My medical skills add experience

Chapter 465 The surgery is bad, the difference between people is too big

"It's really nothing to say. I just saw the patient's preoperative pictures and barium contrast. I guess you performed a total gastrectomy on her."

Zhou Can explained with a smile.

Barium angiography is used to check the condition of the cardia and digestive tract, and the patient is usually given a barium dose directly, which is referred to as a barium meal in medicine.

Some patients will have great concerns when taking it. This can be assured, and there is basically no harm.

The barium meal used for gastrointestinal examination is a suspension of medicinal barium sulfate. It is insoluble in water and lipids, so it will not be absorbed by the gastrointestinal mucosa and is basically non-toxic to humans.

If you want to say that there is no toxicity at all, there is no guarantee for this.

After all, it is a chemical agent.

It’s just that the vegetables, fruits, and various processed foods we usually eat contain much more additives than imagined.

A barium meal test may be less toxic than eating a spicy bar or chewing a piece of betel nut.

This inspection will not be done frequently, but only once when necessary, so there is no need to worry too much.

The detoxification ability, resistance ability, self-cleaning ability and recovery ability of our human body are far beyond our imagination.After many toxic and harmful substances enter the body, they will be quickly decomposed by our liver.

If the liver can't handle it, the kidneys will cooperate to excrete the toxic substances from the body.

At the same time, our sweat glands also have the function of detoxification.

If the food you eat is highly toxic, don't worry, the body will immediately activate a dual protection mechanism of vomiting and diarrhea.Vomit out the poisonous content in the stomach, and then enter the intestinal tract, and then quickly excrete it in the form of diarrhea.

It can also be seen from here that our bodies love themselves more than we do.

"Yes, what I did for her was indeed a total gastrectomy. My idea is that losing her stomach is better than losing her life. Even if it can only help her extend her life by five years, I think this operation is of great significance .Under normal circumstances, if there is no relapse, her lifespan can even be extended by ten years, 20 years, or even longer."

Director Le is considered a veteran in cardiothoracic surgery.

In terms of surgical ability, he is quite good.

Any operation will cause some harm to the patient's body.After evaluation, the attending doctor felt that the benefit of the patient far outweighed the damage through the operation, so it was worth it.

Losing the stomach, a digestive organ, will definitely have a bad impact on the body.

In the future, food can basically only be liquid food.

Also can bring a lot of inconvenience.Without a stomach to store food, you definitely need to eat smaller meals more frequently.There is also food reflux, which also makes patients suffer.

Losing the stomach not only reduces the ability to digest and store food, but also loses an important protective barrier for oral consumption.There is gastric acid in our stomach, which can almost eliminate most germs and viruses.

Lose it, and there is no such barrier.

Therefore, we must cherish every organ of the body.If a problem is found, seek medical treatment in time.

If you keep procrastinating, it is easy to miss the best time for treatment.

The body is like a house.When there is a fire source in a room, put it out quickly, and the items in the room will be slightly damaged at this time.As far as the whole house is concerned, it has almost no effect.

If you wait until the fire is strong and all the items in the room are burned before putting out the fire, at least the room will be lost.

Every organ in the body is equivalent to a room with its own unique function.

It is difficult for other rooms to replace its functions.

For example, if the kitchen burns out, there is no way to cook anymore, and we can only eat takeaway every day.

"After you cut off the stomach, did you pull the jejunum into the diaphragm and anastomose the esophagus end-to-side?"

Almost everyone is in the same vein as Director Hu Kan, and they can guess a little bit about the operation method.

"Amazing! That's exactly how it works."

Director Le nodded in acknowledgment.

"Is the nutrition tube inserted into the distal end of the jejunum?"

Zhou Can asked again.

"That's right." Director Le admired Zhou Can so much, he could even deduce the surgical plan accurately just by taking a few glances. "Doctor Zhou must have found out the cause of the patient, so don't tease me, tell me quickly! You know, I'm impatient."

Director Le couldn't help urging.

Based on his understanding of Zhou Can, it is certain that Zhou Can has already made a diagnosis.

It's just that Zhou Can has always been low-key, and he doesn't speak easily until he is absolutely sure.

"Hey, I won't hide it from you. I did have a preliminary diagnosis. But whether it is as I thought, further testing is needed." Zhou Can smiled. The first thing he said was not an answer, but an emphasis on the need to examine the patient. Only then can a treatment plan be determined.

Medication and treatment are rigorous matters.

No matter how experienced the doctor is, as long as it is not an emergency life-saving situation, he must not rely solely on the doctor's subjective assumptions to treat.

Even if it is an emergency rescue, it also needs to be supplemented by some necessary inspections.

