Path of Medicine With a System

Fear, for adults, there are too many things that can bring them fear, such as taking a bumpy small plane like a tractor. And the biggest fear of children is to leave their parents.

Bart is lying on the flatbed with antibiotics on one hand. The operation was too big, and antibiotics were routinely administered intravenously the day before the operation. The other hand tightly grasped the corner of the hospital gown. Although it was covered with a quilt, the curled up body was still obvious. Tilting his head, his big innocent eyes looked pitifully at his parents who were far away. I wanted to cry, but I didn't dare to cry when I looked at the two older sisters in white coats beside me.

The surgical trolley disappeared at the end of the corridor, and Bart's mother didn't know what to do. Her two hands were shaking and she didn't know where to put it.

Huaguo Hospital, as long as it is on the third level of comprehensive. There is a rule, three super large departments, general surgery, respiratory, orthopedics, and many hospital leaders are orthopedics. Then there are all kinds of high-end orthopedics, but it's strange that such a tall place can't even connect a little finger.

Zhang Fan was already waiting in the operating room. Bart was the patient in their group, and Wang Yanan was supposed to be on the operating table, but the girl was feeling a little uncomfortable these days, so she let Xue Fei do it. I don't know what kind of deal this guy made with Xu Xian in private.

Xu Xian happily entered the operating room, looked at Director Gao, and then said to Zhang Fan: "Doctor Zhang, I will be the third assistant for this operation, is that okay? Teacher Xue has a bit of diarrhea."

Before Zhang Fan could speak, Lao Gao said, "He's itchy again. Why don't you say he didn't improve at all." Zhou Chengfu left, although he left quietly, but Lao Gao was still a little sad .

Xue Fei and Zhou Chengfu were the disciples he brought out during the most difficult time. They were not his own sons, but they were the two with the deepest affection. The scene of the three of them huddled together for warmth is vivid in my memory. But now, one left the master for his own future. And the other one is just out of tune.

Although Zhang Fan is also considered his disciple, but for Zhang Fan, he always feels that there is something missing, maybe what is missing is the process of training. Zhang Fan got up so fast, he was about to look up before he even noticed. So when talking about Xue Fei, Lao Gao gritted his teeth a bit.

Everyone knew about Xue Fei's problems, and Zhang Fan couldn't explain it. Xue Fei was definitely not in the department at this time, and he might have gone to play mahjong with his aunts long ago.

"Xiao Xu, what major are you in?" Pharaoh asked gleefully and with a smile on his face. He is proud of Lao Gao's disciples who don't live up to their expectations. Compared with Lao Gao, his disciples are much better. Several attendings are better than each other, but they can't compare with Zhang Fan!

"Director Wang, I graduated from the Department of Spine and Orthopedics." Xu Xian had already stood with Zhang Fan to watch the X-rays and MRI, but when he heard Lao Wang's question, he turned around and answered in a hurry.

"Oh! Spine orthopedics department, why did the hospital assign you to the joint orthopedics department? Isn't this a waste, it's inappropriate. I have to ask."

After Xu Xian was admitted to the department, the orthopedics department was divided into three, so there was such a thing. When Old Wang said this, Xu Xian couldn't answer.

Xu Xian was down-to-earth and capable, of course Lao Gao couldn't bear it, he rolled his eyes at Lao Wang and said, "What's wrong, he's an orthopedic surgeon first and foremost."

"Pick up the patient!" The head nurse's voice came over. The head nurse in the operating room helped the roving nurses bring Bart in. "Little friend, don't be afraid, it doesn't hurt at all, you'll be fine after you wake up." Then he gently touched Bart's little face where the hairs and goosebumps stood up.

Little Bart was lying on the bed, holding the head nurse's hand tightly with the hand that hadn't been injected. Don't look at the head nurse who is usually a monster, but she really has an affinity for children.

"Sister! Don't go!" The head nurse was about to talk to Zhang Fan and the others after sending her to the place. As a result, after he came out of the ward, Bart, who had been silent all this time, blushed and spoke.

"Oops,

Haha, be good, be obedient, my sister won't leave. "The head nurse was really happy. She was really happy to let such a pure and flawless child call her sister, and her heart blossomed.

Bart, who is like a lamb, is nervous and afraid, but the gentle comfort from the head nurse is the only thing he can rely on in this strange and strange place.

Putting his little hand into the quilt, he took out something tremblingly, "Here you are, a bone stone!" Bart found a bone that looked like some kind of animal from somewhere, and it looked a little jade-like. It's Bart's favourite.

