Since 1981 Health School Chapter 511

  Chapter 511 The first endoscopic surgery

  Chen Qi took the CT film and looked at it carefully.

  Speaking of the CT machines, Chen Qi had a vision and sold two sets to Yuezhong People's Hospital at once, which also made Yuezhong People's Hospital the first municipal hospital in the country to have two CTs.

   Even in the whole country, it is the kind that ranks first.

  After the People's Hospital had a CT machine, the clinical level has taken a qualitative leap. At the same time, it has attracted patients from all over the province to come to see a doctor. The two CT machines do not take a break, creating a lot of inspection profits every day.

   Now that the peaches are ripe, Chen Qi, the peach grower, picked the fruit himself, and it was as enjoyable as it could be.

   After watching the CT film, Chen Qi thought that the fishbone was really a bit troublesome. The fishbone was stuck in the esophagus horizontally, and it couldn't go up or down, which caused the esophagus to be blocked.

  Thinking of this, Chen Qi said to the head nurse next to him:

   "Please help me get another esophagoscope, let me take a look inside first."

  As soon as she heard that Dean Chen was about to attack again, the head nurse gave her a wink, and the little nurse next to her rushed over and pushed the endoscope over.

  Chen Qi took a look and shook his head:

   "Not enough, take all the endoscopic accessories I gave you, and I will choose some tools myself. Today I will teach you a trick on the spot, using the small operation of removing fishbone under the esophagoscope.

   This operation is very simple. After putting down the endoscope, use a special clip to clamp the fishbone and take it out. There is no need to take traditional surgery anymore. The skin is cut open, the sternum is opened, and the esophagus is cut open to take the fishbone. "

  As soon as these words came out, the little doctors next to him were all excited.

  Yang Caisheng hurriedly asked: "Dean Chen, is this kind of operation mature? Did it come from abroad?"

  Chen Qi didn't know how to answer this question, so he said ambiguously:

  “Endoscopic technology is just emerging abroad, and some simple operations using endoscopes are currently only performed in top hospitals, but you should remember that this is a general direction in the future.

Surgery in the future must be minimally invasive, especially our gastroenterology surgery. No longer need to cut this or that like traditional surgery. At that time, it will be done by making a few holes in the abdomen and inserting the tube. All surgical steps, this is also called laparoscopic technique. "

   In the 1980s, there were also endoscopic technologies such as gastroscopy and colonoscopy in China, but they were only used for inspection rather than treatment.

  What Chen Qi wants to do is to make Yuezhong People's Hospital the first hospital in China to carry out laparoscopic surgery.

   This step alone can make Yuezhong People's Hospital a first-class domestic and one of the leading hospitals in the world. With Chen Qi's political achievements, the People's Hospital can perform operations that others cannot.

   After a while, the nurse brought all the endoscopic accessories.

  Although these instruments are second-hand tools, the instruments used by the world's No. 1 Mayo are still several years ahead of ordinary hospitals in this era.

  Chen Qi picked and selected, and finally found the endoscope tube he needed.

  After simple preoperative preparations, Chen Qi took the tube and was ready to start his own performance.

At this time, doctors from various departments were already standing inside and outside the ward, especially the other 5 departments of internal medicine. I heard that the dean is going to play a new technology that can make internal medicine also perform surgery. Now everyone is interested. .

  Surgical operations make money, which physician is not envious?

  In the past, internal medicine was very aggrieved, because internal medicine was often scolded by surgeons as: a coward who can talk but not do it.

  If physicians can also perform surgery, they are typically able to move both their mouths and hands. Wouldn't they be invincible all over the world?

  So when several directors of internal medicine and chief physicians heard that Dean Chen was doing something in the six internal departments, they all rushed to watch the fun.

   This is pitiful for the little doctors in the ward. They originally wanted to follow the dean and witness with their own eyes how the endoscopic surgery is performed.

  Good guy, now a large group of directors and deputy directors have come, and they can only stand at the door with their necks stretched out. Your little doctor has the nerve to stand in the ward?

  So the intern was first "asked" out of the ward by the old doctor.

  But the ward is too small, and the space is still not enough, what should I do? So those little doctors, except the bed doctor, were all cleared out.

   When Chen Qi looked up, he found that a group of doctors had changed silently in the ward.

  Just now, they were a group of young and energetic little fresh meat and beauties, but suddenly the style of painting changed, and they all became a group of old bacon.

