Chapter 386 The details can be guessed, but there is no way to imitate it
During the puncture, color ultrasound showed bleeding in the retroperitoneum and abdominal cavity, and there was also fluid accumulation around the liver and spleen, so hemorrhage was considered.
Luo Hao knew very well that he couldn't wait.
As for Feng Zixuan’s problem, it is not really a problem, but Luo Hao believes that liquid metal robots are relatively expensive now and cannot be implemented on a large scale for the time being.
Luo Hao was thinking about it and suddenly remembered that in the past, neurosurgery had to go through the computer program to find the best approach before performing an operation.
Of course, this neurosurgery refers to the world's top neurosurgery research center abroad.
Only they have the time to go there again.
There are two or three surgeries a week, and each operation costs hundreds of thousands of dollars. There must be time to go over the details.
As for other people, everyone must be responsible for themselves, and there is no need to pay for medical treatment.
And domestic? Every surgeon can't schedule enough surgeries, and the funny metric of bed turnover rate must be included in the assessment indicators.
The treatment method should be the same as that of neurological centers in the United States and Canada, and on average at least half of the surgeries are performed every year.
I can’t do all the hard work now. If I do less than half of it, that’s a joke.
Looking at whether the patient's minor illness will be cured directly or directly to the crematorium?
It is not in line with Chinese people’s ideas.
"Lao Meng, there is a patient in the Department of Nephrology who suffered from massive bleeding due to renal puncture. Please go and make preoperative instructions for interventional hemostasis." Luo Hao returned to the interventional catheterization laboratory and began to make arrangements.
Meng Liangren nodded, with a trace of solemnity on his square face.
"The patient's family members are emotionally unstable and there is a risk of medical disputes."
Meng Liangren nodded again, with a trace of solemnity on his square face.
"Xiaozhuang, send the next patient here, hurry up!" Luo Hao said, "I'm done with the operation, and the patient on the other side can be sent in."
"Okay. "Zhuang Yan ran out immediately.
The entire medical team began to rotate rapidly, in perfect harmony, without even the rustling of Erhei's robotic arm.
Twenty-one minutes later, Luo Hao's operation ended, and another three minutes later, the patient with hemorrhagic shock caused by renal puncture was brought over.
Meng Liangren walked to Luo Hao seriously.
"Professor Luo, the patient's family may want to complain."
"Yes."
"It has nothing to do with us, but I paid special attention to the pre-operative instructions." Meng Liangren's voice was a little low, and it was obvious that the communication this time was extremely difficult.
Luo Hao also knows the feelings of the family members of such patients. A simple renal puncture can save a person from hemorrhagic shock, which he would not be able to accept.
There is a high probability that the patient's family members will be unhappy. It is a small probability event that the nephrology department responds improperly, causing the unhappiness to turn into a complaint.
But what to do next?
One of the characteristics of modern medicine is that it is not stable and has an extremely low accident rate.
This is why it is important to pay attention to preoperative instructions before each operation.
Although a preoperative explanation would be of little use if something really happened, it is better than nothing.
"Prepare for surgery." Luo Hao nodded, and Meng Liangren began to get busy.
"Little Luo." Feng Zixuan saw Meng Liangren preparing for surgery and walked to Luo Hao, "There is nothing wrong with the patient."
"Director Feng, you know, all surgeries... …”
Luo Hao only said half a sentence, paused under Feng Zixuan's sharp gaze, and then smiled.
"Director Feng, no problem."
Feng Zixuan's expression softened a little.
"I think there should be a small pseudoaneurysm in the kidney. B-ultrasound... It is difficult to find that the puncture needle sticks to the pseudoaneurysm, causing bleeding."
"Just bolting is enough. I will superselect it carefully during the operation so as to minimize the impact on the patient's future kidney function." Luo Hao gave Feng Zixuan a definite answer.
"That's right, talking to me is like talking to the patient's family! You have to change this problem." Feng Zixuan scolded him familiarly.
“I understand, Director Feng, I won’t do it again.”
Luo Hao smiled gently.
Feng Zixuan was very satisfied with Luo Hao's attitude. As for the complaint, Feng Zixuan really didn't take it to heart.
The First Hospital of the Medical University performs 100,000 surgeries a year and receives countless complaints. If they all cared about it, I am afraid that he, the medical director, would not be able to work for long.
