Chapter 325

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

Bart was lying on the flat car with antibiotics hanging from one hand. The operation was too big. Intravenous antibiotics had been given a day before the operation. The other hand tightly grasped the corner of the patient's clothes. Although it covered the quilt, the flexion and curling of the body was still obvious. With his head on his side and innocent big eyes, he looked pitifully at his parents far away. I wanted to cry, but after looking at the two sisters in white coats around me, I didn't dare to cry.

The flat car disappeared at the end of the corridor. Bart's mother didn't know what to do. The two trembled and didn't know where to put it. They kept crossing and rubbing, muttering and talking.

Huaguo hospital, as long as it reaches the comprehensive level III. There is a rule. There are three super large departments, general surgery, respiration and orthopedics, and the leaders of many hospitals are from orthopedics. Then orthopedics all kinds of high-precision, but it is strange that such a tall place can't connect with a little finger.

Zhang Fan is already waiting in the operating room. Bart is the patient of their group. He was supposed to let Wang Yanan go to the operating table. As a result, the girl is a little uncomfortable these days, so she let Xue Fei go. I don't know what kind of deal she made with Xu Xian privately.

Xu Xian happily entered the operating room, looked at director Gao, and then said to Zhang Fan, "Dr. Zhang, can I be the third assistant for this operation? Mr. Xue has diarrhea. "

Before Zhang Fan spoke, Lao Gao said, "he's itchy again. You said, "why doesn't he improve at all?" Zhou Chengfu left. Although he left quietly, Lao Gao was still a little sad.

Xue Fei and Zhou Chengfu were his disciples brought out at the most difficult time. They were not his own son, but they were also the two with the deepest feelings. The scene of three people holding together to keep warm in those days was vivid. But now, one left the master for his own future. The other is directly out of tune.

Although Zhang Fan is also his disciple, for Zhang Fan, he always feels that he lacks something. Perhaps what he lacks is the process of teaching. Zhang Fan got up so fast that he didn't notice. He was about to look up. So speaking of Xue Fei, Lao Gao is a little gnashing his teeth.

Everyone knows Xue Fei's problem. Zhang fan can't explain it if he wants to. At this time, Xue Fei is definitely not in the Department. He may have played mahjong with his aunts long ago.

"Xiao Xu, which major are you?" Lao Wang gloated and asked with a smile. Lao Gao's disciples are proud if they don't work hard. Compared with Lao Gao, his disciples are much more powerful. One by one, several leaders are more powerful, but they can't compare with Zhang Fan!

"Director Wang, I graduated from spine orthopedics." Xu Xian had already stood with Zhang Fan to watch X-rays and MRI, but as soon as he heard Lao Wang's question, he quickly turned around and answered.

"Oh! Spine orthopedics, which hospital assigned you to joint orthopedics. Isn't this a waste? It's inappropriate. I have to ask. "

After Xu xianding, orthopedics was divided into three, so there was such a thing. When Lao Wang said this, Xu Xian couldn't answer.

Xu Xian was practical and capable. Of course, Lao Gao was reluctant to give up. He rolled his eyes at Lao Wang and said, "what's wrong? He's an orthopedic doctor first."

"Pick up the patient!" The head nurse's voice came. The head nurse in the operating room helped the itinerant nurse bring Bart in“ Children, don't be afraid. It doesn't hurt at all. Just sleep. " Then he gently touched Bart's small face with bristles and goose bumps.

Little Bart lay on the bed, holding the head nurse's hand tightly with his non injected hand. Although the head nurse is usually evil, she really has affinity for children.

"Sister! Don't go! " After the head nurse sent them to the place, she was ready to have a few words with Zhang Fan. As a result, Bart, who had not spoken since he came out of the ward, blushed and spoke.

"Ouch, ha ha, good, obedient, sister won't go." The head nurse was really happy. She was really happy to let such a pure child call her sister. Her heart blossomed.

