Chapter 856: 856
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"Hang the thread with the small round needle, turn back and lengthen the thread. Secretary Ren and the vital signs of the patient will be handed over to you.
Dr. Chen, extend the anesthesia time!
Dr. Wang, please talk to the patient's family. We need to make two preparations.
Once the spleen preservation fails, splenectomy must be performed, and the risk of the operation must be explained to the patient's family members. "
"Good!"
"Yes!"
Ren Li agreed. After listening to Zhang Fan, Dr. Wang immediately agreed and left the operating room with a thick stack of surgical consent.
The instrument nurse hung the absorbable thread on the smallest round needle with considerable difficulty.
Needles, all kinds of leather needles, round needles, and special absorbable thread with needles, there are many kinds in medical treatment.
The round needle is actually the needle of your own sewn clothes. It is broken and bent into a full moon shape, just like a full moon machete.
The skin needle is as like as two peas, and the difference is on the needle.
The head of a round needle is sharp, while the head of a leather needle is like a triangular thorn.
Skin needles are used to sew skin and cartilage, and round needles are used to sew soft tissues and organs under the skin.
Because of the different needles, if the skin needle sutures the soft tissue under the skin, the result is that the tissue is split.
Although a small needle can be divided into three, six, nine, etc. in the hospital, for example, the round needle brought by the absorbable thread of a country is quite easy to use.
It is sharp, as if the material has its own smooth oil. When it is inserted into the tissue, it does not have a little dryness.
Moreover, the most awesome thing is that its material is used as a skin needle. It is easy to use. Skilled doctors can use it to penetrate flat bones, such as ribs.
But the price is also good-looking, one thread, one needle, more than 400! This is still the price of the hospital. If it's in a beauty salon, it costs thousands.
In order to prevent repeated use in the hospital, there is no threading hole at the end of the needle. It is a thorough disposable product.
To tell the truth, doctors like to use this foreign needle and thread if it's not the price.
It's estimated that small needles don't make money. Domestic manufacturers don't work hard. Then the domestic needles are really difficult to use.
Especially for doctors with slightly poor skills, if the slight force is not appropriate, the needle will be broken and bent first.
The nurse complained, the anesthesiologist urged, and the superior doctor criticized. Really, young doctors can bully and cry for needles.
Although Zhang Fan has no requirements for needles, he also likes to use them. They are not dry at all. When they are inserted, they are very smooth, just like wordy popsicles.
After receiving the needle, Zhang Fan looked up at the anesthesiologist. The anesthesiologist nodded to Zhang Fan gently, "Zhang hospital can start."
"Good!"
Abdominal tissue, including gastrointestinal, liver, pancreas, spleen and kidney. These abdominal organs have great autonomy, and they don't urinate much.
For example, intestinal peristalsis is managed by the intestine itself. If you eat too much, eat stimulating food, or tease with something from the back door, people will accelerate peristalsis.
But for other stimuli, they are also lazy. They don't give back to the brain what happened.
For example, if the intestinal tract is perforated, only after the intestinal fluid flows out will it make people roll around in pain.
What is intestinal fluid? This thing is strong alkali. Even so, the pain point of the abdomen is not very clear.
Abdominal organs are not very sensitive to temperature, cutting and acupuncture.
However, abdominal organs are the most sensitive to the pull force. This is why the second brother of the grassland will * * when he sees any prey.
Once you bite the head of the cecum and look back, whether you are a two ton rhinoceros or a big male lion with sharp teeth, you can lie on the ground and cry for Dad in pain.
Therefore, when doing abdominal surgery, when the old doctor takes the little doctor, he will say, "slow down, slow down, move gently, don't pull!"
If the patient is pulled frequently, even if the patient has anesthesia, it will lead to agitation and even painful shock.
And when abdominal pain occurs, you must not take painkillers at home, such as ibuprofen and diclofenac sodium sustained-release tablets.
Never eat it. This thing doesn't pee your brain very much. Once you take painkillers, it will cover up your condition.
Looking at the anesthesiologist nodded, Zhang Fan stabilized his mood and calmed his mind.
"Start!"
Lao Zhao took tweezers in one hand, gently fixed the spleen in his hand in the other hand, and then showed the field of operation clearly to Zhang Fan.
Suture. In organs, the stomach is the best suture. It has three or four layers of structure, and the texture is tight, just like a pocket.
The spleen is the most difficult to sew. How can I say this? It's like a crisp water radish or a green apple rich in water.
You'll know the difficulty of this operation by stitching a green apple with a needle.
Once this thing splits, it is very difficult to serve. The angle of the needle is a little deviated. Let alone sew, it can give you a few more lobes.
Each needle is a gamble. You don't know if your needle will split the spleen tissue.
Moreover, when the seam becomes smaller and smaller, it is more difficult to sew, because the more it reaches the edge, the more likely it is to crack.
Just like a ceramic, this thing breaks not only at one point, but sometimes, due to the problem of torque, this thing can open the whole spleen.
Therefore, the older the doctor, the more afraid he is to get rid of the spleen, because if he is careless, his previous efforts will be wasted.
However, for Zhang Fan, there is no problem with accuracy and stability.
Zhang Fan took a long breath and saw that the full moon needle was 90 degrees into the spleen wound.
