My medical skills add experience

Chapter 377 Mother and baby are safe, the role of the teacher

Zhou Can doesn't care about other people's strange eyes.

There are two main types of aortic dissection, one is type A, which is highly dangerous and requires thoracotomy for treatment.The risk is extremely high, and the entire operation process is very complicated, which has extremely high requirements on the doctor's surgical experience and skills.

Even so, the mortality rate of type A dissection surgery is still as high as 30%.

There are also some very good surgical teams who specialize in this kind of surgery, which can reduce the mortality rate to about 10%.

Relatively speaking, one in ten patients died, and the mortality rate was still extremely high.

The other is type B dissection, which can usually be treated with intervention.Solved by placing a covered stent.

That is, endovascular repair of the aorta, through the puncture of the femoral artery, the aortic stent graft is implanted in the breach, and the breach is completely closed to seal the dissection, so as to achieve the purpose of clinical treatment.

At present, there are very few traditional surgeries.

Because of the high risk and high technical requirements, there are not many surgical teams that can complete it.

Unfortunately, the pregnant woman was found to have aortic dissection during pregnancy, and it was type A.Seeing that one dead body and two lives were about to happen, the experts in the hospital finally decided to perform cesarean section operation and dissection operation at the same time after discussing several sets of operation plans.

Before entering the operating room, a critical illness notice was issued to the family.

To be honest, now everyone is saving lives based on the conscience of doctors.

If this pregnant woman can be saved, the newly born child will be able to grow up under the care of mother's love in the future.Otherwise, the child would be very pitiful without a mother at birth.

Why is the mortality rate of type A dissection surgery high?

Because it is a thoracotomy, the heart needs to stop beating during the operation, and artificial blood vessel replacement or bypass is performed. The operation is complicated and takes a long time, and there are many postoperative complications.

Every patient with type A dissection is basically close to death.

Some patients, even if the operation is successful, still die after the operation.

For this operation, the whole process is carried out under the monitoring of ECG and hemodynamics, and the blood pressure needs to be strictly maintained at around 120/80 mm Hg.

From the above surgical conditions and basic steps, we can see how difficult the operation is.

During the operation, the left and right brachial artery, the left external carotid artery and one femoral artery should be freed respectively, and then 4 guide wires should be inserted from the femoral artery on one side of the lower extremity to the corresponding catheter for observation under radiation After the specific situation, and then decide the specific program of surgery.

This patient requires aortic replacement.

After all, Director Xueyan's surgical ability is still a bit weak. After doing it for so long, she is stuck in the most critical and difficult step.

After Zhou Can took over, the two doctors in obstetrics and gynecology directly felt that there was only more scariness, not the scariest.

I saw him outputting a meal to the patient, fast and fierce.

Compared with Director Xueyan's gentle, gentle and slow operation, they are completely different surgical styles.

"All right!"

After more than 30 minutes, Zhou Can let out a sigh of relief, and finally fulfilled his mission and successfully completed the aortic replacement.

"Sister Yan, the rest of the operation is still up to you!"

After Zhou Can completed the most difficult operation steps, he was ready to give up his position.

His address to director Xueyan is also from behind the scenes to the front of the stage, and there is no need to cover up.

In front of everyone, she also directly called her Sister Yan.

"Your operation is fast, and time is life. You should do it! I'll help you."

Director Xueyan has always treated him very well.

If there is an opportunity to practice surgery, as long as Zhou Can is competent, she will give it to Zhou Can.

This is an intention to train Zhou Can, so that he can quickly become a core member of the cardiothoracic surgery department who can take on heavy responsibilities.

Today, Zhou Can's surgical ability is getting stronger and stronger, and he is basically competent for most difficult operations in cardiothoracic surgery.His status in the cardiothoracic surgery operating room is also getting higher and higher.

Gradually formed a new surgical team centered on him.

In fact, there were signs of this a long time ago, but it is more obvious now.

Everyone is a sensible person. With their abilities and talents, it is impossible to take over the heavy responsibility of Director Hu Kan in a short period of time.Only Zhou Can can make everyone see hope.

Cardiothoracic surgery is already in turmoil and crisis.

If there is not a new core person to take over before Director Hu Kan falls, the cardiothoracic surgery business may shrink sharply in a very short period of time, and be ruthlessly eliminated from the list of first-class departments by the market.

In the past year or so, this sign has become very obvious.