Bart's pure eyes are like a clear spring. The head nurse, a young woman who had experienced countless winds and rains, suddenly had a sore nose and tears fell directly.

"Thank you! My sister doesn't want it."

"Sister, take it! Bow stone, bless you."

"Well! Sister takes it, sister takes it! You will be my sister's real brother from now on." Although he didn't know what surgery was in an unfamiliar environment, he also knew it was not a good thing.

Innocent, pitiful but with a very sincere look in his eyes, he directly touched the head nurse who is also a domineering nurse in the operating room. "Hey! What is missing is what makes it so precious. The sincerity in the world of children is so precious in the world of adults." Lao Gao also felt a little deeply.

"Yes." Lao Wang nodded involuntarily. The head nurse held the wolf hair stone given by Bart, and the other hand held Bart's little hand, crying uncontrollably until Bart was slowly anesthetized and fell asleep!

"I'm going to wash my face. Zhang Fan must be careful!" The head nurse stood in front of the operating room door and said to Zhang Fan deliberately.

"Don't worry!" Zhang Fan nodded. The itinerant nurse helped Xu Xian disinfect, while Zhang Fan, Lao Gao, and Lao Wang brushed their hands. Spread the sheet, cover the hole towel, after everything is ready.

Zhang Fan put on his gloves, took the scalpel from the equipment nurse, and wiped the skin to be cut with alcohol cotton ball. Turning his head to look at the clock hanging on the wall of the operating room, he said softly, "The operation has begun."

Bart is on his stomach. There is a special operating bed for this position. Many people have gone to the big bath to take a bath and have a massage. It is the kind of bed with a hole at the head of the bed, and you can put your face on it.

Zhang Fan is the chief surgeon, Lao Wang is the first assistant, Lao Gao is the second assistant, and Xu Xian is the third assistant. Zhang Fan's operation was originally performed at relatively low air pressure, and Bart Jr. came here for a while before the operation, and the atmosphere of the operation became even more gloomy.

No one has the desire to speak, this may be the tragedy of adults! Simple things are luxuries that can no longer be obtained.

The scalpel made an incision on the immature skin, and a white line was pulled out of the skin in an instant, which was the dermis. Then the handle of the knife spreads the subcutaneous tissue. Then change the electric knife and start to stop the bleeding.

Surgery, as long as it is a traumatic operation, must be entered layer by layer according to the physiological level, and the bleeding should be stopped layer by layer. Experts, especially some surgeons who pay attention to details, look at their operations as if they were art.

Clean, tidy, distinct layers, clear anatomy, and almost no bleeding in the entire surgical field. And some doctors who are not very skilled, don't know whether it is for the pursuit of speed or because they don't know anatomy. The layers are not clear, and the bleeding that fills the field of vision is really like a slaughterhouse.

Continue to extend inward, expose the spinous process, incise the supraspinous ligament, and then gently separate the incised ligament to both sides. "Periosteal stripper." After the bone was leaked, Zhang Fan said softly.

The surgical nurse accurately handed the periosteal stripper to Zhang Fan. On the operating table, passing things is genteel. Sharp tools, such as knives, scissors, etc., should be pointed at themselves when passing them.

When passing it to the opponent's hand, you must make a downward pressing action, and you can't let go until the opponent makes a resisting force. For this one detail, many nurses have to practice it many times, is it simple? It's simple, but you must practice this action as a subconscious action so that your muscles have memory to be considered qualified.

It's not demanding, because nothing is left to chance on the operating table. Some special equipment may be just one, if it falls to the ground during the transfer process, it will be an accident directly.

Zhang Fan used a periosteal dissector to stick to the spinous process, and pushed the thoracic paraspinal muscles from the subperiosteum to the tip of the transverse process, and stopped when the lumbar spine was exposed outside the articular process.

"Gauze!" Lao Wang stared at Zhang Fan's movements intently. Lumbar spine surgery aside, there is a lot of bleeding. Human evolution is very advanced. As long as it is around the bone, it will be accompanied by large blood vessels and important nerves.

The spine not only supports the body, but also protects the derivatives of the brain, so there are many large blood vessels. During the operation, the large blood vessels can be avoided, but the small blood vessels branching from the large blood vessels cannot be avoided from being destroyed.

When performing surgery, the emphasis is on the sight and the hand. When the chief surgeon speaks an order, other people do not have to think about it. For example, at this time, there were two hemorrhages in the lumbar bypass.

