crazy scalpel

"Isn't the meningioma recurring?" Wen Xudong paused for a moment, and then happily said: "That's right, how can the meningioma grow so fast? Let me just say, it must be cut cleanly at my uncle's level. How could it be?" Recurrence? Then it would be better this way, since this is the case, it should be transferred to my uncle, he is familiar with this patient, and he is more comfortable in dissecting the patient during the operation. What do you think?"

Xie Ke secretly rolled his eyes, this Wen Xudong is really an idiot, why is there no sense of crisis at all, he said: "Deputy Director Bian may have misdiagnosed, I suspect that this patient has something wrong at all. Meningioma, but it can't be seen on the film for the time being, I'll ask him to have a lumbar puncture, and we'll see the analysis report when the time comes."

"Impossible!" Wen Xudong grabbed Xie Ke's arm: "What do you mean, tell me clearly. How could my uncle misdiagnose it? Even the tumor was removed during the operation, and it can still be misdiagnosed? There are videos taken before and after the operation to prove it, so you can’t talk nonsense. Besides, what else can it be if it’s not a meningioma that grows on the arachnoid? Could it be an aneurysm? Hahaha, it’s so funny!”

"..." Xie Ke: "Your joke is very cold. Let me go and wait for the test results."

Wen Xudong followed Xie Ke into the ward in a daze. At first he thought that Xie Ke was talking nonsense because he didn't want to transfer the patient away, but now seeing that Xie Ke was so serious, he knew that something was wrong.When I thought about my uncle's misdiagnosis, then... it would be terrible.

Wen Xudong's heart was in a mess. He was thinking whether he should report to his uncle immediately, but he also felt that he could not leave now, otherwise no one would know if Xie Ke said something bad to the patient and his family. .If I stay here by myself, I can at least help spread a rumor or something.

Thinking of this, Wen Xudong decided to stand aside and see what was going on.

Xie Ke ignored him, and told the patient that he wanted a lumbar puncture, but before he could do it, Wen Xudong suddenly pulled him aside and said secretly: "Doctor Xie, let Xiao Huo do the blood drawing and lumbar puncture. , you can just guide and guide by the side."

Xiao Huo is an intern brought by Wen Xudong.Xie Ke glanced at Wen Xudong when he heard the words, a little confused about what he meant.However, if an intern has never had a chance to do it, they will never have experience and proficiency, and Pang Fu did not specify the candidate for the waist wear, so Xie Ke still gave up the position and gave it to Xiao Huo.

Xiao Huo was standing by and watching, but Wen Xudong suddenly asked him to do a waist piercing, and he was so nervous that he felt the same way.He wasn't nervous because he wanted to do something, it was purely because his boss Wen Xudong and the genius doctor Zihong in the department were watching, and his attention was now focused on himself, so he was nervous.

The blood needs arterial blood, so the blood from the femoral artery must be pumped first. Xiao Huo let Pang Fu lie down on his back with trembling, and then he located the inner side under the inguinal ligament, and fixed it with the index finger and middle finger to the place where the pulsation is the strongest, and then stabbed the syringe Insert and pull the plunger to draw the blood out.

Xie Ke watched from the side and nodded again and again. This little Huo is still very capable of manipulating things, and he is also very accurate in finding points. It seems that he is a person who knows how to use his brain when doing things.

After the blood needle is pulled out, the bleeding at the puncture point is to be held down with sterile cotton.Originally, Xie Ke was relatively close, and he should be the one to stop the bleeding, but Wen Xudong probably wanted to sell himself in front of Pang Fu, so he took the initiative to press the needle in front of Xie Ke the moment Xiao Huo pulled out the needle. go down.It's a pity that he didn't press well. Not only did he fail to stop the bleeding, but he also bled, and the backlog formed a big lump under the skin.

Coincidentally, at this time, Pang Da and Pang Tian came in together after completing the formalities. Seeing such a big blood bag bulging behind the father's waist, Pang Da just frowned, but Pang Tian yelled : "What's going on? Why don't you just draw blood and cerebrospinal fluid? How did you make my dad like this?"

I can't blame Pang Tian for making a fuss, anyone who sees a blood bag that is about the size of a golf ball bulging behind their thighs will find it a little scary.In fact, this is really not a big deal, it just looks a bit psychologically shadowy.

Wen Xudong was very ashamed and annoyed, and was about to tell them, this is normal, is it normal to bleed after a puncture?This is a large artery, the blood flow pressure is already high, it is normal to bleed a little more, but he did not expect that it is a normal situation for him, but it is not for Xie Ke.

Xie Ke saw that Wen Xudong hadn't pressed well, so he pushed him away and went into battle himself.I saw Xie Ke pinch Wen Xudong's finger and remove it, took a bulging blood bag and immediately found the exit and burst out.Xie Ke stretched out a finger and pressed lightly, then wiped off the blood on the skin with cotton, and no new blood flowed out.And after Xie Ke held it down, the blood bag didn't rise at all.About 5 minutes later, Xie Ke took away his finger, and the bleeding had completely stopped, so Xie Ke bandaged it up.

