Back in 2002 as a doctor

He told Shen Lang what he had just encountered in the emergency department. Shen Lang's pupils were not equal in size or round, and the gossip patterns contained in them began to spin crazily.

He kept regretting that he should have gone to see it together.

Li Qinghua returned to the director's office after checking the room. He didn't think about the "magic" old lady just now, but was thinking about one thing.

The volume of thoracic surgery in the Third Hospital has increased by leaps and bounds. Li Qinghua had already made a judgment a month ago, so it was not a happy event.

What made him happy this morning was another matter. When Zhou Congwen was called to the director's office, Li Qinghua hesitated for a long time but didn't say anything.

Just last night, Li Qinghua ground out a whole egg!

He was ecstatic at the time, which was a milestone.

Moreover, he recently cooperated with Professor Chen in the operation. Many steps before shooting were performed by Li Qinghua himself. He believes that his hand feels hot and his skills are maturing day by day.

I didn't expect to work so hard to create a brand new world so soon after coming to the Third Hospital.

Both the volume of surgery and his own technology have improved by leaps and bounds.

Life is really poor and there is no way out, and there is another village in the dark.Being able to get to this point is due to Zhou Congwen's role.

However, Li Qinghua didn't want to let Zhou Congwen down. He had completed his first goal, and his next goal was to surpass Zhou Congwen.

Li Qinghua also knew it was difficult, but no matter how difficult it was, Zhou Congwen was not a carbon-based creature?If the talent is higher than yourself, then you have to put in more effort.

Immersed in joy, Li Qinghua leisurely looked at the form on the table.

I have already promoted the physical examination, and many things will follow naturally.

After an unknown amount of time, there was a knock on the door.

"Please come in." Li Qinghua sat upright, put his hands on the desk and looked ahead, restraining all his joy.

Zhou Congwen pushed the door in.

"Director, here comes a patient with spontaneous pneumothorax." Zhou Congwen said, "Take a look and see if you need emergency surgery under laparoscopy."

"Okay." Li Qinghua was overjoyed, his hands itched unbearably.

The patient is a 32-year-old male patient. The trachea is in the middle of the physical examination. The tactile fremitus of the left lung is weakened. The drum sound of the left lung is percussed, and the right lung is voiceless. and pleural friction rub.

On the chest radiograph, there was a left hydropneumothorax, and the outer edge of the left lung was compressed by about 50%.

Inquiring about the medical history revealed that it was not the first time that the patient had suffered from pneumothorax, it was estimated that he had suffered from pneumothorax before, and there was adhesion between the left lung and the pleura.

This time the bulla ruptured again, the lung tissue was compressed, and the adhesion was stretched, causing a small artery to tear and bleed.

Surgery, nothing to say.

Although Zhou Congwen was "asking for instructions", Li Qinghua knew very well that he was actually notifying himself.

"Congwen, let me do this operation." Li Qinghua discussed with Zhou Congwen.

"Well, then I won't go." Zhou Congwen said lightly.

Li Qinghua looked sideways at Zhou Congwen with a smile on his face, and was relieved when he saw that he didn't show any displeasure.

It's just a very simple spontaneous pneumothorax. Go up and try it yourself. Li Qinghua has already started to dive a little at this moment, and wants to go on stage immediately.

Recently, Li Qinghua felt hot to the touch, and Li Qinghua couldn't hold back his soaring heart.

Zhou Congwen didn't care what Li Qinghua was thinking. Before he came, Li Qinghua could have performed a similar operation with laparoscopic surgery, but it would take a long time to "waste".

As for now, with the experience of dozens of thoracoscopic wedge resections of small pulmonary nodules, it is impossible to get it down.

Shen Lang is the doctor in charge of the bed. After busy work, he completed various preoperative preparations in the shortest time and took the patient to the operating room.

Zhou Congwen was also idle when he was idle, so he went with him to see how far Li Qinghua's level had improved.

"Congwen, I thought about it."

When changing clothes in the locker room, Li Qinghua said to Zhou Congwen with a smile.

"What came to mind?"

"A simple pneumothorax doesn't need three holes at all." Li Qinghua threw Wang Zang.