A few minutes later, Luo Hao was dressed neatly, and Shen Zizai also came on stage to act as Luo Hao's assistant.
Luo Hao was not polite to Shen Zizai.
After all, the patient has entered a state of hemorrhagic shock, so it would be good to stop the bleeding a minute earlier.
The patient is placed in the supine position.
Disinfect and drape both sides of the groin area.
After asking about the allergy history, Luo Hao used 5ml of 2% lidocaine to infiltrate the right inguinal area subcutaneously and into the femoral artery sheath for local anesthesia, then performed a modified Seldinger technique to puncture the right femoral artery and successfully introduced the guidewire.
Luo Hao did not rely on the centralized catheter, but chose and inserted the 5F-C2 catheter without hesitation.
First, explore the main trunk of the right renal artery, and perform DSA angiography, which shows: the right renal artery and the right adrenal artery are running normally, the right renal parenchyma is perfectly displayed, and no contrast agent spillage is seen.
Seeing this scene, Feng Zixuan’s face was so gloomy that it looked like it was about to drip.
"Director Feng, don't be nervous." Technician 66 tried his best to persuade.
He knew that no bleeding was seen in the right renal artery angiogram, which meant that the operation was not simple and had begun to change in a complicated direction.
"What do you think about it?" Feng Zixuan asked.
"I have nothing to consider, I just trust Professor Luo." Technician 66 grinned.
He was not wearing a mask in the operating room, and his teeth were not very white, but his smile was extremely sincere.
Technician No. 66 is telling the truth.
"When you were in India, you left early..."
Feng Zixuan's face turned dark when he heard this.
“Professor Luo encountered many unexpected situations, but none of them were too difficult for him. Basically, changing the catheter can solve the problem. I have never seen anyone who does better interventional surgeries than Professor Luo. "
Technician No. 66 is chatting with Feng Zixuan. Luo Hao has already replaced the catheter in the operating room.
A 5F pigtail catheter was introduced and positioned above the opening of the celiac trunk. Abdominal aortography was performed. A branch of the superior mesenteric artery - a pseudoaneurysm was found at the distal end of the right colon's supply artery.
The location of the pseudoaneurysm was adjacent to the lower pole of the right kidney, and a microcatheter was introduced into the target vessel. Repeat angiography showed that the contrast agent overflowed into the abdominal cavity.
"Look, let me tell you." Technician No. 66 was a little proud, "But this position can penetrate and bleed, which is really impressive."
He was still there just now because Professor Luo completed the operation according to his own words and was feeling proud in his heart, but the next second he realized that he had said the wrong thing.
Technician No. 66 raised his hand and slapped himself very lightly.
"Director Feng, I..."
Feng Zixuan didn't even look at Technician No. 66. He stared at Luo Hao who was undergoing surgery through the leaded glass.
I thought there was a problem with the renal artery, but the reality was that the right kidney was fine.
Who would have thought that the bleeding pseudoaneurysm is actually a branch of the blood supply artery of the right colon providing blood supply.
But Luo Hao didn't hesitate at all and found out the problem in the second step.
Feng Zixuan had even imagined in his mind that if Luo Hao was not there, Shen Zizai would have to undergo at least 3-5 angiograms to find the bleeding artery.
The more contrast was taken, the less the bleeding artery was found. The patient's blood pressure dropped sharply, and Shen Zizai's movements were deformed due to nervousness.
The more deformed the movements, the slower the surgery will be.
Directly closed loop, forming negative feedback.
But Ronaldinho is so stable! The branches of the blood supplying arteries to the right colon were seen on the second angiogram, and the surgery was indeed uneventful.
Feng Zixuan nodded slightly.
After discovering the bleeding point, Luo Hao introduced the tip of the microcatheter into the opening of the pseudoaneurysm, and slowly injected about 0.2ml of tissue glue through the microcatheter under fluoroscopy.
The subsequent DSA angiography showed that the pseudoaneurysm was filled and sealed, and there was no sign of contrast medium overflow.
Luo Hao immediately withdrew the microcatheter.
The operation is over!
Feng Zixuan glanced at the time, 11′12″.
ox!
