My Medical Skills Give Me Experiences Chapter 149

Zhou Can was still very steady, and carefully sucked out all the blood accumulated in the patient's brain.

With the help of the probe of the endoscope, he began to look for the bleeding point.

The formation of a hematoma is due to the rupture of a blood vessel, which prevents the blood from being discharged from the body after bleeding. Eventually, the blood is sealed in a certain area of ​​the body, forming a hematoma.

Usually, there are hematomas on the extremities or the epidermis of the body, and the problem is basically not serious.

If the amount of bleeding is small, you don't even need to go to the hospital, just apply ice on your own.

The function of ice is to constrict blood vessels, stop bleeding or further reduce bleeding.

After a lot of people have sprained their feet, they rub safflower oil and bruise medicine on the swollen area, which is actually incorrect. Doing so may aggravate the condition.

Especially in the case of a fracture, it is even more impossible to do so.

Instead, it is right to pour cold water on the swollen area.

With the help of water temperature, the broken blood vessels are quickly contracted and the bleeding is automatically stopped. Can't get rid of hematoma, but can't make hematoma worse.

To say which parts of the hematoma most harmful?

Intracranium and spine, these places are infiltrated or compressed by hematoma, which is the most harmful.

The patient who was being treated had a hematoma in the brain, which led to intracranial hypertension. And it compresses important brain tissues such as the brainstem, lobes, and nerves, which will lead to the patient's coma, and even a rapid decline in various vital signs.

Now the hemorrhage is drawn out, the intracranial pressure is reduced, and the effect of puncture and drainage in the brain is actually the same.

"Director Wen, I found two bleeding points, do you want to use electrocoagulation to stop the bleeding?"

After Zhou Can's two performances yesterday and today, Director Wen's trust is already very high.

If electrocoagulation is performed at insignificant sites, the risk is very small.

But in the cranium, and close to the brainstem region.

This risk factor is very high.

Director Wen's gaze was fixed on Zhou Can, "Have you ever participated in electrocoagulation to stop bleeding during surgery before?"

Zhou Can was immediately happy.

Of all his medical skills, the level of hemostasis is the highest.

At present, they have reached the middle level of attending.

"I have participated in hemostasis surgery many times, and I am about 80% sure that the two bleedings will be stopped without harming other brain tissues."

Just say 80% sure, that is really very conservative.

This is a very good way of speaking.

It's like eating 80% full and making tea 70% full.

"Okay, try it!"

Director Wen recalled that his hands trembled when operating the endoscope before, so he simply delegated power once. Because if he did it himself, it might not be as good as Zhou Can's operation.

Under normal circumstances, it is impossible for the surgeon to shake his hands during any operation.

Only when the heart is highly nervous can the hands tremble.

This is a loyal response of the body.

Zhou Can manipulated the endoscope for electrocoagulation to stop bleeding. Compared with ordinary electric coagulation knife, the use is slightly different.

The main thing is to test the ability to operate the long arm.

His hemostasis technique is already very powerful, plus the implantation technique and grasping technique are at least level three. Therefore, the whole process of hemostasis went smoothly and was completed with ease.

"Doctor Zhou's hemostasis is no worse than that of a senior doctor! And he has a very high talent for endoscopy, tsk tsk, it's really enviable!"

Director Wen stared at the endoscope display screen, watching Zhou Can's entire process of hemostasis clearly.

The movement is clean and neat, and the hemostasis is accurate, fast and good.

Note that Director Wen used the word envy at the end.

That's because his own talent in endoscopic surgery is very ordinary.

Seeing that Zhou Can has both traditional and endoscopic surgery talents, I felt it.

There is really no one in a million who possesses these two surgical talents at the same time.

At present, the cultivation of endoscopic surgery talents in China is based on traditional surgical talents. This is the basic, compulsory course.

Especially the four basic surgical skills of surgery.

Then wait until the traditional surgery has a certain foundation, and then select people with satisfactory endoscopic operations for further training.

Therefore, major domestic hospitals, and even some county-level tertiary hospitals are already able to do some endoscopic surgery projects.

But to say that they do a particularly good job, it should be rare.

The most frightening thing is that some surgeons think that it is very simple to operate the endoscope. Maybe these doctors can also do some simple operations by manipulating the endoscope.

