Chapter 1561

"Brother Yun, look what you said. It's a normal complication, but we didn't do it on purpose. We all hope the patient is well. Who can deliberately knock the Kirschner wire out of the bone." President Zhou listened to Su Yun's words. His face turned white and explained again and again.

"Have the ability to go out and explain to the patient's family." Su Yun will not let go.

"Boss Zheng, do you think Zhou always goes now or later?" President Wang came to round up the game.

I've been in Haicheng for some time, and I have a lot of communication with orthopedics. I know that President Zhou is honest and a little Niang.

This kind of person will be bullied to death by Brother Yun if he fights alone. The one-sided rolling finally made president Zhou cry.

He didn't care about Zhou's life or death, but if he wanted to die, he had to do the operation before he died.

"Well..." Zheng Ren pondered, "in a few minutes, the pericardial fibrous tissue was stripped off. Please take out the Kirschner wire by President Zhou."

President Zhou realized that the patient's Kirschner wire was still there

Also, if you're not here, it won't be so big.

Generally, before the operation, the Kirschner wire will be taken out after half a year. Even if he did it himself, President Zheng estimated that it had been three years since the operation, and the patient didn't come for the second stage operation. It should be said.

After a while, President Zhou finally figured out the problem.

He was so flustered that President Zhou scolded himself.

When they chatted, Zheng Ren had cut the open heart bag in the left ventricle as far as possible to the posterolateral side and chose the area without calcification.

Stratification is seen below the incision, and the pericardial effusion has been sucked clean.

Find the stratification outside the epicardium, blunt separation along the stratification, and gradually expand the scope.

Blunt separation is Zheng Ren's unique skill. At this time, it is also handy to separate the adhesion between the epicardium and the fiberboard.

"Zheng Zong, how did you come back?" President Zhou looked at Zheng Ren's operation and suddenly remembered that President Zheng had gone to the imperial capital? He asked in amazement.

As soon as he said this, President Zhou immediately realized that it was wrong and directly lowered his head to avoid facing Su Yun's disdainful eyes.

But it's OK to look down and pretend to see the operation. You can't deliberately block your ears.

"Mr. Zhou, did you go through it, or did you open the door and see the world of Truman? A Kirschner wire drifted away at the far end and was scared like this?" Su Yun's voice was full of infinite contempt.

"It's just Kirschner wire. If a hospital in our city carries out cervical surgery, you won't be able to sleep all night?"

"Homesick, come back and have a look." Zheng Ren's serious nonsense, "Mr. Zhou, please brush your hands."

"Ah?" President Zhou was distracted and gave a trance.

"The operation is almost finished. Come up and take the Kirschner wire, and we'll close our chest." Zheng Ren glanced around and had to accept the fact that he stayed to close his chest.

It's still 912 convenient. After the operation, you can walk away without thinking about closing your chest and abdomen.

Unconsciously, Zheng Ren's thinking has become the thinking of professors and directors.

Close your chest and abdomen? It's a little doctor's job. What does it have to do with me.

Zheng Ren peeled off the pericardium in order.

Try to resect in pieces. In case of myocardial rupture, the stripped pericardium can be used to repair and stop bleeding.

Of course, this is just a preventive measure. Zheng Ren just subconsciously did it. He didn't think that this problem would occur with his master level cardiothoracic surgery skills.

The pericardial slice on the right is separated to the atrioventricular sulcus on the left, and the upper boundary is below the thymus. The upper boundary of the left pericardial slice was separated to the main pulmonary artery trunk, and its constriction ring was cut off to avoid serious postoperative right ventricular overpressure.

In the lower boundary, the thickened pericardium outside the diaphragm key was completely dissociated or removed; The posterior boundary completely dissociates the pericardium of the left ventricle as far as possible.

When separating the interventricular sulcus, Zheng Ren's hand speed was a little slow. Here, pay special attention not to damage the coronary artery branches.

But only the heart with big fist, according to the order, blunt separation step by step, and the separation is completed in an instant.

After the operation, Zheng Ren asked for warm saline gauze to cover the incision.

It's best to keep the chest opening.

Otherwise, if the heroic operation of orthopedics was blind, Zheng Ren was afraid that President Zhou would chisel through the patient's aorta at once.

Change the incision and pay attention to the sterile area. Zheng Ren took a look at ECG monitoring.

The patient's vital signs are stable, and this difficulty should be overcome.

"Boss Zheng, you said this heart problem, how can the first symptom be in the abdomen?" President Wang recalled the patient's medical history. Although he didn't know it in detail, if he received it, he might not expect to have chest disease.

Ask boss Zheng's ideas, which will be used for reference in the future.

"Didn't you see how the left phrenic artery was squeezed during the operation just now?" Su Yun said: "patients with long-term chronic injury have gradually become accustomed to it, so they just say they have chest tightness. However, the symptoms of nausea and vomiting caused by abdominal digestive tract ulcer and bleeding are typical, which is really easy to be missed."

"Boss Zheng and Brother Yun, how did you find out?" Mr. Wang said with admiration.

"The patient complained of chest tightness and shortness of breath. Auscultation of respiratory sound is very normal." Zheng Ren said casually: "Mr. Wang, normal physical examination, some simple major items still need to be done, but we can't be careless."

President Wang was stunned and smiled bitterly.

According to the regulations, physical examination must be done, and it is a complete set.

But the clinical thing is not that simple.

Half an hour is not enough for a set of tests to be done. The emergency department is so busy that there is no time for detailed examination?

Besides, the situation is definitely not so simple.

A female patient came to diagnose appendicitis. She had to do chest and vulva physical examination. Isn't that a hooligan?!

Many doctors who have just entered the clinic are planted in this pit.

President Wang can only smile bitterly at Zheng Ren's statement. However, the patient complained of chest tightness. He should be able to auscultate. He should be able to.

President Zhou took the first-line orthopedic doctor to disinfect and lay out the list and began the operation.

Taking Kirschner wire is one of the smallest operations in orthopedics. It should have been no difficulty for president Zhou.

But today this operation is very awkward.

He was so careful that he hardly dared to use violence.

But the Kirschner wire has been deeply buried in the callus and can't be taken out without violence.

In the past, when the diagnosis and treatment of orthopedics did not include the cervical spine and lumbar spine, it was called "Carpenter".

A chisel, axe and saw are available.

The operation was also heroic, and it was over when it hit the belt.

Zheng Ren sighed when he saw that President Zhou couldn't let go.

He had to do enough protection for president Zhou in his chest, protect it with a layer of gauze pad, and then block the Kirschner wire with the iron sheet of the big hook. In this way, the Kirschner wire will not cause too much damage even if it moves under violence.