Not to mention anything else, the total monthly operation volume of cardiothoracic surgery has been steadily declining.Although there has not been a catastrophic decline, compared with the data at the peak period, whether it is the number of outpatients, emergency visits, or the total number of operations, it has dropped by almost one-third.

The decline in the volume of diagnosis and treatment is directly reflected in everyone's income.

I believe that many people can feel the decline in income.

……

Nearly an hour later, the operation was over, and the life of the parturient was saved through the efforts of so many people, and finally survived.

It's just that she might not be able to breastfeed the baby.

Because she needed to be admitted to the specialized ICU of cardiothoracic surgery, the child born by the cesarean was barely premature because it was less than 37 weeks old.In addition, the baby's own nutrition is somewhat weak, and it may have to live in an incubator for about a week.

Overall the operation was very successful.

The lives of adults and children were saved, and a human tragedy was avoided.

"Dr. Zhou's surgical ability is so strong! I'm Zhao Jie, a surgeon in the Department of Obstetrics and Gynecology. This is my assistant Qin Feifei. It's a great honor to know you."

The surgeon in the obstetrics and gynecology department took off his mask and greeted Zhou Can with a smile.

This is a female doctor in her 40s with an ordinary appearance.

But her surgical skills are very strong, and she led others to perform the cesarean section of the woman just now.

Her medical assistant was a tall male doctor who nodded friendly to Zhou Can as a greeting.

"You have won the prize! I am also very happy to meet you and Dr. Qin."

Zhou Can took off his gloves and took the initiative to shake hands with him.

This Dr. Zhao can preside over a cesarean section alone, at least at the level of the deputy chief physician.He took the initiative to meet with him. As a resident doctor who just finished his training, he must lower his attitude and be more enthusiastic and friendly.

"I look forward to further cooperation with the cardiothoracic surgery department in the future. Thank you so much today! Director Hu, if there is nothing to do here, we will withdraw first."

After Zhao Jie and Zhou Can got to know each other, they didn't talk too much in the operating room.

That is to say, get acquainted first.

This is because she saw Zhou Can's strong surgical ability and heard Zhou Can's many names, so she was so enthusiastic about Zhou Can.

Doctors are no longer fighting alone. When encountering difficult cases, they often need to ask doctors in other departments to teach them, or even invite them to joint consultations.

An excellent doctor like Zhou Can is familiar with him now, so it will be convenient for him to ask for help next time.

Therefore, behind everyone's communication, it is essentially for profit.

After the puerpera was sent to the specialized ICU, new patients were soon brought into the operating room.

Not every patient is wheeled into the operating room.

Patients who need to lie on the trolley are basically critically ill patients who have lost their mobility.

For patients who can walk on their own, nurses usually take the patient into the operating room.

The patient was able to walk, but with difficulty, and seemed to have severe breathing problems.

The patient was anesthetized shortly after lying on the operating table.

During the patient's anesthesia, Zhou Can did not help the anesthesiologist to perform the anesthesia together, but picked up the patient's information to understand first.

"Xiao Zhou, this operation is up to you! The repair of bronchopleural fistula belongs to the fourth-level major operation. You must be careful and careful during the operation. I will guide you every step of the operation. This operation, Xue Yan has already mastered the basics, and Director Le is almost ready, so I just want to help Zhou Can and learn it again."

Director Hu Kan made the main arrangements for the operation.

"OK!"

Director Le readily agreed.

At present, their surgical team, director Xueyan, him, and Zhou Can, should be the three main forces.

Everyone has their own strengths. In terms of comprehensive surgery ability, Zhou Can is the strongest.

Both he and Xueyan had to admit this.

Talent is something that can sometimes easily smooth out the age gap.

Director Le is slightly older than Director Xueyan, and both of them have more than 15 years of surgical experience, so they are considered veterans.But compared with Zhou Can, the overall strength is obviously weaker than Zhou Can.

You know, Zhou Canman has made every effort to plan, and it has only been three years at most since he touched the scalpel.

It took only three years to catch up with chief physicians like them who have worked hard for 15 years. Talent must be an important factor.

……

I have been busy until after nine o'clock in the evening, and I call it a day.

Zhou Can watched the experience of many surgical techniques increase a lot, and his heart was filled with joy and a sense of accomplishment.

This feeling of making a little progress every day makes him very at ease.

After such a long period of practice and actual combat, and the accumulation of time, the quick knife technique will soon be upgraded.