You ask, what if it is a critical illness such as chest sudden onset or cerebral hemorrhage?
Even for this type of emergency and critical illness, at most, some basic rescue measures, such as cardiopulmonary resuscitation, should be done first, and then relevant examinations should be performed urgently on the patient.Before the test results come out, absolutely no doctor dares to use thrombolytic drugs or perform surgery on the patient.

If a cruel rescue condition had to be set, the patient was comatose during the consultation, and the receiving doctor knew from experience that the patient had a cardiovascular blockage.Even the receiving doctor can deduce which coronary artery is blocked by virtue of superb medical skills and rich experience.

At this time, emergency intervention to open the thrombus can save the patient's life.

If you have to wait until the CT or even angiography examination to determine the surgical plan, the patient will definitely die.

At this time, should we rely on the experience of the receiving doctor to perform surgery to save the patient, or insist on waiting for the results of the examination?
It is a pity that knowing that the patient will die when the test results come out, he still has to wait.

It's not that the doctors are unwilling to help, but that no doctor dares to gamble his future with the house.In case the patient fails to be rescued and the family members sue in court, the doctor is likely to die.

In order to protect themselves, doctors can only wait for the test results.

During the waiting process, we can only do some basic rescue measures, and never dare to operate or intervene in surgery.

Even medication is extremely cautious.

This is the harsh reality.

It's not that doctors are unkind and sympathetic, but that they must operate in strict accordance with relevant procedures.

"This patient underwent anastomosis of the jejunum and esophagus. Based on her symptoms and surgical plan, I boldly infer that her cause is likely to be a serious postoperative complication, reflux of bile sweat and pancreatic juice."

Zhou Can gave the diagnosis conclusion.

Director Le fell into deep thought after hearing this.

"The reflux fluid is mostly alkaline, without the neutralization and buffering of gastric acid in the stomach, so it is more invasive to the esophageal mucosa. Therefore, whenever reflux occurs, the patient will feel unbearable pain behind the sternum and loss of appetite. Naturally, if things go on like this, the body’s physical fitness will definitely decline severely.”

He made further analysis based on Zhou Can's conclusion.

Zhou Can just nodded with a smile, indicating that was exactly the case.

"Then how to solve this problem?"

Director Le humbly asked him for advice.

The cause has been found, and it is not immediately fatal, leaving enough time for the doctor to treat it.

What we have to do now is to find a way to treat and change the status quo of patients.

"This has already been operated on, so I'm afraid it's a bit troublesome. If there is no operation, there is a way to solve it."

Zhou Can's expression became serious.

He is not a god, and some postoperative complications are almost unsolvable.

Make bricks without straw.

The previous surgeon had already removed a certain part of the patient's tissue, and even if he knew how to treat it, there was nothing he could do.

"Did I ruin the operation?"

Director Le is also a smart person, although Zhou Can didn't say it clearly, he already understood a little bit.

A qualified doctor generally does not criticize other doctors for failing to perform well.

At most, like Zhou Can, click a little bit.

Basically, it is impossible to hold the previous surgeon accountable.Because the patient's family members signed before the operation.Fully informed and agree to the surgery.

Even knowing that the signing before the operation will bring huge risks, there is basically no solution.

When it's time to sign, you have to sign.

If the family members do not sign, there is no way to perform the operation.

Only one hospital can be changed.

Moreover, the professional level of the family members is definitely far inferior to that of the attending doctor. Taking the medical knowledge of online popular science such as Baidu and Zhihu to teach the doctor how to make a surgical plan?Don't be funny.

As long as there are family members who dare to do this, if the attending doctor can't explain it, they will give up and let the family members find another Gao Ming.

Now some smart patients and their families like to ask several hospitals before the operation, and dare to make multiple comparisons of the operation plan formulated by the doctor.This is actually a relatively safe approach.

Of course, the premise of doing so must be a chronic disease, and you need to have sufficient time, money, and energy to go to several hospitals.

If the selected hospitals are all large hospitals, some potential risks can basically be avoided.

Zhou Can really couldn't answer Director Le's question directly.

Even though the two have a good relationship, in front of Director Le, he admitted that he botched the operation.This is extremely stupid.

Even if people don't have any opinions in person, there must be some thoughts behind them.

If you meet that kind of arrogant doctor, you may turn against each other directly.

"Doctor Zhou, is there any way to solve this patient's postoperative complications?"

Director Le asked a question in a different way.

"Show me your operation plan and operation records, and then you can take advantage of this time period to do a 24-hour bilirubin monitoring examination for the patient. If possible, it is best to supplement it with gastroscopy, mainly to observe the bile reaction. The condition of the flow and the etiology are clarified."

Zhou Can did not rashly "point the country".