On the edge of the spleen tissue with a wound like a flower petal, the needle holder in Zhang Fan's hand held a round needle and stabbed it firmly into the tissue.
When suturing cartilage or even penetrating flat bone or fascia, the force of wrist must be used.
This fragile tissue must use the power of fingers, not only have clean penetration, but also impartial stability.
Human body sewing is not sewing clothes. You can come any way with a needle in your hand.
For human body suture, the round needle is clamped by the needle holder, so the force is transmitted to the needle through the needle holder.
Just as you use pliers to hold nails and put them into wood, once you use improper force, the nails you hold are like a person who is not used to high heels and walks awkwardly.
If this happens after this time, don't think like it. The spleen can definitely become a spleen flower, so you can only cut it.
With the insertion of Zhang Fan with his breath closed, each insertion, Zhang Fan will insert with his breath at the most stable moment, and then seize the time to spread it out.
This thing doesn't use reckless force. Anyway, where is the spleen? I can't go in without my life.
Every insertion, not to mention Zhang Fan, is Zhao Quanping, director of general foreign studies, who is a help, involuntarily stopped breathing.
It seems that he is deeply afraid that his breathing will affect Zhang Fan's insertion.
One, two. The distance between the pins is as neat as measured with a ruler.
The profession of surgery is slightly the same as that of chefs. In the profession of chefs, men do the best, while men do the best in surgery.
Not tall, just this suture.
When Zhang Fan and his students had an operation class in college, the teacher anesthetized the students and tied the skinned rabbits to the operating table.
Then let the students practice stitching.
At that time, to tell the truth, we were all first brothers and first sisters. Who had done this job.
The result of stitching is that boys sew better than girls.
The spleen like a crisp apple slowly exudes a trace of blood with the stitches. Lao Zhao glances at Zhang Fan. He doesn't even dare to wipe blood.
Zhang Fan's sewing is not smooth and fast. Looking at the sweat on Zhang Fan's forehead, the itinerant nurse didn't dare to wipe it.
At this time, the wound on the spleen slowly closed and closed like a crying child's mouth.
For this kind of suture, stability is the foundation and speed is the key. There is a prime time saying in trauma medicine.
For example, the spleen is full of tissues constructed by various small bubbles. It can hold and eat, but there are few blood vessels.
Once it causes ischemia for a long time, even if it is sutured, it will also cause ischemic necrosis.
Zhang Fan sutured quickly. He was like a perspective eye. Every time the needle went down, he would avoid the blood vessels in the spleen.
There is only a light layer of superficial bleeding on the surface of the spleen, which is absolutely not like the emergence of blood flowers.
Doctors, although most doctors have the same education, they show different skills during surgery.
Some doctors, like slaughtering pigs, are full of blood in the operation field.
He rushed forward with his head down in the blood, cut an appendix, and then the patient had to have a blood transfusion of 400cc.
On the operating table, for such a poor doctor, the only resistance weapon for patients under anesthesia is bleeding.
Therefore, an excellent surgeon is not only good at hemostasis, but also good at avoiding bleeding in advance.
On the operating table, it can be said that 1g of bleeding needs 10g of treatment.
"Boost!" After Zhang Fan sewed the last stitch, his left hand gently released the curved forceps held out of the splenic door. This loosening is not complete.
But the mouth of the curved forceps has just left the blood vessel, but it can clamp the blood vessel again immediately if necessary.
The left hand is blessed, and the right hand is gently pressed on the wound sutured by the spleen.
This particularly fragile tissue sometimes leads to body contracture due to suture, and then the body will collapse after reperfusion.
Therefore, the suture of this kind of tissue is too wonderful. Sometimes after failure, even the doctor can't find out what's wrong.
Zhang Fan is confident in his own technology, but he can't guarantee it in case.
Therefore, before the blood does not fill the spleen, we must not be careless.
The main idea at this time is a human life.
Ren Li gave the medicine in person, and the booster medicine entered the medicine pot bit by bit. Slowly, the discolored spleen slowly began to turn darker and darker.
There was also significantly more bleeding at the stitches.
"What's the blood pressure?"
"High pressure 120 mmHg, low pressure 90 mmHg!"
Zhang Fan pressed on the upper hand of the spleen. At this time, he also began to feel the swelling of the spleen slightly.
Just like the cat's temptation, he licked it gently, then licked it deeply, and finally put his tongue directly on Zhang Fan's hand.
Swelling is inevitable, not to mention this kind of injury. Even if you slap someone, your face will swell, not to mention this kind of injury.
When the blood pressure rose to normal blood pressure and the spleen lay steadily, I heard Lao Zhao breathe a long sigh of relief.
"Come on, wipe the sweat for Zhang Yuan and wipe it for me. I'm almost thin!"
Can you not be nervous? Just like a time bomb, you can blow it up again at any time!
"Close the abdomen, go out and tell the patient's family that the patient's spleen is wrapped!"
As soon as the head nurse heard this, she quickly ran out first. The little doctors on one side haven't reflected it yet.
"Stop crying, all right, all right, wipe away your tears. The patient has been rescued and the spleen has been saved!"
Pulling down the mask, the head nurse with her face exposed stood at the door and told the family about the patient.
With that, the head nurse turned proudly into the operating room.
Her high head and erect chest seem so proud and charming. She likes this feeling and being surrounded by people's eyes of gratitude and worship.