Zhang Fan simply said: "Stop the bleeding." Which one to stop first, which one to stop later, how to stop the bleeding, whether to use gauze or electrocoagulation knife, these are all rules, these are all rules and regulations, and this is all knowledge.

And both assistants and nurses must keep an eye on the operator's steps.

After Zhang Fan took the gauze handed over by Lao Wang, he began to stuff it and press it. During the operation, a lot of bleeding is not leakage but oozing. When the muscle is detached from the bone, the blood oozes out like sweating. At this time, it is impossible to stop the bleeding with electric knife or silk thread. This requires gauze compression to stop bleeding.

And the gauze used in the operation cannot be dry gauze. It must be soaked in saline before it can be used. This is not a bandage. If a piece of dry gauze is handed at this time, Zhang Fan can directly drive the assistant and equipment nurse out. Because the tissue under the skin is so delicate, dry gauze is like sandpaper.

"Retract." Zhang Fan said to the assistant after stuffing the gauze.

They are not beginners, they are already ready. As soon as Zhang Fan opened his mouth, Lao Gao and Xu Xian pulled the skin apart with retractors to expose the surgical field of view as much as possible.

Retractors are the most feared thing for surgical residents, especially general surgery residents. What is this thing like? It is an L-shaped blunt alloy, which is very hard, and ordinary people cannot deform it.

Orthopedic surgery is a bit better, but general surgery is really sad. The large hook is estimated to be the same size as the bend of an adult's arm. For operations such as gastric resection, the second and third assistants will do one thing from the beginning to the end, pulling the stomach with steady force.

The surgical site is too deep. They couldn't see that during the four or five hours of surgery, they just dragged it in a daze. If it was not done well, the surgeon was not happy. After one operation, the hands and arms could no longer move.

After the surgical field of view is opened, the critical period of the operation is entered. This time is the time to reflect the level of the surgeon. How to adjust and how much to adjust is too difficult.

In the video data, looking at the spine and opening the body to see the spine are two different things. In terms of video data, you still have an overall concept.

The surgery opened up the few places that needed to be adjusted, and the longest length was no more than ten centimeters. The anatomy is not clear, or the technique is not in place, and the bones to be adjusted cannot be found or not.

This is no joke, let alone the spine. It is a simple plate removal operation after a clavicle fracture. Before the operation, the clavicle and the steel plate can be felt directly on the skin, as if just a little bit under the skin, which seems very simple.

But the fact is that when the operation is done in one piece, the drape is covered, and the scalpel is drawn, the subcutaneous tissue swells, then bleeds, and the muscles are stretched. Ok! What about the steel plate? I can't find it! This has happened to many doctors who have transferred.

What Zhang Fan has to do now is to change this deformed whole or let it develop in the expected direction in the future.

Then we must first destroy its original connection. It is very dangerous at this time, because the spinal cord is in front of the spine. This position is fixed and not changed because the patient is lying on his stomach. For example, the skin on the back should be in front of the spine according to normal. In fact, the professional terms on the operating table are not like this, but just the opposite.

More than an hour has passed slowly, almost two hours. Zhang Fan and Lao Wang's sweat was like beans, and they couldn't wipe it off during the tour, so they directly used a towel to pad their foreheads.

The rongeur is the sharp-nosed vise that everyone uses on weekdays. Zhang Fan bit open the bone, and then used a curette to remove all the broken bones, cartilage, and soft tissues between the vertebrae.

The cleanliness here must be clean. Because once a small bone fragment enters the spinal cord, the mild one is postoperative inflammation, and the severe one is the patient's lifelong waist pain or corresponding limb numbness.

Take care of these. The most dangerous step of the operation came. At this time, the position needs to be adjusted. Before adjusting the position, the abnormal bone fragments must be separated.

How to separate them? Anyone who has eaten animal spines knows that the spinous processes of the spine are stacked together. If they want to separate them at this time, they have to split them. Yes, they have to split them by force. At this time, it cannot be light or heavy.

If it is too light, not to mention that it cannot be split, it will also increase the number of fragments of the bones. Heavy, the front is the spinal cord. "Crack! Crack!" Zhang Fan gritted his teeth and split the spinous process with two strokes.

Zhang Fan didn't realize how difficult it was, but for Lao Gao and Lao Wang, the voice seemed to strike at the apex of their hearts, and their hearts were hanging. If at this time, the hand slipped or the force was too heavy, the consequences would be unimaginable.

Xu Xian was also sweating, even though he graduated with a master's degree. But this kind of operation is considered difficult in provincial hospitals.

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