You should have gone to Ronaldinho for a consultation as early as possible and be more reserved! Feng Zixuan cursed himself in his heart.
The microcatheter was withdrawn, but Luo Hao and Shen Zizai did not step down.
Luo Hao placed his hands in the surgical area and seemed to be talking to Shen Zizai.
Feng Zixuan thought about it, pressed the intercom, and Luo Hao's voice came from the speaker.
"Bamboo is the dominant one in the Qinling Mountains. It's a real headache. Now the money paid to the villagers every month is more than 20,000 yuan. Director, how difficult is it to raise a pet? If it weren't for the country's support for scientific research, If it had been the time when your professor was selling tea eggs when you were young, I would have taken the bamboo to the streets to perform."
"..." Feng Zixuan was stunned.
"That's bamboo! You earn a lot from the surrounding areas! Whatever you spend, bamboo earns it himself!" Shen Zizai must be standing on the side of bamboo, his butt is crooked.
“I’ve earned tens of millions from peripheral products, but I’m going to use liquid metal to make a suit of clothes for Bamboo. You don’t know how expensive liquid metal is, and the money is not enough for a suit of clothes, even a bellyband.
Fortunately, I can still apply for funds from Qingchang, but I am responsible for both projects, so there is a problem, so I am going to talk to Brother Geng and see if we can get more bamboo around. ”
"Liquid metal can be used in this way? A suit of armor weighs dozens of kilograms...convert it to tens of thousands of grams?" Shen Zizai was surprised.
Feng Zixuan just listened silently to Luo Hao and Shen Zizi's chat.
Although the patient's operation was over, Luo Hao did not step down. It was a bit strange to stand on the operating table and chat with Shen Zizai.
But Feng Zixuan guessed that Ronaldinho was cautious and planned to do another imaging in ten minutes to see if there were any bleeding spots.
The patient’s family was restless, but the bleeding was successfully stopped at one time, and the patient’s family could still accept it. If he enters the palace for the second or third time, I'm afraid the patient's family will have to settle the dispute.
It's better to be cautious, it's better to be cautious, Feng Zixuan advised himself in his heart.
"By the way, remember to leave me a copy of Bamboo's new peripherals."
"Don't worry, Director, I want 800 copies first, and it will take two hours to mail them." Luo Hao said this without feeling depressed, and then looked at the patient, "Do you like bamboo?"
"That giant panda? The one whose son had a full moon a few days ago?" The patient's mental state Okay, let’s start chatting with Luo Hao.
“Yes, if you like it, I will leave you a new set of peripherals.”
"Okay, okay, okay, okay." The patient responded excitedly, "Do you know who he is? I heard that he is called the King of Qinling. I will come back from Qinling in a while, and the tickets for the Panda Museum have been reserved for a few months. "I can't see it."
"I raised the bamboo." Luo Hao squinted.
"???" Luo Hao smiled and began to tell the patient about the past of bamboo, a story with ups and downs, but not complicated.
Ten minutes later, Luo Hao ended the story "just right".
Feng Zixuan glanced at the time, 10 minutes, no more, no less.
This story... Feng Zixuan even felt that Luo Hao told it deliberately. While telling the story, he observed the patient's communication and communication, and made his own judgment on the condition.
Even Feng Zixuan couldn't help but sigh that he could be so meticulous.
Luo Hao then performed another angiogram of the superior mesenteric artery. No signs of contrast agent spillage were found, and the blood supply to the right colon was good.
The patient was clear and clear, and even asked Luo Hao to gossip about the bamboo. He lost a little blood, but it did not reach the level of hemorrhagic shock.
"Okay, the operation is over and went very well." Luo Hao smiled, "When you go back, tell Director Geng of the Nephrology Department and ask her to give me your address, and I will mail you five and ten copies."
"Thank you, thank you."
"Hey, you're welcome. We met in the operating room, this is fate." Luo Hao squinted his eyes and said, "Bamboo is also destined to me, our main specialty It’s just a coincidence. A few peripheral items are not valuable, but you can get them before they are released and give them to the children around you.”
Feng Zixuan sighed.
He knew exactly what Luo Hao was doing.
But this kindness cannot be refused by others, and Feng Zixuan knows it well.
Although medical disputes cannot be completely eliminated, it can at least reduce the hostility of patients and their families by 20%, at least.
