My medical skills add experience

Chapter 494 Doctors can't just treat diseases with a knife as their foot
In the operating room, the anesthesiologist Qu Zi and the anesthetist nurse are performing general anesthesia on the patient.

Since the last time I talked with Zhou Can, the frequency of her surgery in the emergency department has become more and more frequent.When encountering operations that require general anesthesia and spinal anesthesia for patients, Zhou Can will always consult with her.

Sometimes, she felt that the operation was too risky and did not agree to take the risk.

Zhou Can could only try his best to persuade her.

Fortunately, she has a high degree of trust in Zhou Can's surgical ability, and the two have cooperated many times, and they have a certain foundation of trust in each other.So in most cases, it was Zhou Can who succeeded in persuading her.

After the patient was under general anesthesia, Zhou Can began to perform laparotomy on the patient.

Because the patient's physical condition is very weak, like a light that may be extinguished at any time in a rainy night, Qu Zi's nerves were tense as soon as the operation was performed.

Fortunately, Zhou Can's operation was not only fast, but also extremely stable.

During laparotomy, with the six-level incision technique, coupled with the blessing of fast knife technique and steady knife technique, it is really silky and smooth like flowing clouds and flowing water.

Open the abdominal cavity and go straight to the ileocecal where the source of bleeding is.

A large mass over 9 cm in diameter was found in the ileocecal.

The mass wall is very thick.

"Good guy, why did you grow such a big lump?"

Dr. Xu stood beside his apprentice Luozhan, and was quite surprised to see such a big lump.

"It doesn't feel like a tumor, it's probably blood inside!"

Zhou Can's sixth-level debridement was not given for nothing.

I stared at the lump for a few times, pressed it with my finger a little, and I already knew it in my heart.

"Teacher, do you need to suck out the effusion in the mass first?"

"It's okay! This lump is not easy to suck, and it will probably break if touched."

Dr. Xu's surgical experience must be many times richer than Zhou Can's.

He said it's okay, basically he won't miss it.

In terms of the degree of prudence of the operation, Dr. Xu ranked second, but no one would dare to rank first.

After all, because of an accident, he directly ruined his future and life.Once bitten, twice shy.

During surgery, Dr. Xu is not only strict with his fellow doctors, but also stricter with himself.

Even if he loves Zhou Can to the extreme, as long as Zhou Can dares to be sloppy during the operation, he will be scolded until he can't even lift his head.

Zhou Can tried to move the mass with his hands in order to separate the adhesion between the mass and the surrounding tissues.

Whoa!

Unexpectedly, as soon as it was moved, it broke immediately.

Blood flowed out immediately.

"Yang Zhi, suck out the accumulated blood!"

"it is good!"

In fact, Yang Zhi was already ready without Zhou Can's instructions.

"If your team can have one more hand-washing nurse, it will be more complete."

Anesthetist Qin Yue said beside her.

She didn't talk much before, since Qu Zi said last time that she wanted to tie up with Zhou Can's team, when she saw Zhou Can, she would always smile and nod.During the operation, if she finds some problems or deficiencies, she will take the initiative to point them out.

"Hey, I want to hire another surgical nurse to help Qiao Yu share the work pressure, but you also know that the surgeries I do are still mainly primary and secondary surgeries, and I can't support so many people!"

Zhou Can's statement is relatively modest.

With the terrifying amount of operations performed by his surgical team every day, recruiting a hand-washing nurse can fully support him.

But this will definitely lead to a reduction in the income of Qiao Yu and Ma Xiaolan.

Neither of them came from a good family situation, and both wanted to earn as much money as possible.

The work is a bit tiring, and the two have no complaints.

Zhou Can has no intention of recruiting surgical nurses for the time being.

While speaking, Yang Zhi had already sucked out the effusion in the mass.

"I feel that there is not only accumulated blood in this mass, but also carrion-like necrotic tissue. I am afraid that this section of intestine must be completely cut off."

Zhou Can looked at the aspirated fluid and found that the patient's ileum was worse than imagined.

It would be great if we could find out earlier, maybe we could cut a little less intestines.

It may even be cured by direct drug treatment without surgery.

After careful examination, he found that not only the ileum where the mass was located showed signs of necrosis, but also the mesenteric lymph nodes were significantly enlarged and thickened.

"Cut it!"

After seeing it, Dr. Xu agreed to remove this section of intestine and mesenteric lymph nodes.

After carefully cutting out this section of ileum and mesenteric lymph nodes, Zhou Can felt extraordinarily at ease.It's not that he has obsessive-compulsive disorder, but every time he helps a patient cut out the lesion tissue, he feels a great sense of accomplishment.

[The experience value of the fast knife method is +1, and the experience value of the steady knife method is +1. 】

At this moment, he sensed that there seemed to be a major breakthrough in his sword technique.I can't say how to break through, it seems to be a matter of course.

In the past, when he performed the steady knife technique, it seemed that there was a mountain on the scalpel.

