Chapter 199

From a technical staff to a comprehensive technical management staff, the change of mentality does not happen in a day.

Not only my own mentality has an adaptation process, but also the mentality of my colleagues, friends and family members.

When Zhang Fan first became the assistant director of the Orthopedics Department, Lao Gao once told Zhang Fan.

The mentality of managers in the medical industry is different from other industries, and it is very changeable and complex.

Zhang Fan didn't understand at the beginning, but now he finally has a little understanding. That is, technicians do not obey.

This is not the personality of one two-person doctor, but the generality of the entire industry.

Just like some little doctors and nurses secretly calling Zhang Fan to be a black man.

Among the names of the famous ethnic groups in the frontier, Maimaijiang is not necessarily the most popular, but for the Han people, Maimaijiang is the most catchy.

So, I don't care how many times you come, I just go all the way. Calling Maimaijiang became the Xiaoming of the Han people in the frontier.

The little nurse called Zhang Fan for Heimaimaijiang, which was full of a trace of admiration, strangeness but hope to be familiar.

And when the little doctors called Zhang Fanhei Maimaijiang, most of them were jealous and unwilling to admit it.

The same young man, also graduated from a bachelor's degree, why is he so powerful?

Probably because he is black!

Zhang Fan doesn't mind this matter at all, he is like a king now, constantly inspecting his chassis, and constantly digging for materials that can be made.

It is too difficult to find talents in the medical industry. Not only must they work hard, but they must also have talent.

Moreover, one must have a mentality that can withstand tremendous pressure. Not only can one be able to withstand pressure, but also one's character is very important.

In this line of work, if you don’t have a good heart, then let it go if there are no problems. If there is a problem, it is a big problem. If you want to pull up a team and build a good team, it is not much easier than improving your surgical skills.

Patients who were transferred from the Hospital of Traditional Chinese Medicine were scheduled for surgery. On the day before the surgery, Zhang Fan held a morning meeting for pre-operative discussion in General Surgery.

The current general surgery department in the city hospital, the liver and gallbladder has long been separated and independent, and although the anorectal department is separated, it is not yet independent. Often there are many operations, and the general department of the family still needs to send people to help.

As for vascular surgery,

Few people go to special research. First of all, this subject develops relatively late, and the requirements for hardware equipment are also very high.

In the past, the city hospital had this heart but not that strength. After Zhang Fan's trip to Shanghai, he brought a lot of equipment.

In fact, Zhang Fan is slowly considering the necessity of establishing a vascular surgery, so now, Zhang Fan has to slowly observe.

Vascular surgery, the real essence of vascular surgery is to dig out the west wall to fill the east wall.

Therefore, the macroscopic view of vascular surgeons must have a certain height, which is different from other general surgeries and is specific to a certain organ.

For example, the appendix, it’s a great thing to cut it, and the gallbladder, for example, is also the same reason, even if the pancreas is the most difficult to mess with, it’s a great thing to cut it off.

But the blood vessels are not good, this thing is a closed loop, if antagonize the disease in a closed loop, this requires doctors to have a strong perspective on the overall situation.

Therefore, Zhang Fan also began to investigate slowly. If there is no candidate for the city hospital, he will cultivate it himself.

The morning meeting was very successful, but Zhang Fan's goal was not achieved. The general surgeons were very rude and rarely mentioned conservative treatment.

Although the patient's condition is very serious, the possibility of conservative treatment is already very low, but everyone's views on conservative treatment are still a bit superficial.

For angiolymphatic disease, surgical treatment is the last resort, and conservative treatment is the kingly way.

For example, the treatment of lymphatic diseases, although Huaguo started relatively late, but relying on the baking and binding therapy created by academician Zhang Disheng, the first plastic surgery person in Huaguo, the No. 9 Hospital of Shanghai has become the leader in the plastic surgery industry.

In terms of lymphatic treatment, Huaguo's treatment method is still unique.

It is estimated that this old gentleman is also a glutton. The baking binding method he invented is similar to the roast duck.

For example, for patients with lymphedema of the lower extremities, elastic bandages or tight stockings should be used to compress the patients first.

Then put it into a special oven, according to the tolerance of the patient, the temperature is as low as 60° and as high as 130° for baking.

Evenly heated, the patient's edema is significantly improved, but what is the principle of this thing, for now, everyone has no conclusion, but it works!

It is estimated that when the old man watched the roast duck rotate and heat up, his body shrank, but he rarely lost a lot of body fluids, so he was inspired!

Otherwise, there is no way to explain this thing with medical theory.

The old man is also a man of God! The Ninth Hospital of the Shanghai City is famous all over the world, and the students brought out by the old man almost monopolize the Ninth Hospital of the Shanghai City.

However, foreign treatment methods focus on rehabilitation, that is, manual massage.

What do you mean, the tissues of the human body are actually isolated, such as the calf muscles.

These muscles are wrapped together by a wear-resistant outer mold one by one, just like frozen meat in the refrigerator. It looks like they are frozen together, but they are actually separated by plastic one by one.

The edema is between the muscles. The conservative concept abroad is to use massage to open the gap between the upper and lower.

Let the lymph in other places absorb the blocked lymph fluid.

The advantages are obvious, and the disadvantages are also obvious. First of all, this kind of physical therapist must be professionally trained.

This physiotherapy method is not about stepping on the back, pushing the oil, and pulling down the shutter to make you feel comfortable.

This kind of technique can be regarded as a violent massage. It needs to open the barrier of the upper and lower tissues. The technique is almost impossible to massage the swelling of the legs to the reproductive (a) organs.

Therefore, not to mention the high cost of this kind of treatment, it also takes a long time. If the main labor force of a family has this problem, it will be a disease that will kill the whole family.