Before the operation, the doctor told the patient that he was critically ill and might die on the operating table. The hearts of the family members were rolled by a road roller, and there was black fog in front of them.
During the operation, the doctor came out of the operation and told him that he might have to cut the spleen. Although it is necessary to cut off an organ, as long as people can be saved, their families are willing to do whatever they want.
When the patient's family members only had a little hope, that is, just rescue the person, the beautiful and plump nurse proudly told them that the person was alive.
Family members are really pulled from the abyss to the top of the peak. This sense of happiness is really particularly exciting.
The gray haired old man cried with his little granddaughter in his arms.
One month after the operation, I heard that the female owner of the hardware store sold the shop and gave the money to the female owner of the glasses store, and then got the understanding of the owner of the glasses store.
This is what Zhang Fan occasionally heard when the little nurses in the hospital gossip.
After the spring, the annual medical practitioner examination began to sign up again.
The technology of the hospital has been at the forefront of tea, but Ouyang still feels that it is not enough. It should not only be at the forefront of technology, but also in examinations.
Those Xueba who scored more than 500 in the exam, such as Naduo, Xu Xian and Xue Xiaoqiao, and the directors of various subjects were led by Ouyang to set up an exam counseling class.
Of course, Ouyang certainly didn't let Zhang Fan go. Zhang Fan is the main person in charge of the tutorial class.
Ouyang's current ruling philosophy is to fight with the government. She sends Lao Gao first. Lao Gao can't do it, and then she comes out.
Almost all the internal affairs of the hospital were on Zhang Fan and Ren Li's head.
Ren Li is hard-working. Zhang fan can't afford to be naughty now and then. Ouyang is becoming more and more thief.
As soon as Zhang Fan opened her mouth, she said that she had worked all her life, either low back pain or headache, or headache or upset. Now she can't even feed the cactus, so Zhang Fan must be considerate of her.
Zhang Fan has no way to say!
Anyway, just one word. If I don't work, you can do it yourself.
For the small doctors who took the exam for practicing doctors this year, although Zhang Fan gave them guidance, the bad news also frightened them.
Ouyang has said that doctors who have passed the examination of 500 will be given more bonuses and performance for half a year, while doctors who have passed the examination of less than 500 will be given more bonuses and performance for one month.
For doctors who fail in the first exam, they will stop paying all kinds of performance on the day when the results come out, and only 600 yuan per month will be given for living expenses. Those who fail in the second exam will be directly given the termination of the labor contract.
As soon as the red headed documents of the hospital came out, there was a howl. With the continuous improvement of the reputation of the Municipal People's Hospital, now I want to enter this unit. To tell the truth, some undergraduates spent a lot of thought. If they were dismissed because of the exam, really, how to live in the tea element medical circle and how to mix in the tea element medical circle.
On the day of the opening of the auxiliary class, the examinees who wanted to take the tea element examination in that year were not only from the Municipal People's Hospital, but also young doctors from other hospitals.
The deputy director of the medical office wanted to drive these doctors out of the hospital. Isn't it cheap for our hospital!
It was stopped by the director of the medical department. Chen Sheng knew Ouyang too well. Sure enough, when Ouyang found the strange doctor in the auditorium, the wrinkles on his face were smiling.
How famous the hospital is, isn't it relying on the support of peers, the envy and jealousy of peers!
If these doctors are really kicked out, Ouyang will definitely be angry.
Besides, if you can find some good seedlings in the study class, Ouyang is absolutely confident to dig people over. The old lady's abacus is very good.
Zhang Fan was the first teacher on the podium in the tutorial class.
When Zhang Fan boarded the podium, there was an instantaneous buzzing below.
Please report us if you find any errors so we can fix it asap!
"Hang the thread with the small round needle, turn back and lengthen the thread. Secretary Ren and the vital signs of the patient will be handed over to you.
Dr. Chen, extend the anesthesia time!
Dr. Wang, please talk to the patient's family. We need to make two preparations.
Once the spleen preservation fails, splenectomy must be performed, and the risk of the operation must be explained to the patient's family members. "
"Good!"
"Yes!"
Ren Li agreed. After listening to Zhang Fan, Dr. Wang immediately agreed and left the operating room with a thick stack of surgical consent.
The instrument nurse hung the absorbable thread on the smallest round needle with considerable difficulty.
Needles, all kinds of leather needles, round needles, and special absorbable thread with needles, there are many kinds in medical treatment.
The round needle is actually the needle of your own sewn clothes. It is broken and bent into a full moon shape, just like a full moon machete.
The skin needle is as like as two peas, and the difference is on the needle.
The head of a round needle is sharp, while the head of a leather needle is like a triangular thorn.
Skin needles are used to sew skin and cartilage, and round needles are used to sew soft tissues and organs under the skin.
Because of the different needles, if the skin needle sutures the soft tissue under the skin, the result is that the tissue is split.
Although a small needle can be divided into three, six, nine, etc. in the hospital, for example, the round needle brought by the absorbable thread of a country is quite easy to use.
It is sharp, as if the material has its own smooth oil. When it is inserted into the tissue, it does not have a little dryness.
Moreover, the most awesome thing is that its material is used as a skin needle. It is easy to use. Skilled doctors can use it to penetrate flat bones, such as ribs.
