Chapter 276

The preparation for surgery is very fast. China is one of the few countries that can advance medical expenses. No matter what, the country is really moving forward, developing and improving. Now there are relatively few cases of fee evasion in hospitals.

In the early years, when township hospitals could still perform cesarean section, and when county hospitals were still very effective, many people without money left sick family members or children in the hospital! This is the cunning and helpless cunning of small citizens, because they have no money.

Then, the township hospital or county hospital directly treated him and took care of the meal! Then, after the treatment, the patient's family came. Carry wheat or flour to offset the fee! This kind of thing is not an example, it is very much.

Now, once this phenomenon occurs, the doctor's first consideration is not treatment, but whether someone will come to pay for it. It doesn't matter if it is cured, but whether it can be cured or not? Who dares to reach out!

Then in recent years, people have flocked to the city, the farms have shrunk, and the township hospitals are like deserted temples. There are few people in the lonely buildings! Medical malpractice has been greatly reduced, but this unit has also become an inflamed appendix. It's time to cut it off!

Lao Yang, a lonely old man who can't be considered as a temporary worker of the serial health service, entered the operating room with several steel bars inserted in his stomach. It's too strange. With the movement of the surgical cart, the steel bar is shaking like a hairless chicken wing, shaking with the fat in Lao Yang's abdomen.

Once he entered the operating room, Zhang Fan's expression immediately changed. Usually, he always smiled. When he saw anyone, he smiled first and then spoke. It was a humble smile. His habit from small to large can't be changed now.

But this is also good. Zhang Fan's smile makes the patients he receives very satisfied with Zhang Fan. "Dr. Zhang is not only good at medicine, but also polite! Always smiling. Let people feel warm! "

But as soon as he entered the operating room, the smile on his face disappeared. Although he was wearing a blue disposable mask, his sharp eyes were no longer the one who smiled at everyone. At this time, Zhang Fan was a general who wanted to kill. He held a knife with light and returned only when he saw blood!

"Speed up blood transfusion! Give cardiotonic drugs, correct acidosis, open three channels, relax blood vessels, see urinary potassium supplement! " Now Zhang Fan is really great. There are only his voice in the operating room.

Lao Gao of orthopedics and Lao Li outside his chest stood quietly opposite Zhang Fan with both hands on standby! Anesthesiologists and nurses quickly implemented Zhang Fan's orders.

Anesthesiologist, a special doctor in the hospital. In the early years, anesthesiologists were all from clinical backgrounds. Later, they had the Department of Anesthesiology and professional anesthesiologists. In the hospital contempt chain, physicians despise surgeons. Physicians think surgeons are too rough and don't understand anything, so they will cut!

Surgeons look down on anesthesiologists, "they don't understand anything, they will play a pain stick!"

On the operating table, anesthesiologists and surgeons are cooperative rather than affiliated, so ordinary surgeons can't command anesthesiologists.

But in the municipal hospital, Zhang Fan is a special case. His technology is too powerful. He has a tendency to crush. Moreover, in the operating room, Zhang Fan is too difficult to deal with. He has frost on his face and is very angry!

When he gave the doctor's advice, the anesthesiologist didn't have the courage to refute. Achievements, Zhang Fan's achievements are too bright. Let alone ordinary anesthesiologists, even the director of the anesthesiology department is respectful to Zhang Fan on the operating table. He is respectful of Zhang Fan's technology and Zhang Fan's level! This is the technical unit!

"Dr. Zhang, you can start the operation. The patient's vital signs can support the operation at present!" The anesthesiologist reports to Zhang Fan. The patient's condition is critical, and the anesthesiologist has to be careful. After general surgery, the anesthesiologist's anesthesia is generally one word, two words, do it! Then he began to write anesthesia records. He would never be so formal as he is now!

"Disinfection!" Zhang Fan is not nonsense. A word of disinfection, the attending doctor outside the chest began to disinfect!

Lao Yang is too thin. The fat layer on the abdominal wall is very thin. Gently open the skin with a round knife. The fat layer and yellow fat layer are very thin, almost not the upper layer! You don't need an abdominal retractor to pull, and the small retractor is done.

Fat people, especially female obese patients, have abdominal surgery, which is a direct nightmare for doctors. The surgical incision is exquisite. It is not to open the abdominal cavity directly with a knife.