After the morning meeting, Zhang Fan smiled helplessly, and asked the doctors from general surgery to have a barbecue and get a massage. It is estimated that these people would never be willing.

It seems that we can only choose other talents.

After the patient was sent to the operating room, the little nurse in the operating room looked at the meat jar on the patient's leg and dared not laugh.

The anesthesiologist took a closer look and said, "Yuan Zhang, spinal anesthesia probably won't work. The blood vessel fluctuations in this place are not very obvious. General anesthesia is needed."

"Okay! Have you talked with your family?"

Zhang Fan responded.

The general surgeons were one by one, and Zhang Fan asked one by one in the morning. Everyone guessed that Zhang Fan might find someone to specialize in blood vessels.

So, a group of people entered the operating room, quieter than each other, for fear of being ordered by Zhang Fan to get blood vessels.

Twisted melons are not sweet, and Zhang Fan didn't want them to have blood vessels, but it's still okay to scare them.

"The blood vessels are still promising, no overtime, no emergencies, and clean!"

After saying this, one by one rushed to work more quickly.

Zhao Quanping, the director of General Foreign Affairs, smiled, and quietly gave Zhang Fan a thumbs up.

"Zhang Yuan, the disinfection is finished, and the patient is already paralyzed!" the attending physician of general surgery called Zhang Fan flatteringly.

"Operation begins!"

As soon as Zhang Fan entered the state of surgery, he didn't have any other superfluous thoughts.

The operation of lymphatic vessels is similar to that of arteriovenous vessels.

Although not as dangerous as arteriovenous blood vessels, the difficulty is not small.

Arteries and veins are one-to-one, and the difference is that they are different in thickness. If the blood flow can be controlled well, there is not much difference between suturing blood vessels and suturing rubber tubes.

But the lymph is different. After this thing comes out of the muscles, it is like a mouthpart, with a trumpet mouth, and absorbs it with the movement of the muscles.

Therefore, there are three surgical methods for this disease, and these three surgical methods have not been significantly improved on a large scale since they were invented.

In addition to changes in medication, what was done decades ago is actually the same way now.

The first, and the cruelest one, is direct resection, including muscle and lymphatic resection.

For example, if there is a rubber swollen breast, if it is removed directly, men will be scared to death when they hear it.

The second is to promote absorption. To put it bluntly, it is a diversion. The third, and most difficult one, is the reconstruction of lymphatic drainage.

The lymphatic drainage of the calf is actually a bit like a road in Huashan. There is no good way to divert this thing, and it will cause too much damage if it is removed.

Although most doctors will choose resection, because of this method, it is hard to say whether the patient's calf will contract after surgery, but there will never be edema again.

However, Zhang Fan chose reconstruction, which would take a long time, so in the morning, Zhang Fan greeted the doctors on stage in advance.

Eating and drinking less, Zhang Fan only ate some steamed buns and some pickles, and didn't even drink any water.

If you don't want to be so hungry, you have to bring diapers. To be honest, no matter how advanced the diapers are.

The warm feeling on the paper after urinating is really uncomfortable, as if someone spit on the skin and stick to the skin, and I can't wipe it off!

At the beginning of the operation, the meat jar was cut open, and the tissue inside felt like cotton wool or foamed white fungus.

The skin feels like leather in the hand, it doesn’t have the flexibility of human skin at all, it’s just as stiff as a pigskin soaked in water for a long time, it’s a pity to spit it out in the mouth, but it can be chewed for a long time, and the person remains motionless, leaving shadows on the teeth No more.

When the operation is done on this kind of skin, it's like a person is on the snow, puff puff puff, if you use a little force, you can't walk, but if you use a little force, the knife will go in if it doesn't work well.

But to Zhang Fan, no matter how it changes, with a scalpel in hand, thousands of changes are irrelevant.

"Tweezers!" After Zhang Fan cut the skin, he asked his assistant to use the tweezers to pull the skin away, exposing all the tissues inside the calf.

The inside of the calf tissue cannot be seen. Normal people, even if they are obese, have muscle as muscle and fat as fat in the calf.

After the patient's meat jar was cut open, it looked like a pile of water-filled fat pork, with white liquid overflowing everywhere.

The muscles don't have the feeling of tendons, as if they were chewed by a toothless old lady for half an hour, and then spit out the meat with foam.

When the gauze was dipped, a lump of sticky liquid was brought up, and when it was dipped, a lump was brought up. It was really like the feeling that after a boy became Master Lu, he didn't get it on the paper towel, but got it under the skin of the calf.

The tissue on the meat jar is white and greasy, and it feels like your hands are stuck to it when you wear gloves.

Zhang Fan cut open the tissue and looked for lymphatic vessels.

"Zhang Yuan, if it doesn't work, just cut it off. I feel that the edema is too severe. When you pinch it lightly, it's full of protein."

The general director frowned.

"There is still help, you listen to me, come, help me find a suitable vein."

Zhang Fan didn't say much, didn't explain much, and directly assigned the task to Zhao Quanping.

This is the case on the operating table. As long as the chief surgeon hesitates a little, other doctors will give more and more suggestions.

One said the left side, and the other said the right side. Therefore, on the operating table, a surgeon should actually have a certain amount of domineering.

Zhang Fan asked for help, but the assistants wanted to talk, so they stopped talking. Keep your head down and carefully look for the right vein.

Lymphatic blockage is a road in Huashan. What to do, rebuild, shrink the lymphatic entrance first, and then find suitable veins to connect them together.

Therefore, this operation can be done by a vascular surgeon at this time, but the most difficult thing is after the vascular lymphatic connection.