But the price is also good-looking, one thread, one needle, more than 400! This is still the price of the hospital. If it's in a beauty salon, it costs thousands.
In order to prevent repeated use in the hospital, there is no threading hole at the end of the needle. It is a thorough disposable product.
To tell the truth, doctors like to use this foreign needle and thread if it's not the price.
It's estimated that small needles don't make money. Domestic manufacturers don't work hard. Then the domestic needles are really difficult to use.
Especially for doctors with slightly poor skills, if the slight force is not appropriate, the needle will be broken and bent first.
The nurse complained, the anesthesiologist urged, and the superior doctor criticized. Really, young doctors can bully and cry for needles.
Although Zhang Fan has no requirements for needles, he also likes to use them. They are not dry at all. When they are inserted, they are very smooth, just like wordy popsicles.
After receiving the needle, Zhang Fan looked up at the anesthesiologist. The anesthesiologist nodded to Zhang Fan gently, "Zhang hospital can start."
"Good!"
Abdominal tissue, including gastrointestinal, liver, pancreas, spleen and kidney. These abdominal organs have great autonomy, and they don't urinate much.
For example, intestinal peristalsis is managed by the intestine itself. If you eat too much, eat stimulating food, or tease with something from the back door, people will accelerate peristalsis.
But for other stimuli, they are also lazy. They don't give back to the brain what happened.
For example, if the intestinal tract is perforated, only after the intestinal fluid flows out will it make people roll around in pain.
What is intestinal fluid? This thing is strong alkali. Even so, the pain point of the abdomen is not very clear.
Abdominal organs are not very sensitive to temperature, cutting and acupuncture.
However, abdominal organs are the most sensitive to the pull force. This is why the second brother of the grassland will * * when he sees any prey.
Once you bite the head of the cecum and look back, whether you are a two ton rhinoceros or a big male lion with sharp teeth, you can lie on the ground and cry for Dad in pain.
Therefore, when doing abdominal surgery, when the old doctor takes the little doctor, he will say, "slow down, slow down, move gently, don't pull!"
If the patient is pulled frequently, even if the patient has anesthesia, it will lead to agitation and even painful shock.
And when abdominal pain occurs, you must not take painkillers at home, such as ibuprofen and diclofenac sodium sustained-release tablets.
Never eat it. This thing doesn't pee your brain very much. Once you take painkillers, it will cover up your condition.
Looking at the anesthesiologist nodded, Zhang Fan stabilized his mood and calmed his mind.
"Start!"
Lao Zhao took tweezers in one hand, gently fixed the spleen in his hand in the other hand, and then showed the field of operation clearly to Zhang Fan.
Suture. In organs, the stomach is the best suture. It has three or four layers of structure, and the texture is tight, just like a pocket.
The spleen is the most difficult to sew. How can I say this? It's like a crisp water radish or a green apple rich in water.
You'll know the difficulty of this operation by stitching a green apple with a needle.
Once this thing splits, it is very difficult to serve. The angle of the needle is a little deviated. Let alone sew, it can give you a few more lobes.
Each needle is a gamble. You don't know if your needle will split the spleen tissue.
Moreover, when the seam becomes smaller and smaller, it is more difficult to sew, because the more it reaches the edge, the more likely it is to crack.
Just like a ceramic, this thing breaks not only at one point, but sometimes, due to the problem of torque, this thing can open the whole spleen.
Therefore, the older the doctor, the more afraid he is to get rid of the spleen, because if he is careless, his previous efforts will be wasted.
However, for Zhang Fan, there is no problem with accuracy and stability.
Zhang Fan took a long breath and saw that the full moon needle was 90 degrees into the spleen wound.
On the edge of the spleen tissue with a wound like a flower petal, the needle holder in Zhang Fan's hand held a round needle and stabbed it firmly into the tissue.
When suturing cartilage or even penetrating flat bone or fascia, the force of wrist must be used.
This fragile tissue must use the power of fingers, not only have clean penetration, but also impartial stability.
Human body sewing is not sewing clothes. You can come any way with a needle in your hand.
For human body suture, the round needle is clamped by the needle holder, so the force is transmitted to the needle through the needle holder.
Just as you use pliers to hold nails and put them into wood, once you use improper force, the nails you hold are like a person who is not used to high heels and walks awkwardly.
If this happens after this time, don't think like it. The spleen can definitely become a spleen flower, so you can only cut it.
With the insertion of Zhang Fan with his breath closed, each insertion, Zhang Fan will insert with his breath at the most stable moment, and then seize the time to spread it out.
This thing doesn't use reckless force. Anyway, where is the spleen? I can't go in without my life.
Every insertion, not to mention Zhang Fan, is Zhao Quanping, director of general foreign studies, who is a help, involuntarily stopped breathing.
It seems that he is deeply afraid that his breathing will affect Zhang Fan's insertion.
One, two. The distance between the pins is as neat as measured with a ruler.
The profession of surgery is slightly the same as that of chefs. In the profession of chefs, men do the best, while men do the best in surgery.
Not tall, just this suture.
When Zhang Fan and his students had an operation class in college, the teacher anesthetized the students and tied the skinned rabbits to the operating table.
Then let the students practice stitching.
At that time, to tell the truth, we were all first brothers and first sisters. Who had done this job.
The result of stitching is that boys sew better than girls.