What are the details, this is it!
But then Feng Zixuan thought about it, he had to have something to give to him. If it were a hospital, would he give the patient a 3-month ICU experience card?
Or give away ten used syringes?
"Stab~~~"
Luo Hao kicked open the airtight lead door, tore off the lead cap, and threw it aside.
Zhuang Yan followed Luo Hao like a little follower, picking up the lead hat.
This is not the first time I met Feng Zixuan, but every time I see him, my mood changes a little.
Gradually, he has accepted this scene.
"Director Feng, it's done, now it's your job." Luo Hao walked to Feng Zixuan and said with a smile.
“It’s really fast.”
“The operation is simple and it should be done quickly. The bleeding was stopped smoothly and I’m quite satisfied.”
“Ronaldo, that’s good, it’s really good. "It's great." Feng Zixuan said, "To be honest, when I invited you to do the demonstration surgery at Johns Hopkins, I didn't think you were qualified."
Feng Zixuan didn't realize it. Until one of his words stabbed Luo Hao's wound.
Luo Hao raised his right eye and thrust his eyebrows into his temples.
Feng Zixuan felt that the aura on Luo Hao's body had changed, like a sword being unsheathed, and he was stunned for a moment.
But this feeling disappeared immediately.
"Director Feng, it has nothing to do with the surgery. The food they cooked is really unpalatable. Those bullshit French meals and aristocratic ceremonies are all self-made."
Luo Hao said lightly.
"Actually, I'm also surprised that with so many chefs going abroad, why can't they cook Chinese food well?" Feng Zixuan followed Luo Hao's direction and changed the topic.
That moment just now must have been his misunderstanding, Feng Zixuan thought to himself.
But even if it was an illusion, even if there was no reason, Feng Zixuan did not want to get close to that field again.
“Hey, I really know about this!” Luo Hao said with a smile, “Chen Yong told me that he almost starved to death after going to England, and then he called home and asked about braised pork. Practice.”
“Oh?”
As Luo Hao said, he saw Chen Yong walking out of the surgery room and waving.
"Chen Yong! Come and tell Director Feng."
"What are you talking about." Chen Yong was a little confused.
"Tell me about making braised pork in London." Luo Hao had already forgotten what Feng Zixuan mentioned.
When he mentioned the word London, Chen Yong paused slightly, and then his eye circles became a little red.
"Director Feng, let me tell you, I almost starved to death in London."
Chen Yong began to complain. He usually didn't like talking to men, but as long as his experience abroad was involved, Chen Yong Yong suddenly became energetic, but the bitterness continued.
“I was so hungry that I wanted to eat braised pork and my mouth watered every day. When I saw that it was not going to work, I called home and recorded the whole recipe of braised pork and several home-cooked dishes.”
"But when I tried it, it was not the case at all. I thought wrongly."
"It was wrong? What happened?" Feng Zixuan also calmed down at this time and smiled. Ask questions and support.
"I blanch the water first, then add boiling water and stew the meat for half an hour. Let me tell you, Director Feng, at this time I already feel like I'm starting to eat meat, and I can't even speak. Have you ever seen a dog when he's greedy? , That saliva is so silky.”
Feng Zixuan didn’t understand Chen Yong’s comparison of himself to a dog.
“But after stewing for half an hour, I still felt that it was almost boring, so I asked Liuzi next door to borrow a pressure cooker, put garlic, pepper, and cooking wine in it and simmered it for another hour.”
"You can't eat it after it's stewed. Even if I'm so greedy for meat that I bite my tongue, the pot of meat still goes into the trash can."
"Why?" Feng Zixuan was a little surprised.
Even if Chen Yong doesn't know how to cook, if he follows the process, he can at least achieve half the quality.
That’s enough.
“It smells like urine! I feel like I’m not eating meat, but drinking pig urine! Do you understand, do you understand!”
Chen Yong thought of the unbearable past, She was tearful, even sniffling a little, and crying just before she looked at it.
“……”
Feng Zixuan's description of Chen Yong is regrettable.
Although the protagonist is Chen Yong, Feng Zixuan still feels like the smell of urine is in his mouth.
“I was definitely not convinced. I felt that I must have done something wrong, so I bought some meat and started trying again.”
