I run a clinic in the United States

Chapter 346: Handsome Model Worker

Zhou Qiao's arrival is a spring breeze for the doctors at the County People's Hospital.

Many people have enjoyed technological improvements.

Some improvements are simply obvious, can everyone be unhappy?

Not only in terms of technology, it is also a benefit for some of the doctors’ relatives and friends.

The first to see the moon is in the tower near the water, and the duck is the first to know the warmth of the spring river. After seeing Zhou Qiao's strength, especially after the news that the chief physician of the Department of Respiratory Medicine brought his niece to see Zhou Qiao last time and successfully performed the surgery spread, some relatives and friends at home were seriously ill. Doctors and nurses in tertiary hospitals in big cities all felt that they were in trouble. At this time, they all thought of this problem and strongly recommended that sick relatives, friends and family members come to see Dr. Zhou as soon as possible.

Of course, minor illnesses would not bother Zhou Qiao, only serious illnesses would come.

"Little sister, come quickly, don't waste time in other places." A gynecological doctor said on the phone to his 26-year-old cousin who had just graduated from college for more than two years.

Unfortunately, her little cousin was diagnosed seven months ago with a huge pituitary gland tumor growing in her head when she was still young and beautiful. The County People's Hospital will definitely not be able to solve it.

Therefore, the attending physician recommended that his sister go to a tertiary hospital in a big city to see a doctor. Who knew that the tumor was too big and the location was special? It would require multiple surgeries or a craniotomy!

All in all, it is quite troublesome, and the trouble does not matter. The key is that there are many surgeries and the risks are huge.

This little girl and her family are very troubled and have always wanted to find a powerful expert who can help her get it done easily and in one go.

This little girl only wants to have a one-time, minimally invasive treatment to reduce the psychological burden.

Because she is still young and not yet married, and she always goes to see a doctor "secretly", as she doesn't want to make a fuss known to everyone, otherwise it will affect her future search for a partner.

But, where can I find it?

No, during the Chinese New Year, I was still looking for famous doctors in other places.

There are experts who can handle it. They say they are certain and have given a surgical plan. Unfortunately, it does not meet this girl's requirements.

Or to put it another way, the surgical plan is not “ideal” enough, which makes people confused and hesitant.

The attending physician in the Department of Gynecology consulted Zhou Qiao in advance and learned that Zhou Qiao had performed many pituitary tumor surgeries before, published many high-impact academic papers in this field, and was quite accomplished in this field, so , so he called his little sister.

Because, based on this gynecologist's knowledge, Zhou Qiao's skills are definitely among the best in the country. There are few experts in major hospitals who can compare with him.

Zhou Qiao is indeed very young, but his level is here. The iron-clad facts make people believe it.

In fact, Zhou Qiao's skills are top-notch even in the United States, and few experts from major American hospitals can compete with him.

"I've seen Dr. Zhou from my hometown in my circle of friends, but isn't he proficient in heart surgery? In my brain..." The younger sister was suspicious.

"You silly girl, can I still harm you? Let me tell you, the news about you is lagging behind. Dr. Zhou is in our hospital every day, and I still don't understand? The latest news is that Dr. Zhou is an all-rounder, far beyond Everyone imagines that even our dean praises him every day as a treasure. It is the hospital’s honor to have him come back for cooperation and exchange. This is by no means a polite word. Believe me, this is a rare opportunity. Come back quickly and I will take you to Dr. Zhou!”

The attending gynecologist was so anxious that he called the girl's parents to persuade them.

The cousin naturally believed in her sister, so after discussing with her parents, she rushed back overnight.

Then, the attending gynecologist took her to see Zhou Qiao.

Zhou Qiao learned about the condition and watched the films taken before. Indeed, it was quite serious.

The other party's pituitary gland tumor was quite large and very rare, occupying about 1/20 of the adult brain. It was like an iron structure, standing in the sella area of ​​the girl's brain, which is the center of the brain.

Its maximum diameter reaches 6cm, and its shape resembles a fairy gourd. It invades the slope and sphenoid sinus downwards, and pushes up the hypothalamus behind the optic chiasm upwards, protrudes into the third ventricle, and reaches the Monteggia foramen.

Although pituitary adenomas themselves are generally benign and relatively mild tumors, as mentioned above, even benign tumors are by no means a good thing.

Especially, it grows in the core area of ​​the brain.

