Since 1981 Health School Chapter 525

  Chapter 525 The surgeon is completely confused

  The arrival of several directors made Chen Qi a little unexpected.

  He didn't think endoscopic hemostasis of gastric bleeding was such a complicated operation. For Chen Qi, it was too simple, and it was really no different from an injection in the buttocks.

   But he still ignored the era he was in and the hospital.

  For Vietnam, a small third- and fourth-tier city in 1988, endoscopic hemostasis was unheard of.

   Even using an endoscope to remove fishbone can attract so many directors of internal medicine to watch, and it can cause a sensation inside, which is beyond Chen Qi's imagination.

  Through this incident, we can see several problems in domestic medical care in this era.

  On the one hand, doctors, especially young doctors, are very eager for new knowledge and technology, want to learn, and are willing to learn.

  On the other hand, in the 1980s, due to various reasons, there were too few domestic and foreign exchanges.

   The few exchanges are with Sulian, several Eastern European countries, African black uncles, and the so-called Pakistan Railway Cambodia and other countries.

   What advanced medical technologies can these countries have for the two sides to communicate with each other?

   After all, we are too far away from the mainstream world.

In the 1980s, in Yuezhong City, even in Haidong Province, it was impossible to subscribe to a foreign medical journal. Only international-level experts like Professor Chen Qi and Wu Mengchao would regularly receive relevant top medical journals. periodicals.

  However, there are also some visionary, insightful, and ideal doctors who are still pursuing new knowledge diligently.

  Many doctors have a rare opportunity to go abroad. When they go abroad, they use the limited foreign exchange subsidies in their hands to buy those medical journals that have expired instead of buying their own personal items.

  Because expired magazines are cheap, they are also considered as waste products abroad. You can buy a lot of them for a little money, and then bring them back to China for everyone to learn and reference.

   Of course it is a pity that more medical talents choose to stay there and become ABC after seeing the advanced foreign countries.

  So except for a few top experts in China, the vast majority of doctors in China don't know about advanced technology, advanced equipment, and advanced concepts at all, and there is no way to know.

   It is not a crime of war, and doctors are helpless.

  The simplest example is that the equipment that Chen Qi brought back from Mayo has reached the most advanced level in China.

  For example, some endoscopic instruments used in gastroenterology are unheard of by everyone. They are only regarded as the most advanced gastroscopes, but they do not know that "gastroscopes" can also be used for surgery.

   Speaking of this, it is not that Chen Qi is walking 500,000, but is deliberately belittling the country and raising the foreign.

   Only when you know your shame can you be brave and face your own shortcomings. Only in this way can you work hard and catch up with the possibility of surpassing. The same is true for medicine.

  How can we improve if we don't recognize the gap?

  It is a pity that in the following decades, it has been proved that some people in China did not realize where this gap is and how to narrow it.

  As a result, the gap between domestic medical equipment and foreign countries is widening, until later it is impossible to catch up. The top medical equipment and medical chips are still in the hands of Western countries, and they have to spend sky-high prices to buy them.

Of course, this is something.

  Chen Qi laughed after hearing Director Zhu's concerns:

   "Ms. Zhu, don't worry, I am a surgeon, and I have no possibility of changing my career to become an internal medicine doctor, so it is impossible for us in surgery to be eliminated. On the contrary, surgery can do a lot, and the golden age has not yet come."

  Zhu Huoyan didn't doubt Chen Qi's words at all, but his worries didn't disappear.

"But Chen Qi, I heard from others that you said that in the future surgical operations will be minimally invasive. How do we understand this minimally invasive operation? Does it mean that the operation can be completed like a gastroscopy? Anyway, I imagine not come out."

  Comrade Guo also pouted beside him:

   "I think this kid is talking nonsense. How do you insert a tube into my brain surgery operation? Where do you insert it? Not all operations are like gastroenterology, where you can directly face the gastrointestinal tract through an endoscope."

  Chen Qi was making preoperative preparations, choosing the endoscopic tube he was going to use for a while, and at the same time complained in his heart: There is a brain mirror, and it is also a type of minimally invasive surgery.

   But he dare not say this, because he is easy to get beaten:

"Guo Shuji, Mr. Zhu, it's not just endoscopic surgery as you imagined. Minimally invasive is not non-invasive. It still needs to make a few holes in specific parts of the body, such as a simple cholecystitis. Now we need laparotomy. Bar?

The minimally invasive surgery in the future does not need to cut open the abdomen, but only needs to make a few small holes in the abdomen, about 1 cm, and then I will insert a few tubes, which are like a gastroscope with a camera at the top , allowing me to clearly see the internal organs of the abdomen.

