Path of Medicine With a System

People, in fact, can only fight in those few years. The years when you are not married and have no children are the best time to lay the foundation. With the foundation, you may be able to improve with time. Once the sway is over, it will be extremely difficult to struggle again.

That is to say, Zhang Fan has a system, eats and drinks enough, sleeps and wakes up, the battery is full again! In the hospital, especially in the surgical department, because of the excessive workload, the elderly doctors really gritted their teeth and persisted, and even married life became a luxury.

In the general surgery department in the early morning, a group of attending doctors looked listless. The high-hanging hospital is always like a carrot hanging in front of the donkey's eyes. If you don't work hard, it will belong to others.

After arranging tomorrow's operation and explaining some department work, Zhao Pingquan, director of general surgery, said to the doctor, "Now, let Zhang Yuan say a few words."

"Today's operation is the removal of gastroliths for patients with gastrolithiasis. Are you ready for the operation?" After a period of confusion, Zhang Fan is now used to this position.

"Zhang Yuan, get ready. Gastrointestinal decompression has been prepared since the day before yesterday. I have been fasting since yesterday, and all nutrition comes from parenteral." The attending doctor in charge of the bed reported.

"Director, will you perform this operation?" Zhang Fan still respected Lao Zhao.

"Okay, I'll give you a helping hand." Old Zhao likes to have surgery with Zhang Fan, and he can't talk casually except on the hand table. It really seems to be a kind of artistic enjoyment to have surgery with Zhang Fan.

"Okay, call the operating room to pick up the patient number."

Zhang Fan and Director Zhao went to the operating room together. The two chatted while walking, "Recently, the doctors in the department are all screaming, rushing to take the patient number."

"It's all the director's support. General surgery is not like other surgeries. The maturity cycle of doctors is too long."

The two chatted and entered the operating room from the special elevator. For the elevators in the hospital, when the building was being built, Lao Huang got stingy and bought four elevators. At that time, he felt that these four elevators were a bit wasteful.

As a result, the elevators in the surgical building are not enough at all, and someone must organize a queue in the morning. Otherwise, people would argue about taking the elevator every day.

Ouyang is more generous than Huang Huang in this regard. The emergency center has a total of eight elevators, one for emergency patients in the operating room, one for doctors and nurses, and the remaining six for patients and their families.

Entering the operating room, Uncle Jinya saw Zhang Fan, smiled at Zhang Fan ingratiatingly, and wanted to talk, but the attitude of the little nurse who followed him was not as good as Zhang Fan, and he didn't dare to run over to talk to Zhang Fan.

Gold teeth have long been placed where the family members.

Disinfect, brush hands, spread towels, and perform surgery. The stomach, the stomach of the human body, is too boring to describe it in technical terms.

Back then when Zhang Fan was giving lectures, he didn't like to learn the courses of abdominal organs and nerves, and the orthopedics were simple. The anatomy of the abdominal viscera is too much and complicated. The shapes are different, and if you don't work hard, you will get confused.

As for neuroanatomy, it is directly similar to listening to heavenly scriptures, too abstract, with electrical conduction for a while, humoral conduction for a while, and jump conduction from time to time. If you can't understand in get out of class, and don't review after class, the exam will be a mess.

That is to say, when the system came into existence later, Zhang Fan had to go through countless times to understand the anatomy of these two systems.

The esophagus and stomach can be described as cables in plain language. When deriving from the esophagus to the stomach, the cable becomes larger and thicker.

The outer skin is a wear-resistant protective layer, and the inner layer walks blood vessels and nerves.

The structure of the stomach can be divided into four layers, which are divided into mucosal layer, submucosa layer, muscular layer, and serosa layer from inside to outside. The muscle layer can be divided into three parts.

It’s very complicated, because the shape of the muscle layer is not the same. The innermost muscle is oblique, starting from the contact between the esophagus and the stomach and continuing to the duodenum.

This shape makes sense. The oblique shape of the muscles is conducive to the downward flow of food. If you make a circular muscle, maybe the food will be lodged in the stomach.

The middle layer is the circular muscle, which wraps the stomach in circles and increases the firmness of the stomach. The outermost layer is longitudinal, which is to reduce friction with other organs. Because the stomach is always active.

Circle by circle, it is really like a ball of wool.

The stomach can secrete many things, no less than a dozen kinds. In the early years, the medical profession only believed that the stomach only had the function of digestion and grinding, but later it was discovered that the stomach also has the function of secretion.

The main secretion is hcl and some special enzymes. Its pH is between 05 and 1. With this concentration of hydrochloric acid, throwing in an iron tablet may melt it for you.