Wouldn't that cost lives?

Although it is not life-threatening for the time being, if it is delayed for a long time, it will subsequently cause hydrocephalus, mental decline, and difficulty in walking or even standing.

Vision will decrease significantly, and visual field loss may lead to blindness.

Prolonged menstrual cycle or amenorrhea, loss of fertility.

Eye movement disorder, facial sensory loss...

There is no doubt that the quality of life will drop to an unacceptable level, and eventually, it will endanger life and pass away early.

This little girl consulted many well-known hospitals, but the location and size of the tumor made the doctors frown.

Regarding her condition, experts agree on one aspect, that is, the patient's serum prolactin and growth hormone are not high, and such tumors require surgical removal.

There is no doubt about this.

But how to perform the surgery?

Different experts have different opinions on surgical plans. Because every doctor’s level, experience, and thinking are different.

For common diseases, the solutions may be similar, but for "difficult problems", everyone has his own solution.

This is also the complexity of medicine.

Some experts believe that craniotomy via the interhemispheric frontal lobe approach is needed from above. This can remove most of the threatening tumors, but may leave the part in the lower pole sella.

Moreover, this surgical approach is very invasive and the patient needs to shave his hair.

In addition, the length of the large coronal incision of the craniotomy is, in layman's terms, equivalent to the large arc route from Shanghai to New York via Alaska on a small round globe.

Although it can be covered up later when the hair grows back, you can still spot it if you look closely.

This affects appearance very much. Not to mention finding a partner or falling in love, even work may be affected.

As soon as some HR people see that you have had a knife on your mind, they may immediately give up the job.

Even if you join the company, some promotion opportunities may be missed because of this matter.

Therefore, this little girl does not want to choose this technique.

Some experts said that the only way to remove the intracranial part through craniotomy is to perform a second elective transnasal resection of the downward-growing part of the sella.

Some experts also believe that surgery can be performed from below via the nasal cavity and sphenoid sinus approach, but there is a high probability that there will be residue on the tumor, and a second transfrontal surgery will be required after a period of time.

Some even require a third surgery.

The more operations are performed, the greater the time period and risks required. Not to mention, the medical expenses alone are unaffordable for many families. How much does it cost to operate a knife in the brain, even if it is minimally invasive?

None of these surgical plans were satisfactory. As time passed day by day, this little girl felt like her "head was going to explode"!

If she didn't do the surgery, it would really get worse and worse. Just when she was struggling in every possible way, her dear cousin called!

"Dr. Zhou, how is my sister's condition? Can you help her with a one-time minimally invasive treatment?" the attending gynecologist asked.

The little cousin was also looking at Zhou Qiao expectantly, saying to her heart that this doctor is so handsome. From a close distance, he is even more handsome than the photos posted in WeChat Moments! I just don’t know if his level is really as high as my cousin said?

Zhou Qiao smiled and nodded: "It's not a big problem. Let's admit him to the hospital and wait for the operation."

"Ah?" The little cousin was shocked. Is it that simple?

Did you agree so easily? Could it be that you didn't realize the difficulty, or that you didn't understand my appeal clearly?

She couldn't help but ask: "Handsome guy..."

As soon as the words came out, the cousin next to her glared at her. When did she stop being more serious? Dear Dr. Zhou? Well, Dr. Zhou is indeed handsome. If I were ten years younger, I would also be tempted.

But if you call me handsome, you should call me handsome. Why do you sound so coquettish?

The little girl quickly changed her mind and said, "Dr. Zhou, will there be any residue after the operation? Will a second or third operation be needed?"

Zhou Qiao smiled slightly and said: "Don't worry, although the difficulty is very high, I will try my best and I should be able to do it for you in one go without leaving any future troubles."

The attending gynecologist said: "Dr. Zhou said this, and we feel relieved. Thank you, thank you."

I quickly took my little sister to go through the admission procedures. If he didn't leave, looking at the look in the little girl's eyes, he wanted to pounce on Dr. Zhou and eat him.

The younger sister was reluctant to leave, looked back, and couldn't help but mutter in her heart: "Why did Dr. Zhou use the word "engage"? Is there any hint?"

The attending gynecologist patted the distracted little cousin angrily and said, "Can you be more reserved?"

The little cousin suddenly felt aggrieved and said pitifully: "Where am I not reserved enough?"

