This doctor is very stable

Chapter 632 Pulmonary Tuberculosis Surgery 】

Tuberculosis, also known as "tuberculosis", is a respiratory infectious disease caused by Mycobacterium tuberculosis infection.

The lesions mainly occurred in lung tissue, trachea, bronchi and pleura.

In China, tuberculosis is a Class B notifiable infectious disease.

Among domestic infectious diseases, tuberculosis ranks second in terms of incidence and death.

According to the "2018 Global Tuberculosis Report" released by WHO.

2017年全球的结核病潜伏感染人群约为17亿（占世界人口的23%），新发结核病病例约为1000万例，发病率为133/10万。

In other words, 5 in every 1 people has tuberculosis
There are 10 new-onset tuberculosis patients per 133 people with mycobacterial latent infection.

TB affects all ages and all countries.Overall, 90% of new TB cases were adults (age ≥15 years) and 9% were HIV-infected.

The 30 high-burden countries accounted for 87% of the world's new cases.

Tuberculosis is one of the top ten causes of death worldwide.

According to WHO estimates, in 2017, there were about 130 million tuberculosis deaths among human immunodeficiency virus (HIV) negative populations, about 30 tuberculosis deaths among HIV positive populations, and the tuberculosis mortality rate was 17/10.

国内结核病死亡病例约为3.7万例；结核病死亡率为2.6/10万，在30个结核病高负担国家中排第29位。

Globally, the TB incidence rate (i.e., the number of new cases per 10 population per year) has decreased by about 2% per year, and the TB mortality rate (i.e., the number of TB deaths per 10 population per year among HIV-negative people) has decreased by about 3% per year .

中国国家肺结核报告数据显示，肺结核发病率由2015年的63.4/10万，降低到2019年的55.6/10万。

Susceptible groups: HIV-infected patients, diabetic patients, pneumoconiosis patients, immunosuppressant users, the elderly and other people with low immunity are susceptible to tuberculosis.

The classification of tuberculosis (including pulmonary tuberculosis) is essential for its diagnosis, treatment and prevention.

According to the "Classification of Tuberculosis (WS 196-2017)" standard, it is divided into patients with latent Mycobacterium tuberculosis infection, active tuberculosis and inactive tuberculosis.

The first-line treatment for tuberculosis patients is drug therapy combined with chemotherapy.

Therefore, tuberculosis patients whose condition can be controlled will not be easily operated on.

After all, surgery is only physical resection, and cannot completely cure tuberculosis patients.

But what Lin Ran and the others were facing today was a 53-year-old middle-aged male tuberculosis patient.

Patients with tuberculous empyema.

Outside the locker room, just as Lin Ran and the others came back, Lin Qianhong said solemnly.

"When performing operations on tuberculosis patients, disinfection and protective measures must be taken. If you are afraid of danger, you can go home and rest now."

"And the picture of this operation will definitely not be as beautiful as the bullae resection just now. For patients with tuberculous empyema, I don't need to say more."

"But what I want to say is that if you want to be a good cardiothoracic surgeon, you must pass this hurdle. A good cardiothoracic surgeon cannot avoid tuberculosis."

After Lin Qianhong finished speaking, he looked at Lin Ran and the others with a smile.

When Li Qian heard that she was a patient with tuberculosis pus, she remembered the milk tea and spicy sticks she had just drank downstairs.

Her stomach churns at the thought.

At this moment, she even wanted to back down.

Seeing that no one was moving beside her, she endured it.

Those who have the same feeling are Wang Jing and Xu Youyou who are more familiar with the chest.

Girls are more emotional, and boys are much better here.

Lin Ran had watched the video of empyema surgery before, and it was indeed a little disgusting.

But it was not enough to make Lin Ran flinch, and what he just drank was mineral water.

Although it is not comfortable, it feels okay.

Lin Qianhong observed for a while, then smiled. "Hey! Has no one quit? It's quite bearable. Let's start preparing for the operation."

Just after he finished speaking, Li Qian was the first to stand up. She felt that she had entered the operating room and opened the view of the endoscope. She would definitely vomit, so instead of waiting to vomit into the protective clothing, it is better to go to the toilet now.

"Report, please give me 5 minutes."

"I want 5 minutes too."

"Then I'll go too!"

Lin Qianhong nodded, "Go, hurry up."

When he said this, all the girls present ran to the toilet.

Lin Qianhong looked at Lin Ran and the three younger residents, and said with a smile, "Aren't you going to the bathroom? I can give you 5 minutes, really, it's not shameful, anyway, the food is almost digested at night, and vomiting I can't spit out much."

Lin Ran: "I have no problem."

When Lin Ran said this, the other two students in a group were also embarrassed to go!

On the one hand, in the group of girls running to the toilet, Zhang Yong's origin is somewhat unclear.

"The empyema operation is not that exaggerated."

"You don't understand. Tuberculous empyema is incomparable with ordinary empyema surgery. In short, listen to us and spit it out before entering the operating room."

As a girl, she is still a girl who has worked as a resident for several years.

They have experienced more, but the tuberculous empyema is really disgusting.

"That's fine, I'll listen to you. I also vomited a lot when I first entered the hospital. For a while, I went to the toilet to vomit first as soon as I entered the operating room, so that I wouldn't vomit when I entered the operating room."

Facing the toilet, Wang Jing said regretfully, "It's just a pity that Dr. Lin invited me to drink milk tea!"

……

10 minutes later, at 22:[-].

Lin Ran and the others finished the preoperative disinfection and put on protective clothing.

Walking out of the locker room, Lin Qianhong smiled with satisfaction as he looked at the brave girls who were a bit depressed, "I hope you can all gain something."

Walking into the operating room, Liu Xiaowu was so skinny that he lay quietly on the operating table.

He has been sick for several years, but after the beginning of this year, he accidentally caught a cold again.

In the past few months, the cough has become worse and worse, and the medicines I took before are no longer effective.

As a result, he went to the hospital for an examination and was diagnosed with an abscess, requiring immediate surgery.

To be honest, the lingering entanglement of tuberculosis has made him miserable since he fell ill.

Ordinary people suffer from a cold, fever and cough for a few days. He has been suffering from tuberculosis for five years.

Cloudy and rainy, sunny and hot, both will make the condition worse, and coughing will last all day.

Walking into the operating room, Lin Qianhong calmly stood in the position of the chief surgeon.

It was as if this operation was an ordinary lobectomy.

"Doctor Huang, you are still here to help, and Lin Ran is here to hold the mirror."

Generally speaking, surgery is not considered for chronic pulmonary tuberculosis.

Because the operation may cause Mycobacterium tuberculosis to spread to other tissue spaces along the endoscopic space, causing multi-organ infection.

But this patient has reached the point where it cannot be saved without surgery.

Therefore, the hospital decided to perform surgical treatment after informing the surgical risks and obtaining the consent of the patient's family members.

(End of this chapter)