The Godfather of Surgery

What are you rushing, use a sniper rifle to kill the snipers in the opposite woods!

Professor Zhang shouted anxiously.

Zhang Lin turned his head, creaking, not daring to move at all, holding the phone, stiff in a certain movement.

Old Zhang—Professor Zhang!

Sweat dripping from his forehead, and being caught by old man Zhang will end badly. If a button is not buttoned properly, he will be criticized. I don't know what will happen to this game.

Professor Zhang, look, it's fine this afternoon, relax.

Zhang Lin wanted to cry but had no tears, his pleading tone stammered, and he used almost all his courage to squeeze out these words.

professor Zhang--

We'll never dare again next time!

Xiao Wu and Fatty Liang interceded together, sitting cross-legged on the bed, a bit awkward, but didn't dare to move.

Hit, what do I do? Professor Zhang pointed to Zhang Lin's cell phone.

beat?

hit what?

Zhang Lin thinking has been disconnected.

It's time for get off work, come, let's go together. Professor Zhang took out his mobile phone and sat down on the chair beside the desk.

True or false? Everyone was stunned and found that IQ was obviously not enough.

Close the door and lock it! Professor Zhang shrewdly pointed to the door with his chin.

Zhang Lin slid off the bed stiffly, took a step and looked back, waiting for what Xiao Wu and Fatty would say.

Xiao Wu and Fatty were obviously also disconnected. They had no idea. What does Old Man Zhang mean?

Lock the door and turn the handle to confirm.

Come on, form a team and wait for the old lady to urge you to go home for dinner. Professor Zhang beckoned.

——

Director Han was busy for a while, and when he returned to the office, he saw that Yang Ping hadn't gotten off work: Let's take a rest after get off work, if you have one on duty.

Yang Ping said, Professor Zhang has just come over.

Where? Director Han asked.

Yang Ping walked to the door and looked at the corridor: I was still here just now, and I disappeared in a flash.

Director Han also looked out and said, It's okay, let him go for a walk by himself, his legs are completely normal, I saw him playing Tai Chi in the park again in the afternoon. He will come over to us in a few days to help We went out of the outpatient clinic, and in the operating room, I asked for another nurse, Zhou Can! There can only be one anesthesiologist for the time being.

Zhou Can is not bad, he does things smoothly, and he is smart and quirky. Director Han will pick people.

It's enough for the time being, let's talk more about the operation. Yang Ping knew that it was difficult to get people, and the operating room was also tight. This is Director Han's face is big enough to get people so smoothly.

There is a late-stage liver cancer in Huaqiao Building, which has metastasized to the whole body, from chest 1 to chest 4 of the spine. Now the pain in the chest is severe, and morphine does not work. It may be caused by the metastases invading the stretched nerve roots. Director Kong asked me to come to the consultation. , let's take a look together? Director Han was about to go to the consultation.

Okay, let's go together now? Yang Ping was very interested.

Oh, and the academic conference is under preparation. You have to be in charge of the operation here. Director Tan has not arranged a specific division of labor for you. It is enough to have their help. You can do the operation here with peace of mind. The two walked as they walked. chat.

When he arrived at the doctor's office of the Department of Internal Medicine in the Overseas Chinese Building, Director Kong was waiting, his face was red and he was proud of the spring breeze.

It's hard work, the liver cancer is in the advanced stage, the whole body has metastasized, and the spine has metastases. Now the pain in the chest is severe. Morphine can only stop the pain in the liver area, but the pain in the chest cannot be stopped. The pain department has installed an intravenous analgesic pump. It doesn't work, I'll accompany you to see it.

Systemic metastasis of advanced liver cancer, there is no way, only pain relief and supportive treatment to improve the final quality of life.

The patient's face was sallow, breathing in oxygen, lying in a semi-recumbent position on the bed, his facial muscles twitched one after another, and the beads of sweat on his forehead kept rolling down, which was heartbreaking.

The patient's family, his daughter, a tall, young woman, looking mature and capable, stayed by the bed with a sad and helpless expression.

Director Han gave the patient a physical examination and briefly asked about the pain.

Please everyone! The patient's daughter bowed.

