Medical road

"Hang the thread on the small round needle and let the thread go longer. The vital signs of Secretary Ren and the patient will be handed over to you.

Doctor Chen, extend the anesthesia time!

Dr. Wang, can you please talk to the patient’s family, we have to make two-handed preparations.

Once the spleen protection fails, a spleenectomy operation must be performed, and the risks of the operation must be explained to the patient’s family."

"it is good!"

"Yes!"

Ren Li agreed, and Dr. Wang listened to Zhang Fan's words, and immediately after agreeing, he left the operating room with a thick pile of surgical consents.

The instrument nurse put an absorbable thread on the smallest round needle rather laboriously.

Needles, all kinds of skin needles, round needles, and special absorbable thread with their own needles, are particularly diverse in medical treatment.

The round needles are actually the needles of your own stitched clothes that are broken and bent into a moon shape, just like a moon scimitar.

But the shape of the leather needle is exactly the same as the round needle, the difference lies in the needle.

The head of the round needle is pointed, while the head of the leather needle is like a triangular thorn.

Skin needles are used to suture skin and cartilage, and round needles are used to suture soft tissues and organs under the skin.

Because of the different needles, if the skin needle sutures the soft tissue under the skin, the result is that the tissue is split.

Regardless of the small needles, they are divided into different categories in the hospital. For example, the round needles that come with the absorbable thread of a certain country are quite easy to use.

Sharp, as if the material comes with smooth oil, when it is inserted into the tissue, it does not bring a little bit of dryness.

What's more, the most awesome thing is that its material is very good when used as a skin needle. Doctors with good skills can use it to penetrate flat bones, such as ribs.

But the price is also good, one thread, one needle, more than 400!This is still the price of a hospital. If you are in a beauty salon, this stuff can cost thousands.

In order to prevent repeated use in hospitals, there is no threading hole at the end of the needle, which can be regarded as a completely disposable item.

To be honest, if it is not a price issue, doctors like to use this kind of foreign needles.

It is estimated that small needles do not make money, and domestic manufacturers did not make it hard.Then the domestic needles are really not working well.

Especially doctors with a little less skill, suture tougher tissues, if a little force is not appropriate, the needle will bend first.

The nurse complained, the anesthesiologist urged, and the superior doctor criticized it. Really, young doctors can cry with needles.

Although Zhang Fan doesn't have any requirements for needles, he also likes to use this kind of needle that is not dry at all. When inserted, it is particularly slippery, just like a squeaky popsicle, very smooth.

After receiving the needle, Zhang Fan looked up at the anesthesiologist. The anesthesiologist nodded gently to Zhang Fan, "Zhang's hospital can start."

"it is good!"

Abdominal tissue, including gastrointestinal, liver, pancreas, spleen and kidneys.People have a lot of autonomy in these abdominal organs, and they don't urinate the brain very much.

For example, bowel movement, which is managed by the bowel itself. If you eat too much, eat irritating food, or use something to tease from the back door, people will speed up the movement.

But for other stimuli, they are also very lazy and don't give much feedback to the brain what happens.

For example, if the intestine is perforated, only after the intestinal juice flows out, it makes people roll around painfully.

What is intestinal juice? This thing is a strong base. Even so, the pain points in the abdomen are not very clear.

The abdominal organs are not very sensitive to temperature, to cutting, and to acupuncture.

However, the abdominal organs are the most sensitive to the pulling force.This is why the second brother of the grassland will confuse whatever prey is seen.

Once you bite into the head of the cecum, and then look back, whether you are a two-ton rhino or a big male lion with sharp teeth, you can lie on the ground in pain and call Dad.

Therefore, when doing abdominal surgery, the old doctor will definitely say, "Slow down, slow down, be gentle, and don't stretch!"

If the patient is stretched frequently, even if the patient has anesthesia, it will cause agitation and even painful shock.

And when there is pain in the abdomen, do not take painkillers at home, such as ibuprofen and diclofenac sodium sustained-release tablets.

Don't eat it. This thing doesn't urinate your brain much. Once you take painkillers, it will cover your condition.

Seeing the anesthesiologist nodded, Zhang Fan stabilized his emotions and calmed down.

"Start!"

Old Zhao held one hand with tweezers, and one hand gently fixed the spleen in his hand, and then steadily showed Zhang Fan the surgical field clearly.

In the organ, the stomach is the best stitch, with three or four layers, and the texture is tight, just like a pocket.

The spleen is the most difficult to stitch. How can I say it, like a crisp water radish or a green apple rich in moisture.

You know the difficulty of the operation by suturing the green apple with a needle.

Once this thing splits, it's quite difficult to handle. The needle's entry angle is a bit deviated, let alone sewing, it can continue to split a few petals for you.

This kind of needle insertion, every needle is a gamble, you don't know if your needle will split the spleen tissue.

Moreover, when the suture opening becomes smaller and smaller, it is more difficult to suture, because the closer to the edge, the greater the chance of it cracking.