This is what he thought of. He originally imagined that Zhou Congwen would be shocked when he heard it.

Unfortunately, he didn't see surprise or puzzlement on Zhou Congwen's face, but he could vaguely see a trace of... comfort.

What kind of expression is this?

Li Qinghua frowned slightly.

"It doesn't need to be so porous. The general surgery department has already begun to remove the appendix with a single hole." Zhou Congwen smiled slightly, "We have to make progress slowly. We can't let the general surgery department surpass it."

Li Qinghua laughed.

He knew that Zhou Congwen told Dr. Gao about the so-called single-hole appendectomy in general surgery.

It's a pity, Zhou Congwen seemed to have guessed what he was thinking.

Changing clothes and entering the operating room, the anesthesiologist Liu Wei was doing double-lumen intubation, and said hello, Zhou Congwen stood in the corner and watched quietly.

Zhou Congwen felt very helpless that Shen Lang was "self-willed to degenerate" and rejected his invitation several times in a row.

Seeing him busy before and after, brushing his hands and shop list, Zhou Congwen felt that this is the state Shen Lang should be in, instead of writing some science fiction without doing his job properly.

Write again, can you write too big?

It seems that such a comparison is not right, no matter how Shen Lang's surgery is done, he can't do it like himself.

If so, Shen Lang doesn't have to do anything, it's better to stay at home and wait for death.

However, the ceiling of writing science fiction is very certain, and there are not many people who can use this skill to make a living. Even if you count the future web articles, the space to make a living is countless times less than that of being a doctor.

I don't know whether it is right or wrong for Shen Lang to take this step.

The patient was lying on the healthy side, Li Qinghua and Shen Lang brushed their hands on the stage, and Zhou Congwen stood behind to watch them perform the operation.

Li Qinghua made a 9cm incision at the 1.5th intercostal space on the posterior axillary line, and inserted a 12mm Trocar as an observation hole.

The operation hole is located at the 4th intercostal space on the anterior axillary line, the length of the incision is about 3 cm, and the incision protective sleeve is placed.

Everything is very proficient, but you are familiar with it. After so many operations on small nodules, if you are not proficient, then Li Qinghua is not the prince in Zhou Congwen's memory.

Moreover, Li Qinghua is very talented. After dozens of operations, he started to move forward, taking the first step of thoracoscopy.

With this talent, Zhu Jun is really blind, Zhou Congwen thought to himself when he saw Li Qinghua undergoing surgery.

Chapter 0449 Emergencies

The operation went well.

Li Qinghua first checked whether there were adhesions in the chest cavity, and treated them with electrocoagulation hooks according to the type of adhesions.

Two pairs of double-joint oval forceps were placed in the operation hole to assist alternately, and the operation was performed well.

Shen Lang also supported the mirror very well, although there were some flaws, but Zhou Congwen didn't say anything.

During the operation, a large amount of hemorrhage in the patient's chest accompanied by blood clot formation was detected. It was found that there was a cord-like adhesion between the top of the pleura near the left subclavian artery and the tip of the left upper lobe.

The adhesion has been broken, and the broken end of the small artery can be seen in it, and a large number of old blood clots have formed around the broken end of the blood vessel. Based on this, it can be judged that the hemothorax is caused by the rupture of the blood vessel in the adhesion zone.

Li Qinghua clamped the stump of the arteriole with a titanium clip, and did the most urgent treatment first - to stop the bleeding.

After the hemostasis was completed, continue to explore the obvious bullae to determine the surgical target area.

Afterwards, the Olida laparoscopic linear cutting stapler Echelon was inserted, and the bullae were stapled and removed.

Afterwards, warm saline was administered, and the anesthesiologist expanded the lungs to check for small air leaks.

The investigation found two places, and Li Qinghua clipped the base with Hem-o-Lok.

Then flush and inflate the lungs. If there is no bleeding or air leakage, the operation is declared over.

Li Qinghua was very happy.

This operation was much smoother than when I first learned thoracoscopic surgery in the People's Hospital. The feeling of using hands and fingers like arms and fingers is very wonderful.