Although Bart, like a lamb, was nervous and afraid, the head nurse's gentle comfort was the only thing he felt he could rely on in this strange and strange place.

Put your little hand into the quilt, then trembled and took out a thing, "send you, thigh stone!" Bart didn't know where to find a bone that seemed to be an animal. It looked a little jade. It looked like Bart's favorite.

Bart's pure eyes are like a clear spring. The head nurse, a young woman who had experienced many storms, suddenly had a sour nose and tears came down directly.

"Thank you! No, sister. "

"Sister, take it! Bi Shi, bless. "

"Well! Sister, sister! You will be my brother in the future. " In a strange environment, although he didn't know what surgery was, he also knew it was not a good thing.

Innocent, pitiful, but with very sincere eyes, it directly moved the head nurse who is also a call of the wind and rain in the operating room“ Hey! What is missing is precious. The sincerity of the child world is so precious in the adult world. " Lao Gao also felt a little deep.

"Yes." Lao Wang nodded involuntarily. The head nurse took the wolf leg stone given by Bart, and the other hand held Bart's small hand. She couldn't stop crying until Bart slowly fell asleep under anesthesia!

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

"Don't worry!" Zhang Fan nodded. The itinerant nurse helped Xu Xian disinfect, while Zhang Fan, Lao Gao and Lao Wang brushed their hands. Lay sheets, cover holes and towels when everything is ready.

Zhang Fan put on gloves, took the scalpel handed over by the instrument nurse, and wiped the skin to be cut with an alcohol cotton ball. He looked at the clock hanging on the wall of the operating room and said softly, "the operation begins."

Bart is on his stomach. In this position, there is a special operating table. Many people have taken a bath and massaged in the big bath. It's the kind of bed with a hole at the head of the bed that can put their face down.

Zhang Fan's main knife, Lao Wang's first help, Lao Gao's second help and Xu Xian's third help. The air pressure of Zhang Fan's operation was relatively low. Before the operation, little Bart came again. All of a sudden, the atmosphere of the operation became more depressed.

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

The scalpel opened a hole in the young skin, and the skin was pulled a white line in an instant, which is the dermis. Then the handle opens the subcutaneous tissue. Then change the electric knife and start hemostasis.

Surgery, as long as it is a traumatic operation, must enter layer by layer according to the physiological level, and stop bleeding layer by layer. Experts, especially some surgeons who pay attention to details, look at their operation, just like art.

It is clean, neat, well-organized, anatomically clear, and almost no bleeding can be seen in the whole operation field. Some doctors with poor skills do not know whether they are in pursuit of speed or do not understand anatomy. The level is not clear, and the bleeding in the field of vision is really like a slaughterhouse.

Continue to extend inward, expose the spinous process, cut the supraspinous ligament, and then gently separate the cut ligament to both sides“ Periosteal stripper. " After leaking bone, Zhang Fan said softly.

The operation nurse accurately handed over the periosteal peeler to Zhang Fan. On the operating table, there is something particular about passing things. Sharp tools, such as knives and scissors, should be delivered with the sharp blade pointed at yourself.

When it is passed to the other party, you must make a downward movement until the other party makes the opposing force, and then you can let go. On this detail, many nurses have to practice many times. Is it simple? Simple, but you must practice this action into a subconscious action and let your muscles have memory to be qualified.

This is not demanding, because there is nothing lucky on the operating table. Some special equipment may be just one. If it falls underground during transmission, it is an accident directly.

Zhang Fan clings to the spinous process with a periosteal stripper, pushes the thoracic paravertebral muscle to the tip of the transverse process from under the periosteum, and stops when the lumbar spine is exposed to the outside of the articular process.

"Gauze!" Lao Wang stared at Zhang Fan's actions. Lumbar surgery without saying anything else, this bleeding is very much. 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 derivation 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 separated from the large blood vessels cannot be avoided from being damaged.

