Chapter 470

Zhang Fan is young, energetic and has no so-called airs. What was his attitude in the past and what is his attitude now.

It's his habit, a very good habit, to see the patient first“ It's all right. Your tumor is not big. You will certainly recover well after the operation. Don't drink this wine again! "

On the morning of the weekend, Zhang Fan took Ma Yichen and the doctors of hepatobiliary surgery of the Affiliated Hospital for a preoperative ward round.

When Zhang Fan came for the operation, the deputy directors were very active, because they could learn technology, and the hospitalized dog and transferred Wang felt as uncomfortable as his dead father.

"On the big weekend, I came for surgery again. It's been several weeks. Can't you rest for a week!, Can't you change places! " A group of people hugged Zhang Fan for ward rounds, and the young doctors walking behind were helpless!

"OK, OK, I will listen to you. Please use snacks!" There is a very young patient in today's operation. The child is just three years old. His family is holding Zhang Fan's hand and can't wait to kneel down.

Although Zhang Fan is young, he is surrounded by a group of doctors in the provincial hospital. Naturally, he also has a momentum of experts.

Liver, the most afraid of three things, the first fear of all kinds of viruses, especially hepatitis B virus, is directly the liver killer.

Second, fear of long-term heavy drinking and a large amount of dietary fat, which can be prevented or cured.

Third, be afraid of aflatoxin. If you eat bitter melon seeds and moldy peanuts, you must not drink water and spit. This thing is aflatoxin. The liver is afraid of it.

In the operating room, Zhang Fan sat and looked at the patient's examination. Although he had printed the patient's examination in his mind, Zhang Fan still took the trouble to look at the examination.

The two liver and gallbladder directors are also watching the examination with Zhang Fan. Zhang Fan's habit also makes the two directors slowly start to adapt.

Although Ma Yichen was brought by Zhang Fan, including the director of hepatobiliary department, who was very polite to him, the young man was an understanding man and knew his position.

Zhang Fan rested with the director. He actively helped the anesthesiologist put in position and the nurse bind the patients. You can't do it if you don't let me do it. Smile and take the initiative to start.

Zhang Fan occasionally glanced at the busy Ma Yichen and was a little proud, "my eyes are also good!"

"Zhang Yuan, get ready to wash your hands!" The director of the anesthesiology department whispered. The president of the Affiliated Hospital specially explained that as long as Zhang Fan came to the operation, the anesthesiologist must be the director of the anesthesiology department.

"Good! Wash your hands. "

At the beginning of the operation, Ma Yichen was also pulled on the stage by Zhang Fan. "The pony goes on one and has a rest. There are not many such patients in our hospital. We can see more by the light of the affiliated hospital."

Although Zhang fan can designate the personnel for the operation, he still has to say if necessary. He can't eat alone. A vice high school whose face was no longer good-looking was much better when Zhang Fan said so.

Those who work hard are always worthy of respect.

The medical industry is too special. It is a more special existence in a special industry. Not only a good platform is needed, but also the personal efforts of doctors are very important.

A simple abdominal color Doppler ultrasound has the same advanced level of machines, but the reports of good doctors and poor doctors are different. Therefore, although doctors do not rank in the world, hospitals do.

Doctors strive to improve, and then strive to go to a bigger and better platform. The big platform also strives to improve various welfare benefits, and refuels to absorb excellent doctors.

The particularity of the industry has also created the particularity of this profession. High precision is always concentrated in several places, and medicine may develop rapidly. It may create many high-end medical technologies, and then slowly popularize them to benefit the general public.

However, this also forms a threshold and a relative imbalance or inequality. Right and wrong is really a very contradictory issue.

President Wang and his father almost went to the magic capital. For his level, money is not a problem, but for most people, money is the biggest problem, which is also the reason why exercise is popular in European and American countries.

In the early days of China, many people scolded, but those who had no money to see a doctor directly threw the patient in the hospital and turned around and left.

It is no exaggeration that hospitals should not only manage meals, but also try their best to treat others. This is also a major reason why private hospitals cannot develop in China.

"How big is the liver? The liver develops in the first few weeks. What are its characteristics? " Zhang Fan took alcohol to disinfect his skin, and then asked mindlessly.