It can be seen that as he has been practicing for longer and his medical skills have become higher and higher, he has become more cautious in doing things and speaking.

This is also the common performance of all doctors after evolution.

The higher the level of experts, the more cautious they are in the diagnosis and treatment process.

It's not entirely because they are afraid of being slapped in the face, but to look at the problem more comprehensively, and the in-depth comprehensive assessment and judgment have gradually been integrated into their diagnosis and treatment habits.So become more and more cautious when practicing medicine.

Doing so will reduce the chances of capsizing.

Director Le showed all the operation records and the operation plan discussed before the operation to Zhou Can for review and study.

On the other hand, he has begun to arrange for the patient to have a second examination to observe the patient's reflux situation in order to clarify the cause.

Half an hour later, Zhou Can had finished his research and had a surgical improvement plan.

Director Le's inspection results probably won't come out until tomorrow.

Zhou Can called Director Le and told him that he would have a consultation with him when the test results came out tomorrow.Then he rushed to the pediatrics.

There is still a difficult case waiting for him!

When he came to the Pediatrics Department, he went straight to Director Tang Fei's office.

Knocking on the door of the office, Director Tang Fei hadn't gotten off work yet, so she might be waiting for him to come over.

Because when she saw Zhou Can enter the door, she was very happy, and immediately put down the pen in her hand, and got up to make tea for Zhou Can.

You know, this is the chief director of pediatrics.

Zhou Can is just a resident doctor, and it is the benefit of strength that he can be treated so courteously by a director who is second only to the vice president.

Ordinary residents would feel extremely honored and happy if they could enter Director Tang Fei's office for a private chat.

It is estimated that there are only standing parts in the whole process.

Looking at Zhou Can again, the treatment he received was exactly the same level of courtesy.Even the general deputy chief physicians may not be able to get this kind of treatment when they come to Director Tang Fei.

"Doctor Zhou, please sit down! Why are you being polite when you come here?"

Director Tang Fei smiled and asked him to sit down, and closed the office door smoothly.

Zhou Can's expression immediately looked a little unnatural.

Being misunderstood by Director Xueyan's husband has already given him some psychological shadows.He became more careful when dealing with these younger and more beautiful female doctors and nurses.

Especially when entering other people's offices, when there are only two people alone, if you can not close the door of the office, try not to close it.

Otherwise, if another misunderstanding is caused, it will be of no benefit to anyone.

"Don't be cautious, Doctor Zhou, it's not the first time you've come to my place."

Director Tang Fei saw Zhou Can's nervous and embarrassed face, and immediately smiled to comfort him.

"Uh... It's not reserved at all! Can you open the door to the office? I've been a little tight lately."

Zhou Can gave a lame reason.

Puchi!

Who is director Tang Fei? You can tell from his expression that he is not telling the truth.

I couldn't help laughing on the spot.

Zhou Can was even more embarrassed.

"What's the matter with Dr. Zhou today? He looks weird. Did something happen?"

Women's sixth sense ability is too strong.

She knew very easily that something must have happened to Zhou Can.

"Hmm... well..." Zhou Can hesitated.

"This is treating me as an outsider! If there is anything, you can tell me with confidence. Maybe I can give you some ideas and help you solve it! Of course, if you don't want to say it, you don't have to force it .”

Director Tang Fei has always been kind to Zhou Can, and he values ​​his super talent very much.

Zhou Can hesitated, and finally said honestly, "I didn't pay attention when I got along with a female doctor in this hospital. I closed the office door and discussed the patient's condition with her inside, but was misunderstood by her husband. This morning When I was at work, her husband found me and warned me not to associate with his wife. I am not afraid, but I am afraid that I will harm you lesbians, and that would be a serious crime.”

Mentioning this matter made him depressed.

"Giggle!"

Director Tang Fei laughed so hard after hearing this.

"What did I think it was? It turned out to be this kind of thing! You should be careful with other female doctors and nurses, but with me, you should keep your heart in your stomach. My family He never asked me about which man I was dating, he was very relieved of me. And he was bored doing research in the laboratory all day long, so busy that he had no time to care about me. In his words, as long as I don’t give him Just add chaos."

Director Tang Fei explained to Zhou Can.

"You are so beautiful, so he never worried about other men snatching you away?"

Zhou Can couldn't help asking.

He found that the differences between people are too great.

Director Tang Fei's husband and Director Xueyan's husband are simply two extremes.

"If he really cares about this one day, I'd be happy. But as far as he is concerned, his scientific research data is obviously more attractive to him." Director Tang Fei is in her 40s, with a sweet appearance. They are not worried that she will be tricked by other men.

Really fun.

(End of this chapter)