Just like a ceramic, this thing breaks not only to a point, sometimes, because of the torque problem, this thing can give you the entire spleen.

Therefore, the older the doctor, the less dare to get the spleen, because a careless operation is a waste of effort.

However, precision and stability are not a problem for Zhang Fan.

Zhang Fan took a long breath and saw the moon-like needle pierced into the spleen wound at a 90 degree angle.

On the edge of the spleen tissue where the wound was like a petal, the needle holder in Zhang Fan's hand pinched the round needle and pierced the tissue firmly.

When suturing cartilage or even penetrating flat bone or fascia, the force of the wrist must be used.

And this kind of fragile tissue must use the power of the fingers, not only to have clean penetration, but also to be unbiased and stable.

Human body stitching is not sewing clothes. You can do whatever you want with a needle in your hand.

Human body sutures use a needle holder to hold a round needle, so the force is transmitted to the needle through the needle holder.

Just like when you use pliers to hold nails and stuff them into wood, once you use improper force, the nails you hold will be like a person who is not used to high heels. He walks crookedly.

If this happens after this time, don't even think about it. The spleen can definitely become a spleen flower, and it can only be cut.

With Zhang Fan’s breathing closed, every time Zhang Fan is inserted, Zhang Fan will come in at the most stable moment with his breathing, and then take the time to spread.

This thing is not used recklessly, anyway, where the spleen is, I can get in with desperate insertion.

Every insertion, not to mention Zhang Fan, is that Zhao Quanping, the general secretary of general surgery who works as a helper, can't help but shut his breath.

It seemed that I was afraid that my breathing would affect Zhang Fan's penetration.

One stitch, two stitches.The distance between the pins is as neatly arranged as measured with a ruler.

The profession of surgery is slightly the same as that of chefs. In the profession of chefs, men do the best, and men who do the best in surgery are also men.

Not to mention tall, just talk about stitching.

When Zhang Fan and the others were in the university surgery class, the teacher anesthetized the students and tied the rabbits with skins to the operating table.

Then let the students practice stitching.

At that time, to be honest, everyone was the first brother and sister, who did this job.

The overall result of stitching is that boys sew better than girls.

With a crisp apple-like spleen, a trace of blood slowly oozes out of the stitches. Old Zhao glanced at Zhang Fan, he didn't even dare to wipe the blood.

Zhang Fan's sewing is not only stable, but also fast.Seeing the sweat dripping out of Zhang Fan's forehead, the visiting nurse did not dare to come forward to wipe it.

At this time, the post is too critical, the wound on the spleen slowly closes and closes slowly like a crying child's mouth.

For this type of stitching, stability is the foundation and fastness is the key.In trauma medicine, there is a golden time.

Take the spleen, for example, this thing is full of tissues framed by various small bubbles. It can hold and eat, but there are very few blood vessels.

Once it causes ischemia for a long time, even if it is sutured, it will cause ischemic necrosis.

Zhang Fan made a quick suture. He was like a fluoroscopic eye. Every time the needle went down, he would avoid the blood vessels in the spleen.

There is only a faint layer of superficial oozing blood on the surface of the spleen, and there is absolutely nothing like a bloody flower.

Doctors, although most doctors have similar education, the skills shown by doctors are very different during surgery.

Some doctors perform operations just like killing pigs, with blood overflowing in the operation field.

And like a lonely knight, he dashed forward in the blood with his head down, cut an appendix, and then the patient had to transfusion 400cc.

On the operating table, for such a crappy doctor, the only weapon of resistance for patients under anesthesia is bleeding.

Therefore, an excellent surgeon is not only good at stopping bleeding, but also good at avoiding bleeding in advance.

On the operating table, it can be said that 1g of bleeding requires 10g of treatment.

"Boost!" After Zhang Fan sutured the last stitch, he gently let go of the curved forceps blessed by the door of the spleen with his left hand. This looseness is not a complete loosening.

The mouth of the curved forceps has just left the blood vessel, but if necessary, it can immediately clamp the blood vessel again.

The left hand blesses, and the right hand gently presses on the sutured wound of the spleen.

This kind of particularly fragile tissue, sometimes, the body contracture due to sutures, and then after reperfusion, the body will be cracked.

Therefore, the suture of this kind of tissue is too weird, and sometimes after failure, even the doctor himself cannot find out what went wrong.

Zhang Fan is confident in his own technology, but it is just in case that it is not complete.

Therefore, before the blood fills the spleen, you must not be careless.

The main idea at this time is a life.

Ren Li gave the medicine herself, little by little blood pressure medicine entered the medicine pot, and slowly, the colorless spleen slowly began to become darker and darker.

The bleeding at the stitches of the stitches also increased significantly.

"What's your blood pressure?"

"High pressure 120 mm Hg, low pressure 90 mm Hg!"

Zhang Fan pressed his hands on the spleen, and at this time he began to feel the swelling of the spleen.

