The surgeon opens a cheat

Chapter 56 Anti-infective solution washing
Fourth hospital, inpatient ward.

Gong Shuangjiang checked the patient's condition, while Zhang Gu and Xiao Mao followed.

Seeing that Zhang Gu was coming, Gong Shuangjiang introduced the patient's condition to him.

"This patient was riding a horse on a horse farm a few days ago. He was kicked by a horse and injured his upper abdomen. There was a two-centimeter tear in the duodenum and contusion and edema at the head of the pancreas. After we repaired the duodenum, the gallbladder Drainage tubes were placed in the main duct and in the pelvic cavity."

"According to our estimated time, it should take up to three days, and the drainage pus should drop."

"But the problem is that the recovery has not seen any obvious effect, and the body temperature has remained at 39 degrees for the past three days. It is not an option to continue like this!"

Gong Shuangjiang even wondered if there were other hidden wounds that were not found because the exploratory surgery was not thoroughly checked?
Zhang Gu's heart moved, and he said, "Director Gong, why don't you inject Meilan and observe?"

Gong Shuangjiang weighed it up, nodded and said: "You are right, first use this method to rule it out and see if it is duodenal fistula or pancreatic fistula."

He ordered the doctor on duty next to him: "Go to the operation room, inject melanin into the patient for observation through the gastroduodenal decompression tube, and do a color Doppler ultrasound."

Soon after, the results came out.

The two looked at the color ultrasound report and observation results.

"Duodenal fistula and gastrojejunostomy leak should be ruled out."

Gong Shuangjiang nodded: "The color Doppler ultrasound shows that there is a liquid dark area between the liver and kidney, most likely there is still an abscess, this part..."

Zhang Gu took over the words: "This part is mostly pancreatic fistula, and it is also combined with abdominal abscess."

Gong Shuangjiang smiled bitterly: "This is what we are most worried about. Once pancreatic fistula merges with abdominal abscess, it will be difficult!"

This situation is a bit uneven.

Drainage alone has no therapeutic effect, and it is not appropriate to have another operation. This is a very embarrassing situation.

For a while, Gong Shuangjiang couldn't think of what to do.If it doesn't work, it can only be operated again.But once the operation is performed, there is another new surgical risk.

You know, this pancreatic fistula is a postoperative complication of the previous pancreatic anastomosis, and it is the consequence of the operation.

Zhang Gu's heart skipped a beat.

He has a better treatment for this disease.

Then, let me cure it!
It is to relieve the pain of the patient and reduce the risk of reoperation.

Moreover, curing patients in the outer hospital is also showing the superb medical skills of our third hospital, and it is also giving face to the third director, right?

If you pass it back to Director Xiang, can you give us some points first?

In Zhang Gu's mind, he exchanged the previous "appendectomy" with a skill replacement card for "abdominal abscess drainage tube flushing treatment".

Zhang Gu said: "Director Gong, have you tried anti-infection washing treatment?"

Gong Shuangjiang was obviously taken aback.

If he had known, would he have considered operating again?
Zhang Gudao: "For patients with pancreatic fistula combined with abdominal abscess, our third hospital will use the method of anti-infection night flushing."

Gong Shuangjiang was overjoyed, the third hospital was of a higher grade than the fourth hospital, and there were more patients of various kinds, so there might be better treatment methods.

"Okay, you come to the treatment, I will fully cooperate with you."

Zhang Gu said: "Intravenous infusion of cefoperazone first."

Gong Shuangjiang winked at the side, and someone immediately went to do errands.

"Use gentamicin and 30% normal saline to prepare an anti-infective night. The ratio is 250 U of gentamicin to [-] ml of normal saline, and bring it here after the preparation is complete."

Following Zhang Gu's command, the people in Corey all started to move.

Gong Shuangjiang secretly evaluated and judged the principles and effects of Zhang Gu's operations in his heart.

After a while, he pondered: "Is the anti-infection solution to inhibit the secretion of pancreatic juice?"

"This at least has the advantage that the patient's high temperature can be lowered within a day or two."

Gong Shuangjiang nodded slightly, at least this method has short-term effects.

At this time, Zhang Gu had already started injecting the anti-infection solution under the gaze of everyone.

"Remember, at the beginning of the injection, only 10 to 15 milliliters can be injected each time. Too much will cause the abscess wall to burst, and the success will be lost."

"And the operation speed should be slow. If you feel the resistance of bolus injection, let the patient adjust his body position to facilitate the outflow of abscess and reduce the resistance of bolus injection."

"You see, after the injection, it should be sucked out immediately. The purpose of the whole operation is to flush the thick cavity."

Everyone wrote down these operating points one by one.

At this time, Zhang Gu found that the suction fluid in his hand could not be completely sucked out.

"what happened?"

Everyone felt bad, so Gong Shuangjiang also came over.

"What is the reason?"

Zhang Gu thought for a while, and said, "Maybe there is a problem with the placement of the drainage tube."

Gong Shuangjiang's face darkened immediately, and he glanced to the side.

A doctor who performed the surgery looked guilty, with his head bowed.

Zhang Gudao: "It should be that the placement of the drainage tube is wrong. It is higher than the bottom of the thick cavity. The depth and direction of the drainage tube must be readjusted."

After a burst of remedial measures.

The drainage tube was normal, Zhang Gu sucked it again, and it went smoothly.

Gong Shuangjiang was a little scared, with cold sweat streaming down his forehead: "Dr. Zhang, thanks to you being here today, otherwise such a serious problem would not have been discovered!"

Doing an abscess drainage operation, the placement of the drainage tube is wrong!

How is this operation done?

This kind of mistake should not be done!
Gong Shuangjiang was very heartbroken, because of the poor medical skills of the fourth hospital.

A doctor from the third hospital can tell that it is a problem with the drainage tube only by the way of suction.

However, an attending surgeon at the fourth hospital made such a low-level mistake during the operation.

See the whole leopard at a glance.No wonder outsiders say that the fourth courtyard is not as good as the third courtyard.

Gong Shuangjiang felt in his heart that there was still a long way to go if he wanted to improve the overall medical skills of the Fourth Hospital!

Sensing Gong Shuangjiang's disappointed gaze, the surgeon's heart trembled.

At this time, Zhang Gu opened his mouth to ease the atmosphere.

"Just flush the thick cavity like this, once or twice a day. If the drainage is smooth, the amount of flushing fluid can be gradually increased."

So far, the treatment methods are all explained clearly.

Gong Shuangjiang also basically figured out the principle of this treatment method.

He thought about it, and couldn't help nodding: "Is it possible to suppress pancreatic juice to fight infection while intravenous high nutrition supports recovery? This method is good, and it should work. At least, it saves the risk of another operation."

Zhang Gu said with a smile: "Just follow this way to drain for about two weeks, and it should be almost done. If you have any problems during the process, just call me and I will come over in time."

"It's getting late, it's been delayed for a while, we have to rush back to the Third Hospital."

Zhang Gu and Gong Shuangjiang bid farewell.

Gong Shuangjiang shook Zhang Gu's hand tightly, thanked him for a while, and then sent Zhang Gu outside the hospital himself.

Xiaomao felt that Director Gong's attitude towards Teacher Zhang was closer than the attitude towards Zhou Dongfeng when he came here.

Zhang Gu's successive performances today also opened Xiao Mao's eyes.

So it turns out that an excellent doctor like Mr. Zhang is so respected?

This feeling……

Really awesome.

(End of this chapter)