Path of Medicine With a System

Zhang Fan's original plan to accompany his sister to Bayinbulak failed. Shao Hua and Jing Shu signed up for a two-day tour group and went happily to Bayinbulak.

Bayinbulak is an alpine basin in the middle of the Tianshan Mountains, surrounded by snow-capped mountains, with an altitude of about 2,500 meters and an area of ​​23,835 square kilometers, second only to NMG Ordos Grassland. Bayinbulak means abundant spring in Mongolian - "abundant spring water". The grassland is flat and rich in water and grass. It is a typical grass meadow grassland and one of the most important animal husbandry bases in the frontier. There is not only a paradise surrounded by snow-capped mountains, the Kaidu River with "nine bends and eighteen bends", but also the elegant and charming Swan Lake.

During the Ming and early Qing dynasties, the Yuledusi River Basin was mainly the nomadic belt of the Huite tribe in Moxi Mongolia. In the thirty-ninth year of Qianlong in the Qing Dynasty (1774), the Torghut Mongolian tribe led by Ubashi who returned to the east was settled.

Surgery on Saturday. The patient’s grade is not old, and his vital signs are not bad. Hela bought breakfast for Zhang Fan in the morning. Thank you Zhang Fan for the breakfast. He also specifically told Zhang Fan not to eat breakfast. After the three of them ate the buns in a few mouthfuls, they were about to enter the operating room. The patient's family had some contacts in the local area, and Li Jianguo specially comforted the family members in the morning. Generally, such things are done by the doctor in charge, and the director does not show up.

In the operating room, adjust the body position, start anesthesia and disinfection. The steps of incision and exposure vary depending on the location and lesion of the kidney. Li Jianguo chooses a conventional surgical incision, cuts the perirenal fascia and uses various lumbar incisions to reach the perirenal fascia, and then removes the perirenal fascia. The back is divided, a small incision is made, and it is enlarged upward and downward. At this time, care must be taken to avoid damaging the peritoneum.

Hela is the first assistant, and Zhang Fan is the second assistant. This kind of operation is not too difficult for Li Jianguo, and Zhang Fan is fine, but it is a bit difficult for Hela. Where the chief knife.

Slowly separate the kidney. Use your fingers to separate the fascia around the kidney, starting from the convex surface and the back of the kidney, then to the upper, lower pole and front, and finally along the upper part of the ureter to the renal hilum, separating it from the renal pedicle.

Li Jianguo's level is good. Years of experience and cautious character make his operation look very clean. He does not rush the operation, step by step is very solid, no matter how big or small the bleeding is, he must be ligated to stop the bleeding, and he is very careful.

Zhang Fan learned a lot of experience from watching Li Jianguo's surgery. Li Jianguo is the most careful surgeon he has ever seen, and the surgery is also very meticulous.

Start to process the ureter. Separate the lumbar ureter, wrap it around with a gauze strip and lift it, and separate it as far as possible. Clamp the ureter with two hemostatic forceps at the lowest part of the separation section, cut it off between the two forceps, and disinfect the two ends with a small cotton ball dipped in pure carbolic acid, 75% alcohol, and normal saline. The distal ureter is then ligated and sutured.

The operation began to enter the second half. The previous work was to dissociate the kidney, and the rest was to deal with the renal blood vessels, carefully separate the fat tissue at the renal hilus, and expose the renal artery and vein. Renal pedicle forceps or large curved hemostats clamp the renal vessels. Cut off the blood vessel between the two forceps at the distal end, and take out the diseased kidney.

Something happened at this moment!

Because the family members were very anxious, and even asked the superiors to say hello, Lao Li had no choice but to drag the patient into the operating room in a hurry, and did not do many tests.

Originally during the operation, Lao Li was very careful, fearing that something might go wrong. As a result, I was very careful, and something happened.

The patient's kidney mutated into an extra renal blood vessel, and it was an artery. Although it was not thick, it was not thin either. Because it was a mutated blood vessel, and it was on the side of the renal fossa, Lao Li didn't pay attention, cut off the ligated renal pedicle with a scissors, and prepared to remove the affected kidney.

As a result, after stabbing it, the blood spurted out, and the opening of the blood vessel happened to be facing Hela,

The pressure on the kidney blood vessels was not small, and it sprayed Hela all over the face. Hela was in a daze at the time, the blood vessels were all ligated, where did the arterial blood come from, and after the spurt, Hela subconsciously closed her eyes and forgot to help Lao Li.

Lao Li was still holding the blood vessel with a hemostat in his hand, and he didn't have any extra hands to stop the bleeding. His cold sweat came out all of a sudden, and a voice came out in his heart: "It's over! It's a big day today!"

This kind of moment is the moment to embody the assistant the most, but Hela has already been face-to-face with blood! As soon as the blood cooled down, it became more viscous, and it took Hela a lot of trouble to open his eyes. Lao Li was in a hurry, but he couldn't do anything. He didn't dare to loosen the hemostat in his hand, and shouted: "Zhang Fan, Zhang Fan. Hurry up!" Look, where are the blood vessels."

The bleeding at this time cannot be sucked by the suction device at all, the bleeding pressure and volume of the small renal arteries are high, and within a few seconds, the bleeding has already flooded the renal fossa.

At the moment when Lao Li called out Zhang Fan's name, Zhang Fan didn't delay at all, he punched down and blocked the kidney fossa. "Hurry up and wipe Haila's face." Zhang Fan pressed his kidney socket and said to Xun Xun. His position is not good, he can only do this, and the rest depends on his help.

Then he said to the anesthetist: "Quickly lower the blood pressure." Zhang Fan suppressed the bleeding, and Lao Li's nerves were already tense at this time, and said to the anesthetist: "Yes! Yes! Yes! Quickly lower the blood pressure."

The moment Hela was blinded by blood, he was really desperate. Fortunately, today's second assistant is Zhang Fan. If other doctors were transferred, it would probably be troublesome. Zhang Fan's reaction was too fast, and he had already dealt with it without his command.

Fast, steady and accurate. Zhang Fan's fist directly blocked the bleeding. After wiping the blood, Hela was still in a daze, but finally said something out of her head, "Did you not hold the kidney pedicle properly?"

Old Li is crazy. At this moment, instead of rushing to find the blood vessel, he was still dazed, "Stop talking nonsense, are you blind? The hemostat is not clamped properly. This is a mutated blood vessel. Hurry up!"

Lao Li's tone was very serious. Hela, who was not frightened by the bleeding, let Lao Li say that he was scared. When he was stunned, he knew that he had said something wrong. This means that Lao Li's surgery was not done well! Don't do it carefully. Patients with incomplete examinations are afraid of this kind of thing. The doctor can't tell. If the examination is incomplete, they will go for surgery. The mistake must be the doctor's fault.

"Blood transfusion, correct the shock, and increase the fluid rate." Zhang Fan ignored the emotions of the two, and began to give oral medical instructions to the itinerant nurse. The blood was not only sprayed on Hela's face, but also on the walls of the operating room.

The itinerant nurse was in a hurry. As soon as Zhang Fan's oral doctor's order came out, she knew what to do. If you know what to do, you won't be in a hurry.

The blood pressure dropped and the bleeding was less. Hela quickly started to tie the knot. The atmosphere in the operating room was tense. Hela remorsefully wanted to slap herself.