Then his incision skills had been promoted to level five more than three months ago, and he was now at the junior level of the deputy director.The speed of promotion of the important medical skill of pharmacological syndrome differentiation is equally astonishing.

It is also at the fifth level now, and it is moving towards the deputy director intermediate level.

It's just that after being promoted to level 100, the experience value needed to upgrade has increased to [-], which is really not something that can be done in a short period of time.Even though he can often earn extra experience point rewards during the operation, some of which are large rewards of [-] points.

But the accumulation of [-] is still a long process.

In general, his current many important medical skills are all at the level of the deputy chief physician, which is completely sufficient for ordinary occasions.Only when you challenge some difficult cases will you feel strenuous.

As for the ultra-difficult cases, there are many so far that he still can't handle.

"Teacher, you are panting very badly, why don't you take a good rest at home for a few days!" Director Xueyan looked at Director Hu Kan with concern.

"I'm so happy! Today, seeing that you have successfully completed difficult operations such as type A artery dissection and bronchopleural fistula repair, our cardiothoracic surgery strength has been guaranteed. As long as you follow the current trend, you will continue to grow." , I believe that the cardiothoracic surgery department will be able to return to the peak level when I presided over the surgery within five years at most."

Director Hu Kan's face was full of joy.

He was happy from the bottom of his heart to see successors in the department.

"Xiao Zhou, today's two important operations, you must make a summary after you go back. Like the type A artery dissection operation, I have encountered more dangerous ones. At that time, because the blood pressure was not well controlled, the patient's blood vessels died at once. It was broken. At that time, more than a dozen of our medical staff rescued the patient for more than four hours, but ultimately failed to save the patient..."

Director Hu Kan valued Zhou Can the most.

Every time, I will teach Zhou Can that he must guard against arrogance and impetuosity, sum up more and think more.

"Being so late, are you hungry? Let's be surgeons. It's the hardest work. I ordered egg fried noodles for you today. I'm old and afraid of getting angry, so I'll eat with you."

Director Hu Kan looked at the dozens of medical staff in the surgical team slowly, as if looking at his own child.

These people are basically the core surgical team members of cardiothoracic surgery.

Zhou Can took a bottle of pure milk, heated it specially, inserted the tube, and sent it to Director Hu Kan.

"Director Hu, you are afraid of getting angry, so just drink some milk to supplement your nutrition! You are the mentor and backbone of all of us. Only when you are in good health can you guide us all the time. How do others feel during the operation? I don't know. Anyway, as long as you stay by my side, even if you don't say a word, I will feel at ease in my heart. I will think this way subconsciously, in case of a fistula or unexpected sudden Situation, the teacher is sitting there and will definitely help me solve it.”

Zhou Can's words made many people laugh out loud.

"Don't tell me, I feel the same way. Even though I have had surgery for fifteen or six years, once I have a major operation, I turn back into a child. With Director Hu sitting next to me, my courage It's going to be big."

Director Xueyan also said seriously.

"It turns out that you all have this feeling. I was too embarrassed to say it before. After all, I am already 45 years old. If someone laughs at me as a child, how embarrassing it is!"

Director Le's words made everyone laugh even more.

The three of them are the pro-apprentices of director Hu Kan, and they receive the most guidance.

After all, director Hu Kan's energy and time are limited, it is impossible to achieve a bowl of water.We can only focus on training the three of them.Jin Mingxi has gained a lot of training in the past year.

"In my eyes, you are like my children. Watching you grow up, watching you encounter various setbacks, what I can do is to give you the necessary help and guidance like a parent. Xueyan, do you still remember When you took a knife to participate in the operation for the first time, a knife cut through the patient's blood vessel, did you cry in fright?"

Director Hu Kan was evoked by them a scene from the past, with a nostalgic expression on his face.

"Teacher, just save me some face! That happened so many years ago, I didn't expect you to remember it so clearly!"

Director Xueyan was as shy as a little girl.

"Hehe, what's the point! Everyone will encounter all kinds of setbacks and embarrassments on the road of growth, but as long as we can continue to grow, we can become better and better. My first two years, no Fallen on the operating table? Let me tell you, don’t compare yourself with others, but learn to compare yourself. As long as you are better than your past self, that’s enough.”

Director Hu Kan taught them some life insights.

People are more mad than people.

Comparing with others is the most likely to generate many negative emotions, and even feel discouraged and hopeless.This is a very good way to compare yourself with your past self.

(End of this chapter)