the retirement of the attending doctor.

In the operating room, Dr. Wen is the chief surgeon, and besides Dr. Ou, there are two attending assistants. A man and a woman.

The man was in his forties, and the woman looked to be in her mid-thirties.

The remaining few are residents, postgraduates and the like.

As for Dr. Ou appearing in the operating room and participating in this operation, it is probably related to him being the receiving doctor.

After the patient was put on the operating table, the anesthesiologist began to connect multiple life monitoring probes, put on a breathing mask, and implement inhalational anesthesia.

This method of anesthesia is also one that is easier for patients to accept.

After taking a few sips, the consciousness blurred, and he fell asleep quickly.

No pain.

"The anesthesia was successfully implemented, the patient's vital signs were normal, and the operation was possible."

Just wait for this sentence.

Director Wen glanced over the two attending doctors under him.

"For this kind of cerebral aneurysm interventional embolization surgery, the femoral artery at the root of the thigh is the first choice as the puncture point. Remember, you must not give up the distance and seek the shortest. For convenience, puncture directly from the upper body artery. For example, carotid artery puncture is a taboo .”

The three graduate students under him took out their small notebooks, lowered their heads and took notes quickly.

Most medical students are very hardworking.

"Also, you must learn to read films. If the neck of the aneurysm is too wide, the effect of inserting the yellow circle during interventional embolization surgery will not be ideal. At this time, it is necessary to place a stent to help prevent the yellow circle. protrude…"

These surgical knowledge are very advanced and practical.

Zhou Can secretly remembered it in his heart.

His memory wasn't bad, and he didn't bring pen and paper in. He just had to make up another surgery record when he got home from get off work.

"Before the operation, we fully understood the location of the aneurysm based on the DSA three-dimensional reconstruction. Now we will start the femoral artery puncture. Which of the two of you will perform the operation?"

Director Wen looked at his two attending doctors, a man and a woman.

As for Dr. Ou, he is like a child who has no mother's love, being indifferent by the side. Only by watching and studying.

Not to mention Zhou Can.

Standing behind Dr. Ou, he was clearly separated from the residents and graduate students under Director Wen.

"Can I do it?"

The hostess asked in a coquettish tone.

"Tang Li seems to have only completed two cases of coronary artery puncture, I think she will do it this time!"

Director Wen agreed, and the male in charge had no choice but to give up.

"Thank you Director Wen!"

She smiled and thanked sweetly.

In front of male doctors, female doctors still have a big advantage as long as they look good.

Grab the chance of surgery and exercise, one by one.

"Let me help you!"

The male doctor in charge didn't win, not only didn't get angry, but took the initiative to show courteousness.

Skin cleansing is usually done by nurses.

Even if it is secondary disinfection, it is mostly done by residents.

It's a shame to be in charge of doing this.

"Thank you, Dr. Zou!"

She's already washing her hands and getting ready.

After one injection, the blood turned dark red.

The corners of Zhou Can's mouth twitched twice. Apart from being coquettish to the male doctor, this woman probably doesn't have much real skills.

He became an attending doctor at the age of thirty-five, so his education should not be low.

In addition, he has a good relationship with the chief physician of the department, which is why he was promoted.

The young doctors in Tuya Hospital generally have a high degree of education.

Basically, 90% of them have postgraduate education or above.

When she stuck the needle, the blood drawn out was dark red, indicating that a vein was pierced.

When doing puncture or indwelling needle, be sure to observe the color of blood after puncture.

If it is dark red, it is mostly venous blood. Bright red, rich in oxygen, the color of blood is bright red.

It's easy to tell if you've seen it a few times.

"Oh, Director Wen, please help me to see if the puncture is wrong!"

She looked startled.

"Maybe punctured a vein. Let me do it!"

Director Wen's tone was very gentle, without any blame.

This kind of performance greatly reduced Zhou Can's impression of Director Wen.

Not every chief doctor is decent and rigorous.

People like Dr. Ou, Dr. Xu in the emergency department, and Director Shen in the orthopedic surgery department are only a minority.

Especially in recent years, the large-scale invasion of Kamata Hospital has developed rapidly.

The departments of many hospitals have been contracted out to doctors from the Kamata Department. Those people are masters who cannibalize people without spit out their bones.

It is precisely because those people are particularly able to generate income and treat patients as cash machines. They use money to open the way, and they have become a huge cancer that is difficult to eradicate in the medical field in China.

What's even more frightening is that the doctors, who thought they were noble, were dragged into the water one after another, and even followed suit.

Excessive medical treatment, saying that you are sick when you are not sick, all kinds of unnecessary examinations when you enter the hospital, a lot of consumables for surgery, and expensive medicines, which cannot be reimbursed by medical insurance.

Even induce patients to buy various nutritional products that have no medicinal value.

These practices have spread throughout the medical profession.

Countless patients have suffered from it.

Zhou Can is not sure that Director Wen must have a bad style of work. But the female doctor under her hand punctured the patient's vein without a word of reproach, which is very unreasonable in itself.

Unless this female doctor is his daughter, then it is possible to be so tolerant.

Under normal circumstances, if the doctor under his command makes a mistake, even if the chief surgeon doesn't yell, a warning is a must.

Director Wen's gaze swept away and landed on Zhou Can.

Because in the operating room, there is only this strange young doctor who is not his student. When doing chores, this kind of person must be given priority.

"Clean the base of the patient's other thigh!"

The puncture of the femoral artery in that thigh failed. For the sake of safety, it is best to change another leg in a short time.

Zhou Can honestly stepped forward to clean the patient's skin.

He has done this kind of thing countless times.

quite skilled.

"Director Wen, it's done!"

After his skin was cleaned, he stepped off the operating table.

It is definitely impossible for him to stand in this position as a Gui Peisheng.

Director Wen performed the puncture himself.

One needle down, this time the puncture was successful. But Zhou Can shook his head secretly after seeing the other party's manipulation techniques.

At any rate, he is a chief physician, and it stands to reason that his puncture level is at least above that of the deputy director.

As a result, the level of the injection just now was exhausted, that is, the level of attending is low~www.mtlnovel.com~ No wonder the female doctor brought out is so bad, the masters are only at this level, how good can the students be?

"Did you see it? When piercing, you must be aware of it. It doesn't matter if the piercing is too deep or too shallow."

Director Wen successfully completed the puncture, with a slight color on his face.

Next, a catheter is used from the femoral artery into the abdominal aorta, thoracic aorta, aortic arch, and finally into the aneurysm sac.

Although there were some twists and turns in the whole process, it was smooth.

"The most critical step is to introduce the spring ring through the microcatheter to fill the internal space of the aneurysm. To complete this step, it is a test of a doctor's implantation skills."

After the words fell, he had already started to introduce the first yellow circle.

The entire operation can be clearly seen on the display.

The introduction of that yellow circle did not go well.

Stuck in the neck of the aneurysm, always out of reach.

Director Wen's forehead began to sweat.

"The placement of the yellow circle is really difficult to operate. I have practiced for more than ten years, and I have only achieved a little success."

The behavior he tried to explain was more like saving face.

Everyone else is watching and studying seriously.

No one dared to speak.

As time passed by, Director Wen's face turned red.

An awkward, dignified, and tense atmosphere permeated the operating room.

Zhou Can watched the whole process, and he felt that if he was given a chance to get started, he should be sure to place the spring ring into the aneurysm sac.

But at this time, if you take the initiative to invite Ying, you will only be scolded **** by Director Wen.

The placement of the director was unsuccessful, and you, a regular trainee, stepped forward and said, let me try, I am afraid that no director can bear this tone.

Chapter end