When doing surgery, we should pay attention to the eyes and hands. When the master knife says the command, others don't have to think about it. For example, at this time, there are two bleeding in the lumbar bypass.

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

Moreover, 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 fill it. During the operation, many bleeding does not leak but exudes. When the muscles are separated from the bones, it is like sweating blood. At this time, it is impossible to stop bleeding with an electric knife or silk thread. This requires gauze compression to stop bleeding.

And the gauze during the operation cannot be dry gauze. It can only be used after being soaked by normal saline. This is not a bandage. If a piece of dry gauze is handed at this time, Zhang fan can directly drive the assistant and instrument nurse down. Because the tissue under the skin is very delicate, dry gauze is like sandpaper.

"Pull away." Zhang Fan said a word to his assistant after filling gauze.

They're not new. They're ready. As soon as Zhang Fan opened his mouth, Lao Gao and Xu Xian opened their skin with a retractor to expose the surgical field of vision as much as possible.

Retractor is the most feared thing for surgical inpatients, especially general foreign inpatients. What's this thing like? It's an L-shaped blunt alloy. It's very hard. Ordinary people can't deform it.

Orthopaedic dry retractor is better. It's really sad for ordinary foreigners. The large retractor is estimated to be the same size as the bending of an adult's arm. For operations such as gastrectomy, the second and third AIDS do one thing from beginning to end and pull their stomach with stable strength.

The surgical site is too deep. They can't see that after four or five hours of surgery, they just pull it blankly. If it's a little bad, the operator is not happy. After an operation, both hands and arms won't move.

After opening the surgical field of vision, we entered the critical period of the operation. This is the time to reflect the level of the performer. How to adjust and how much to adjust is too difficult.

In the image data, when looking at the spine and when opening the body to look at the spine, it is directly different. In terms of image data, you also have a general concept.

The operation will open those places that need to be adjusted, and the longest is no more than ten centimeters. The anatomy is not clear, or the technology is not in place, and the bone to be adjusted cannot be found.

It's not a joke, let alone the spine. Just a simple plate removal after clavicle fracture. Before the operation, the clavicle and steel plate can be touched directly on the skin, as if they were just a little under the skin. It seems very simple.

But in fact, when the operation is single, the hole towel is covered, the scalpel is drawn, the subcutaneous tissue swells, then bleeds, and the muscles are pulled. ok What about the steel plate? Can not find! This has happened to many transferred doctors.

Now what Zhang Fan has to do is to change the deformed whole, or let it grow in the expected direction in the future.

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

Time has slowly passed for more than an hour, almost two hours. Zhang Fan and Lao Wang sweat directly like beans. They can't wipe it. They directly put a towel on their forehead.

Bone biting forceps are the pointed nose vises that we usually use. Zhang Fan bit open the bone bit by bit, and then used a scraper to remove all the broken bones, cartilage and soft tissue between the spine bit by bit.

The cleanliness here must be clean. Because once a small bone mass enters the spinal cord, the light is the postoperative inflammation, and the heavy is the patient's lifelong lumbar pain or corresponding limb numbness.

Take care of this. Here comes the most dangerous step of the operation. At this time, we should adjust the position. Before adjusting the position, we should first separate these abnormal bone blocks.

How to separate? People who have eaten the animal spine know that the spinous processes of the spine are stacked together. If they want to separate at this time, they have to split. Yes, it is forced splitting. At this time, it can't be light or heavy.

If it's light, it can't be split. It will increase the fragments of bones. It's heavy. The spinal cord is ahead“ Click! Click! " Zhang Fan bit his teeth and split the spinous process twice.

Zhang Fan didn't realize how difficult it was, but Lao Gao and Lao Wang, the voice was like cutting on the tip of their hearts, and their hearts were hanging. If you slip your hand or exert too much effort at this time, the consequences will be unimaginable.

Xu Xian is also sweating, although he graduated with a master's degree. But the difficulty of this operation is counted in provincial hospitals.