godfather of surgery

Chapter 119 Difficult Tasks

"What are you going for, use a sniper rifle to kill the snipers in the woods on the opposite side!"

Professor Zhang shouted anxiously.

Zhang Lin turned his head, creaked, and didn't dare to move. Holding the phone, he froze in a certain movement.

"Old Zhang—Professor Zhang!"

Sweat dripped from his forehead, and if he was caught by old man Zhang, the ending would be miserable. If a button was not buttoned properly, he would be criticized. This game does not know what the end will be.

"Professor Zhang, look, this afternoon is fine, relax."

Zhang Lin wanted to cry but had no tears. He stammered in a begging tone and almost exhausted all his courage to squeeze out this sentence.

"professor Zhang--"

"We won't dare to do it next time!"

Xiao Wu and Fatty Liang interceded together, sitting cross-legged on the bed, their posture was a bit awkward, but they dared not move.

"Hit, what do you want me to do?" Professor Zhang pointed to Zhang Lin's cell phone.

beat?
hit what?
Zhang Lin's thinking has been disconnected.

"Now it's off-duty time, 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 the IQ was obviously not enough.

"Close the door and lock it!" Professor Zhang shrewdly pointed at 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 wanted.

Xiao Wu and Fatty were apparently also disconnected, and had no idea what old man Zhang meant.

Unlock the door and turn the handle to confirm.

"Hurry up, form a team, wait for the old woman 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 left work yet: "Let's take a rest after get off work, as long as there is someone on duty."

Yang Ping said, "Professor Zhang just came over."

"Where is it?" Director Han asked.

Yang Ping walked to the door and looked at the corridor with his head: "I was still here just now, but I disappeared after a while."

Director Han also looked out twice and said: "It's okay, let him walk around by himself, his legs are completely normal, and I saw him doing Tai Chi in the park again in the afternoon. He will also come to our place in a few days to help We went out to the clinic, and in the operating room, I asked for another nurse, Zhou Can! There is only one anesthetist for the time being."

Zhou Can is good, he does things without sloppiness, and he is smart and eccentric. Director Han will pick people.

"It's enough for the time being, let's talk about more operations." Yang Ping knew that it was difficult to ask people, and the operating room was also short-handed. It was because Director Han had enough face to ask people so smoothly.

"There is a patient with advanced liver cancer in the Overseas Chinese Building. It has metastasized to the spine from chest 1 to chest 4. Now the chest pain is severe, and morphine doesn't work. It may be caused by the metastases invading the stretched nerve root. Director Kong asked me to go there for consultation. Are you okay to go and have a look together?" Director Han was about to go for a consultation.

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

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

When we arrived at the doctor's office of the Department of Internal Medicine in the Overseas Chinese Building, Director Kong was waiting. His face was flushed and he was proud of himself.

"Thanks for your hard work. Liver cancer is at an advanced stage, metastases throughout the body, and there are metastatic tumors in the spine. Now I have severe chest pain. 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 take a look."

There is no other way for advanced liver cancer to metastasize throughout the body, only pain relief and supportive treatment to improve the final quality of life.

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

The patient's family member, his daughter, a tall young woman who looked mature and capable, was by the bed, with a very sad and helpless expression.

Director Han performed a physical examination on the patient 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 patient, several people left the ward, washed their hands, and returned to the doctor's office.

"In this case, why don't you go to the ICU?" Director Han was surprised.

"The patient refused to stay in the ICU. If his life was in danger, he refused to be intubated and rescued. He had already signed the informed consent and only asked for analgesia." Director Kong explained.

"This patient may need hospital-wide and out-of-hospital consultations. The family members will invite experts from Attachment [-] and Attachment [-] to come for consultations. Professor Su Qingyun will also come." Director Kong added.

Professor Su Qingyun is the dean of the attached one, the chairperson of the Orthopedics Department of Nandu Province, and a popular candidate for academicians.

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

"Come in!" Director Kong beckoned 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 G City. The group business involves banking, finance, securities, insurance and so on.

Miss Ning's eyes were red, and the area around her eyes was slightly swollen. She said sadly, "Father can't last long. I just want him to suffer less pain and walk with more dignity."

While Ms. Ning was speaking, she wiped her tears with a tissue several times: "If he hadn't been waiting for my brother, he probably couldn't hold on long ago. I'm embarrassing everyone, please!"

Miss Ning clasped 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 video data of this patient: "Xiao Yang, take a look, is there any good way?"

"According to the localization of the pain site, the pain area is concentrated in the sternal angle. It should be that the anterior branch of the thoracic 2 nerve root has been violated and stretched. You see, both CT and MRI have shown that the thoracic 2 nerve root has been invaded and stretched by the tumor. There is no way to do a spinal canal in this part. If the plane is below chest 4, a tube can be placed to anesthetize the plane below, but this plane is not good. Once anesthetized, breathing will be seriously affected, and a ventilator is needed.” Director Han pointed to the electronic device. The image on the viewer screen.

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

Director Han shook his head: "It's very difficult! You see, the puncture is restricted due to the blockage of the tumor; even without the blockage of the tumor, it is impossible to accurately penetrate the sheath of the nerve root. Once the anesthetic leaks out, it will be treated with spinal anesthesia Same effect, affects breathing."

"Blood vessels can also be found through three-dimensional reconstruction of CT angiography, but nerves cannot be found through angiography. It would be great if the relationship between the spatial orientation of nerves and the tumor can be found." Yang Ping said.

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

"Ding dong, mission: hospice care! Complete a case of difficult analgesia, reward [-] points."

The system, which had been silent for a long time, started beeping again. Yang Ping thought that it would no longer release individual tasks. It turned out that the difficulty of the tasks had increased, and those that were not difficult were included in the daily tasks.

"This patient can't be solved by our department alone. We will consult the whole hospital and outside the hospital soon. Let's talk about it after the general meeting. Let's rest after get off work." Director Han is also leaving get off work.

Anyway, Yang Ping had nothing to do when he went back. Director Han applied for VIP permission for him before starting the department. He went into the computer to retrieve 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 for pain relief. If a nerve root block is performed, it must be safe and accurately puncture the thoracic 2 nerve root sheath. This is so difficult that it is almost impossible to achieve, only in theory That's all.

then what should we do?

Yang Ping thought for a long time, after much deliberation, he still settled on nerve root block, otherwise there would be no solution to this problem.
-
"Why are you such a noob?" Old man Zhang reprimanded Zhang Lin.

Zhang Lin scratched his head and laughed.

Old man Zhang's cell phone rang: "I'm not playing anymore, the old lady is urging me to eat."

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

After taking a few steps to open the door, I turned around and said, "Remember! Not during working hours!"

(End of this chapter)