Kewei, wouldn't it be corroded by hcl? Yes, it will be corroded, but it is because there is a weakly alkaline protective layer on the inner surface of the stomach, and there is a bicarbonate barrier with a thickness of about 0.5, which is the most important protective layer of the stomach.

Without this protective layer, even if the muscle of the stomach is ten meters long, it can still penetrate the stomach acid. Eating chili, drinking wine, eating chocolate, and then having stomach pain, it means that there is an ulcer in the stomach.

Anger, especially young women, because the body's secretory function is strong, the various hormones produced after anger will also lead to the reduction of this layer of mucous membrane, so this is also the reason for stomach pain after anger. It is not uncommon for people with a strong temper to perforate their stomachs.

Ulcers are caused when the protective layer of bicarbonate is penetrated by stomach acid. Being angry all the time, being corroded by stomach acid all the time, corroding and corroding, the stomach is open, that is, perforation. The treatment method for perforation is very simple. If the area is small, you can suture it, and if it is large, you can cut the stomach.

Moreover, once the ulcer area is too large and has a certain depth, well, even if it is not perforated, it will become cancerous after a long time, and it will not go away at all.

Therefore, three meals on time, less alcohol, less spicy food, and less anger are the best protection for the stomach.

After anesthesia, surgery begins. "This is a typical example of a small lesion and a serious disease. With such a large stone, the incision in the stomach will not be small, and the patient may experience long-term chronic pain in the future."

While preparing for the operation, Zhang Fan said something to the others. In fact, Zhang Fan said this because he wanted to see if other people had any other ideas.

The result is not! Others just said: "That's right, make a big incision!"

Zhang Fan smiled and said nothing. "Alcohol cotton ball!" Zhang Fan took the cotton ball and began to disinfect the skin for the last time, and then opened a very small hole in the center.

It is about the same size as a normal appendix incision. "Zhang Yuan, the opening is a bit small. How can we get out the stone from this opening?" The director in charge of the bed wondered. "What is this for!" He was confused and couldn't understand!

Old Zhao understood it. But he didn't speak, Zhang Fan turned his head to look at several doctors, and said, "There is no formula for surgery!"

"P! I haven't even finished learning the standard surgery. You are a resident doctor and you don't have a standard operation. What's wrong with you!" Several doctors who heard Zhang Fan's pretense collapsed.

It's not the doctor's fault either. Not to mention other things, there are no less than six surgical methods for gastric ulcer in textbooks, and there are some that are not in textbooks. Only by studying a lot of surgeries can one be sublimated, or have super talent.

There are more and more diseases, and doctors are divided into more and more disciplines. This is an unavoidable thing, but people are a whole, so it is very contradictory. This is also a problem for the future development of medicine.

The abdominal cavity was opened, the bleeding was stopped, the omentum was pulled apart, and the stomach was finally seen. Because of the stone, although he hadn't eaten for two days, the patient's stomach was full.

It's really like a pregnant woman waiting to give birth. "Sharp knife!" After Zhang Fan took the scalpel, he opened a small incision in the stomach, a very small incision.

At this time, talent has widened the distance. Some doctors understand it, but some doctors are still confused.

The doctor who understood it suddenly realized, "Damn! I didn't expect it, this is too simple, and the damage is much smaller."

The doctor, who couldn't understand, was still confused, "What is this for! What can you do with the incision that can only fit one finger!"

"Pliers, hold both sides of the incision." Muscle is different from skin and fat. The skin and fat make a small opening, and if you don't use a lot of effort, the incision will not be extended.

But the muscle is not good, as long as it splits, it will automatically grow bigger with the incision. Zhang Fan used pliers to hold the incision, just to prevent the incision from getting bigger.

Surgical forceps, in the hands of doctors, click! Click! Click! The closed incision. "Gauze! Alice forceps to hold one end of the gauze." Zhang Fan explained to the nurse.

The nurse had never encountered this kind of operation before, so Zhang Fan had to explain it clearly to the nurse. Otherwise, the nurse does not know the steps of the operation.

Surgery, too much about the hard work and talent of doctors. Confused doctors continue to be confused, and doctors who understand have begun to actively cooperate.

The long Alice forceps supported the gauze and entered the stomach along the small hole in the stomach.

"Gently push the stone towards the spray door." Zhang Fan said to the third assistant. The third assistant is a resident doctor. Although he doesn't work long hours, he is very talented. He has already understood the meaning of Zhang Fan's operation.

Cooperating with Zhang Fan's Alice forceps, Zhang Fan's Alice forceps to the left, he gently pushed the stone to the right, and Zhang Fan to the right, he pushed the stone to the left.

