Those years when I hung up and upgraded in the hospital

Chapter 192 Shock and Astonishment

Fang Yun was already familiar with the process of total hip replacement, but as the number of times he worked with Director Chen Shengwu increased, Fang Yun's understanding of total hip replacement became deeper and deeper.

However, after returning, Fang Yun discovered that the first variable about Liu Haihua in the group was that Liu Haihua's problems seemed to be less frequent than before he left. Although there were many, they were all key issues and not trivial.

On the contrary, during the operation, Chen Shengwu had more problems with Liu Haihua.

"Xiao Liu, you said that in this total hip replacement surgery, after the distal plug is inserted, why does it need to be thoroughly flushed? What is the principle?"

"Why do you still need to stuff gauze strips into the bone marrow cavity?" Chen Shengwu asked casually as if it was easy.

Total hip replacement is a level IV surgery, which is the highest level of surgery except for new surgeries.

This kind of surgery is full of details, every step of the operation is the essence, and meticulous pursuit is knowledge.

Liu Haihua straightened his body slightly and replied: "There should be two principles for thorough flushing. The first one is to thoroughly flush the medullary cavity, so as to reduce the amount of bleeding in the medullary cavity and reduce the subsequent formation of blood scab, so as to avoid the formation of blood scab. Loosening of the femoral stem prosthesis and medullary cavity of the joint."

"The second reason is that thorough flushing of the medullary cavity will reduce the fat inside, which will avoid the possibility of fat embolism to a certain extent."

After Liu Haihua replied like this, Chen Shengwu glanced at Liu Haihua: "Do you have anything to add?"

Liu Haihua's eyes were shocked, and after hesitating for a few seconds, he shook his head.

Chen Shengwu smiled casually and did not continue to question Liu Haihua. Instead, he looked at Fang Yun: "Come on, Xiao Fang, tell me."

Fang Yun was inserting gauze strips into the bone marrow cavity at the moment, pushing it in and pulling it out at the same time, scratching the inner wall of the bone marrow cavity.

Fang Yun’s understanding of joint surgery is not as in-depth as Liu Haihua’s, so he replied cautiously: “I think the purpose of reducing the risk of fat embolism is mostly seen in bone cement stems, because bone cement will, to a certain extent, affect the closed structure in the medullary cavity. , increase local air pressure."

"It will cause the fat tissue to be squeezed into the vascular cavity of the medullary substance. However, in terms of biological stems, the femoral stem end relies on the matching of the structure of the stem and the medullary cavity, and will not cause blind ends, extrusion and comparison. Big air pressure.”

"I prefer the first point mentioned by Haihua, but not the second point."

Speaking of this knowledge point, when Fang Yun came back, he happened to see an analysis of this detail in an article review.

Hearing this, Liu Haihua suddenly realized, feeling a little disappointed between his brows.

However, Chen Shengwu encouraged him and said, "Haihua, you have done too much bone cement surgery with Professor Meng, and you may have formed a fixed mindset about it."

"Memory is a good thing, but memory must be flexible. Why do we pay attention to understanding memory? It's because in the process of clinical application..."

Liu Haihua nodded honestly.

Then, Chen Shengwu personally installed the biological stem and artificial femoral head. After manual traction and reduction, he moved the patient's hip joint in all directions on the operating table. No dislocation was found, nor was there any finding of both lower limbs. Don't wait long for objective problems.

Chen Shengwu decisively came to the stage and explained: "The gluteus medius muscle and the surrounding soft tissue must be sutured. These things are the soft tissue structure that protects the dislocation of the hip joint to a certain extent."

"Fang Yun, if this is the case, I will only hold you accountable."

After Chen Shengwu finished speaking, he glanced at Lai Yuan again: "Doctor Lai won't be angry, right?"

Lai Yuan quickly shook his head like a rattle: "No, no, Director Chen, Xiao Fang's basic skills are more solid than mine. Among us, Fang Yun is our main force, and we follow his orders."

Surgery is a discipline that does not focus on appearance, but only on ability.

In surgery, no matter how good-looking you are, no matter how well you memorize the theory, you still have to put it into practice in the end.

Naturally, if the operation is very good and the theory is rich, and the theory can be attributed to the operation, then such a doctor must be very strong.

What's more, Fang Yun's appearance sells better than Lai Yuan... After Chen Shengwu left, Fang Yun said a few humble words to Lai Yuan, and they had a business exchange, which made the point, at least it would not arouse Lai Yuan. Yuan's hatred is enough and harmless.

However, just after this operation came to an end and the next patient was admitted to the operating room, Fang Yun habitually browsed through all the patient's examination information before the operation.

His face changed suddenly.

If he saw it correctly, in addition to hip osteoarthritis, this patient also had something stuck in the femoral sheath.

But whether it is schwannoma or something else, Fang Yun has not yet been able to determine.

This was not because Fang Yun wanted to show off deliberately, but because Fang Yun had not looked at the patient in detail at all. Ning Zaiming was responsible for this case.

Fang Yun went to Han City to wander during the Dragon Boat Festival holiday.

Even after coming back, Fang Yun's first reaction was to handle and carefully check the patients in his own charge and in charge of it. How could he possibly think that there would be problems with the patients in charge of others?
Immediately, Fang Yun said to Lai Yuan without hesitation: "Brother Yuan, please ask the anesthesia teacher not to give anesthesia first. There is something in the patient's femoral sheath!"

"Either the surgery needs to be changed, or the surgery may need to be canceled and done again tomorrow."

"What?" Upon hearing Fang Yun's words, Lai Yuan's face turned pale.

It is a big no-no to temporarily discover a new problem before surgery.

However, Fang Yun is definitely not an alarmist and is very low-key.

Naturally, Fang Yun was not someone who deliberately hid his clumsiness.

Fang Yun blinked at Lai Yuan.

Lai Yuan hurriedly negotiated with the anesthesiologist and circulating nurse in a low voice. Fang Yun, on the other hand, directly called Chen Shengwu. After only ten seconds of brief conversation, Chen Shengwu hung up the phone decisively and unilaterally.

In less than 3 minutes, Director Chen Shengwu rushed to the operating room from the rest room somewhere.

At this time, Fang Yun and Lai Yuan were already analyzing the patient's MRI results on the white-light reader. Fang Yun was pointing to the top area of ​​the hip MRI, where many people were doing hip joint readings. A place that is often overlooked when watching movies.

The location of the femoral sheath is in the inguinal ligament.

The hip joint is beneath the inguinal ligament.

The reason why the MRI of the hip joint was done was because Director Chen Shengwu suspected that the patient's morning stiffness was rheumatoid arthritis, and it was to see if there was a large amount of synovial hyperplasia in the hip joint.

But whether it was the result of the imaging department or the result he saw after reading the film, the diagnosis was ruled out and he only thought it was a simple hip osteoarthritis.

However, Fang Yun captured such a point very keenly.

The lump in the femoral sheath is not large in size, but its shape is particularly weird, as if it is surrounding the femoral vein and femoral nerve——

When Chen Shengwu looked at Fang Yun, Fang Yun only explained in a low voice: "Director Chen, I didn't look too carefully when I checked the ward in the morning, so I found it late. I'm sorry."

"Cancel the operation!" Chen Shengwu naturally couldn't be angry, but looked at Fang Yun, full of shock and astonishment. He also realized that Fang Yun's MRI reading skills, with the blessing of sports medicine, had reached What he understands is the realm of entering a house.

What does it mean to enter a house? It means looking at the whole country and the whole province, and you can take it out for a walk without being embarrassed.

Schwannoma, probably looks like this.

(End of this chapter)