Such as appendectomy, polypectomy, etc.

When the success rate of these operations reaches more than 80%, they start to feel anxious.

Think how amazing you are.

Then, if tumors appear in the patient's body, minimally invasive surgery will be strongly recommended to the patient.

Especially women's breast tumors, granulomas and so on.

The incision is small, which can keep the female patient's graceful figure to the greatest extent. Most female patients will choose more expensive minimally invasive surgery when they hear it.

As a result, the tumor was not cut clean, and the operation was not done cleanly, resulting in recurrence and pus.

Even caused many patients to lose the chance of second surgery.

Such a doctor is the worst.

For the sake of personal performance and so-called endoscopic surgery achievements, ignoring the serious consequences that patients need to bear.

Zhou Can manipulated the endoscope to check it carefully again, and finally found another bleeding point.

This time, I did not ask for instructions again, and directly electrocoagulated to stop the bleeding.

Finally all done.

After taking out the new blood accumulation, Zhou Can asked for instructions, "Director Wen, do you think it is possible to remove the endoscope now?"

"Get out!"

Director Wen readily agreed.

Zhou Can carefully withdraws the endoscope.

Insertion experience +1.]

The first time to complete the intracranial endoscopic operation, the experience value of implantation operation +100, the experience value of grasping operation +100, and the experience value of hemostasis +100.】

Good guy, I got a reward of up to 300 experience points at once.

This is also the highest experience reward that Zhou Can has obtained since the operation.

Risks and benefits coexist.

It seems that if there is an opportunity to perform in the future, we should grab it and have to grab it.

Congratulations, your grasping technique has been upgraded to level 4, the current experience value is 60/10000, and the attending physician is at the lower level. It can complete the grasping of endoscopic curves, the precise displacement of the inserted spring ring, the operation of built-in blood vessel clips, and the auxiliary work of grasping diseased tissues in endoscopic resection. 】

Good fellow, it is said that misfortunes never come singly, but I didn't expect good luck to come in a bunch!

Zhou Can was as happy as drinking honey when he felt the brand-new fourth-level grasping technique.

There is another advanced medical skill at the attending level.

If this trend continues, it should no longer be a dream to upgrade all general medical skills to the deputy director level and advanced medical skills to the attending level within one year.

"Does the burr hole need to be repaired?"

"unnecessary!"

Director Wen replied directly.

"Does the dura need to be stitched?"

This is the rhythm of Zhou Can's frantic search for opportunities for surgery and exercise.

"Theoretically, as long as you pay attention to hemostasis and postoperative infection, the dura mater actually has a certain self-repair ability. It will grow together with the temporalis muscle."

Director Wen patiently guided Zhou Can.

The three graduate students were frantically taking notes.

Several residents were also taking notes. Surgical knowledge needs to be continuously accumulated.

Because there are too many problems encountered in the operation.

The best way for newcomers is to take more notes, have time to review more, consolidate and deepen memory.

In this way, you can be familiar with it in the future operation process and use it flexibly.

"Of course, if you want to repair it, it's also possible. Usually, tension-reducing sutures are performed." Director Wen gave a supplementary conclusion after inspecting the wound.

After Zhou Can heard this, he immediately became interested.

"Can you leave it to me to stitch it? I promise to do my best."

Zhou Can has practiced sewing skin too many times.

It is the first time to suture the dura mater.

"How is your suture technique? If you have a resident doctor with above-average suture level, I can consider entrusting you to do it." Director Wen will never dare to underestimate Zhou Can now.

Because Zhou Can's surgical abilities are better than each other.

In particular, the endoscopic hemostasis ability revealed just now is really shocking.

Even Dr. Zou, who had a good opinion of Zhou Can, had to admire Zhou Can.

Because Zhou Can's ability to stop bleeding is no worse than his 40-year-old attending physician.

Now I wonder how this kid practiced?

"The level of suturing is not bad, and the level of a resident doctor should be good." Among all the current medical skills of Zhou Can, suture and ligation have the highest experience value. All are at an excellent level.

Just over a thousand short of being promoted to the deputy director level.

Any resident who compares with him will definitely be tortured to the point of doubting his life.

"Okay, try it!"

This suture also required endoscopy.

