Doctor's Life Simulator

Chapter 350 Card face!Go to Xiehe Hospital to make flying knife
Thinking of this, Director Dong's eyes suddenly brightened. The young doctor who cooperated with Academician Zhong before was not the best candidate.

If you have the solid basic skills and fast operation of the doctor, plus your own surgical experience, the success rate is still very high.

The more Director Dong thought about it, the more he felt that it was feasible, so he immediately called Wen Yunqi, the dean of Zijingang No. [-] Hospital, and asked Wen Yunqi to tell the dean of Hecheng No. [-] Hospital to tell Qin Lang to come to the capital to save the scene.

And he edited another prestige: "Professor Liu, it's okay if you can't make it through, but I have a request, that is, can we provide remote guidance during our surgery in the future."

After all, remote guidance does not take much time compared to doing the surgery in person.

After a while, Director Dong received a reply letter from Professor Liu: "Yes."

Of course, Qin Lang readily agreed to Director Dong's invitation from Xiehe Hospital. After all, the research and development of smoking cessation drugs has entered the laboratory stage, and now he only needs to control the key nodes.

After Qin Lang arrived in the imperial capital, he waited for Dr. Tu to pick him up.

Dr. Tu is the attending physician under Director Dong. Originally, he learned from Director Dong that Professor Liu from the Second Hospital of Harbin Medical University was very excited when he came back for the flying knife operation. Because of this, he didn't sleep well last night and thought about a lot of questions.

After all, Professor Liu is the top in heart transplantation, and he is a character written in textbooks.However, he suddenly received an order saying that Professor Liu would not come, and asked him to pick up a young doctor from Zhejiang Province, this time he would be the first assistant of Director Dong, and all of Dr. Tu's expectations were shattered.

In particular, it was even more difficult for him to accept that the doctor who received him was under 30 years old.

"Is there no one in our Union Medical College Hospital? Why did Director Dong think of inviting such a young doctor?"

Dr. Tu was only an attending physician after all. He was not qualified to participate in Academician Zhong's surgery, so he didn't know much about Qin Lang.

As a normal doctor, it can be inferred from common sense how proficient a doctor under the age of 30 can be, even if he has participated in heart transplantation.

One, three, or ten?
Doctor Tu was very unconvinced in his heart. When he saw Qin Lang's figure, he was even more surprised. Qin Lang looked too young.

"Are you Qin Lang from Zhejiang Province?"

Physician Tu asked indifferently, and his face was not too good-looking.

"Yes, you are Doctor Tu, right?"

Qin Lang was still in a good mood. After all, he had another chance to come to Xiehe to participate in the operation.Moreover, this time it was in the form of a flying knife, and there was a surgery fee.

The cost of a heart transplant is basically between 20 and 40 yuan. This time, Director Dong is the chief surgeon and Qin Lang is the first to assist. Although the cost of a top doctor like Professor Liu is not as high as that, after all, Director Dong is also the heart surgeon of Union Medical College Hospital. A director of surgery.

There is still a 30 surgical fee. According to the degree of contribution, Qin Lang can get at least 5 to 15. Of course, after the operation is completed, Director Dong will allocate it according to the degree of participation.

Although Qin Lang's family is rich and has a monthly salary of more than [-] yuan, who can refuse more money?
Moreover, the operation fee also represented the true worth of a knife-throwing doctor.

For some directors of Zijingang, it is not bad to have a throwing knife of [-] to [-] yuan at a time. Therefore, the price of Qinlang's throwing knife is already at the domestic first-class level.

In addition to the operation fee, the more important thing is that the flying knife represents the honor of a doctor.

Taking the current flying knife market in Huaguo as an example, high-end doctors have to compete across the country, especially when they come to Union Medical College Hospital to fly knives, which is a recognition of the top technology in the industry.

Under normal circumstances, there are two ways for this kind of flying knife, one is to be introduced by peers, and it can be recognized by peers, after all, it is superior in some aspects.