  Cai Fengyao, Director of the First Internal Medicine Department, Zhang Yuanming, Director of the Second Internal Medicine Department, Xia Hua, Director of the Third Internal Medicine Department, Peng Xingli, Director of the Fourth Internal Medicine Department, Song Xuewen, Director of the Fifth Internal Medicine Department, and none of the five internal medicine directors appeared.

   Even Jia Liangcai, the director of the Department of Internal Medicine who was originally in the outpatient clinic, rushed over.

  The ward was packed like sardines, and even Lan Lijuan and the head nurse had to stand close to the wall.

   Not to mention the corridors, even the windows are full of little doctors, there is no way, who told them to be squeezed out.

   Fortunately, the doctor was still a bungalow at this time, and it was safe to squeeze in the window.

   "Hey, Director Jia, Director Cai, Director Zhang, Director Xia, Director Peng, Director Song, why are you all here?"

   Fortunately, Chen Qi is an intern doctor at the People's Hospital, and he knows all these big boss-level department directors, otherwise, he really wouldn't recognize all his subordinates on the first day of work.

  Director Jia said with a smile:

   "Isn't it heard that Dean Chen is going to come up with an international new technology? We all want to come and see. Who doesn't know that following Dean Chen can have meat and learn the best technology."

   "Director Jia is right, Dean Chen, you can't hide your secrets."

   "That is, I didn't bully you when you and Lijuan came to practice internal medicine. Today, you can't patronize the sixth department and forget about our second department."

   "What's the internal two and internal six? Our internal medicine is a family. We learn technology together and surpass surgery together. Everyone agrees."

   "Director Song is right~~~~"

  The atmosphere in the ward was much more lively than before, but the patient was a little nervous.

  Good guy, I'm stuck with a fishbone, is it necessary for all the internal medicine experts in the hospital to gather together? What is it that is hiding from him?

  So the old man grabbed his son's hand tightly, and with the last bit of strength he asked earnestly:

   "Son, you, you tell me, is my father dying?"

   "Dad, what nonsense are you talking about? The dean is going to perform a minor operation on you to remove the fishbone."

   "Fart, it takes so many directors to take a fishbone? It's over, it seems that this fish meal is the last meal in my life."

  Oh, by the way, there is another person at the scene who is particularly nervous right now, and that is Wang Fang, the doctor in charge of the bed.

  The little girl is going to cry again now. Now not only the dean is here, but also the chief of the medical department, and so many directors of the internal medicine department are here, and then she is asked to report the medical records by a little doctor.

  She really wanted to shout: The concubine can't do it.

  It seems that the misdiagnosis of the first bed just had a great impact on her.

  Lan Lijuan patted Wang Fang on the shoulder after seeing it, and encouraged:

   "It's okay, feel free to report, it's normal to be under pressure, but this is also an opportunity, you can show your face in front of everyone. And you are not representing yourself now, but the face of our internal six departments, come on."

  As soon as Wang Fang heard that the honor of the department was tied to her, it was as if she had been given a chicken blood injection, and immediately regained her energy.

   These days, collective honor is above all else, and Wang Fang is ready to fight.

  While the dean and directors were still chatting, she hurriedly opened the medical records quietly, and carefully reviewed the conditions of the patients in the next few beds, so that she knew the bottom line.

  Director Jia saw the tube in Chen Qi's hand and asked:

   "Dean Chen, are you going to use this endoscope for surgery?"

  Chen Qi was wearing a gown at this time, put on his hat and mask again, and said confidently:

"Okay, since everyone is here, let's take a look at this minor operation, the removal of esophageal foreign bodies. Of course, this involves the Department of Gastroenterology. If you want to learn, I will give you a learning direction and guidance for your other departments in the future. Goal, now we hurry up."

  The directors are the same as the interns. Although they are old enough to be Chen Qi's parents, they are not very motivated to study.

  As Chen Qi's esophagoscope slowly entered the mouth, followed the base of the tongue and throat to reach the esophagus, everyone's eyes were focused on the TV screen.

   After a while, a thick yellow-white fish bone appeared in front of everyone on the screen.

   I saw that this fishbone was like a sharp knife, with both ends particularly sharp. Moreover, the fishbone had penetrated deeply into the patient's esophagus, and one end had pierced the esophageal wall and was about to pass through the mediastinum.

  In addition, the patient has been coughing hard and wants to vomit from time to time. This behavior causes the esophagus to shrink continuously, and the fishbone tends to get deeper and deeper.

