Chapter 1184

This is a patient who underwent radiofrequency ablation of liver cancer today.

Advanced liver cancer, multiple intrahepatic metastasis. This diagnosis, ten years ago, could declare that the patient had no therapeutic value and died after three to six months of survival.

However, with the clinical development of interventional surgery, this kind of disease can not only delay for a period of time, but also the cure rate has increased from 0 to about 25%.

In addition, 912 carried out the research on three-dimensional reconstruction of 64 row CT operators, which improved the cure rate of liver cancer again.

Embolization + radiofrequency ablation is indeed an effective means to treat liver cancer. Even Zhao Wenhua and Zheng Ren have to admit that it is of great benefit for operators to do 64 row CT three-dimensional reconstruction by themselves.

The immediate patient was hepatectomy for liver cancer a year ago and relapsed after operation. Because left hemihepatectomy and postoperative recurrent lesions are surgical contraindications, interventional therapy is the only means.

Zhao Wenhua admitted the patient to the hospital in the outpatient department. After interventional embolization, he underwent radiofrequency ablation this morning.

The focus was close to the diaphragm. Zhao Wenhua chose the method of transthoracic radiofrequency ablation.

This is just an ordinary means of operation. Both Zhao Wenhua and director Kong have done more than a thousand cases.

The effect is also very good. As long as we pay attention to burning the needle path, there will be no complications of implant transfer.

Clinical data show that implant metastasis is really rare.

But in front of the patient, there was another complication - bleeding.

Zhao Wenhua was manic. He was really a dog. When he withdrew the needle, he cautiously burned the blood vessels and needle path, and even complicated with bleeding.

Really.

Now the only hope is to stop the bleeding.

Three groups of hemostatic drugs were used, and even pituitrin was pumped into the pituitary gland by micro pump. The bleeding still could not be stopped.

Thoracic surgery consultation, Fang Lin's chest bottle.

For a moment, the chest bottle was almost full, and Fang Lin had to clamp the chest tube with hemostatic pliers. He judged that the patient probably needed thoracotomy. However, after explaining to Zhao Wenhua that it was the judgment of chest department, Zhao Wenhua refused the proposal of thoracotomy.

In fact, Zhao Wenhua's idea is also very simple. How thick can the RF needle be? However, the ordinary needle is so thick and thin that it will not cause much damage to blood vessels. Moreover, there are no large blood vessels at the position of the needle. When the needle is out, it is cauterized carefully.

I've done everything I can. Even if it's bleeding, it's time to stop. If you open your chest at this time, it will be at least a medical accident.

Wouldn't it be better if we could stop the bleeding by ourselves and end up happy?

Now the doctor-patient dispute is so serious that normal complications are regarded as medical accidents. It's really distressing. Zhao Wenhua is worried and picks up his hair one by one.

Fang Lin was helpless and went back with a sigh. He is just a doctor who consults and does his own disposal. As for whether the patient should be transferred to general chest surgery, Zhao Wenhua should make up his mind.

This is a medical rule. Fang Lin can't just drag the patient onto the operating table.

Zhao Wenhua looked at the film and felt sad. He carefully recalled the operation process. There was nothing to improve. He was also trembling and gave full play to his level to the limit.

As long as it is surgery, there will be complications. No matter how high the level is, it can not be avoided.

Zhao Wenhua tried to avoid waiting for Zheng Renxian to make a mistake. That guy is like walking a tightrope. No matter how difficult the operation is, he has to try it. It's strange not to make mistakes.

But something unexpected happened to him. Zheng Ren didn't make a mistake, but he made a mistake first.

The patient's postoperative bleeding is not his own mistake, but bad luck and complications. (Note 1)

If Zheng Ren did not exist, the patient Zhao Wenhua would have accepted it. Send to thoracic surgery to stop bleeding under thoracoscopy. A very small operation can solve the problem quickly. But after Fang Lin put forward his proposal, Zhao Wenhua thought it was a conspiracy.

What's the relationship between Fang Lin and Zheng Ren? No one in the hospital doesn't know.

Zhao Wenhua knew about the accident and the rescue. This is Zheng Ren, a dog. He looked at himself fiercely and waited for his mistakes. Zhao Wenhua thought in his heart and refused Fang Lin's suggestions without hesitation.

Just waiting for Fang Lin to leave, Zhao Wenhua began to hesitate and worry again.

What if the bleeding doesn't stop? He took a look at the patient's blood pressure in almost a few minutes for fear that the blood pressure could not stop falling. At that time, everything will be on stage.

I hope not.

Every fluctuation of one or two values in arterial blood pressure monitoring will make Zhao Wenhua's heart beat constantly. When he rose, he saw hope. Come down, he's going to hell.

It was already three thirty in the middle of the night, and he was still observing and judging anxiously.

Zhao Wenhua never reopened the hemostatic forceps. He gradually had an idea. Bleeding is because there is negative pressure in the patient's chest, and the bleeding at the position of blood vessel rupture can not be stopped at all.

There is only one way to change the negative pressure state - let the blood accumulate in the chest.

After that, vascular occlusion and bleeding stopped. It seems that it is also a way to slowly solve the problem of atelectasis.

After hesitating for a long time, Zhao Wenhua decided to adopt this method.

Nevertheless, he took care of the patients very carefully. Later, I stopped walking around and took care of myself in front of the bed. At this time, he didn't trust anyone. Only when he was in front of the patient's hospital bed, his uneasy heart would be more stable.

The situation has not changed for the better or worse, but it has not changed. Blood pressure is maintained at 80 / 40 mmHg on the premise of continuous blood transfusion, which is regarded as hemorrhagic shock, but it is not serious.

In addition, the basic blood pressure before operation is low, which is acceptable.

It's just that such a night is so hard.

Almost every doctor has had such nights, more or less.

If there were no Zheng Ren, Director Wei would still be doing extremely complicated surgery on the operating table... No, if there were no Zheng Ren, the patient would die when he came on stage, so he wouldn't have to suffer for a long time.

After watching the film again, Zhao Wenhua returned to the patient's bedside, sat on the bench and stared at the monitor.

The patient's family was grateful. They explained that there were complications before the operation. Unexpectedly, they met him.

This is bad luck. The patient's family members are reasonable and recognized.

Professor Zhao has been nursing at the bedside since the situation occurred, and the patient's family members also expressed their gratitude. Only Zhao Wenhua knows what to do is the best choice.

He just couldn't make that choice.

Although it is just an ordinary complication, no one can avoid it. Zhao Wenhua still wants to try not to go to the palace again and can't give Zheng Ren the handle to attack himself.

Zheng Ren is fine. At the thought of Su Yun who is like a male League star around him, Zhao Wenhua can't stop getting bored from his heart.

That man has the worst heart!

……

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Note 1: try hard to add lucky value to boss Zheng in order not to make mistakes. Being a doctor is really important.