The surgical incision is layer by layer. Find a gradual way to cut the skin and stop bleeding. Then peel off the fat layer. There are blood vessels in the fat layer and need to stop bleeding, and then reach the muscle layer. If the muscle layer does not need to be disconnected, it is blunt separation. Generally speaking, use the knife handle or fingers to open a hole along the texture! Then the peritoneum.

Like peeling onions, peel them layer by layer. If it's a two knife, one knife goes straight to the abdomen. It's dangerous. It's also a very serious sequelae after operation.

For patients with thick abdominal fat layer, doctors really have a headache. When a female obese patient cuts the skin, the plump yellow fat directly collapses the incision, and the fat flows out like yellow peach jelly!

It's nothing. The most difficult thing is the thickness of the fat. Five centimeters thick is nothing. The small retractor can't be used directly. You must use the upper abdominal retractor.

In those years, a transferred gynecologist performed caesarean section and took the initiative to ask for suturing when he finally sutured. As a result, the patient's fat layer was thick and slippery. The fat was grease and a good melting lubricant.

As a result, accidentally, the suture needle fell into the fat from the needle holder! Then, in a few seconds, with the slight muscle tremor, the suture needle swam in the fat layer and couldn't be found! The teacher's face turned white!

All three are experts. The operation entered very quickly. When opening the abdomen, Rao was a well-informed Lao Li who almost spit out. After the steel bar was inserted into the stomach, it was directly inserted into the intestines. The small intestine and large intestine were punctured.

Human evolution is very scientific. Every node of the digestive tract from top to bottom has a door. How to say, the connection between the esophagus and the stomach is a spout door. This door prevents gastric acid from entering the esophagus. There is pylorus from the stomach to the small intestine, and there is also a door from the small intestine to the large intestine. So it's impossible to spray feces all over your mouth!

The contents of the small intestine are chylous food to be digested, while the large intestine is feces. After the steel stick pierced the intestinal wall, the contents of large and small intestines flowed out.

Green, is not easy to digest leek leaves, chewed leek leaves, dotted with stars covered the abdominal cavity, and then stained yellow by feces in the large intestine, just like egg yolk stained on leek, covered the abdominal cavity! The sour smell is coming!

"It seems that the fried egg with leek this evening!" Lao Li said after suppressing the surging nausea.

"This is not an egg. The egg is not so thin. It should be fecal residue on the leek!" Lao Gao doesn't feel good either!

Speaking can reduce this disgusting feeling. Although there is no scientific basis, when you see a very disgusting thing, cheer up to speak and describe the disgusting thing in front of you, and you will never spit it out. Doctors in general surgery master this skill!

The smell of sour and fermented is like old rancid tofu covered with hair. It smells terrible. The itinerant nurse was directly discouraged, "Er! Uh! Eh! " Like a pregnant woman with hiccups, she ran out for three minutes and the head nurse came!

"Ah! You are so disgusting. You stink to death, and then leek, fried leek, egg fried leek. We Xiao Chen threw up directly! " There's no way. The head nurse will replace Xiao Chen.

"Hehe, I'm still young. The head nurse is the head nurse. There's no response at all." Lao Li is a little embarrassed.

"I have rhinitis and can't smell ~! I can't smell it~ Ha ha! " The head nurse felt for the first time that this rhinitis was good.

rinse! Keep flushing! The operation is too troublesome. The intestinal breaks must be repaired one by one. Lao Gao and Lao Li are uncomfortable and disgusting. In fact, Zhang Fan is also uncomfortable! The smell is too sour. The smell of disinfectant in the operating room can't be suppressed at all.

The two of them desperately said disgusting words, and Zhang Fan had no way to join. If even the anesthesia and instrument nurses said they vomited, it would be troublesome. When they opened the abdominal cavity and the sour smell came to their face, Zhang Fan pinched the back of his right hand with his left hand. He pinched it with his left hand. His left hand was absolutely right and his right hand was green!

Nausea is only a matter of tens of seconds. People still have a strong tolerance. After the first wave, they will be fine. At this time, even if this leek with yellow soup is sprayed on their faces, it is estimated that they will not be sick!

"Head nurse, wash the nail file in normal saline! A thousand ml first. " Zhang Fan said to the head nurse.

Clean, keep cleaning! The yellow and green feces were finally cleaned“ Change gloves! "

After changing his gloves, Zhang Fan poured salt water into his abdomen, flooded his intestines, and said to the head nurse, "head nurse, hit nitrogen."

"You will bully your sister!" The head nurse deliberately said Zhang Fan.