"The look in your eyes!" The attending gynecologist glared and shook his head.

"Ah?" The little cousin immediately covered her face, feeling hot, and then said with some uncertainty, "Sister, is it really that obvious?"

"What do you think?"

"Okay." The little cousin felt ashamed, and then said happily, "If the operation is successful, I will stay here for a few more days."

"Stay a few more days, do you think it's a hotel? You can stay as long as you want? Let me tell you, with your disease, based on Dr. Zhou's usual style, or the quality of the surgery, you will be discharged in one or two weeks. "

"What? So fast?" The little cousin was surprised!

"Isn't that right? Anyway, Dr. Zhou came to our hospital and performed so many difficult surgeries. Some of his patients were no worse than you, and they were discharged in about a week."

"What a pity." The girl couldn't help but lick her lips as she thought of Zhou Qiao's handsome face.

Her cousin: "..." She was speechless.

I couldn't help but think of a joke in the hospital. It was said that a young man fell in love with a nurse and pretended to be sick every day, or injured himself and came to the nurse for injections or bandages.

Yes, I did become familiar with it over and over again.

Then, the young man found an opportunity to confess his feelings.

The result was rejected! The reason is that my body is too weak and I have to come to the hospital every day. Who can bear it in the future?

However, it is human nature for young people to want to find a partner and fall in love.

It's all due to hormones.

This attending gynecologist is a veteran. When he was young, he worked tirelessly in this area. It can be said that apart from work and study, all he thinks about is falling in love all day long.

"Is it because of this disease that my little sister's hormones surged? So she seems to be a bit of a nymphomaniac? Isn't it possible?" The attending physician shook his head.

The surgery arranged by Zhou Qiao for this girl was: transnasal sphenoidal surgery, opening the tuberculum sellae, jointly operating above and below the optic nerve to promote the collapse of the high-level tumor, completely resecting the tumor, and then performing a mucosal flap on the sellar floor to repair the cerebrospinal fluid. Rhinorrhea.

The surgery is performed via the transnasal sphenoid sinus approach, which results in less surface trauma. With Zhou Qiao’s perfect level, the surgery can be performed successfully in one go, avoiding the pain of multiple surgeries.

However, other experts cannot perform the same surgery due to the large size of the tumor and its special location.

This is the difference between mastery and perfection.

Moreover, transnasal sphenoidal resection of suprasellar tumors is a difficult operation in itself.

The larger the tumor, the longer the suprasellar surgical operation, the more surrounding structures involved, and the greater the risks that need to be faced.

During the operation, it is necessary to dissect and separate the anterior communicating complex, optic nerve, lamina terminalis, hypothalamus, third ventricle and other structures. In particular, the optic nerve chiasm lies in front and below the only way to remove the tumor. Repeated and alternating operations are performed in front of and behind the optic chiasm. , the operation precision and technique are very demanding.

Zhou Qiao took action and finished it in almost two hours. This was because the speed was slightly slowed down so that the spectators could see more clearly.

Through this case, many departments, especially neurosurgery, benefited a lot from listening to Zhou Qiao's lectures, assisting in surgeries, and observing.

Postoperative management also poses a great challenge to the hospital.

Because the tumor resists the hypothalamus and the third ventricle, there will inevitably be mild or severe hypothalamic reactions after surgery, which requires the medical team to have considerable intensive care capabilities to help patients survive the period of acute postoperative reactions.

Obviously, the County People's Hospital does not have such strength.

Fortunately, Zhou Qiao is here.

Zhou Qiao guided everyone in every detail, and he can be called a "handsome model worker", helping everyone get through this difficulty together.

The nursing team has also benefited greatly.

After the operation, the patient's hypothalamic response was stable and controllable, and the sellar floor was tightly repaired. Zhou Qiao expected that he would be discharged from the hospital in about eight days.

Critical care team: “…”

If they are left to do this on their own, they should not think about being discharged from the hospital until twenty days or even a month.

However, without a handsome doctor like Zhou Qiao coming to check the ward from time to time, the girl would be bored and find it too long. Rather than like now, I feel that the hospitalization time is too short and a pity.

The pathology report showed that the girl's removed ACTH adenoma was a silent ACTH adenoma with sparse granules. This type of adenoma is more common in young women.

Some tumors may prefer middle-aged and elderly people, but some tumors, like LSP, specifically target young girls.

(End of this chapter)