During the few minutes of waiting, Xie Ke was not idle. He explained to Xiao Huo: "Stopping bleeding is not a technical job, but it is also important to stop it well. Because when you puncture, you wear it diagonally. The distance from the skin to the blood vessel has to go through the subcutaneous tissue, so the puncture point on the skin and the puncture point on the blood vessel are not on the same vertical line. When we stop bleeding, we need to press the bleeding point of the blood vessel, not the skin. Bleeding point. If you only press the bleeding point of the skin, the blood in the blood vessel is still flowing out, and there is no outlet for venting outside, so it will be accumulated under the skin and form a blood bag."

At the same time, Xie Ke turned his head and said to Pang Tian: "Because the arterial blood pressure is relatively high, the blood bag is a little bigger. It's fine to stop it now. It doesn't matter. Don't be nervous."

Pang Tian nodded and said nothing more.

Xiao Huo's eyes lit up when he heard this, he had never thought of this problem before!In fact, the reason is very simple, but he has seen this kind of aortic puncture many times, and there are not many people who are as clean as Xie Ke when hemostasis!

As long as you think about the relationship between the two true and false bleeding points, even the most clumsy person can stop the bleeding correctly.

In fact, although Xie Ke said this to Xiao Huo, he actually said it to Wen Xudong.It was just because Wen Xudong was already a formal doctor with several years of qualifications, Xie Ke was afraid that he would be uncomfortable, so he took the opportunity of Xiao Huozai to explain this hemostasis point.

However, Wen Xudong's face turned green and white one after another. He didn't think that Xie Ke was taking care of his face. Instead, he thought that Xie Ke was only talking to Xiao Huo and leaving him aside on purpose to embarrass him, so he treated Xie Ke even more. Get upset.

Xie Ke thinks that Xiao Huo is good, he is willing to listen and learn, and judging from his blood-drawing gestures, at least he has learned what he should know during the internship.So I continued to let him do waist puncture with confidence.

After Xie Ke's guidance and encouragement, Xiao Huo gained confidence in himself, and his movements became firm and steady.He put Pang Fu sideways, felt the lumbosacral joint and began to find the puncture point.After disinfection and local anesthesia, Xiao Huo recalled what Wen Xudong usually did, and used a 20-gauge needle to pierce the intervertebral space he had touched just now.

Pang Tian originally wanted to say not to let the little doctor do it, let Xie Ke do it, but his brother Pang Da pulled him aside, so he just ignored it and just watched.

Seeing Xiao Huo's movements, Xie Ke felt that the angle was not very good, so he reminded him: "Insert the needle along the direction of the spinous process, slowly and don't rush, and don't rush to puncture when you feel the bone, the needle is slightly Step back a little, adjust the angle and then puncture, so as not to hurt the arachnoid."

It was the first time Xiao Huo heard that a formal doctor was willing to teach him this way, and he was moved to tears and blushed.Only Wen Xudong curled his lips at the side, just doing a waist piercing, and there are so many sayings. I think he was self-taught back then, and he always found a position and pierced in all at once. If he made a mistake, he just pierced again.

Xie Ke smiled gently at Xiao Huo: "It's actually very simple, don't worry, you can definitely do it well."

Xiao Huo nodded, and followed Xie Ke's instructions. The dura mater was easily pierced to the subarachnoid space, and then the needle core was pulled out to release the cerebrospinal fluid.After draining the liquid, Xiao Huo put the needle core back and pulled out the puncture needle.The hemostasis here is more convenient, and it is also pressurized and then bandaged.

After the blood and cerebrospinal fluid were drawn and sent to the laboratory for testing, Xie Ke asked Pang Fu to lie on his back and rest.

Pang Da stayed by the bed, and Pang Tian followed Xie Ke out.While waiting for the results of the examination, Pang Tian followed Xie Ke all the time, and he went wherever Xie Ke went.Xie Ke couldn't help laughing: "Why are you following me?"

Pang Tian: "I think you are very powerful now, you must be able to cure my dad, right?"

Xie Ke looked affirmative: "I will try my best."

"Oh, I hate your doctor saying such things the most." Pang Tian said anxiously: "Why does this sound so insecure? By the way, you must have a solid foundation in your heart, right? What the hell is my dad doing?" Sick?"

Xie Ke: "After all the tests are done, can't you wait for the test results?"

Pang Tian: "Oh, then you must cure my dad. He is only in his sixties."

Xie Ke conveniently opened a can of glucose for him to drink, "Don't worry, there is no guarantee for things like medical treatment, especially this kind...but we will really try our best."

Pang Tian took it and took a sip. It was delicious, and he relaxed a little, and joked: "What kind? It's not cancer anyway."

"..." Xie Ke didn't know what to say, because it was really possible.

After the test results came out, Xie Ke found no cancer cells, but the protein content in the cerebrospinal fluid was very high, the leukocytes increased, and the lactate dehydrogenase also increased.In addition, carcinoembryonic antigen is also high.

Carcinoembryonic antigen cea is a glycoprotein that can elicit an immune response in patients.It was first discovered in the intestinal tissue, and later proved to exist widely in the human body, and of course the digestive system has the most.

Carcinoembryonic antigen is a tumor marker, whether it is malignant or benign, it may increase, but the benign ones are far lower than the malignant ones.

And Ponfort's cea is obviously too high.