Knowing the operation, it is good to be an assistant. Zhang Fan did it very smoothly. Lao Zhao looked at the young resident doctor in surprise. "Ma Yichen, yes. Have you had this kind of surgery before?" Old Zhao said.

The second assistant is the attending doctor, and he is not confused yet. I didn't expect this kid to understand the operation already. One has been working for less than half a year, and the other has been working for ten years. This is the difference in talent.

"Director, I have never had this kind of operation before." Ma Yichen said to Director Zhao Quanping with a smile.

Ma Yichen, a graduate student of Sanchuanbei Medical College, because his father is doing business in the frontier, he is a graduate of Chuanbei General Gastroenterology. If you want to stay in Xihua, graduate students are not enough.

After graduation, he simply came to Frontier Chasu. Originally, I was going to study for a few years, and then I would go on to further study in Kaobo. I didn't expect that the small hospital in this small place is so powerful.

Zhang Fan also looked up at the young man. Although wearing a mask, it can be seen that the young man should be very handsome, and his body is also very good.

Zhang Fan used the Alice forceps to hold the gauze and slowly changed the direction. The previous surgery went very fast, but now it slows down. This is a job that relies on patience. Don't be in a hurry. If you are in a hurry, you have to start all over again.

Ma Yichen cooperated very well, and Lao Zhao was tempted. Zhang Fan is the best example in the hospital. Zhang Fan's success, even with Lao Gao, has suppressed several orthopedic directors.

"Which direction do you want to go in the future?" Before Lao Zhao could speak, Zhang Fan spoke first.

"Continue to work on gastrointestinal tract, I like gastrointestinal tract very much." Ma Yichen said with a smile.

"You..." Old Zhao just opened his mouth, and Zhang Fan immediately said, "Don't limit yourself to gastrointestinal. Although you are a master's degree in gastrointestinal, it's better to broaden your horizons. I have several liver tumors in the Affiliated Hospital of Bird City this weekend. Surgery, come and take a look with me."

"Okay, Zhang Yuan." Ma Yichen probably laughed.

This is not an interrogative sentence, but an affirmative sentence. Zhang Fan is also tempted. He has good talent and is young. This is Miao Zi. For the surgery, if Zhang Fan was with Xue Fei, he would drive Zhang Fan to death.

It's not that Xue Fei's skills are not good, but that his talent is not good enough. There are so many things that he doesn't think through, and this young man can figure out Zhang Fan's intentions in such a short period of time. This is talent.

"Zhang Yuan, it's not suitable!" Lao Zhao was not happy. "P, I won't say anything if you are overbearing in surgery. Now I'm starting to get my apprentice's attention." Before, Lao Zhao hadn't realized that Ma Yichen's talent was so good.

"It's good for him to be more knowledgeable. After all, there are still few patients in our place. The director pulls the hook, and quickly uses the suction device to suck the blood. The blood comes out." Crooked, what could be done?

Bit by bit, Zhang Fan finally wrapped the stone with gauze. "Oh. I understand!" The doctor in charge of the bed only now understood Zhang Fan's intentions.

He is Lao Zhao's apprentice, "You only understand!" Lao Zhao was so angry that his liver hurt.

"Hehe!" The doctor in charge of the bed smiled a little embarrassedly. I have already scolded my mother in my heart, "I don't make it clear, who wants to know what you are going to do!"

"Electric drill! Wide retractor!" The four sides of the gauze have already pulled out the incision. At this moment, Zhang Fan used the gauze to lift up the stone in Uncle Jinya's stomach and hang it in the air.

The electric drill is to break down the stones in the stomach, and the wide retractor is to protect the incision from being damaged by the electric drill.

Picking up the electric drill, Zhang Fan began to drill along the small incision towards the stone in his stomach. Protein mixed with calcium and hair, very strong.

After the drill bit went down, it splashed like gypsum powder. Because of the hair, the high temperature of the drill bit directly produced a smell of burning hair. Drill up, drill down, drill left, drill right. Several assistants pulled the gauze vigorously.

It is necessary to use a lot of force to remove the gauze. Once the hand is slippery, the drill may enter the body. Finally, with a click, the stone cracked.

"Awesome! It's amazing. The method is good. The damage is small and simple, which is equivalent to a minimally invasive operation." The attending doctor said enviously. He also had a pang in his heart, "Why didn't I think of it. If you do this, the operation will be too simple."

Then drill, take a bigger stone and continue to drill a smaller one. At this time, it is not easy to drill, "Bring it up a little more!" Zhang Fan said.

Several other doctors were holding the gauze vigorously.