The spleen like a crisp apple slowly exudes a trace of blood with the stitches. Lao Zhao glances at Zhang Fan. He doesn't even dare to wipe blood.
Zhang Fan's sewing is not smooth and fast. Looking at the sweat on Zhang Fan's forehead, the itinerant nurse didn't dare to wipe it.
At this time, the wound on the spleen slowly closed and closed like a crying child's mouth.
For this kind of suture, stability is the foundation and speed is the key. There is a prime time saying in trauma medicine.
For example, the spleen is full of tissues constructed by various small bubbles. It can hold and eat, but there are few blood vessels.
Once it causes ischemia for a long time, even if it is sutured, it will also cause ischemic necrosis.
Zhang Fan sutured quickly. He was like a perspective eye. Every time the needle went down, he would avoid the blood vessels in the spleen.
There is only a light layer of superficial bleeding on the surface of the spleen, which is absolutely not like the emergence of blood flowers.
Doctors, although most doctors have the same education, they show different skills during surgery.
Some doctors, like slaughtering pigs, are full of blood in the operation field.
He rushed forward with his head down in the blood, cut an appendix, and then the patient had to have a blood transfusion of 400cc.
On the operating table, for such a poor doctor, the only resistance weapon for patients under anesthesia is bleeding.
Therefore, an excellent surgeon is not only good at hemostasis, but also good at avoiding bleeding in advance.
On the operating table, it can be said that 1g of bleeding needs 10g of treatment.
"Boost!" After Zhang Fan sewed the last stitch, his left hand gently released the curved forceps held out of the splenic door. This loosening is not complete.
But the mouth of the curved forceps has just left the blood vessel, but it can clamp the blood vessel again immediately if necessary.
The left hand is blessed, and the right hand is gently pressed on the wound sutured by the spleen.
This particularly fragile tissue sometimes leads to body contracture due to suture, and then the body will collapse after reperfusion.
Therefore, the suture of this kind of tissue is too wonderful. Sometimes after failure, even the doctor can't find out what's wrong.
Zhang Fan is confident in his own technology, but he can't guarantee it in case.
Therefore, before the blood does not fill the spleen, we must not be careless.
The main idea at this time is a human life.
Ren Li gave the medicine in person, and the booster medicine entered the medicine pot bit by bit. Slowly, the discolored spleen slowly began to turn darker and darker.
There was also significantly more bleeding at the stitches.
"What's the blood pressure?"
"High pressure 120 mmHg, low pressure 90 mmHg!"
Zhang Fan pressed on the upper hand of the spleen. At this time, he also began to feel the swelling of the spleen slightly.
Just like the cat's temptation, he licked it gently, then licked it deeply, and finally put his tongue directly on Zhang Fan's hand.
Swelling is inevitable, not to mention this kind of injury. Even if you slap someone, your face will swell, not to mention this kind of injury.
When the blood pressure rose to normal blood pressure and the spleen lay steadily, I heard Lao Zhao breathe a long sigh of relief.
"Come on, wipe the sweat for Zhang Yuan and wipe it for me. I'm almost thin!"
Can you not be nervous? Just like a time bomb, you can blow it up again at any time!
"Close the abdomen, go out and tell the patient's family that the patient's spleen is wrapped!"
As soon as the head nurse heard this, she quickly ran out first. The little doctors on one side haven't reflected it yet.
"Stop crying, all right, all right, wipe away your tears. The patient has been rescued and the spleen has been saved!"
Pulling down the mask, the head nurse with her face exposed stood at the door and told the family about the patient.
With that, the head nurse turned proudly into the operating room.
Her high head and erect chest seem so proud and charming. She likes this feeling and being surrounded by people's eyes of gratitude and worship.
Before the operation, the doctor told the patient that he was critically ill and might die on the operating table. The hearts of the family members were rolled by a road roller, and there was black fog in front of them.
During the operation, the doctor came out of the operation and told him that he might have to cut the spleen. Although it is necessary to cut off an organ, as long as people can be saved, their families are willing to do whatever they want.
When the patient's family members only had a little hope, that is, just rescue the person, the beautiful and plump nurse proudly told them that the person was alive.
Family members are really pulled from the abyss to the top of the peak. This sense of happiness is really particularly exciting.
The gray haired old man cried with his little granddaughter in his arms.
One month after the operation, I heard that the female owner of the hardware store sold the shop and gave the money to the female owner of the glasses store, and then got the understanding of the owner of the glasses store.
This is what Zhang Fan occasionally heard when the little nurses in the hospital gossip.
After the spring, the annual medical practitioner examination began to sign up again.
The technology of the hospital has been at the forefront of tea, but Ouyang still feels that it is not enough. It should not only be at the forefront of technology, but also in examinations.
Those Xueba who scored more than 500 in the exam, such as Naduo, Xu Xian and Xue Xiaoqiao, and the directors of various subjects were led by Ouyang to set up an exam counseling class.
Of course, Ouyang certainly didn't let Zhang Fan go. Zhang Fan is the main person in charge of the tutorial class.
Ouyang's current ruling philosophy is to fight with the government. She sends Lao Gao first. Lao Gao can't do it, and then she comes out.
Almost all the internal affairs of the hospital were on Zhang Fan and Ren Li's head.