  In addition, I have two tubes extending in here, which actually replace my hands. For example, separating tissues, removing diseased organs, suturing and ligating, etc., can be done through two tubes.

Think about it, laparotomy does a lot of damage to patients, especially older patients, but if only a few holes are made, the incision is small, the damage is small, and the recovery is fast, this may be the future of surgery. Major Trends in Surgery. "

   What Chen Qi said was "laparoscopic surgery",

  For example, rigid hysteroscopes, laparoscopes, cystoscopes, arthroscopes, ventriculoscopes, thoracoscopes, vaginoscopes, etc., not just flexible gastroscopes, bronchoscopes, laryngoscopes, and colonoscopes.

  As soon as these words came out, Old Man Guo and Director Zhu were both thinking.

  Yi Zewen and other young doctors are already simulating how to do surgery with two tubes? It's completely incomprehensible if you haven't really gotten started with all this kind of stuff.

  The doctor is holding a seminar here, and Bai Xue's parents are waiting a little bit:

   "I said doctor, can you hurry up, my daughter is waiting."

   "Oh, oh," Chen Qi remembered that there was a patient lying next to him, who was looking at him resentfully.

   "I'm sorry, I'm sorry, these are the scribes and directors of our hospital, and we forgot about business as soon as we chatted, okay, I will perform the operation right away."

   Lan Lijuan and head nurse Shou personally assisted, while Comrade Guo and Director Zhu surrounded the monitor, watching Chen Qi slowly lower the gastroscope tube.

   There is no problem with the esophagus.

   There is no problem with my stomach either.

  Chen Qi skillfully operated the gastroscope all the way down through the pylorus to the duodenum.

  Because this is an emergency gastroscopy, there is no fasting before the operation, so there are a lot of secretions and food residues in the intestinal cavity, but Lan Lijuan, who has sharp eyes, has already noticed the abnormality immediately.

  She didn't say anything, she just tapped the screen with her finger.

  Chen Qi understood in seconds, and began to wash with physiological saline. The onlookers unconsciously stretched their heads forward a little, wanting to take a closer look.

   Sure enough, with the flushing of normal saline, bright red blood streaks can be clearly seen flowing in the flushing fluid.

  The bleeding point is found.

  Master Nurse Shou happily comforted Bai Xue in a soft voice:

   "Comrade Bai Xue, we have found the real cause of your illness. It really is gastrointestinal bleeding. You are not epileptic. You are really wronged."

  As a lesbian, it is easier to be angry and sympathetic to Bai Xue's experience, so the female doctors and nurses next to her were a little excited.

  Bai Xue's tears flowed down in a flash. When Bai Xue's parents heard it outside the treatment room, they hugged each other and cried again.

  Director Zhu didn't know there was such a piece of gossip, and his mind was more on the operation. At this time, he started to ask questions from a professional point of view:

   "Chen Qi, I found the bleeding point, how should I treat it with the endoscopic surgery you mentioned?"

  Traditional surgery, at this time, should be pulled to the operating room, cut open the stomach to find the bleeding point on the gastrointestinal tract, and then ligate to stop the bleeding.

  If it is ulcer bleeding, or the bleeding site is not ideal, and part of the stomach or intestine will be removed, the operation will become bigger and bigger.

  As long as laparotomy is performed, it is generally grade II or III. Not only is the patient suffering, but the medical expenses are not affordable for ordinary families.

  Chen Qi leaned against the screen to study, confirmed the bleeding point, and smiled.

   Picked out a special small tube from the endoscope box, plugged it through the endoscope hole, and stuffed it into the stomach.

   At this time, everyone can see from the screen that a blunt head appears on the top of the gastroscope.

   Chen Qi looked at the screen again, rinsed the bleeding point repeatedly, and then resolutely pointed the blunt head at the bleeding point, pushed it once, and relaxed; pushed it twice, relaxed; pushed it three times, relaxed.

  Looking at the big and small directors next to him, he didn't know what Chen Qi was doing, but no one said anything, for fear of missing any details.

   After hitting three times, Chen Qi rinsed the wound with normal saline again. By this time, the bleeding point had miraculously no fresh blood flowed out.

   "Come on, okay, the bleeding has stopped."

  duang~~~

  All the doctors onlookers dropped their jaws in shock, and the bleeding stopped just a few times at the exit point? The operation was successful?

   Director Zhu also took a look at his watch. The whole process took less than 10 minutes from the gastroscopy, right?

  Old Guo couldn't bear it anymore, and asked in surprise:

   "I figured it out. There is something wrong with the tube inserted behind you. If there is no accident, it should be using the same principle as an electric knife, using electrocautery to stop bleeding, right?"

