Since 1981 Health School Chapter 764

 Chapter 764 The real cause was found

 Bedside head CT is actually a mini-compact machine, mainly used for skull examination, including oral panoramic films.

 This machine is mainly used for critically ill patients or in field operations. It is very precious.

Chen Qi has locked the door, and the patient Wang Wenxiang is blind, so he is not afraid of leaking the secret.

He took out a special treatment bed from the space, then asked Xiao Wenxiang to lie down on it, and put his head into the machine.

　　　Gurgling, the machine started to start.

At the same time, Chen Qi had already taken out more than a dozen radioactive lead clothes and wrapped himself tightly from head to toe. Fear of death has always been a characteristic of a certain person.

 After 5 minutes, the machine will automatically stop.

This bedside CT is the most advanced 320-slice CT. Needless to say, it has such sharpness and can also perform three-dimensional reconstruction.

After a while, the machine automatically spit out a few pieces of film. Chen Qi looked at the light and took a breath of air.

This surgery was very difficult to perform. The tumor in the bone had invaded from the anterior cranial fossa to the junction of the middle cranial fossa and the posterior cranial fossa. The tumor had all adhered together.

The key is that this place is where the brainstem is (I mentioned the importance and danger of the brainstem earlier)

On this point, whether it is Meng Yushu or Ge Minghua, there is no problem with the judgment of the two professors. They have analyzed that surgery is a restricted area of ​​​​life. It is no wonder that Meng Yushu and Ge Minghua do not dare to operate. It is not that they are unwilling, but they dare not .

To be on the safe side, Chen Qi took out a high-frequency vascular color ultrasound machine from the space and began to examine the distribution and direction of blood vessels on Xiao Wenxiang's "horse face".

Chen Qi was thinking while watching.

This operation has two fatal points. If one of them is not good, the patient will die on the operating table.

 One is the brainstem.

  Reasonable selection of individualized surgical approaches plays a vital role in the treatment of brainstem lesions, which requires the surgeon to have an in-depth understanding of the anatomical basis of the brainstem, tumor growth characteristics, and rich experience in various surgical approaches.

 Brainstem "forbidden zone" surgery is divided into 13 brainstem "safe zones" and 10 surgical approaches.

 Chance Chen Qi needs to think carefully about the specific type of surgery and make a surgical plan in advance, which also tests Chen Qi's skills.

 If the brainstem is damaged during the operation, it goes without saying that the operation will fail and the patient will die or not get off the operating bed.

 The second problem is bleeding.

There is a thick common carotid artery on both sides of the carotid artery, and the internal carotid artery and external carotid artery are located on the carotid artery.

The internal carotid artery supplies blood to the brain, while the external carotid artery has seven to eight branches in the oral cavity and maxillofacial region, such as the superior thyroid artery, lingual artery, facial artery, ascending pharyngeal artery, occipital artery, postauricular artery, maxillary artery, etc. wait.

In addition, there is a vertebral artery that enters the brain through the cervical spine, so the blood supply to the mouth and maxillofacial region is very rich.

So it can be foreseen that the amount of blood loss during Xiao Wenxiang's surgery will not be small, but to what extent will it be?

The springs will come up one after another just like the Baotu Spring in Jinan. This is something that will definitely happen during the operation.

  If the bleeding point cannot be found in time and the bleeding cannot be stopped quickly, the patient will eventually die from hemorrhagic shock.

  Don't forget that half a month ago, Xiao Wenxiang was hit at the sharp corner, and the amount of bleeding reached 1000ml. However, for a petite girl like Xiao Wenxiang, the amount of bleeding in the whole body will not exceed 3500ml.

 The above two difficulties are like two roadblocks. If Professor Meng Yushu and Ge Minghua were to perform the surgery, the mortality rate would be almost 80%.

Especially for a doctor like Meng Yushu who does not engage in maxillofacial surgery, it is not unusual to have a mortality rate of 99%.

 As for letting Chen Qi go on his own...

Chen Qi now knows the bottom of the cards, the distribution of blood vessels, and the location and extent of tumor invasion. He is already 70 to 80% confident.

 Coupled with his skills and golden hand, there will be no big problem in performing this operation. Chen Qi has this confidence.

 But now I want to know where this “horse face” comes from? This examination alone is not enough, such as CT, and a puncture is required.

 Chen Qi has probably guessed what the problem is, but medicine, like courts, requires evidence, and this evidence is "biopsy."

 Then with the help of Professor Ge, Chen Qi took out the bone penetration tool and began to drill holes in Xiao Wenxiang's facial skull.

 Although local anesthesia has been provided, the pain is really unbearable by ordinary people.

Little Wenxiang was also in pain and cried out in pain. Moreover, because of her facial deformation, the sound she made when she cried was like a kitten meowing, which was very pitiful.

 That's it, she didn't even move, allowing Chen Qi to successfully get the specimen in one go. Professor Ge felt very distressed: "Wen Xiang is good, don't worry, as long as uncle finds out the cause of the disease and performs surgery on you, you will definitely recover."

Little Wenxiang was whimpering and nodding her head.

