Medical road

People, in fact, can struggle only in those few years.The years without getting married and having no children are the best time to lay the foundation. With the foundation, over time, you might be able to improve.Once the sloshing has passed, it will be extremely difficult to struggle again.

Zhang Fan also has a system. After eating and drinking enough, he sleeps and the battery is full again!In the hospital, especially in the surgical system, because of the excessive work, the doctors who are a little older are really clenching their teeth and insisting, even the married life has become a luxury.

In the early morning general surgery, a group of attending doctors looked wilted.The high-hanging hospital is like a carrot hanging in front of a donkey. If it doesn't work hard, it belongs to others.

After arranging the operation for tomorrow and explaining some department work, General Surgery Director Zhao Pingquan said to the doctor: "Now, let Zhang Yuan say something."

"Our operation today is the removal of a gastrolith for patients with gastrolith. Are you ready for the operation?" After a period of confusion, Zhang Fan is now used to this position.

"Yuan Zhang, ready. Gastrointestinal decompression has been prepared the day before yesterday. I have been fasting since yesterday, and all nutrition is outside the intestines." The doctor in charge of the tube bed reported.

"Director, are you undergoing this operation?" Zhang Fan still respects Lao Zhao.

"Okay, I'll give you a hand." Lao Zhao likes to have surgery with Zhang Fan, and can't talk casually except on the hand stage. Surgery with Zhang Fan really seems to be an artistic pleasure.

"Okay, call the operating room to receive the patient number."

Zhang Fan and Director Zhao walked to the operating room together.The two chatted as they walked, "The doctors in the department recently screamed, rushing to collect the sick number."

"It's all your support from the director. Unlike other surgeons, the doctor's maturity cycle is too long."

The two chatted and entered the operating room from the dedicated elevator.When building the hospital’s elevators, Huang was stingy and made four elevators. At that time, he felt that these four elevators were a bit wasteful.

As a result, the elevators in the surgical building are now not enough, and someone must organize a line in the morning.Otherwise, someone quarrels about taking the elevator every day.

Ouyang is better than the old in this respect. The emergency center has a total of eight elevators, one for the emergency department of the operating room, one for doctors and nurses, and the remaining six are reserved for patients and their families.

Entering the operating room, Uncle Jinya saw Zhang Fan, smiled at Zhang Fan in favor, and wanted to talk, but the little nurse who followed was not as good as Zhang Fan, and he dared not run over to talk to Zhang Fan.

Jin Ya has been placed in the family members.Disinfect, wash hands, spread towels, and go to surgery.The stomach, the stomach of the human body, is too boring to describe it in professional terms.

When Zhang Fan was in the interpretation class, he didn't like to learn the abdominal organs and nerve courses. Orthopedics was simple.The dissection of abdominal organs is too much and too complicated.They have different forms, and if you don’t work hard, you will get confused.

And neuroanatomy is directly similar to Ting Tian Shu. It is too abstract. It will be electrical conduction, humoral conduction, and jump conduction will appear from time to time.If you don’t understand in get out of class, and do not review after class, the exam will be a paste.

That is to say, there was a system later, and it took Zhang Fangan countless times to understand the anatomy of these two systems.

The esophagus and stomach can be described as cables in plain language.When it derives from the esophagus to the stomach, the cable becomes larger and thicker.

The outer skin is a wear-resistant protective layer, and the inner layer carries blood vessels and nerves.

The structure of the stomach can be divided into four layers, from the inside to the outside into the mucosal layer, submucosal layer, muscle layer, and serosal layer.The muscle layer can be divided into 30%.

It's complicated. The shape of this muscle layer is not the same. The innermost muscles are oblique, starting from the contact between the esophagus and the stomach and continuing to the duodenum.

This shape makes sense. The oblique muscle shape is good for the downward movement of food. If you make a ring-shaped muscle, maybe the food will be trapped in the stomach.

The middle layer is the annular muscle, which wraps the stomach in circles to increase the firmness of the stomach.The outermost layer is vertical, which is to reduce friction with other organs.Because the stomach is always active.

It's really like a ball of woolen yarn.

The stomach can secrete many things, no less than a dozen kinds.In the early years, the medical profession only believed that the stomach had only the function of digestion and grinding, but later discovered that the stomach also had the function of secretion.

The most important secretions are HCL and some special enzymes. Its pH is between 0.5 and 1. This kind of concentration of hydrochloric acid, if you throw in an iron tablet, it may be able to melt you.