"It's not Doctor Zhang who called you! Not a bully! " Lao Li started driving.

"Dead ghost!" When the head nurse gave Lao Li a white look, the director joked with the head nurse, because they were almost the same age. For young nurses, these directors had to keep a little face.

There are too many places where the intestines are punctured. You must observe the air leakage like a balloon! How? Easy! It's a plastic nozzle like a tire for a car. After inserting the chrysanthemum, it starts to slowly pump air into the intestines.

This treatment method has no major sequelae, that is, there are many farts after the operation. If it is more serious, it is like continuous shooting. And sometimes, there may be burping within a few days after the operation, or what kind of burping with the smell of stool!

"Off!" Zhang Fan saw a bubbling place. Then start stitching.

"Open!"

"Off!"

Again and again, finally no bubbles.

"All right, head nurse, remove the." After Zhang Fan reconfirmed, he said to the head nurse.

"Oh, it's terrible. There are holes in my intestines!" Lao Li said sympathetically.

"It's OK. The steel sign is not thick. It's estimated that Lao Wang next door will be in trouble. The tree branch is not a steel sign! " Said the head nurse.

When this was said, it was cold. No one paid attention to her. She also felt as if she was wrong. She hurriedly took gauze to wipe the sweat for the doctors.

After the abdomen is cleaned, start closing the abdomen“ Dr. Wang, help close the abdomen. " Zhang Fan said to the attending doctor outside his chest.

"OK."

Generally speaking, Zhang Fan will not give the operation to others, but not today. He must speed up the operation, because he still wants to see which operation next door.

No matter what the family members or patients do, these are not important. Doctors, when wearing white coats, they should close their emotions and speak with professional quality. No matter who the other party is, whether high or low, large or small, we should go all out.

It is a great trust that patients can give their lives to you. Please cherish this trust. In this era of money, this trust is precious!

If the chest is not serious, Zhang Fan is going to have an operation in advance and go next door to have a look.

The main treatment outside the chest is suturing the abdominal incision. Zhang Fan, Lao Gao and Lao Li are ready to open their breasts.

And Lao Wang next door, it's really numb. The scalp is numb. After opening the abdomen, the little girl's stomach was not as disgusting as Lao Yang next door. The little girl drank beer without eating at night, and in order to diet and lose weight, she didn't eat much on weekdays, so her intestines were fairly clean.

What makes Lao Wang numb is that the little girl's intestines are rotten. The tree branch is not a steel bar. The steel bar is thin and straight. Even if it is inserted through the body, it is just a pair of eyes.

And this tree branch is troublesome. It's too troublesome. Several intestines have been inserted and eroded, and bleeding is not the most troublesome thing.

Now the most troublesome thing is intestinal necrosis! This is the case in several places. Vaguely, the intestines are a little blue. This is because the blood cannot flow back, resulting in the heavier color of the intestines.

"Xiao Li, go and see what step Zhang Fan has taken." Lao Wang, don't dare to start, he said to the itinerant nurse. Because if the little girl's operation is carried out by conventional means, she can hardly retain much intestines. According to the conventional method to do the operation, it becomes a typical operation, perfect, people die!

This is not a time to talk about face and medical status! Lao Wang is ready to ask for help!

"Head nurse, director Wang asked me to ask Dr. Zhang what step they have taken in their operation."

"What happened next door?" Before the head nurse spoke, Zhang Fan immediately looked up and asked.

"The intestinal tract is badly damaged. Director Wang asked me to ask here."

Zhang Fan, who was already a little worried, was even more worried. This is not Zhang Fan's arrogance. He has to do as much as he has the ability to live up to the system given by God. First of all, it's about human life. He has to do as much as he can. What he doesn't say is that he is a doctor! A more qualified doctor will do so. Whether there is a system is the same.

When he opened his chest, Lao Yang had a big life, that is, his ribs were broken badly, and there was nothing wrong with his lungs and heart! Luck in misfortune!

"Director, I'm off!" Zhang Fan stopped and said to Lao Gao and Lao Li.

"Go! It is estimated that Lao Wang is in big trouble! " Lao Gao said.

Zhang Fan doesn't talk nonsense. He gets off the stage directly. Take off your surgical clothes while you're down. This is a polluting operation. You must wash your hands again. Just as Zhang Fan took off his gloves and grabbed the lace of the surgical suit, the system that had not spoken for ten thousand years made a sound!