Just like a cat probing, lick it lightly, then lick it deeply, and finally put the tongue directly on Zhang Fan's hand.

Swelling is inevitable, not to mention this kind of injury, even if you slap a person, your face will swell, let alone this kind of injury.

When the blood pressure rose to normal, where the spleen was lying steadily, I heard Lao Zhao let out a long sigh of relief.

"Quickly, wipe off the sweat for Zhang Yuan, and wipe it for me by the way, I'm almost thinning!"

Can you not be nervous? Just like a time bomb, you can blow it up again at any time!

"Close the abdomen, go out alone, and tell the patient's family that the patient's spleen is covered!"

When the head nurse heard this, he ran out quickly, but the little doctor on the side hadn't reflected it yet.

"Don't cry, let's go, let's wipe away the tears, the patient is rescued, and the spleen is saved!"

The head nurse, who pulled down the mask and showed his face, stood at the door and informed the family members of the patient's condition.

After speaking, the head nurse turned his head proudly and entered the operating room.

The high head and the straightened chest seemed so arrogant, she liked this feeling, like being surrounded by people with grateful and admired eyes.

Before the operation, the doctor told the patient that he was critically ill and might die on the operating table. The hearts of the family members were as if they were crushed by a road roller, and there was a black mist in front of them.

During the operation, the doctor came out of the operation and informed that the spleen might be cut.Although an organ needs to be cut off, any family members are willing to save the person.

When the patient’s family only has a little hope left, that is, as long as the person is rescued, the beautiful and plump nurse proudly informs them that the person is alive.

The family members were really pulled from the abyss to the top of the peak. This kind of gratitude is really exceptionally exciting.

The gray-haired old man holding his little granddaughter crying is called a hearty.

One month after the operation, I heard that the female owner of the hardware store sold the shop and gave the money to the female owner of the optical shop, and then obtained the understanding of the owner of the optical shop.

This is what Zhang Fan occasionally heard when the hospital nurses were gossiping.

After the beginning of the spring, the annual examination for practicing physicians began to register again.

The hospital's technology is now at the forefront of the tea, and Ouyang still feels that it is not enough. Not only must the technology be at the forefront, but even the examination must be at the forefront.

Naduo, Xu Xian, and Xue Xiaoqiao had exam scores above 500, and the directors of various subjects were led by Ouyang to set up an exam tutorial class.

Of course, Ouyang certainly didn't let Zhang Fan go. Zhang Fan was the main person in charge of the tutoring class.

Ouyang’s current ruling philosophy is to think one thing is one thing, and to quarrel with the government, she will send the boss first, and if the boss can’t do it, she will go out again.

Almost all the internal affairs of the hospital fell on Zhang Fan and Ren Li's heads.

Ren Li worked hard, and Zhang Fan couldn't help but occasionally want to make trouble. Ouyang became more and more thief.

As soon as Zhang Fan spoke, she said that she had done it all her life. It was either a backache or a headache, or a headache or an upset. Now even the cactus ball can't support her, so Zhang Fan must be considerate and considerate of her.

Zhang Fan can't say anything!

Anyway, just one sentence, if I don't work, you can figure it out.

For the young doctors who took the exam for practicing physicians this year, although Zhang Fan and the others were counseling, the bad news also made them frightened.

Ouyang has already spoken out. Doctors who have passed the test of 500 points will be given a bonus and performance for more than half a year, while doctors who have passed the test of less than 500 points will be given a bonus and performance for one month.

For doctors who did not pass the first examination, the payment of various performances was stopped on the day when the results were released, and only a monthly living allowance of 600 yuan was given. Those who did not pass the second examination were directly given the termination of the labor contract.

As soon as the red-headed documents of the hospital came out, there was a wailing. With the continuous improvement of the reputation of the Municipal People’s Hospital, I now want to enter this unit. To be honest, some undergraduates have spent a lot of thought. If they are dismissed because of the exam, really, in Cha Cha How to live a vegetarian life, how to mix in the tea medical circle.

On the day when the auxiliary class opened, the candidates who had to take the test of Chasu were not only from the Municipal People's Hospital but also young doctors from other hospitals.

The deputy director of the medical office wanted to expel the doctors from the outer hospital. Isn't it cheaper than our hospital!

The result was stopped by the director of the medical department.Chen Sheng knew Ouyang too well, and as expected, when Ouyang found doctors full of strangers in the auditorium, the wrinkles on his face were full of smiles.

How famous is a hospital? Isn't it relying on peer support? Isn't it just relying on peer envy and jealousy?

If these doctors were really driven out, Ouyang estimated that he would definitely be furious.

Besides, if you can find a few good seedlings in the study class, Ouyang is absolutely confident to dig people over, the old lady's abacus is very good.

Zhang Fan is the first teacher in the remedial class.

When Zhang Fan boarded the podium, there was an instant buzzing sound below.