The two directors knew that this was Zhang Fan's question to his little assistant. They smiled and looked at Ma Yichen.

"The liver weighs about 1200 ~ 1500g and is about 25cm long. At the fourth week of the embryo, the liver protrudes from the foregut and evolves into the liver.

The liver is the largest chemical field in the human body, and almost all hormone inactivation is in the liver.

Most vitamins are stored in the liver,... "Ma Yichen did not disappoint Zhang Fan. He methodically put the liver aside from physiology to pathology, anatomy to biochemistry.

"The pony has a good foundation!" When Ma Yichen finished, director Li of the second Department of hepatobiliary praised him.

Zhang Fan didn't say anything, just nodded. If he didn't even have some skills, Zhang Fan wouldn't expect him to do anything.

At the beginning of the operation, for the operation of the liver, Zhang Fan has penetrated and entered the liver area very quickly. There was nothing to say before entering the liver. When choosing the incision, Zhang Fan deliberately said one sentence and then said nothing.

In the first operation, the patient was a male in his fifties. When he entered the liver area, the tumor was very obvious.

The liver, as long as it is normal without pathological liver, can actually make people have a pleasant feeling.

The normal liver covered by the film reflects a soft luster under the shadowless lamp, a little rose red, which can be regarded as oily and smooth. It can really make people feel close.

But with a tumor, it's different immediately. Cancer cells are too domineering. If the normal growth rate of liver cells is walking, the growth rate of liver cancer cells is aircraft.

When a cell becomes cancerous, the cells that cannot be found under light microscope begin to grow, one becomes two, two becomes four.

With the rapid growth, almost all the nutrients in the region are absorbed by it. The growth becomes larger and larger in circles. The external cancer cells continue to proliferate, while the internal cancer cells continue to die.

When the number of deaths increases, cancer cells break down. Something like pus will flow out.

And the shapes are different. The most typical is a giant tumor, which protrudes from the liver like an abscess on a mangy dog, indicating that it is white and boring because of the existence of a liver capsule.

The cancer cells are tightly wrapped by the capsule, just like the brain flower tightened by plastic film. The obvious blood vessels grow and rot and die.

The coexistence of freshness and corruption can not only make people feel sick, but also make people feel afraid. Yes, it is fear. This thing is like the black (a) society, lying on the liver.

The scalpel is open, a little stripping along the liver and gallbladder, and the electric scalpel coagulates blood. The electrocoagulation taste of muscle fat is like barbecue, with a meat flavor.

The liver is rich in many chemicals. After electrocoagulation, the smoke produced is a little coquettish and a little smell of overnight urine.

"When separating the tumor, if you are not sure, use the knife handle." Zhang Fan explains while doing.

The two directors have already started. Zhang Fan now chooses the method with many steps but less difficulty.

The two directors kept nodding and absorbed in learning Zhang Fan's steps.

After cleaning, the disgusting tumor, like a broken brain flower, was completely removed by Zhang Fan.

The liver tumor was removed. Although there was a big pit on the liver, the liver at this time seemed to know that the danger had been exposed. Even the blood was lovely.

"How's it going? Do you feel it?" After removing the tumor, Zhang Fan also breathed a sigh of relief. Tumor surgery is not fracture fixation.

Even if the manipulation of fracture fixation is rough and the steel plate is ugly, it is not a problem, but the tumor is different.

Ulceration and unclean cleaning can make the operation fail, so every operation of liver tumor is not easy.

It is no exaggeration that only after the resection is completed, Zhang Fan breathes easily like a relieved load.

"I feel a little, but I still seem to lack a little." After thinking about it, the director of the Fifth Department of liver and gallbladder said.

"Yes, it seems that it's so close now." The director of the second hepatobiliary department also said.

"Well, then continue to do it and make more than a dozen more. It's estimated that you can try it." Zhang Fan, sweeping the head and tail of the operation, said.

Ma Yichen still doesn't realize the difficulty of the operation. After all, he is not a master of hepatobiliary major, but he admires the accuracy of Zhang Fan's operation.

There are few cases of blood exposure after a knife, which shows that Zhang Fan is quite familiar with anatomy and can avoid a larger artery with each knife.