At this moment, he has a new understanding and breakthrough in the steady knife technique.

When he holds the scalpel and lands on any part of the patient's body, there will be an extremely subtle feeling of landing.

The tip or blade of the knife is extremely sharp, and when it falls on the skin or organs of the body, it will immediately cut the part where the blade is located.

To use the scalpel as a 'foothold' is simply crazy thinking.

I am afraid that no doctor dares to use the scalpel as a body fulcrum during surgery.

Even if it is only 0.1 kg of force to press it up, it is enough to cause fatal injury to the patient.

To regard the scalpel as a foothold requires the strength and use of the knife by the surgeon to reach a height that is difficult for ordinary people to reach.

Zhou Can couldn't wait to check the attributes of medical skills.

[Steady knife method, current experience value: proficiency level 1/100000, as stable as a mountain, as nimble as a swallow, with the knife and two feet as the fulcrum, like a tripod.Integrate into all knife-wielding surgical procedures. 】

as long as you try very hard, you can achieve anything.

After a long period of practice, his steady knife technique was finally promoted to the second level - the proficiency level.

When performing a knife, the knife is a fulcrum of the body, forming a three-legged stand with the two feet.

According to the laws of physics, a triangle can form the most stable physical structure.

The wisdom of the ancients was extremely advanced, and the three-legged giant tripod was cast in the time of Dayu to restrain the floods and beasts.

The famous Kyushu tripod has nine statues in total, all of which are three-legged.

Zhou Can didn't expect that the second realm of steady knife technique is to use the knife as the foot, forming a three-legged posture with the feet.This kind of high-level saber comprehension is beyond the imagination of the brain.

You can only practice it over and over again, practice makes perfect, and you will naturally realize the knife skills in practice.

This is also a profound understanding of the use of power.

I don't know if the second level of Director Hu Kan's Steady Sword Technique is also a tripartite confrontation?
Director Hu Kan has passed away, I am afraid there is no way to go to verify it.

Steady saber technique and fast saber technique are both the saber techniques that Zhou Can values ​​most, and each has its own advantages.

Now that the steady sword technique has been promoted to the proficient level, and the quick knife technique is also a proficient level, will it cause an imbalance of power between the two sword techniques, and affect his unique sword technique after combining the fast knife technique and the steady knife technique?
After experimenting, he found that he was not affected in any way.

On the contrary, because of the successful advancement of the steady knife technique, the self-created knife technique has become more stable and flexible.

After cutting off the diseased intestinal segment and enlarged mesenteric lymph nodes, Zhou Can debrided the surrounding tissues and removed suspicious secondary lesions.

Cancer is not the only way to spread.

If the ulcer is not treated in time, it will also lead to the rapid spread of germs.

Such as the most common gastric ulcer, usually, the disease has a certain self-limiting.However, if the patient's physical fitness is poor, or if the correct treatment is not timely, it may lead to an increase in the size of the ulcer.

100% of the inner wall of the excised ileum of this patient has decayed.

It's not cancer, but it's as dangerous as cancer.

If it wasn't for the admission to the hospital due to hemorrhagic shock this time, if the patient drags on for a while, the intestines may be directly ruptured.

When the time comes, just one intestinal perforation will be enough to kill him.

After intestinal perforation, intestinal contents enter the abdominal cavity, and peritonitis will definitely occur.

Zhou Can's surgery is definitely equivalent to saving the patient's life.

In the process of debridement, the just-promoted Steady Saber Technique should naturally be used in actual combat to make it addictive.

The biggest feeling is that debridement becomes easier, faster, safer and more perfect.

In the past, even if his debridement technique was promoted to the sixth level, he never dared to use the word perfect for debridement of patients.

At best it was just right and the debridement was excellent.

At this moment, he used the evaluation word perfect for the first time.

Don't look at just cleaning up the wounds of general surgery now, if it is used to clean up dense lymph node tumors, I believe he can also be competent.

This is just one of the benefits of the promotion of the Steady Knife Technique. I believe that whether it is dissecting difficult body parts, or removing extremely difficult lesions, or separating extremely difficult adhesion tissues, etc., the Steady Knife Technique can help him. Surgical capabilities to a new level.

By the time Zhou Can completed the operation, the closure of the cavity was completed, and the patient's vital signs had stabilized.Only then did Doctor Xu stare at Zhou Can in surprise and said, "Xiao Zhou, just now I saw you debride the wound, and your surgical ability has obviously stepped up to a new level. You are not only as dexterous as your tongue, but also as stable as a mountain. It seems that you have worked hard in the past two years." Well!"

"Hey, the teacher's eyes are still vicious, and you can't hide anything from you. The level of saber technique has indeed made a breakthrough in the technique."

Zhou Can's strength has been upgraded to a higher level, and his mood is also very good.

It is not a big deal to complete the resection of part of the ileum and mesenteric lymph nodes.