“Shredded green pepper and pork, I felt like I was stewing in urine after putting it in the pot. ."
! "
"Later, when I asked about it, I found out that pigs abroad don't taste good because they are not castrated."
"Huh? What's more? Don't eunuchs smell like urine after castration?" Feng Zixuan said no. untie.
"Director Feng, it's like this. Part of the unmetabolized androstenone in adult boars is deposited in fat and muscles, causing boar meat to smell like urine."
"? ? ? ”
“Not to mention the smell of urine, skatole, also known as 3-methylindole, is produced by microbial fermentation of tryptophan in the large intestine of boars. br>
Absorbed through intestinal tract and enters blood circulation. Skatole is metabolized in the boar's liver, and the unmetabolized skatole in the boar's body is deposited in the boar's fat and muscles, causing the boar's meat to smell like manure. "
"The smell of urine and feces combined together, like a pig pen, who can get in and take a bite? You say so. "
"..."
Feng Zixuan thought for a while, something seemed to be wrong.
"There is no castrated male pork in the UK? And isn’t there a sow? ”
"The imported Brazilian pork there is basically all boars, and there are very few sows. Chen Yong is also unlucky. He even bought boar pork several times."
"And judging from the appearance, it's also... It’s hard to tell a boar from a sow, so it’s like this.”
“Director Feng, don’t go abroad, it’s hell.” Chen Yong raised his fist exaggeratedly and complained. road.
“It’s not that exaggerated, but it’s true that the food is not delicious. Snails are all made in China now. Steaks and other things are from Argentina, but the way they cook them... By the way, Director Feng said It seems that the price of beef imported from Argentina has been ridiculously high this year. Let’s go eat western food together tonight?”
“Are you sick?” Chen Yong said angrily, “Isn’t the hot pot delicious? Is it delicious? I don’t know how to feed Wuchang rice, you are a white-eyed wolf.”
Facing the extreme Chen Yong, Luo Hao just shrugged.
"Okay, I'll come find you after get off work." Feng Zixuan happily accepted the topic.
When the time came to apply pressure to stop the bleeding, Feng Zixuan took the patient away.
The patient’s family members gathered around and asked about the situation. The patient’s face had begun to show signs of blushing. She kept telling the family members about the bamboo peripheral dolls that would be available in the future.
Bamboo, bamboo, is it still useful in resolving medical disputes?
Feng Zixuan thought to himself.
Although it cannot be said to be completely useful, a little bit is always okay. It resolves a small amount of hostility and makes communication smoother. Do we understand each other?
Some things cannot be avoided.
With Ronaldinho here, I can do things with ease. Not only did the surgery seal the bleeding point, but I also "conveniently" resolved some of the patient's hostility.
This man does everything impeccably, and Feng Zixuan's favorable impression of Luo Hao has reached 100%.
Let's treat the medical team to a meal in the evening. After watching Director Tang handle the problem, Feng Zixuan called Director Geng from the Nephrology Department to go find Luo Hao.
Although there is one more "outsider", I don't think Luo Hao will be dissatisfied.
The patient's condition is stable, and the patient's family members are gradually calming down and can communicate.
But Feng Zixuan is not in a hurry. It will be better to wait until the patient recovers before talking.
He believed Director Tang.
After the problem was solved, Feng Zixuan made himself a cup of tea and sat in the office leisurely watching short videos for an hour.
At the end of the day, Director Geng came to Feng Zixuan and asked Luo Hao to go to dinner together.
"Director Feng, thank you." Director Geng had not yet recovered from his anxious state, but he still said thank you calmly.
"Professor Luo performed the surgery, don't thank the wrong person."
"Professor Luo...well, I do have to thank him, but medical disputes are not limited to surgery."< br>
Feng Zixuan thought blankly about the ten minutes Luo Hao waited for after the operation. The more he thought about it, the more interesting it became. The more he thought about it, the more he felt that Luo Hao's movements were full of meaning.
"For dinner tonight, please thank Professor Luo more. You know his new topic."
Director Geng shook his head in confusion.
"Boss Chai from Xiehe has been in charge of the work these days, and the scientific research operation has been successfully completed. Similar situations can be transferred to your nephrology department, and then you don't have to worry about renal puncture problems."
“Huh?!”
(End of this chapter)