"It's so fierce. Even in such a complex place as the liver, you can know the shape of the vascular system! Terrible! " Ma Yichen unconsciously made a comparison with Zhang Fan and found that the gap was too big.

There was an operation in the morning, and the nurse was replaced, but the doctor and anesthesiologist could not be replaced. They hurried to continue the next operation after lunch.

In terms of the physical consumption of surgery, it is estimated that orthopaedic surgery can definitely enter the top three of all operations, but orthopaedic surgery is relatively not so energy-consuming for doctors.

Tumor surgery is different. It takes a lot of energy. Doctors don't force themselves to concentrate on the operation, especially when it comes to cleaning.

Sometimes, perhaps a little omission will cause endless pain to patients.

After a few casual meals, Zhang Fan sat in the hall of the operating room and began to close his eyes and rest for a few minutes.

There is no intermission in this series of operations. When one operation is completed, the patients of the other operation have been hung with antibiotics and sent to the operating room.

The chief surgeon can rest for ten minutes. If there is no other replacement doctor, the assistant will be busy positioning and helping with anesthesia.

Posture is very particular in surgery. It's not just throwing people on the operating table and cutting knives.

The position of the patient should first ensure the convenience of the surgeon. Moreover, because the patient has not moved for a long time, some cushions should be placed in the place where the subcutaneous fat is weak to prevent crushing the skin.

This is no joke. As long as two hours of compression, necrosis and ulceration will occur in places with less subcutaneous fat, and it is ischemic necrosis and ulceration. It is particularly troublesome for this kind of injury to recover.

It will spread. When a patient in one department is transferred to another department, the handover nurse will make a comprehensive examination of the patient's skin.

Once bedsore occurs due to improper nursing in the hospital, this is a medical accident.

Why is the nursing cost of ICU so high? Let alone others, first of all, the nurse turns over and slaps the patient's back very frequently, once every 15 minutes.

In the ICU of a large hospital, there are absolutely no less than 30 patients, and the maximum number of night nurses is no more than six. We can imagine how much the workload is.

After dinner, he wants to sleep. Zhang Fan hardly drinks coffee at ordinary times, but with this continuous operation, Zhang Fan has to drink some instant coffee. Sometimes he has to go to red bull, otherwise he can't keep up with his energy.

During the operation in the afternoon, Ma Yichen was a melon eater under the operating table. The young man looked very good. He helped the nurse wipe the doctor's sweat and adjusted the air conditioner. Anyway, he was not idle.

This is a learning attitude.

For the operation in the afternoon, Zhang Fan didn't have the energy to explain it in the morning. After all, people's energy is limited.

Zhang Fan did it quickly and carefully. The two directors also knew that Zhang Fan was a little tired and didn't talk much. In the operating room, there was only the sound of a ticking monitor.

President Wang's father's operation was put on the next morning. The night he separated from Zhang Fan, he began to inquire about Zhang fan through various relationships.

Although according to the president of the Affiliated Hospital, Zhang Fan is very powerful, after all, he is his father, and he is still a little worried.

"Lao Zhao, Zhang Fan of tea vegetable..." this is a call to Zhao Jingjin.

"President Ouyang, this is..." this is to learn from leader Zhang Fan.

"Lao Chang, ask about someone." After asking several people, they all said that Zhang Fan was very powerful.

He was relieved, but they were all frontier doctors. He decided to ask the doctors who left the frontier. After all, they were not in the same area and should not cover up for him.

The old man in the mainland often felt that the dark clouds covered the sky. He changed his number, but for this rich man, he still sent his new number.

However, when he heard the other party say to inquire about a person, he began to become bad. When he hung up, he didn't dare, and he didn't dare to tell lies. He could only bite his teeth and say he was unfamiliar.

Zhang Fan, isn't he familiar! He's so familiar!

After Mr. Wang understood, he began to order his secretary, "are you satisfied with the place where Zhang Yuan lives?"

"Satisfied, the best suite in the Frontier Hotel. When I got up in the morning, president Zhang was in good spirits." The female secretary holds her hands gently and puts them slightly below her lower abdomen.

"Prepare 200000 cash and send it directly to his room in the evening, so I won't show up. Be polite and tell Zhang Yuan that the labor fee belongs to the labor fee. This is my little intention. "

"OK!"