Because it's under the skull.

A hole so small that ordinary sewing crochet hooks can't get in.

Zhou Can manipulated the endoscope and carefully sutured under the endoscope. This is also the first time he has performed endoscopic sutures.

His idea is also simple.

Taking advantage of the fact that Director Xie has not implemented dimensionality reduction and suppression on him, it is one time to get a chance to practice surgery.

In particular, this kind of endoscopic operation opportunity is difficult to obtain with other doctors.

It just so happened that Director Wen did not have the talent for advanced surgery, which gave Zhou Can a very good development opportunity.

As soon as Zhou Can finished his first stitch, there was a sound of breathing in the operating room.

Dr. Zou and Tang Li all stared wide-eyed, watching Zhou Can complete the endoscopic suture in shock. They didn't expect Zhou Can's sewing skills to be so good.

Leave the two of them far behind.

"My God! Doctor Zhou's suture level is probably no different from that of the deputy chief physician." Tang Li thought that her suture level was not bad, but compared with Zhou Can, it was not even a star.

"This kid is powerful enough!"

Doctor Zou muttered to himself.

As for the next few residents and graduate students, don't mention it.

Their level is still very good, and they can't see how good Zhou Can's stitching is.

I only know that the stitching is neat and fast.

Director Wen stared fixedly at the screen without speaking.

Maybe he was worried about interfering with Zhou Can's operation.

So dare not have any disturbance.

He even reached out and pressed down to stop other doctors from speaking.

Zhou Can let everyone see how good Gui Peisheng can be. It took less than five minutes to complete all the sutures.

"Director Wen, please check."

After he finished the stitching, he respectfully asked Director Wen to check it out.

The first time you complete endoscopic suture, you will be rewarded with +100 suture experience and +100 ligation experience. 】

So cool.

The first time to operate an endoscope, the reward is really rich.

The experience value is directly increased by hundreds and hundreds.

"No, no!"

Director Wen shook his head repeatedly, with a serious expression, and fixed his eyes on Zhou Can.

These words were like a basin of cold water pouring down Zhou Can's head.

Drenched him to the core.

All the excitement and joy turned into a sincere attitude of humbly accepting opinions.

"Ah... It's my first time suturing the dura mater. I didn't do it well. Please point it out, and I will correct it immediately."

Zhou Can originally thought he sewed well.

As a result, he got such a low evaluation from Director Wen, which was a big blow to him.

"No, no, no, I'm not saying that you haven't stitched it up. I'm just suspicious of your identity. I have worked in Tuya for more than 30 years, and I have never seen such a perverted Gui Peisheng as you. Well, it can also be understood as an outstanding talent for advanced surgery. But your hemostasis, suturing, and ligation operations have all reached the attending level. This is really a long time to see."

Director Wen is not a fool.

A Gui Peisheng has a high level of operation in a certain operation, which can be understood as a lot of practice.

But the level of all kinds of surgery is so good, it is only possible to achieve it unless it is practiced in the mother's womb.

The training period for surgeons is extremely long, and it is difficult to make small achievements in less than ten years.

No matter how good the talent is, it's not so good, right?

too exaggerated.

"Hehe, I was taken aback. I thought it wasn't sewn properly."

Zhou Can heaved a sigh of relief, as long as the operation wasn't a failure.

"Maybe I usually like surgery very much and practice it a lot, so my foundation is a bit thicker than regular Pearson. That's all, it's not as exaggerated as you said!"

The explanation he gave was far-fetched.

It's just that this matter is irrelevant, and no one will go into it.

I can't find anything if I try to check.

Zhou Can really worked very hard, practicing surgery every day after work.

"A while ago, I heard some directors talking about it, saying that our hospital recruited Gui Pei this year and gave birth to two evildoers, one with abnormal surgical skills, and one with theoretical knowledge who beat the directors of various departments. Seeing is believing. I used to be dubious. I totally believe it now."

The other monster Director Wen mentioned should be Du Leng.

Dr. Haigui is really awesome.

However, the academic qualifications of overseas returnees are sometimes quite watery.

Judging from the powerful strength Du Leng has shown so far, it should be the genuine one.

"Doctor Zhou, don't stand still, just sew up the patient's scalp! Let me appreciate your superb suturing skills again. It's very demeanor of Dr. Xu back then."

