The road to the rise of great doctors

Chapter 28

Taking the prepared 50ml syringe, normal saline and a small bottle of contrast agent, Liu Dong and the two accompanied the patient to the imaging department for cystography examination.

When arriving at the imaging department, the patient lay down on the examination bed in the imaging department.According to Zhu Guoliang's instructions, Liu Dong mixed the contrast agent and saline in proportion, and then used a syringe to draw a large tube of the prepared liquid.

Considering that they might undergo radiography later, Liu Dong and Zhu Guoliang both put on lead suits and scarves to protect their thyroid glands and eggs, which are vulnerable to damage.

If a person receives less radiation, basically the impact is minimal.But doctors are different. Compared with patients, there are too many opportunities to operate under radiation.According to national regulations, it is the standard for radiation workers to have regular and annual physical examinations.And wearing heavy lead clothing can protect doctors and reduce the risk of cancer.

They made a ready gesture to the imaging doctor, and after seeing the response, Liu Dong and Zhu Guoliang worked together to inject the mixed liquid into the bladder through the urinary catheter. When the patient felt some need to pee, he stopped. .The urinary catheter is then clamped.

Instruct the patient to maintain posture and not to move.

The two opened the door and went to the imaging room of the imaging department to check the results of transurethral cystography.

Sure enough, under X-ray, you can see the space around the bladder, and you can see the contrast agent leaking out.The diagnosis of bladder rupture was confirmed.

Zhu Guoliang and Liu Dong looked at each other, and their different expressions betrayed their different moods.

In clinical work, bladder rupture is relatively rare.It is generally more common to be injured when the bladder is full, or when the bladder itself has disease, it is also easy to be injured.

When the bladder is empty, it shrinks in size and is hidden in the pelvis. It is protected by the pelvis and is generally less susceptible to injury.When the bladder is full, the bladder will be higher than the pubic symphysis and may be injured if exposed.

The diagnoses of both patients are clear, both have indications for emergency surgery, and contraindications have been ruled out, so at least two surgeries will be performed tonight.

Zhu Guoliang silently clasped his hands together, praying that there would be no new emergencies.Liu Dong was a little excited.

Human sorrows and joys are not interlinked.

Taking the opened hospitalization slip, the patient's family members went to go through the hospitalization procedures.The two of them sent the patient to the ward first.

Because after the bladder ruptures, the urine leaks into the abdominal cavity, which may cause abdominal infection of the patient.Therefore, it is necessary to follow the treatment principles and carry out preventive anti-infective treatment before surgery. For the most commonly used cephalosporins, a skin test must be done first. If the skin test is negative, you can take antibiotics with you when you go to the operating room and start within 30 minutes before incision. Medication.

Fully inform the patient and family members of the diagnosis and recommended treatment plan, the proposed surgical method, as well as possible comorbidity risks, treatment plans, etc., complete informed consent and obtain a written signature.Check again, the preoperative preparations are in place.Then Zhu Guoliang called the operating room, and someone from the operating room would come to pick up the patient shortly.

Liu Dongze spoke to Zhu Guoliang and went to the operating room first.When the patient arrives in the operating room and is prepared for anesthesia, Liu Dong will call Zhu Guoliang and Fan Hai, and it will not be too late for them to go down.

In Zhu Guoliang's view, Liu Dong has initially won the trust of his superior doctor in the preliminary work, and he indeed has the ability to complete the preliminary preparations independently.

When he arrived at the operating room, because the patient had not yet come down, Liu Dong took a walk around the operating room and found that there were quite a lot of surgeries in the operating room, including emergencies and unfinished daytime surgeries.Orthopedics has the most emergencies, followed by general surgery and pediatric surgery.

Uncompleted surgeries during the day are mainly concentrated in neurosurgery and cardiac surgery.

I greeted the nurse in the operating room and the anesthesiologist, and said that he was next door, and that the patient could tell him later.The nurse took one look at him and agreed.

While waiting, Liu Dong watched the appendicitis surgery at the general surgery department.Acute appendicitis is a common disease in general surgery. In severe cases, it can cause suppuration, necrosis, and even develop into septic shock, affecting life safety.Surgery is the standard treatment for acute appendicitis.When sewing, the purse-string suture method is more elegant.After reading it, Liu Dong felt that he had gained a lot.

Near the end of the appendicitis surgery, the patient with renal trauma was taken to the operating room.Liu Dong then returned to the operating room, comforted the patient with a few words, and reassured the patient.At the same time, tell Zhu Guoliang and Fan Hai that they can come down.

After the anesthesia was completed, Fan Hai and Zhu Guoliang arrived at the operating room. When they came in, they saw Liu Dong disinfecting and spreading drapes.By the time they finished brushing their hands and put on surgical gowns, Liu Dong had already put on surgical gowns and fixed all the instruments and arranged them neatly.

"Hey, the young man works very neatly. He performed well." Fan Hai glanced at Zhu Guoliang and praised Liu Dong.Then he continued: "The position is also good. This patient is still suitable for the transabdominal approach. The space is large. We can go straight to remove the kidney, but at the same time we can also briefly explore other abdominal organs. There must be no hidden dangers."

Liu Dong smiled slightly. Wearing a mask, he could only see his eyes bending. There were no unnecessary movements. Because the concept of sterility is particularly important in surgery, it is generally taboo to have too many unnecessary movements on stage.

The three-person operation went quickly.The kidney was quickly freed along the peripheral fat sac, and at the same time, the kidney's arteries and veins were freed and ligated at the renal hilum.The ureter is freed as far as possible and disconnected after distal ligation.

In less than half an hour, the key steps of the operation were completed.Continuing exploration revealed no other injuries.After adequate hemostasis and flushing, you are ready to end.

When the circulating nurse heard that the items were to be counted, she smiled and said, "You three are all fast shooters today. You are so fast. You have to be fast to close the abdomen and suture the skin for a while."

Fan Hai said: "Man, you must do it when it's time to do it, but you can't be soft."

Zhu Guoliang interjected and said, "You can take the emergency patient below. Is the room opposite available? If so, anesthetize him there. Our people will go there after the anesthesia is done."

The circulating nurse goes to call the patient who has a ruptured bladder.Fan Hai also stepped down first, so he didn't need to do the rest of the work himself.

Liu Dong seized the opportunity and asked Zhu Guoliang: "Teacher Zhu, I'm about to finish my transfer. I've done the abdominal sealing many times. I should be able to finish it. Can you take a break first? Can you see how I can do it?" "

As people reach middle age, their endurance declines somewhat.Zhu Guoliang felt a little tired. Thinking of Liu Dong's performance in the past, he asked him to operate first.Big deal, replace him in time.

I saw that after Liu Dong got permission, even though Zhu Guoliang's assistant performed the work very sloppily, he still operated the equipment neatly and neatly by himself.After closing the abdominal cavity, it did a beautiful job indeed.The subsequent subcutaneous suturing of the skin is a piece of cake.

Seeing this, Zhu Guoliang stepped down first, leaving Liu Dong to cut the thread and apply the dressing.The operation ends.

Then after the patient wakes up, confirm that someone from the operating room will be sent to the ward.Liu Dong quickly brushed his hands again, ran to another operating room, and put on the surgical gown again.There, a bladder operation was just beginning.
(End of this chapter)