Medical road

"Then ethanol, hey! This operation is entanglement." Old Zhao also said helplessly.No way, this operation is too nonsense, the worm sac is ruptured, and if you want to kill it completely, it is estimated that the worm was not killed, and the person was killed first.Don't kill it completely, it may relapse after a while.

"Yeah." Zhang Fan replied softly.Hemostasis and ligation, Zhang Fan and Zhao Jingjin quickly prepared before entering the abdomen.

"Punch." Zhang Fan said to the itinerant nurse.

The itinerant nurse lifted the salt water prepared early and began to wash Zhang Fan's gloves and Zhao Jingjin's gloves in turn.

This is a general rule, because these surgical gloves have talcum powder on them in order to be easy for doctors to wear. If this thing gets into the stomach, it can make the intestines of the patient stick together after the operation, so they must be washed before entering the abdomen.

When you enter the abdomen, you should not rush to perform an operation. You must first explore it. Simply put, it is to look through the various organs regularly and sequentially.Open the liver to see if there are worm sacs under the liver and gallbladder, and open the intestines to see if there are any behind the peritoneum.

Zhao Jingjin cooperated with Zhang Fan to turn the patient's organs."Let's do free ligament first." Zhang Fan said after turning over for a while without finding obvious sacs.What is this kind of thing?Looking through the intestines to look for the worm sac, it is very awkward, but this is the method of this kind of operation, there is no good way.

If it is multilocular echinococcosis, surgery is the only treatment, and the highest resection rate is 58%.In other words, one of them will almost always recur. Once it recurs, the most thorough treatment is to cut the liver directly and then replace the liver.Therefore, eating raw meat has a price.

And this thing has different numbers of testicles (a) balls, sons (a) uterus, and genital holes.In other words, this thing is estimated to be one-to-many, or many-to-one, and the pedigree is not messy, super scary stuff.

After the investigation, Zhang Fan said: "Change the gauze, remove all the white gauze, don't go on the stage again."

"Okay!" Baoyin nodded, then counted the number of gauze with the visiting nurse.There are ten before going on stage, and there must be ten when off stage. This is the regulation.

The sac on the skull is relatively superficial and relatively small.The liver is generally deeper and larger.The worm sac is the largest in the head and is like a small egg.In the liver less than 4cm, it can be treated conservatively, which means it is not surprising that this thing grows into a small ball in the liver.

If the ascus is regarded as pearl jelly in the skull, then the size in the liver is about the same as the small glutinous rice balls, the shiny small glutinous rice balls, the small glutinous rice balls that drip with water with a touch.

Separating little by little, Zhang Fan will definitely open it to see if there is an ascus hidden in it.After Baoyin took the blue dressing onto the table.Zhang Fan began to enter, and the separation around the liver was clear.

The liver is too complicated. It is not only a synthetic secretory organ, but also a detoxification and decomposition organ. So this is a super chemical factory. There are various pipes in it, and the sacs grow here, and then secrete fluid that sticks to the liver. On various pipelines.

It doesn't matter if the small tube is stuck to the inferior vena cava or hepatic vein, it will be super troublesome.

"Probe." After the separation was clear, Zhang Fan said to the itinerant nurse.In this type of operation, it is necessary to see the relationship between the internal structure of the liver and the sac. There is still error in doing color Doppler ultrasound through the belly. Therefore, after freeing the peripheral ligaments and blood vessels of the liver, Zhang Fan began to use color Doppler ultrasound to explore the liver.

Zhang Fan and Zhao Jingjin looked at the color Doppler ultrasound screen carefully at the same time. Zhang Fan slowly moved the color Doppler ultrasound probe under his hand, which was wrapped in sterile gloves.

"It's okay, there is no major blood vessel, Director Zhao, can you take a look again?"

"Okay, I'll watch it again." Be careful before the operation, and rest assured during the operation. Cross-checking between the two is more secure.

"It didn't touch the major blood vessels." Zhao Jingjin said in confirmation after doing it again.

"Okay, let's get started, sharp knife." Zhang Fan said.

Holding a sharp knife, Zhang Fan slowly separated the liver from the parenchymal boundary along the worm sac. There were many ducts in the liver, and the operation was very slow. There were several ducts in almost one cut.

Constantly ligating and cutting, it is not the worst luck, if you lean on the hepatic vein, you can only pray for God to change the liver.

After cutting off all the blood vessels and biliary tract that entered the cyst, Zhang Fan directly used the blue dressing to gently take the cyst with the liver tissue out of the liver.

Looking down from the shadowless lamp, the patient's liver was directly a pit, and a pit the size of a small bowl was cut down by a knife.After taking down the worm sac, Zhang Fan looked at the surroundings very carefully, for fear that it had another sac on the side.

"No!" Zhang Fan looked at it once, and Lao Zhao looked at it again.

"When you come to Dr. Lu, you can also see. Are there any white sacs?" Zhang Fan said to Lu Shuyan.

"No!" Lu Shuyan said after taking a look.

"Okay, let's open the worm sac." The contents of this worm sac are very important for treatment.If the sac fluid is clear and contains small fragments, it means that the sac is active and the tissue around the sac must be killed with medicine.

If the sac fluid is milky, it means that the sac has been weakened, but it is still infectious.If the inside of the capsule is toothpaste-like, it means that the hydatid inside is dead, and there is no need to kill the surrounding area.This is the same as human amniotic fluid.

After Zhang Fan took the worm sac away from the operating table, he cut the worm sac with a scalpel. A milky liquid flowed out, and it was still watery. The pressure in it was not small, indicating that there were too many reproductive bugs.

The moment I cut it with a knife, it was really like a glutinous rice dumpling with white sesame filling that had not been finely ground. It was bitten into a small bite, and it flowed directly into a bend.

"Bag." Zhang Fan directly put the entire plate into the tissue bag.Then said to the tour: "This must be strictly disinfected."

"Ok."

Then, Zhang Fan continued to change his gloves.The cyst has been removed, and no other cysts have been found in combination with color Doppler ultrasound. Zhang Fan said to Lao Zhao, "Director Zhao, do you need ethanol?" In this regard, he still doesn't have much experience with Lao Zhao.

"Forget it, the operation was very clean, and no other worm cysts were found. This patient's liver has been tested by alcohol. It is too fragile. Use formalin."

"Okay!" Zhang Fan is better at listening to people's advice to eat a full meal.

Gently use formalin-dipped gauze, and gently wipe the inner wall slowly.Wiping and watching whether there is any formalin remaining, if this thing survives, it will be a big trouble.

"Flush!" A large amount of saline, more than a dozen bottles of normal saline, was directly rinsed for several minutes, and the original vermilion liver was almost white.

After more than five hours, the operation was finally over.