Wang Atu stood outside the ward. Hearing the cry of his daughter inside, he was so distressed that he burst into tears. At this moment, the father and daughter felt so helpless inside, and at the same time they complained that God was so unfair...

 Fortunately, the laboratory department of Peking University Third Hospital had someone on duty at night, so Chen Qi successfully found an optical microscope and began to perform the biopsy himself.

Professor Ge was old after all. Although he stayed with me, he fell asleep on the table after a while.

Chen Qi was actually tired after a day's journey, but he knew that he didn't have much time in the capital, and he had to compete for success in everything.

This time he came not only to help Professor Ge, but as a doctor, his hands were really itchy. Of course Chen Qi was also curious about such a difficult and complicated disease.

If doctors all over the country are at a loss, but he can perform the operation smoothly, this sense of accomplishment will be lost, it will be wonderful.

Hunted until daybreak, Chen Qi woke up Professor Ge:

 “Lao Ge, Lao Ge wake up.”

Ge Minghua slept soundly and woke up immediately (a characteristic of medical staff): "Hmm, Chen Qi, how's it going? Oh, it's already dawn, and you've been studying all night."

Chen Qi stretched himself while reporting the report:

“The pathological results are out. Take a look for yourself. These are irregularly arranged, immature bone trabeculae and mesenchymal cells.”

Professor Ge was also thinking while looking at the microscope, but after thinking for a long time, he couldn't think of a disease that matched it.

“Chen Qi, what do these irregularly arranged immature bone trabeculae and mesenchymal cells represent? I haven't really studied this yet.”

"This is actually a self-limiting benign bone fibrous tissue disease. Normal bone tissue is generally absorbed and replaced by homogeneous spindle cell fibrous tissue and dysplastic reticular bone trabeculae, and then the reticular bone is not It is caused by the stagnation of bone maturation in the mature stage or poor differentiation of the mesenchyme that constitutes the bone.

The bone fiber structure is poor or bone fiber malnutrition, and abnormal hyperplasia of fibrous tissue with bone capacity into bone capacity. This fiber abnormal hyperplasia replaces normal bone quality, so it is a deformity rather than a true tumor. "

Ordinary doctors don't understand what Chen Qi is talking about. As a top professional, Professor Ge from Peking University responded:

“This sounds like ossifying fibroma?”

 Chen Qi shook his head:

“It is not ossifying fibroma. Although ossifying fibroma also occurs in the maxillofacial region, it is a real tumor.

Fibrous dysplasia, also known as osteitis fibrosus, is a disease characterized by bone fibrosis and is not necessarily a real tumor.

Professor Ge, look at these CT films. Ossifying fibroma usually produces a maxillofacial mass effect, with obvious abnormal low-density shadows.

Fibrous dysplasia only produces inflammatory changes in local lesions, accompanied by local bone structural abnormalities. Look here, there are very obvious inflammatory changes. "

Professor Ge's eyes bulged out:

“Hey, where did you get this CT film? The resolution is so high and the picture is so clear. I have never seen it before.”

 Doctors are very excited about advanced medical equipment and can't put it down. It is obvious that Professor Ge knows his stuff.

“Hey, you don't have to worry about where this CT film came from, but you can't take it out now, but now this biopsy alone is enough, enough for you to brag in front of your peers at the national conference tomorrow.”

Professor Ge also laughed after hearing this:

"It's not tomorrow, it's today. Don't you love food the most? To express my gratitude, let's go, I'll take you to drink the most authentic old BJ's bean juice, paired with pickles and burnt rings, the taste will be overpowered Hatred."

"Lao Ge, are you treating me to drink bean juice to repay a favor or to take revenge? Do you think I can drink this stuff from the south? Okay, okay, help me find a halal noodle shop and have a bowl of beef noodles. it is true."

"Hey, you kid is really unlucky. You can't get used to the favorite delicacies of the people in our capital. You missed it. You missed it."

 Chen Qi yawned:

"If you miss it, just miss it. I haven't slept all day and night. Please help me find a hotel. I have to go and sleep for a while."

 Professor Ge is a little strange:

“Hey, this morning's national conference clinic is a rare one. Well-known experts from all over the country will come here. Everyone wants to give Peking University some face. Why don't you go and see it?”

"Don't go. What's the use of being in a nest? Those experts in the country can only do that. They are experts in civil war and outsiders in foreign wars. They are mules or horses and go to the international stage to compete with others. Put that little thought into practice. How well spent on academics?”

 Chen Qi is really not very interested in the domestic medical community.

It has been 10 years since he was reborn, and he has encountered a lot of infighting. You can forget that someone from abroad is trying to stumbling upon you, but your own countrymen are still messing with their own people all day long, so why bother?

Of course, that's not to say that the country is useless. That's not true. Professor Wu Mengchao, Chen Qi's idol in his previous life, and the team he led are definitely as awesome as the world.

Hepatobiliary and pancreatic surgery, China is far ahead in this discipline.

Of course, this one is far ahead. It has triggered many medical ethics lawsuits and even entered the blacklist of foreign journals, which makes people speechless and helpless.

 (End of this chapter)

Chapter end