Another way is to find out according to the picture, patients or family members, through the editor-in-chief list in the medical textbooks to select the candidates for surgery, generally speaking, the doctors who can appear in the textbooks are the industry's top fighters.

No matter which way, being invited by Xiehe to throw knives is enough to make Qin Lang proud and make Doctor Tu jealous.

Along the way, the car drove very fast, Dr. Tu was a little annoyed and didn't say anything along the way.

Qin Lang didn't care about this, he just closed his eyes and focused.

Soon, Dr. Tu brought Qin Lang to Xiehe Hospital.

"Doctor Qin, Director Dong is still having an operation. In this case, I'll show you the patient's condition and information first, and then we'll look at the donor and recipient."

Dr. Tu said in a calm tone that he also wanted to know how capable Qin Lang, the little doctor invited by Director Dong, was, and to see if he dared to accept the offer.

"Row."

Soon, Dr. Tu took over the patient's condition:

Patient, Jiang Crouching Tiger, male, 55 years old.

Symptoms: Refractory congenital heart disease combined with Eisenmenger syndrome, undissected complex congenital cardiovascular malformation combined with pulmonary atresia, left heart hypoplasia, mitral valve atresia, aortic valve atresia, and late cystic fibrosis End-stage respiratory failure combined with right heart failure.

Cardiopulmonary failure complicated by bronchiectasis, idiopathic pulmonary fibrosis, or obstructive bronchitis.

While looking at the case in Qinlang, Doctor Tu on the side asked intentionally:

"Doctor Qin, this patient has a lot of complications, and at the same time, he is very old, with aging blood vessels, and the difficulty of heart transplantation is very high. Even the deputy chief physician of our department dare not try it lightly. Originally, Director Dong and the patient's family were together. Professor Liu from the Second Hospital of Harbin Medical University was appointed to be the surgeon. Unfortunately, Professor Liu recently had an emergency operation, so he couldn’t make it through. Afterwards, he could only guide him remotely. Afterwards, Director Dong was the surgeon. You came to help. It’s not that I don’t trust you. You really look too young. You should have done a few heart transplants, so there won't be any problems."

"Doctor Qin, if you can't do it, I advise you to give up early, otherwise the operation will really start, and if something goes wrong, you can't afford it. The status of the patient is a bit special."

Dr. Tu persuaded directly, and then stared at Qin Lang's reaction, did you panic?
Under the master-level heart transplantation, Qin Lang had already started to design the operation plan in his mind, so he didn't pay attention to Dr. Tu's persuasion at all, and gave a very focused order:
"I need the donor's information. In addition to fully meeting the criteria for heart transplantation, I also need the preoperative X-ray chest film of the heart-lung transplant donor."

Seeing that Qin Lang ignored his good words of persuasion, Dr. Tu frowned, but before he could respond, Qin Lang raised his head and looked at him sharply. This time, it was the order of the superior doctor to the subordinate doctor: "I need an anterior chest x-ray of a heart-lung transplant donor."

After several generations of accumulation, the aura of Qin Lang was very majestic. Doctor Tu blurted out: "The X-ray chest film of the heart-lung transplant donor before the operation is clear, and there is no lung infection, contusion, pulmonary edema or atelectasis. .”

As the attending physician of Union Medical College Hospital, Dr. Tu's job is still very good, and he is still very well prepared for the operation.

However, finding himself under the pressure of Qin Lang and honestly explaining the situation, Dr. Tu was a little annoyed at his embarrassing behavior!

"Mechanical assisted breathing? Ventilation pressure? Chest volume and receptor size?"

However, before he could think about it, Qin Lang's next question came one after another, which was very serious and professional. In a daze, Dr. Tu seemed to see his chief physician, flipping through the medical records and asking questions.

Although he didn't like Qin Lang's anti-customer questions, he couldn't deny Qin Lang's professionalism and every question that hit the point.