But the stomach, won't it be corroded by HCL?Yes, it will be corroded, but it is because there is a weakly alkaline protective layer on the inner surface of the stomach, with a bicarbonate barrier of about 0.5mm thickness, which is the most important protective layer of the stomach.

Without this protective layer, even if the stomach muscles are ten meters in length, stomach acid can penetrate.Eating peppers, drinking wine, eating chocolate, and then having stomach pain, this means that there is an ulcer in the stomach.

Anger, especially young women, because the body's secretion function is strong, the various hormones produced after being angry will also cause this mucous membrane to decrease, so this is also the cause of stomach pain after being angry.It is not uncommon for a person with a big temper to perforate the stomach.

Ulcers are caused by gastric acid penetration through the protective layer of bicarbonate.I have been angry, have been corroded by gastric acid, corroded and corroded, and the stomach is clear, it is perforation.The treatment of perforation is very simple. If the area is small, you can sew and if the area is large, you can cut the stomach.

Moreover, once the area of ​​the ulcer is too large, it will appear to a certain depth. Well, even if it is not perforated, it will become cancerous after a long time, and it will not run away.

Therefore, three meals on time, less alcohol, less spicy food, and less anger are the best protection for the stomach.

After anesthesia, the operation begins."This is a typical example of small lesions and serious diseases. With such a large stone, the stomach incision will not be small, and patients may experience long-term chronic pain in the future."

Zhang Fan said something to others while preparing for the operation.In fact, Zhang Fan said this to see if other people have any other ideas.

No results!Others just said: "Yes, make a big cut!"

Zhang Fan smiled and said nothing."Alcohol cotton ball!" Zhang Fan took the cotton ball and started the final disinfection of his skin, and then opened a very small opening in the center.

It is about the same size as an ordinary appendix incision."Zhang Yuan, the opening is a bit small, how can I take out the stone with this opening." The director of the bed was puzzled."What is this going to do!" He was confused and couldn't understand it!

Old Zhao understood.But he didn't say a word. Zhang Fan turned his head and looked at several doctors and said, "There is no final formula!"

"MMP! I didn't even finish the procedure of the procedure, your resident doctor started to operate indefinitely, what a world!" The doctors who were forced by Zhang Fan to pretend to collapse.

This is not to blame the doctor.Other than that, there are no more than six types of gastric ulcer surgery in textbooks. There are also some textbooks that are not included in the textbook. Now there is a sentence of indefinite surgery, which makes people not live.Only a lot of learning a lot of surgery can sublimate, or have super talent.

There are more and more diseases, and the division of doctors into more detailed disciplines. This is no way, but the human being is a whole, so it is very contradictory. This is also a problem for the future development of medicine.

Open the abdominal cavity, stop the bleeding, pull open the omentum, and finally see the stomach.Because of the stone, although he hadn't eaten for two days, the patient's stomach was full.

It's really like a pregnant woman expecting to give birth."Sharp knife!" After Zhang Fan took the scalpel, he opened a small opening in his stomach, a very small opening.

At this time, the talent has been widened, some doctors understand, some doctors are still confused.

The doctor who understood it suddenly realized, "Damn! I can't think of it, this is too simple, and the damage is much smaller."

The doctor who couldn't understand was still confused, "What are you going to do! What can you do to open a mouth that can only be put in a finger!"

"Pliers, hold both sides of the incision." Muscles are different from skin and fat.The skin and fat pull a small opening, if you don't use great effort, it will not let the incision develop.

But the muscle doesn't work. As long as it splits, it will automatically become larger with the incision. Zhang Fan used pliers to hold the incision to prevent the incision from getting bigger.

Surgical forceps, in the hands of the doctors, click!Click!Click!The closed incision."Gauze! Alice pliers bless one end of the gauze." Zhang Fan explained to the nurse.

A nurse has never encountered this kind of surgery, so Zhang Fan has to explain it clearly to the nurse.Otherwise, the nurse does not know the procedure of the operation.

Surgery is too demanding of the doctor's hard work and talent.The confused doctor continues to be confused, and the doctor who understands has already begun to actively cooperate.

The long Alice forceps blessed the gauze and entered the stomach along the small hole in the stomach.

"Gently push the stone toward the spray door." Zhang Fan said to the third assistant.The third assistant is a resident doctor. Although he doesn't work long, he is talented. He already understands Zhang Fan's surgery.

Cooperating with Zhang Fan's Alice pliers, Zhang Fan's Alice pliers turned to the left, and he gently pushed the stone to the right, Zhang Fan turned to the right, and he pushed to the left.