  Director Xia of the third internal department was a little anxious when he saw this:

   "Hey, this position is too dangerous. Look at the head of the fishbone. If it goes a little deeper, it will pierce the thoracic aorta. It will be life-threatening, and there will be no time for rescue."

  How dangerous is this?

  There are three strictures in the human esophagus:

  The first stricture is located at the entrance of the esophagus. When swallowing, there will be pain near the esophagus, causing dysphagia.

  The second stenosis, about 7 cm behind the entrance. This is the most dangerous place because the esophagus is attached to the thoracic aorta.

  The third stricture is also the exit of the esophagus, and there are fewer problems here.

  Now the fishbone of this patient is just at the second stenosis, so it is easy to injure the thoracic aorta.

  Note, what is mentioned here is "aorta". As long as these three words appear, it means a crisis, a red alert.

  The thoracic aorta is the largest arterial vessel in the human body, and the blood vessel pressure is very high. If a breach is formed, the bleeding will be jet-like, like a fountain, and there is no chance of rescue.

   This is a fight with a gangster. You have been stabbed in the stomach a few times, and you can be rescued if you rush to the hospital. It is not like you were stabbed and died on TV.

   But if you are unlucky, someone will be stabbed in some femoral artery or carotid artery with a random knife, and the blood will rush out five or six meters away.

  So very unfortunate, those who are stabbed will see the king of Hades, and those who stabbed people will be shot.

   This shows the importance and fatality of the aorta.

  Director Cai from the First Division shook his head when he saw it:

   "Our internal medicine department can't do anything about this fishbone. If it is taken out by force, the two ends of the fishbone will be like a knife. It will definitely cut the esophagus wall. The operation will be more complicated then."

   "Yes, this situation should be sent to surgery, and drug treatment is definitely not effective."

   "It seems that this knife is inevitable, Dean Chen, what can you do?"

   Everyone's eyes once again focused on the young dean.

  Chen Qi was actually complaining again in his heart, and his luck was really bad.

   Just now, 1 bed almost overturned. I originally thought that the 2 beds of fishbone would be simpler, and then I pretended to be aggressive and used the endoscope to take out the fishbone, which won the applause of the whole house.

  Good guy, the fishbone on No. 2 is more complex, which is basically beyond the scope of endoscopy.

  But I have already blown the bull out just now, and now I say that I can't do it in front of so many directors?

  The dean doesn't want to lose face?

  Besides, real clinicians worship the "powerful". Whether Chen Qi can secure the position of Dean, the support of the directors of clinical departments is very important.

If these old directors take this lightly and feel that they have nothing to say and can't do things well, not only will the dean's prestige be damaged, but in the future, he will issue orders and make related reforms, and they will act in a yin and yang way, making it difficult for you .

  So today this endoscope removes fishbone, if you do it, you have to do it!

  Lan Lijuan saw her husband looking at the screen with a serious expression on the fishbone, so she knew that her husband had encountered a problem.

  The other doctors stared wide-eyed, full of confidence in the dean who often went abroad, and wanted to see how he could use the endoscope to remove the fishbone?

   Time passed by every minute, and the ward became quiet again.

  Suddenly, Chen Qi's eyes lit up, and he ordered again to the head nurse beside him:

   "Head nurse, please help me get a three-chamber two-capsule catheter."

  Three-lumen two-capsule catheter is composed of three lumen tubes, gastric balloon and esophageal balloon.

  The main function is to stop bleeding by compressing and stopping bleeding from ruptured varices of the esophagus and gastric fundus.

  The specific method of use is to poke the tube into the stomach and esophagus through the mouth like a gastroscope, and then see where the bleeding is, and then inflate the gastric balloon or esophageal balloon.

   After the sac cavity is inflated, it will bulge up like a balloon. Clinically, it uses the physical method of air pressure to stop bleeding.

   This thing is actually rare in hospitals of later generations. Even in the 1980s, the three-chamber two-capsule catheter was not used much clinically, and it was generally only available in gastroenterology.

  Seeing the young dean using this unpopular tool, question marks flashed in the minds of several directors in the ward.

  Because in their cognition, there is no way to equate the three-chamber two-capsule tube with taking fishbone.

  Only Jia Liangcai, director of the Department of Internal Medicine, and Cai Fengyao, director of the First Department of Internal Medicine, were thoughtful and seemed to have grasped a little idea.

Although Qi Damin, the head of the medical department, said nothing, he was the head of the doctor's department, so he stood very close to Chen Qi. At this time, he was also full of curiosity, wanting to see what the new head could do. .

  (end of this chapter)

Chapter end