Chapter 1560 Full Set of Physical Examination (Leader Linyuan He Xianyu Plus 1)

"Brother Yun, look at what you said, this is a normal complication, but we didn't do it on purpose. We all hope that the patient is well, who can deliberately knock the Kirschner wire out of the bone." President Zhou listened to Su Yun Saying this, her face turned pale with fright, and she continued to explain.

"Go out and explain to the patient's family if you have the ability." Su Yun refused to forgive.

"Boss Zheng, do you think Zhou is always here now, or at a meeting?" President Wang came to smooth things out.

I have been in Haicheng for a while, and I have communicated a lot with the orthopaedic department. I know that Mr. Zhou is honest and a bit mother.

This kind of person will be bullied to death by Yun Ge'er if he is singled out. The one-sided crushing finally made President Zhou cry.

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

"Well..." Zheng Ren pondered for a while, "In a few minutes, the pericardial fibrous tissue has been stripped off, please take out the Kirschner wire."

It was only then that Mr. Zhou realized that the patient's Kirschner wire was still there...

Also, if it wasn't there, it wouldn't be such a big deal.

Generally, before surgery, it will be explained that the Kirschner wire will be removed after half a year. Even if it is done by himself, Mr. Zheng estimates that it has been three years since the operation, and the patient did not come for the second-stage operation. This should be talked about.

Frightened for a while, Mr. Zhou finally figured out the problem.

I was so flustered, and President Zhou blamed himself a few words in his heart.

When they were chatting, Zheng Ren had already incised the pericardium in the left ventricle.

Delamination is seen below the incision, and the pericardial effusion has been aspirated.

Locate the layers outside the epicardium, blunt dissection along the layers, and gradually expand the scope.

Blunt dissection is Zheng Ren's specialty. At this time, it is also handy to separate the adhesion between the epicardium and the fibrous plate.

"Mr. Zheng, why are you back?" Mr. Zhou looked at Zheng Ren's surgery and suddenly remembered that Mr. Zheng had gone to the imperial capital? Without thinking, he asked in amazement.

As soon as these words came out, President Zhou immediately realized that something was wrong, and lowered his head directly, so as not to face Su Yun's contemptuous gaze.

But it's okay to bow your head and pretend to watch the operation, but you can't intentionally block your ears.

"Mr. Zhou, are you traveling through, or did you push the door open and see the world of Truman? A Kirschner needle strays from the far end, so you are scared like this?" Su Yun's voice was full of infinite contempt.

"It's just Kirschner's needles. If this is the first hospital in our city to carry out cervical spine surgery, you can't sleep all night long?"

"I'm homesick, come back and have a look." Zheng Ren said nonsense seriously, "Mr. Zhou, please go and brush your hands."

"Ah?" Mr. Zhou was distracted, and groaned in a trance.

"The surgery is almost done, you come up to get the Kirschner wire, and we will close the chest again." Zheng Ren glanced around and had to accept the fact that he stayed and closed his chest.

912 is still convenient. After the operation is completed, you can walk away by throwing your hands, and you don’t need to think about closing the chest and abdomen.

Unconsciously, Zheng Ren's thinking has become the thinking of a professor and director.

Close the chest, close the abdomen? It has nothing to do with me whether the little doctor's work is good or not.

Zheng Ren peeled off the pericardium in sequence.

Try to cut into slices as much as possible. In the event of myocardial rupture, the pericardium that has been stripped can be used to repair the bleeding.

Of course, this is just a preventive measure. Zheng Ren just did it subconsciously, and he never thought that such a problem would occur with his master-level cardiothoracic surgery skills.

The pericardium on the right is separated to the left atrioventricular groove, and the upper border is below the thymus. The upper border of the left pericardium was separated to the main pulmonary trunk, and its constriction ring was cut to avoid severe postoperative right ventricular hypertension.

The lower boundary completely frees or resects the thickened pericardium beyond the diaphragmatic key; the posterior boundary completely frees the pericardium showing the left ventricle as much as possible.

When separating the interventricular sulcus, Zheng Ren's hand speed was a little slower, and special care was taken not to damage the coronary branches.

But it's just a fist-sized heart, bluntly separated step by step according to the sequence, and the separation is completed in an instant.

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

It is best to keep the opening of the chest.

Otherwise, the heroic operation of the orthopaedic department is really blind, and Zheng Ren is afraid that President Zhou will pierce the patient's aorta all at once.

After changing the incision, paying attention to the sterile area, Zheng Ren glanced at the ECG monitor.

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

"Boss Zheng, how can the first symptom of this heart problem be in the abdomen?" Mr. Wang recalled the patient's medical history. Although he did not know the details, if he consulted himself, he would not have thought of chest disease.

Ask Boss Zheng's ideas, and it will be a reference in the future.

"You didn't see how the left phrenic artery was squeezed during the operation just now?" Su Yun said, "The patient has gradually become accustomed to long-term chronic injury, so he just said that he had chest tightness. But the abdominal peptic ulcer and bleeding caused the Nausea and vomiting, the symptoms are more typical, and it is really easy to be missed.”

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

"The patient complained of chest tightness and shortness of breath, and auscultation for breath sounds is normal." Zheng Ren said casually: "Mr. Wang, a normal physical examination, some simple major items are still to be done, but not sloppy."

President Wang was startled for a moment, then smiled bitterly.

According to the regulations, a physical examination is a must, and it is a full set.

But clinical things are not so simple.

It takes half an hour to complete a set of inspections. The emergency department is so busy, how can there be time for a detailed examination?

Then again, it's definitely not that simple.

A female patient came, diagnosed with appendicitis, and insisted on doing a chest and vulva physical examination. Isn't that a hooligan? !

Many doctors who have just entered the clinic fall into this pit.

President Wang could only give a wry smile to Zheng Ren's remarks. However, the patient complained of chest tightness, and he should be able to auscultate it himself.

Mr. Zhou took the front-line orthopaedic doctor to disinfect, lay out the list, and start the operation.

Taking Kirschner wire is one of the smallest operations in orthopaedics, and it should have been no difficulty for Mr. Zhou.

But today's surgery is extremely awkward.

He was cautious and hardly dared to use violence.

But the Kirschner wire has been deeply buried in the callus, and it cannot be taken out without violence.

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

Adze, chisel, axe and saw, everything is available.

The operation was also heroic, and it was over with a bang and a hit.

Zheng Ren sighed when he saw that President Zhou couldn't let go of his hands and feet.

He had to do enough protection for President Zhou in the chest cavity, protect him with a layer of large gauze pad, and then block the Kirschner wire with the iron sheet of the large curved hook. In this way, even if the Kirschner wire is moved violently, it will not cause too much damage.