Basically, this is what Dr. Tu spent a lot of time preparing before, and he originally wanted to report to Director Dong.

Dr. Tu sighed, he was still a professional after all, and said what he was going to show in front of Director Dong:

"Mechanical assisted breathing does not exceed 48 hours, and the ventilation pressure does not exceed 30mmHg. When the inspired oxygen concentration is <40%, the arterial blood gas analysis is normal. The sputum bacterial culture is negative. The chest volume is similar to the size of the recipient."

After listening to Dr. Tu's report, Qin Lang closed the file very naturally, and praised Dr. Tu: "Not bad, the preparation work is very careful."

Dr. Tu's face was darkened, he looked at Qin Lang calmly, praised him solemnly, and slandered: Thank you.

"Then let's look at the condition of the receptor now?"

After all, Qin Lang was new here, so he asked very politely.

Originally, Dr. Tu wanted Qin Lang to show his timidity when facing the donor and the recipient, but he didn't expect to shoot himself in the foot. He simply stopped letting Qin Lang see the patient and said directly:

"Doctor Qin, I checked the time and it's almost time. Let's go to Director Dong's office and wait together."

"That's fine too."

Qin Lang's tone was slightly disappointed.

Seeing Qin Lang's expression, Dr. Tu became even more depressed. What kind of player is this?Such a young doctor, how can he be so high-level, and the most important thing is that he is very handsome.

In his cognition, Union Medical College Hospital is not without young Yushu Linfeng doctors, but when these doctors' skills catch up to the director level, either their heads will be bald, or their stomachs will be protruding.

There is no one like Qin Lang, who is handsome, black, and good at work!
Soon Doctor Tu invited Qin Lang to Director Dong's office. Along the way, many nurses looked at Qin Lang with eyes lit up.

However, it's a little strange, when did Dr. Tu have such a handsome little follower.

After waiting in Director Dong's office for a while, Director Dong arrived late.

After seeing Qin Lang, Director Dong walked over and was very happy:
"Director Qin, welcome to our Union Hospital again. This time, it happened to be in time for a difficult heart transplant. I lack a suitable assistant, so I thought of you. I hope you can cooperate with Academician Zhong like last time." cooperate with me."

Director Dong went straight to the point. After listening, Dr. Tu's eyes widened and he looked at Qin Lang in surprise. This guy even cooperated with Academician Zhong's surgery.

Of course, Qin Lang had no objection to Director Dong's arrangement. Anyway, preoperative preparation was preoperative preparation, so it didn't count.

During the operation, it is not unheard of to grab shifts and seize power.

Seeing Qin Lang's humility, Director Dong was very satisfied: "Doctor Tu, please go and invite the doctors from all the departments that cooperate with you. We will hold a consultation in a while, and at the same time announce that Director Qin will cooperate with me for assistance."

"Hey." Doctor Tu responded and ran out quickly.

"Director Qin, what do you think of this consultation?"

Director Dong looked at Qin Lang, and he also had a thought of comparison. In addition, it was also a rehearsal for the consultation later.

After all, Qin Lang was asked to come over to help him. If Qin Lang lost the chain in consultation and surgery, he would be the one to bear the responsibility and bear the blame in the end, so he had to be cautious.

Regarding Director Dong's question, Qin Lang didn't even think about it, and said in a very relaxed and general way:
"After a consultation, combined with the latest information of the patient, I suggest to conduct demonstration and discussion from the following three aspects: first, donor heart and lung resection, second, recipient heart and lung resection, and third, donor heart and lung Resection and Combined Transplantation."

Hearing the macroscopic and comprehensive understanding, Director Dong was also a little unexpected, and also became interested: "Tell me specifically?"

Qin Lang nodded lightly, then explained to Director Dong in detail.