  Chen Qi gave a thumbs up:

   "Ginger is really old and hot, and Comrade Guo is really an expert in the doorway. This is called photocoagulation to stop bleeding. The principle is to use photocoagulation to coagulate the protein of the irradiated local tissue and cause thrombus to form in small blood vessels.

  Look at the bleeding point just now, it is obvious that a small artery in the stomach is broken, so it is most convenient to use photocoagulation to stop the bleeding. If it is a small superficial hemorrhage, norepinephrine can also be sprayed on the lesion to achieve the goal of hemostasis.

  In addition, if it is bleeding from esophageal and gastric varices, a sclerosing agent can be injected to stop the bleeding, such as 1% ethoxysclerosing alcohol. In addition, there are argon gas hemostasis, hemostatic clip hemostasis, varicose vein ligation hemostasis and so on.

  Basically no matter what the cause of your gastrointestinal bleeding, you can use the above methods to perform minor hemostasis surgery through gastroscopy, and it's not just for gastric bleeding. Let's take a look here again, is there a small polyp? "

  Everyone's eyes were focused on the monitor again, only to see a 4mm flesh-like protrusion in the greater curvature of the stomach.

  Everyone nodded in unison. They are all professional doctors, so naturally they couldn't make a mistake.

"Although gastric polyps are a benign disease, if they are not treated for a long time, they may turn into cancer. If they encounter it, it is fate, and of course it is not only fate. This gastric bleeding hemostasis, gastric polypectomy, isn't it? Two surgeries?

  Is it possible to charge more for two surgeries? What does it mean to create a business, what does it mean to grow profits, and voila, that's how it came about. Of course, Comrade Bai Xue, don't worry, we will only charge you once today, and we will give you a big discount for opening today. "

  Bai Xue couldn't speak with a gastroscope tube inserted in her mouth, so she couldn't help but rolled her eyes after hearing Chen Qi's words.

  The directors and young doctors around all laughed happily.

  But after careful consideration, I feel that the dean is right. One more step, one procedure, one operation, can charge a sum of money.

   Surgery is highly profitable.

  According to the policy formulated by Dean Chen, high business performance means high bonuses, who doesn't like banknotes.

  Lan Lijuan quietly kicked her husband:

   "What are you talking about, Guo Shuji and Teacher Zhu are here, don't talk nonsense, and do a good teaching operation."

  Chen Qi was speechless after hearing this, and thought that when he went back tonight, he must let this disobedient department director have a taste of what it means to be a storm from the dean!

   "Okay, then I will show you how to remove gastric polyps under the gastroscope. Watch it, this operation is very fast, I am not responsible for the playback."

  Old Guo was upset: "There's so much bullshit, do it quickly."

   Chen Qi picked another tube of a different type and inserted it into the gastroscope tube again. At this time, a metal head was seen on the display. "

  A little doctor suddenly said excitedly:

   "Oh, I see, this is an electric knife, is Dean Chen going to use an electric knife to remove polyps?"

  Chen Qi nodded:

   "Hey, smart, it seems Director Lan has no weak soldiers, everyone is optimistic, just cut the polyp like this, rinse it again to make sure the incision is not bleeding, and it's done."

  Dean Guo's eyes widened again: "Just a few seconds to solve the problem?"

  Chen Qi was already collecting the tube at this time, "Okay, the bleeding has stopped, the polyps have been removed, and the operation was a perfect success."

   After finishing speaking, Chen Qi did not forget to comfort the poor woman:

"Comrade Baixue, in the face of rumors and rumors, if you need us to issue a medical certificate for you, don't be too sad. I don't think the people in your in-law's family are easy to get along with. Instead of being angry at your in-law's family, it's better to find a better one." People."

  Bai Xue smiled wryly, and said hoarsely and sincerely:

"Thank you, Dean Chen. I'm not the kind of woman who cries, makes trouble and hangs herself. My in-laws have long been dissatisfied with me. Even if I have a medical certificate, they won't believe it. I don't need them to believe it either. I'll just live on my own."

  As soon as these words came out, Chen Qi was surprised, thinking that this girl is really wise, quite independent, beautiful, with a good figure, and a stable job...

   Shouldn't miss it?

  Don't think wrongly, Chen Qi didn't think about taking a concubine or raising a child for himself, but he suddenly thought of one of his old subordinates, Yan Shifan from the Fourth Academy of Yuezhong.

  Why did you think of Yan Shifan? This is another heartbreaking and sad thing, which makes people quite speechless.

  (end of this chapter)

Chapter end