Director Wen accidentally mentioned the fallen Dr. Xu.

It shows that Dr. Xu had a great influence in surgery at that time.

"Thank you Director Wen for your trust."

Zhou Can didn't talk nonsense, and directly took the needle holder and crochet needle from the equipment nurse, and started suturing.

He found that the equipment nurses for this major operation were all experienced and highly professional.

All kinds of coordination are in place.

There is no need for Zhou Chanduo to say what kind of thread to use for suturing different parts and how big a thread to use.

All are prepared early.

Just pick it up and use it.

And some details are done very well.

The suturing was done under the endoscope just now, but everyone didn't see Zhou Can's suturing technique clearly. Now that the scalp is stitched up, everyone has completely opened their eyes.

"His suture level is higher than mine. Today is an eye-opener."

Dr. Zou was a little depressed.

It was originally a level four operation.

It turned out to be Zhou Can's solo show.

This is a level four surgery! Who would have thought that most of the key tasks of the surgery would be done so naturally by a Gui Peisheng.

Zhou Can's operation speed began to inherit Dr. Xu's 'fast' style.

The head wound was quickly sutured.

"Not bad, this suture makes me feel happy just looking at it. The patient's current physical condition is extremely weak, and the knee joint operation will be performed by the orthopedic department after a while."

The car accident patient injured not only the head, but also knee joints and other parts.

The trauma has already been dealt with.

"After the patient's intracerebral hematoma was removed, his vital signs have actually recovered quite well. Compared with when he first entered the operating room, it is simply a world of difference. With his current state, I even suspect that he only needs to stay in the ICU for a while. You can transfer back to the general ward in a day or two."

Anesthesiologists have confidence in their patients.

He should be the person who knows the patient's life situation best.

"Haha, you can give such an optimistic evaluation, it seems that this operation is not bad. After waking up from general anesthesia, push it back to the ICU to observe!"

Director Wen successfully completed a difficult operation and was in a good mood.

He looked up at the clock on the wall.

"It seems that we can go to scientific research earlier today! Compared with traditional surgery, endoscopic surgery does have advantages!"

Originally, according to his previous estimate, it would take at least four to eight hours to perform a traditional craniotomy on a patient.

The key is to avoid unexpected situations along the way.

The patient's vital signs have dropped drastically, and if necessary, the operation must be stopped~ www.mtlnovel.com~ Lixuan to carry out first aid.

That would take longer.

"Endoscopic surgery is indeed a major development trend. However, for some diseases, endoscopic surgery and minimally invasive surgery cannot be solved well. Therefore, I don't believe that traditional surgery has been completely eliminated."

Tang Li's advanced surgery talent is very poor.

She must have thought deeply about the prospect of both surgeries.

After all, young people, everyone is most afraid of being eliminated by the times suddenly.

"You are right. There will still be room for traditional surgery for a long time. However, we must also see the rapid development of endoscopic surgery and its various advantages. Just like our Chinese traditional medicine, in just a hundred years, I was directly squeezed by Western medicine into a state of survival."

Director Wen is still pessimistic about the prospects of traditional surgery.

He even took Chinese medicine as an example.

"Our Chinese medicine in China is not bad, and my classmate studying abroad told me a strange phenomenon. At present, we do not pay attention to Chinese medicine and despise Chinese medicine. But foreign countries are just the opposite, and they have begun to vigorously develop Chinese medicine. Not only have they quietly developed more than 10,000 A variety of traditional Chinese medicine is planted, and a Chinese medicine research center has been opened, and many powerful Chinese medicine practitioners have been dug from our country."

When Dr. Zou talked about this, he was very heartbroken.

Chinese medicine has now become an eternal pain in the hearts of many medical practitioners.

The market chooses everything.

It is an indisputable fact that the market for Chinese medicine is very small.

Some far-sighted doctors and scholars have begun to call for the protection of the inheritance of traditional Chinese medicine. Only with little effect.

Zhou Can took a deep look at Dr. Zou, and his impression of this changed a lot following what he said just now.

To be honest, Zhou Can's attitude towards Chinese medicine has always been relatively neutral.

Neither praise nor derogation.

It is a rational and objective view.

Chapter end