"Okay, okay, Director Qin, your understanding of heart transplantation is comparable to that of the top professors in China. What you said was mentioned by Professor Liu from the Second Hospital of Harbin Medical University before. What you said is exactly the same, of course, what surprised me even more is your improved operation optimized for the patient's condition."

After hearing Qin Lang's idea, Director Dong already had a solid foundation in his heart, and he became more and more confident that Qin Lang would cooperate with his surgery.

After all, he has seen Qin Lang's basic skills with his own eyes. What Qin Lang lacks now is his understanding of heart transplantation, and being able to explain the operation plan so deeply is enough to prove that Qin Lang specializes in this operation. Coupled with his own years of experience in heart transplantation, it is enough to deal with accidents during the operation.

"Then let's go to the consultation."

Director Dong got up and said to Qin Lang with admiration.

Soon, Director Dong brought Qin Lang to the consultation room. In the consultation room, experts from other departments had already attended.

Of course they had already heard that Professor Liu from the Second Hospital of Harbin Medical University rejected this difficult operation because of something, and Director Dong had no choice but to invite another foreign aid to assist him in the operation.

However, after seeing Qin Lang for the first time, all the doctors were a little confused for a long time.

"Such a little doctor, isn't Director Dong joking?"

Regarding the questioning thoughts of doctors in various departments in the consultation room, Director Dong cut them straight to the point:

"This is Qin Lang, Director Qin, whom I invited from Hangzhou Zijingang No. Director Qin is invited to assist me with this heart transplant. Welcome!"

Hearing Director Dong's words, there were intermittent applause and more scrutinizing eyes in the consultation room.

For this, Qin Lang didn't care at all. After all, he came here for surgery, not to make friends. As for the questioning eyes, it's just so-called. Anyway, when the surgery starts, these guys' knees will be broken.

"Director Dong, let's start discussing the surgical plan."

Qin Lang said very directly, after all, he will be charged for flying knives for a while, and every word he says must be deducted from heart transplantation, and it must be dry goods.

"Okay, then Director Qin tell me what you think?"

Director Dong also said encouragingly, and he also understood that if Qin Lang wanted to get the approval of these doctors, he could only speak with his real skills.

"Then let's start with donor heart and lung collection."

Qin Lang motioned Dr. Tu to scroll to the corresponding slide and began to explain:
"The donated heart and lungs were taken out as a whole. The preoperative preparation and most of the operations were basically the same as those of the homologous orthotopic heart transplantation. The median incision was made through the chest, the pericardium was exposed by thoracotomy, and the pulmonary veins on both sides were widely dissected, and the ascending aorta was freed. , innominate artery, and superior vena cava were banded separately, and the azygos vein was ligated"

Hearing Qin Lang's operation plan, these doctors all nodded silently.

"Free the trachea to the 5cm above the carina, and the front of the trachea near the carina should be less separated, so as not to damage the collateral blood supply from the coronary artery. Intravenous injection of heparin 3mg/kg, and prostaglandin E120ng/(kg·min), In order to eliminate the reaction of pulmonary blood vessels to cold perfusion fluid. Ligate and cut off the superior vena cava at a high position, close to the diaphragm, clamp the inferior vena cava with a blood vessel clamp, and cut it off at the upper side of the clamp. Block the main artery after cardiac arrest. Artery, aortic root perfusion cold crystalloid cardioplegia 500 ~ 1000ml"

Hearing Qin Lang's in-depth plan, these doctors were a little unbelievable: "Director Qin, why does your plan feel a little familiar and a little strange?"

On the side, Director Dong took a sip of tea with the presence of an old god, and muttered in his heart:
"After a while, Director Qin will come up with the improved operation, and you will know what talent is."

Sure enough, 1 minute later, Qin Lang mentioned the optimized and improved operation: "Perfuse the main pulmonary artery with 14°C modified collin lung protection solution with French No. 4 suction tube"

"Qin Lang, let me interrupt, what is the improved collin lung protection liquid?"

(End of this chapter)