Ren Li is hard-working. Zhang fan can't afford to be naughty now and then. Ouyang is becoming more and more thief.
As soon as Zhang Fan opened her mouth, she said that she had worked all her life, either low back pain or headache, or headache or upset. Now she can't even feed the cactus, so Zhang Fan must be considerate of her.
Zhang Fan has no way to say!
Anyway, just one word. If I don't work, you can do it yourself.
For the small doctors who took the exam for practicing doctors this year, although Zhang Fan gave them guidance, the bad news also frightened them.
Ouyang has said that doctors who have passed the examination of 500 will be given more bonuses and performance for half a year, while doctors who have passed the examination of less than 500 will be given more bonuses and performance for one month.
For doctors who fail in the first exam, they will stop paying all kinds of performance on the day when the results come out, and only 600 yuan per month will be given for living expenses. Those who fail in the second exam will be directly given the termination of the labor contract.
As soon as the red headed documents of the hospital came out, there was a howl. With the continuous improvement of the reputation of the Municipal People's Hospital, now I want to enter this unit. To tell the truth, some undergraduates spent a lot of thought. If they were dismissed because of the exam, really, how to live in the tea element medical circle and how to mix in the tea element medical circle.
On the day of the opening of the auxiliary class, the examinees who wanted to take the tea element examination in that year were not only from the Municipal People's Hospital, but also young doctors from other hospitals.
The deputy director of the medical office wanted to drive these doctors out of the hospital. Isn't it cheap for our hospital!
It was stopped by the director of the medical department. Chen Sheng knew Ouyang too well. Sure enough, when Ouyang found the strange doctor in the auditorium, the wrinkles on his face were smiling.
How famous the hospital is, isn't it relying on the support of peers, the envy and jealousy of peers!
If these doctors are really kicked out, Ouyang will definitely be angry.
Besides, if you can find some good seedlings in the study class, Ouyang is absolutely confident to dig people over. The old lady's abacus is very good.
Zhang Fan was the first teacher on the podium in the tutorial class.
When Zhang Fan boarded the podium, there was an instantaneous buzzing below.
"Hang the thread with the small round needle, turn back and lengthen the thread. Secretary Ren and the vital signs of the patient will be handed over to you.Dr. Chen, extend the anesthesia time!Dr. Wang, please talk to the patient's family. We need to make two preparations.Once the spleen preservation fails, splenectomy must be performed, and the risk of the operation must be explained to the patient's family members. ""Good!""Yes!"Ren Li agreed. After listening to Zhang Fan, Dr. Wang immediately agreed and left the operating room with a thick stack of surgical consent.The instrument nurse hung the absorbable thread on the smallest round needle with considerable difficulty.Needles, all kinds of leather needles, round needles, and special absorbable thread with needles, there are many kinds in medical treatment.The round needle is actually the needle of your own sewn clothes. It is broken and bent into a full moon shape, just like a full moon machete.The skin needle is as like as two peas, and the difference is on the needle.The head of a round needle is sharp, while the head of a leather needle is like a triangular thorn.Skin needles are used to sew skin and cartilage, and round needles are used to sew soft tissues and organs under the skin.Because of the different needles, if the skin needle sutures the soft tissue under the skin, the result is that the tissue is split.Although a small needle can be divided into three, six, nine, etc. in the hospital, for example, the round needle brought by the absorbable thread of a country is quite easy to use.It is sharp, as if the material has its own smooth oil. When it is inserted into the tissue, it does not have a little dryness.Moreover, the most awesome thing is that its material is used as a skin needle. It is easy to use. Skilled doctors can use it to penetrate flat bones, such as ribs.But the price is also good-looking, one thread, one needle, more than 400! This is still the price of the hospital. If it's in a beauty salon, it costs thousands.In order to prevent repeated use in the hospital, there is no threading hole at the end of the needle. It is a thorough disposable product.To tell the truth, doctors like to use this foreign needle and thread if it's not the price.It's estimated that small needles don't make money. Domestic manufacturers don't work hard. Then the domestic needles are really difficult to use.Especially for doctors with slightly poor skills, if the slight force is not appropriate, the needle will be broken and bent first.The nurse complained, the anesthesiologist urged, and the superior doctor criticized. Really, young doctors can bully and cry for needles.Although Zhang Fan has no requirements for needles, he also likes to use them. They are not dry at all. When they are inserted, they are very smooth, just like wordy popsicles.After receiving the needle, Zhang Fan looked up at the anesthesiologist. The anesthesiologist nodded to Zhang Fan gently, "Zhang hospital can start.""Good!"Abdominal tissue, including gastrointestinal, liver, pancreas, spleen and kidney. These abdominal organs have great autonomy, and they don't urinate much.For example, intestinal peristalsis is managed by the intestine itself. If you eat too much, eat stimulating food, or tease with something from the back door, people will accelerate peristalsis.But for other stimuli, they are also lazy. They don't give back to the brain what happened.For example, if the intestinal tract is perforated, only after the intestinal fluid flows out will it make people roll around in pain.What is intestinal fluid? This thing is strong alkali. Even so, the pain point of the abdomen is not very clear.Abdominal organs are not very sensitive to temperature, cutting and acupuncture.However, abdominal organs are the most sensitive to the pull force. This is why the second