Let's study it. Director Kong comforted the patient.

After seeing the patients, several people left the ward, washed their hands, and returned to the doctor's office.

Why don't you go to the ICU in this situation? Director Han wondered.

The patient refuses to stay in the ICU. Once his life is in danger, he refuses to be intubated or rescued. He has signed the informed consent and only asks for analgesia. Director Kong explained.

This patient may need both hospital-wide consultation and out-of-hospital consultation. The family members will invite experts from Attached 1 and Attached 2 to come for consultation together, and Professor Su Qingyun will also come, Director Kong added.

Professor Su Qingyun is the dean of the First Attached, the chairman of the Department of Orthopedics of Nandu Province, and a popular candidate for academician.

At this time, the patient's daughter came over and knocked on the office door.

Come in! Director Kong greeted her to sit down.

This is Miss Ning, Mr. Ning's daughter. Director Kong introduced.

Mr. Ning is the patient just now. According to Director Kong's introduction, this patient has a lot of background. He is a well-known rich man in city G. The group's business involves banking, finance, securities, insurance, etc.

Miss Ning's eyes were red and puffy. She said sadly, Father won't last long. I just want him to be less painful and walk with more dignity.

As Miss Ning spoke, she wiped her tears with a tissue several times: If he hadn't been waiting for my brother, he probably wouldn't be able to hold it any longer. It's embarrassing everyone, please!

Miss Ning put her hands together.

We will try our best to find a way. Director Kong comforted her.

Back at the Department of General Orthopedics, Director Han called up the patient's image data: Xiao Yang, look, is there any better way?

According to the location of the pain site, the pain area is concentrated in the sternal angle, which should be the invasion and stretch of the anterior branch of the thoracic 2 nerve root. You see, CT and MRI both show that the thoracic 2 nerve root is invaded and stretched by the tumor. There is no way to do a spinal canal in this part. If the plane is below the chest 4, you can put a cannula and anesthetize the plane below the plane, but this plane will not work. Once anesthesia, it will seriously affect breathing and need to be on a ventilator. Director Han pointed to the electronic device. Image on the Reader screen.

How about a highly selective nerve root block? Yang Ping suggested.

Director Han shook his head: It's very difficult! You see, the tumor is blocked and the puncture is limited; even if there is no tumor block, it is impossible to accurately penetrate the sheath of the nerve root. The effect is the same, affecting breathing.

Blood vessels can also be found through CT angiography 3D reconstruction, but nerves can't be found through angiography. It would be easier if the relationship between the spatial direction of nerves and tumors could be found, Yang Ping said.

It's not easy to handle. Even if you know the spatial relationship, how can you guarantee that you can penetrate the nerve sheath? Director Han said.

Ding Dong, mission: Hospice! Complete a difficult case of analgesia, reward 16,000 points.

The system that had been silent for a long time ding-dong again. Yang Ping thought it would not release individual tasks. It turned out that the difficulty of tasks has increased now, and those that are not difficult are included in daily tasks.

This patient can't be solved by our department alone. There will be a hospital-wide consultation and an out-of-hospital consultation soon. Let's talk about it after the general consultation. Let's take a rest after get off work. Director Han is also leaving get off work.

Yang Ping had nothing to do when he went back anyway. Before opening the department, Director Han applied for VIP permission for him. He went into the computer and called up the patient's information, read it several times from beginning to end, and thought hard.

The focus of this patient is that spinal anesthesia cannot be used to relieve pain. If nerve root block is performed, it must be foolproof and accurately puncture the thoracic 2 nerve root sheath. This is so difficult that it is almost impossible to achieve, but theoretically speaking That's all.

then what should we do?

Yang Ping thought about it for a long time, and after thinking about it, he still settled on the nerve root block, otherwise this problem would not be solved.

——

Why are you such a rookie? Old Man Zhang reprimanded Zhang Lin.

Zhang Lin scratched his head and laughed.

The old man Zhang's cell phone rang: I'm not playing anymore, the old woman urged me to eat.

He got up and walked, turned around: Can't play during work hours? You can after get off work!

After taking a few steps to open the door, he turned back: Remember! Not during work hours!