If you understand the operation, just help it. Zhang Fan did it very smoothly. Old Zhao looked at the young resident in surprise."Ma Yichen, it's okay. Have you had this kind of surgery before?" Old Zhao said.

The second assistant is attending, and he is still not confused yet. I didn't expect that this kid has already opened up and understood the operation.One has been at work for less than half a year, and the other has been at work for ten years. This is the gap in talent.

"Director, I have never had this kind of surgery." Ma Yichen said to Director Zhao Quanping with a smile.

Ma Yichen is a graduate student of Sanchuanbei Medical College. Because he is doing business in the border area, he is a graduate of Sichuanbeipu gastroenterology.If you want to stay in Xihua, graduate students are not enough.

After graduation, he simply came to Frontier Tea.Originally, I was going to work for a few years, and then Kaobo continued his studies. I didn't expect that the small hospital in this small place could be so powerful.

Zhang Fan also looked up at the young man.Although he is wearing a mask, it can be seen that the young man should be very handsome and his body is also very good.

Zhang Fan slowly changed the direction while holding the gauze with Alice pliers.The previous operation was carried out very quickly, but at this time it became slow. This is a work that depends on patience. You can't worry. If you are in a hurry, you have to start all over again.

Ma Yichen cooperated well, and Zhao was tempted.Zhang Fan is the best example of a hospital. Zhang Fan's early days, even with Lao Gao, suppressed several orthopedic directors. This is the apprentice cow, and the master is also starting to cow.

"Which direction do you want to take in the future?" Zhang Fan spoke first before Zhao said.

"Continue to engage in gastrointestinal management, I like it a lot." Ma Yichen said with a smile.

"You..." Old Zhao Gang said, and Zhang Fan immediately said, "Don't be limited to gastrointestinal. Although you are a master of gastrointestinal, it is best to broaden your horizons. I had several liver tumors at the Bird City Affiliated Hospital on weekends. Surgery, follow me to have a look."

"Okay, Zhang Yuan." Ma Yichen probably laughed.

This is not an interrogative sentence, but an affirmative sentence.Zhang Fan is also tempted, with good talent and young age, this is the seedling.For the operation, if Zhang Fan was with Xue Fei, he could make Zhang Fan half angry.

It's not that Xue Fei's skills are not good, but his talent is not good. There are so many things that he didn't want to understand, and this young man can figure out Zhang Fan's intentions in such a short time, this is talent.

"Zhang Yuan, isn't it appropriate!" Old Zhao was unhappy."MMP, I don't want to say anything about being overbearing in surgery. Now I'm starting to hit my apprentice's attention." In the past, Lao Zhao hadn't found Ma Yichen's talent so good.

"More knowledge and knowledge is good for him. After all, there are still few patients in our place. The director pulls the hook, hurry up and use the suction device to suck blood, and the blood comes out." The senior official crushed the person to death, and Old Zhao was angry. It's crooked, what could be done?

Little by little, Zhang Fan finally wrapped the stone with gauze."Oh. I understand!" The doctor who managed the bed, only now understood Zhang Fan's intentions.

He is Lao Zhao's apprentice, "You only understand!" Lao Zhao Qi's liver hurts.

"Haha!" The doctor in charge of the bed smiled a little embarrassedly.I already scolded my mother, "I don't know how to make it clear, who wants to know what you are doing!"

"Electric drill! Wide hook!" The gauze has already been cut out on the four sides. At this time, it is equivalent to Zhang Fan using the gauze to lift the stone in Uncle Golden Tooth's stomach.

The electric drill is to break down the stones in the stomach, and the wide hook is to protect the incision from being damaged by the electric drill.

Picking up the electric drill, Zhang Fan began to drill along the small incision towards the stone in his stomach.Protein mixed with calcium and hair are very strong.

After the drill bit went down, it splashed out like plaster powder. Because of the hair, the high temperature of the drill bit directly produced a smell of burning hair.Drill upward, downward, left, and right.Several assistants pulled the gauze vigorously.

The gauze must be removed with great strength. Once the hand slips, the drill bit may enter the body.Finally, listening to a click, the stone cracked.

"Cow! It's great, the method is good. The damage is small and simple, which is equivalent to a minimally invasive operation." The attending doctor said enviously.In his heart, there was also a mMP, "Why can't I think of it. In this way, the operation is too simple."

Then drill, take the larger stone, and continue to drill smaller.It's not easy to drill at this time, "Put it up a little more!" Zhang Fan said.

Several other doctors held gauze vigorously.