brother of the grassland will * * when he sees any prey.Once you bite the head of the cecum and look back, whether you are a two ton rhinoceros or a big male lion with sharp teeth, you can lie on the ground and cry for Dad in pain.Therefore, when doing abdominal surgery, when the old doctor takes the little doctor, he will say, "slow down, slow down, move gently, don't pull!"If the patient is pulled frequently, even if the patient has anesthesia, it will lead to agitation and even painful shock.And when abdominal pain occurs, you must not take painkillers at home, such as ibuprofen and diclofenac sodium sustained-release tablets.Never eat it. This thing doesn't pee your brain very much. Once you take painkillers, it will cover up your condition.Looking at the anesthesiologist nodded, Zhang Fan stabilized his mood and calmed his mind."Start!"Lao Zhao took tweezers in one hand, gently fixed the spleen in his hand in the other hand, and then showed the field of operation clearly to Zhang Fan.Suture. In organs, the stomach is the best suture. It has three or four layers of structure, and the texture is tight, just like a pocket.The spleen is the most difficult to sew. How can I say this? It's like a crisp water radish or a green apple rich in water.You'll know the difficulty of this operation by stitching a green apple with a needle.Once this thing splits, it is very difficult to serve. The angle of the needle is a little deviated. Let alone sew, it can give you a few more lobes.Each needle is a gamble. You don't know if your needle will split the spleen tissue.Moreover, when the seam becomes smaller and smaller, it is more difficult to sew, because the more it reaches the edge, the more likely it is to crack.Just like a ceramic, this thing breaks not only at one point, but sometimes, due to the problem of torque, this thing can open the whole spleen.Therefore, the older the doctor, the more afraid he is to get rid of the spleen, because if he is careless, his previous efforts will be wasted.However, for Zhang Fan, there is no problem with accuracy and stability.Zhang Fan took a long breath and saw that the full moon needle was 90 degrees into the spleen wound.On the edge of the spleen tissue with a wound like a flower petal, the needle holder in Zhang Fan's hand held a round needle and stabbed it firmly into the tissue.When suturing cartilage or even penetrating flat bone or fascia, the force of wrist must be used.This fragile tissue must use the power of fingers, not only have clean penetration, but also impartial stability.Human body sewing is not sewing clothes. You can come any way with a needle in your hand.For human body suture, the round needle is clamped by the needle holder, so the force is transmitted to the needle through the needle holder.Just as you use pliers to hold nails and put them into wood, once you use improper force, the nails you hold are like a person who is not used to high heels and walks awkwardly.If this happens after this time, don't think like it. The spleen can definitely become a spleen flower, so you can only cut it.With the insertion of Zhang Fan with his breath closed, each insertion, Zhang Fan will insert with his breath at the most stable moment, and then seize the time to spread it out.This thing doesn't use reckless force. Anyway, where is the spleen? I can't go in without my life.Every insertion, not to mention Zhang Fan, is Zhao Quanping, director of general foreign studies, who is a help, involuntarily stopped breathing.It seems that he is deeply afraid that his breathing will affect Zhang Fan's insertion.One, two. The distance between the pins is as neat as measured with a ruler.The profession of surgery is slightly the same as that of chefs. In the profession of chefs, men do the best, while men do the best in surgery.Not tall, just this suture.When Zhang Fan and his students had an operation class in college, the teacher anesthetized the students and tied the skinned rabbits to the operating table.Then let the students practice stitching.At that time, to tell the truth, we were all first brothers and first sisters. Who had done this job.The result of stitching is that boys sew better than girls.The spleen like a crisp apple slowly exudes a trace of blood with the stitches. Lao Zhao glances at Zhang Fan. He doesn't even dare to wipe blood.Zhang Fan's sewing is not smooth and fast. Looking at the sweat on Zhang Fan's forehead, the itinerant nurse didn't dare to wipe it.At this time, the wound on the spleen slowly closed and closed like a crying child's mouth.For this kind of suture, stability is the foundation and speed is the key. There is a prime time saying in trauma medicine.For example, the spleen is full of tissues constructed by various small bubbles. It can hold and eat, but there are few blood vessels.Once it causes ischemia for a long time, even if it is sutured, it will also cause ischemic necrosis.Zhang Fan sutured quickly. He was like a perspective eye. Every time the needle went down, he would avoid the blood vessels in the spleen.There is only a light layer of superficial bleeding on the surface of the spleen, which is absolutely not like the emergence of blood flowers.Doctors, although most doctors have the same education, they show different skills during surgery.Some doctors, like slaughtering pigs, are full of blood in the operation field.He rushed forward with his head down in the blood, cut an appendix, and then the patient had to have a blood transfusion of 400cc.On the operating table, for such a poor doctor, the only resistance weapon for patients under anesthesia is bleeding.Therefore, an excellent surgeon is not only good at hemostasis, but also good at avoiding bleeding in advance.On the operating table, it can be said that 1g of bleeding needs 10g of treatment."Boost!" After Zhang Fan sewed the last stitch, his left hand gently released the curved forceps held out of the splenic door. This loosening is not complete.But the mouth of the curved forceps has just left the blood vessel, but it can clamp the blood vessel again immediately if necessary.The left hand is blessed, and the right hand is gently pressed on the wound sutured by the spleen.This particularly fragile tissue sometimes leads to body contracture due to suture, and then the body will collapse after reperfusion.Therefore, the suture of this kind