At least many deputy directors of surgery and chief physicians have this surgical ability.

But to find out the cause of this patient, complete the operation quickly, and successfully save the patient's life, combined, it is quite awesome.

"The breakthrough is Lao Hu's steady sword technique, right? The quick sword technique I taught you also needs to work harder!"

There was some sourness in Dr. Xu's tone.

Seeing that Aitu has made a major breakthrough in the stable sword technique, but the quick sword technique has been tepid, he obviously has some taste.

"The quick knife technique has not failed, and I have been practicing it! I just want to make a breakthrough. In addition to hard training, opportunity is also very important. You can't tell when you will break through, and you will definitely be happy when the time comes."

Zhou Can's Quick Sword Technique has already been promoted to the proficient level. If he wants to advance to the next level, the experience value required will increase by ten times. How can it be so easy?
"By the way, has the excised intestine been sent for inspection?"

Zhou Can asked Dr. Pu.

At present, he can only run errands for such chores as sending for inspection.

"It has been sent for pathological examination. It is estimated that the report will be released later."

Doctor Po replied.

……

When I was about to leave work in the afternoon, the patient's pathology report came out.

The intestinal wall of the intestinal section submitted for inspection was thickened, and the incision showed that it was soft, fishy, ​​and necrotic.Under the microscope, a large number of reticuloendothelial cells proliferated in the intestinal lymphoid tissue, forming macrophages, and phagocytized lymphocytes, red blood cells, and nuclear fragments were seen in the cytoplasm, and some intestinal wall ulcers formed and died.

Seeing this, Zhou Can couldn't help secretly admiring Director Shang of the Department of Gastroenterology. The patient really had typhoid fever.

As long as macrophages are formed, it is basically 100% confirmed to be typhoid fever.

He then looked down and found that the lymph nodes were enlarged, and typhoid cells could be seen under the microscope.

The above changes are consistent with typhoid fever.

Now, the reason why the patient's high fever persisted was finally solved, the largest source of bleeding was also successfully found, and the bleeding was successfully stopped through surgery.

Necrotic bowel segments were also removed.

As long as the lesion progresses to the typhoid stage, it means that the lesion has entered the necrotic stage.

Zhou Can learned a lot from this case.

It is also a rather rare cause of disease among the many difficult cases he encountered.

Typhoid fever has been difficult to treat since ancient times.

Chinese medicine even developed a typhoid school based on typhoid fever.

He summed up his diagnosis experience and decided to write an article on diagnosis experience after get off work. He believed that next time he encountered a similar case, he could avoid a lot of detours.

Now that it has been clearly diagnosed that the patient has typhoid fever, it will be easy to handle.

Bleeding has stopped, only anti-infection, anti-typhoid treatment is enough.

On the third day, the patient's body temperature had returned to normal.His vital signs have also stabilized.There was no continuous drop in blood pressure, shock and other symptoms.

In view of the fact that this patient still has gastric ulcer and old bleeding, it shows that the patient's usual diet and work and rest patterns are very poor.

A 20-year-old boy is the golden age with the best body.

However, the entire digestive tract was already in crisis, and even developed to the point of typhoid fever.

Zhou Can felt that it was necessary to have a good talk with the patient's family.

Unexpectedly, the child's father saw that his son's condition had improved and had already returned to work.A father's love for his children is as thick as a mountain, yet extremely silent.

He is the breadwinner of the family, and his son spent a lot of money on medical treatment, so he has to work hard to make money to support the family.

The child's mother obviously couldn't control her son, and she was almost obedient to her son, treating her son like an emperor.

Seeing this scene, Zhou Can couldn't help falling into silence.

A doctor can cure a patient's disease, but he can't change the patient's family education environment, let alone change the patient's bad living habits.

Out of the doctor's sense of responsibility, Zhou Can still decided to talk to the patient himself.

In terms of age, Zhou Can is not much older than the patient.

After get off work, after checking the ward, Zhou Can sat down in front of the patient's bed.

The patient's mother was very kind to him.

After all, it was Zhou Can who cured her son's illness.

Seeing her son's condition improving day by day, and being dragged back from the gate of hell by the doctor, she is grateful to every doctor and nurse who participated in the treatment of her son.

"How old are you now?"

Zhou Can also doesn't know how to get close to others, because usually others take the initiative to get close to him.

I can only find something to talk about when I have nothing to say, and talk to the patient first.

"Freshman!"

"Freshman is good. I just got out of the bitter sea of ​​the college entrance examination and entered the university campus. I can live a comfortable life in a very relaxed way. If I'm lucky, I might even get a beautiful girlfriend."

"Hey, isn't that right! Compared with my previous high school life, I also feel that college life is simply heaven."

Patients were struck by his words.

"Are you talking about girls?"

Zhou Can asked.

The patient subconsciously glanced at his mother standing beside him, but said nothing.

This kind of thing, regardless of gender, will avoid parents.

(End of this chapter)