The hard work of grinding eggs with a grinder in the past few months has fully and perfectly rewarded.

Even if you don't touch it with your hands, but use long pliers to operate, everything will be smooth and smooth, no worse than the previous big uncovering operation.

Li Qinghua beamed with joy.

"Congwen, how are you doing?"

Even Li Qinghua was a little proud at this time.

"Not bad." Zhou Congwen gave a pertinent evaluation.

The anesthetist Liu Wei said, "Director Li, the operation went really smoothly."

"Simple, it should be."

"It has nothing to do with simplicity, the basic operation can tell the level. Your laparoscopic level has improved so fast!" Liu Wei did not hesitate to praise him.

Praise others for doing well, and don't scold others for doing poorly.Liu Wei will definitely do the matter of people carrying people in bridal sedan chairs.

Moreover, the thoracic surgery operations are becoming more and more mature, and Liu Wei is also very happy, which proves that his initial choice was not wrong.

"About 1800ml of blood clot was removed during the operation." Li Qinghua estimated a figure and told Liu Wei and Shen Lang.

This is the number that goes into the anesthesia note, nursing note, and surgery note.

"Blood transfusion?"

"I don't need it for now, go back and check the blood routine to see how the hemoglobin is doing." Li Qinghua didn't care much.

1800ml of blood sounds like a lot, but the "faucet" of bleeding has been turned on, and the patient is still young, so he will not be transfused if he can.

On this point, Li Qinghua thinks differently from others.

He has experienced the chaotic era of blood transfusion in the past few years. At that time, blood sellers were everywhere, and many people were infected through whole blood.

So Li Qinghua subconsciously has this habit to avoid some accidents.

Zhou Congwen didn't say much. Sometimes the upper and lower limits of medical principles are very different. The key is that the patient is young and recovers quickly, so it really doesn't matter whether blood is transfused or not.

Flush, close the chest, and 10 minutes after the operation, Liu Wei judged that the patient had met the requirements for extubation, pulled out the double-lumen bronchus while sucking sputum, and inhaled pure oxygen through the mask.

Zhou Congwen was very satisfied with all the steps in perfect harmony.

Liu Wei is a bit of a stalker, but his level is indeed outstanding in the plane of the Third Academy, and he is as careful as a hair.

Many anesthesiologists in the third hospital can't do the step of suctioning sputum during extubation, but Liu Wei pays attention to it.

Although it is a detail, it can explain the problem.

Everything was fine, whether it was Li Qinghua, Liu Wei, or even Shen Lang who had given up, performed very well. Zhou Congwen squinted his eyes for a few minutes, the patient was in a stable condition, and Shen Lang had already lifted the sterile sheet to flatten the cart.

Zhou Congwen turned to leave to make room for the flat car.

The moment he turned around, the alarm sounded from ECG monitoring.

Call the police? !

Zhou Congwen frowned.

Ordinarily it shouldn't be, there is nothing to be picky about the operation, even if you go up by yourself, that's it.

If you pick and choose, you can find some bugs, but it's not a big deal.

The point that may go wrong is that the patient's bleeding volume is relatively large, and Li Qinghua did not give blood, which will not cause the monitor to suddenly alarm.

Zhou Congwen turned around in the flash of his mind, and the blood oxygen saturation on the ECG monitor had dropped to 66%!

The patient's arterial blood pressure rose up to 210/130mmHg, and the heart rate rose up to 152 beats/min.

Anesthesiologist Liu Wei held the mask on the patient's face, and stared at the ECG monitor in a daze.

What's going on here?

He had no idea, his head was dewy.

Both surgery and anesthesia are quite satisfactory, not to mention textbook level.

However, after extubation, problems occurred when the patient wanted to return to the ward.

Zhou Congwen took off the sterile gown covering the patient's body to keep warm, and glanced at the patient's lower limbs.

The patient had a large number of reticular ecchymoses on both lower extremities, which were so dazzling.

"This is..." Liu Wei, the anesthesiologist, was dumbfounded. He knew that something must have happened, but he didn't know what happened if he wanted to break his head.