of tissue is too wonderful. Sometimes after failure, even the doctor can't find out what's wrong.Zhang Fan is confident in his own technology, but he can't guarantee it in case.Therefore, before the blood does not fill the spleen, we must not be careless.The main idea at this time is a human life.Ren Li gave the medicine in person, and the booster medicine entered the medicine pot bit by bit. Slowly, the discolored spleen slowly began to turn darker and darker.There was also significantly more bleeding at the stitches."What's the blood pressure?""High pressure 120 mmHg, low pressure 90 mmHg!"Zhang Fan pressed on the upper hand of the spleen. At this time, he also began to feel the swelling of the spleen slightly.Just like the cat's temptation, he licked it gently, then licked it deeply, and finally put his tongue directly on Zhang Fan's hand.Swelling is inevitable, not to mention this kind of injury. Even if you slap someone, your face will swell, not to mention this kind of injury.When the blood pressure rose to normal blood pressure and the spleen lay steadily, I heard Lao Zhao breathe a long sigh of relief."Come on, wipe the sweat for Zhang Yuan and wipe it for me. I'm almost thin!"Can you not be nervous? Just like a time bomb, you can blow it up again at any time!"Close the abdomen, go out and tell the patient's family that the patient's spleen is wrapped!"As soon as the head nurse heard this, she quickly ran out first. The little doctors on one side haven't reflected it yet."Stop crying, all right, all right, wipe away your tears. The patient has been rescued and the spleen has been saved!"Pulling down the mask, the head nurse with her face exposed stood at the door and told the family about the patient.With that, the head nurse turned proudly into the operating room.Her high head and erect chest seem so proud and charming. She likes this feeling and being surrounded by people's eyes of gratitude and worship.Before the operation, the doctor told the patient that he was critically ill and might die on the operating table. The hearts of the family members were rolled by a road roller, and there was black fog in front of them.During the operation, the doctor came out of the operation and told him that he might have to cut the spleen. Although it is necessary to cut off an organ, as long as people can be saved, their families are willing to do whatever they want.When the patient's family members only had a little hope, that is, just rescue the person, the beautiful and plump nurse proudly told them that the person was alive.Family members are really pulled from the abyss to the top of the peak. This sense of happiness is really particularly exciting.The gray haired old man cried with his little granddaughter in his arms.One month after the operation, I heard that the female owner of the hardware store sold the shop and gave the money to the female owner of the glasses store, and then got the understanding of the owner of the glasses store.This is what Zhang Fan occasionally heard when the little nurses in the hospital gossip.After the spring, the annual medical practitioner examination began to sign up again.The technology of the hospital has been at the forefront of tea, but Ouyang still feels that it is not enough. It should not only be at the forefront of technology, but also in examinations.Those Xueba who scored more than 500 in the exam, such as Naduo, Xu Xian and Xue Xiaoqiao, and the directors of various subjects were led by Ouyang to set up an exam counseling class.Of course, Ouyang certainly didn't let Zhang Fan go. Zhang Fan is the main person in charge of the tutorial class.Ouyang's current ruling philosophy is to fight with the government. She sends Lao Gao first. Lao Gao can't do it, and then she comes out.Almost all the internal affairs of the hospital were on Zhang Fan and Ren Li's head.Ren Li is hard-working. Zhang fan can't afford to be naughty now and then. Ouyang is becoming more and more thief.As soon as Zhang Fan opened her mouth, she said that she had worked all her life, either low back pain or headache, or headache or upset. Now she can't even feed the cactus, so Zhang Fan must be considerate of her.Zhang Fan has no way to say!Anyway, just one word. If I don't work, you can do it yourself.For the small doctors who took the exam for practicing doctors this year, although Zhang Fan gave them guidance, the bad news also frightened them.Ouyang has said that doctors who have passed the examination of 500 will be given more bonuses and performance for half a year, while doctors who have passed the examination of less than 500 will be given more bonuses and performance for one month.For doctors who fail in the first exam, they will stop paying all kinds of performance on the day when the results come out, and only 600 yuan per month will be given for living expenses. Those who fail in the second exam will be directly given the termination of the labor contract.As soon as the red headed documents of the hospital came out, there was a howl. With the continuous improvement of the reputation of the Municipal People's Hospital, now I want to enter this unit. To tell the truth, some undergraduates spent a lot of thought. If they were dismissed because of the exam, really, how to live in the tea element medical circle and how to mix in the tea element medical circle.On the day of the opening of the auxiliary class, the examinees who wanted to take the tea element examination in that year were not only from the Municipal People's Hospital, but also young doctors from other hospitals.The deputy director of the medical office wanted to drive these doctors out of the hospital. Isn't it cheap for our hospital!It was stopped by the director of the medical department. Chen Sheng knew Ouyang too well. Sure enough, when Ouyang found the strange doctor in the auditorium, the wrinkles on his face were smiling.How famous the hospital is, isn't it relying on the support of peers, the envy and jealousy of peers!If these doctors are really kicked out, Ouyang will definitely be angry.Besides, if you can find some good seedlings in the study class, Ouyang is absolutely confident to dig people over. The old lady's abacus is very good.Zhang Fan was the first teacher on the podium in the tutorial class.When Zhang Fan boarded the podium, there was an instantaneous buzzing below.
