godfather of surgery

Chapter 122

I have seen a lot of synovial chondromatosis of the knee, so many are rare.

Xiao Wu took off the film, so as not to make the secret fear feel uncomfortable again, he admitted the patient to the hospital, and perfected the preoperative examination and operation arrangement.

Yang Ping continued to study the puncture of patients in Huaqiao Building, and repeatedly simulated the puncture with the help of images constructed in his mind to adjust the angle of the puncture, so as to achieve a sure hit.

Song Zimo didn't rest at noon, he stayed in the laboratory to practice arthroscopy, Tang Fei called him from the cafeteria for lunch, he ate in the dining room of the department, and continued to practice in the afternoon.

It is said that in the trauma orthopedics department, as long as there is no special event every night, he would practice until after ten o'clock, sometimes until twelve o'clock.

The CT and MRI [-]D reconstructions of patients in the Overseas Chinese Building have been completed. Thin-layer scanning shows that the reconstruction results are very clear. Director Han compared Yang Ping's paintings with the reconstructed images on the electronic film reader. There is almost no big difference in the spatial structure. Yang Ping Flat drawings are more expressive.

Director Han checked the time, it was already 04:30, he put down what he was doing, and took Yang Ping to the Overseas Chinese Building to attend the conference.

In the conference room of the Internal Medicine Department of the Overseas Chinese Building, several directors have arrived, and Director Zhao of the Medical Affairs Department has also arrived. Everyone gathers around the oval table to discuss Mr. Ning's condition privately in advance.

Director Kong greeted Director Han and Yang Ping to sit down. Each seat on the table was equipped with a high-definition tablet computer. The resolution is much higher than ordinary ones, just to be able to see the details of the video pictures clearly.

Director Kong kept calling, and people came in one after another. The directors of the hospital, several professors from outside the hospital, and Director Zhuang from the Department of Internal Medicine also came to help accompany the experts from the outer hospital.

"This is from the Second Affiliated Hospital—"

"This is from the First Attached Hospital—"

"This is from the Cancer Hospital—"

Several directors came over and took their seats one by one. Director Kong and Director Zhuang made arrangements with ease, without any negligence or omission. The two brothers from the Overseas Chinese Building can be regarded as figures on the scene.

The consultation naturally depends on seeing the patient. Someone has already proposed to see the patient first. Director Kong took someone to the ward to see the patient, and Director Zhuang helped accompany the patient.

Everyone used this time to catch up on the old days. These experts are usually familiar with the directors of relevant departments of Sanbo Hospital. They often get together in meetings, and some of them are brothers.

We are usually busy, so it is rare to meet each other, except for academic conferences, it is this kind of conference to meet, chat a few words, and talk about each other's current situation.

Only Professor Su Qingyun from Attachment [-] has not yet arrived. He is the main expert of this association. Although the patient has liver cancer, the problem to be solved now is caused by spinal metastases. The popular candidate is naturally the most important expert for this consultation, and the meeting was postponed from three o'clock to five o'clock to wait for him.

Su Qingyun is still the dean of the No. [-] Attached School, he is busy with affairs, and it is already very face-saving to be able to take the time to come here. Everyone privately discusses how sacred this patient is, and invited Professor Su to come forward in person. Usually, some other hospitals have consultations. Even if he is invited, they will send students there. join.

In a few minutes, Professor Su hadn't shown up yet.Yang Ping met Professor Su before. The Municipal People's Hospital once held an academic meeting. Professor Su went there. It was from a distance, not as close as it is now.

Professor Su has published more than a dozen articles in top international orthopedic journals such as AJAM and JBJS, with extremely high impact factors, so he is at the peak level in China and has a place in the world.

Some raised their wrists to look at their watches, others looked at the door, and some whispered to each other, but they all waited patiently.

"Speak up boldly later, don't be stage-frightened. In academic matters, one is one and the other is two. There is nothing to be modest about." Director Han explained to Yang Ping in a low voice.

At five o'clock, Professor Su came in under the guidance of Director Kong, followed by a young doctor who looked very similar to Professor Su.

As soon as Professor Su came in, he greeted everyone with a smile: "Sorry! Everyone has been waiting for a long time!"

In fact, he wasn't late, he just came in on the hour, it's just that the others came earlier.

Professor Su is more than 50 years old, not old at all. He wears glasses, a Chinese tunic suit and a white shirt inside. He has a refined and elegant demeanor, showing everyone's demeanor. The strong aura comes from the accumulation of long-term high academic positions.

Everyone came forward to shake hands with him. When shaking hands with Director Han, Professor Su stayed longer: "Brother Han, long time no see."

Seeing Yang Ping beside Director Han, Professor Su asked, "Who is this?"

"Doctor Yang, my student!" Director Han introduced.

Yang Ping shook hands with Professor Su.

"The young man has an extraordinary temperament. Professor Han is famous for his poisonous vision. He has not recruited a doctor for many years, but he prefers to be short rather than indiscriminate. It seems that he has picked a good seed." Professor Su said with a smile.

"This is Dr. Su!" Director Han introduced the young man next to Professor Su.

"Su Nanchen!" The young man beside Professor Su shook hands with Yang Ping.

"Yang Ping!" Yang Ping could feel his confidence and calmness.

When Director Han was in Shanghai, he and Professor Su were outstanding figures of the young generation of orthopedics. However, Director Han went from Shanghai to Sanbo in Nandu. If he wants to start a new business, he cannot compare with Professor Su academically, but The foundation is still there.

The two cherished each other, exchanged a few simple greetings, and then took their seats.

"That's Professor Su's son. He graduated from the eight-year program of Union Medical College and is a young talent in orthopedics. After graduation, he studied in the Minnesota Twin Cities Spine Center and the New York Hospital for Special Surgery. He will be your strongest in the Southern Division of the Golden Knife Award. In the national competition area, he is a rare super-strength opponent, and he is also an all-around player." Director Han said next to Yang Ping's ear.

A tiger father has no dogs. This Dr. Su is not only a good-looking talent, but also graduated from the eight-year program of Xiehe. famous.

Professor Su must have high hopes for his son, otherwise such meetings would be brought with him, and bringing him with him would allow him to see the world, participate in more exchanges, and even help him build his reputation and contacts.

Everyone sat down, the consultation began, Director Zhao presided over, and the doctor in charge of the bed reported the medical records.

After reporting the medical records, Director Kong added: "Dear experts, respected Professor Su, I would like to ask you to take time out of your busy schedule for consultation today. The problem that this patient needs to solve at present is the severe pain in the chest. Thank you all!"

"Let's see the patient first? Is it convenient?" Professor Su suggested.

Director Kong took everyone to see patients in the ward. Professor Su personally asked about medical history and physical examination, and other professors also selectively asked medical history and physical examination according to their own needs.

After seeing the patients, everyone washed their hands and returned to the meeting room.

Director Xu of Sanbo Pain Department spoke first: "This patient was admitted to the hospital the day before yesterday. From the time of admission to the present, we have been following up on the treatment of pain. According to the step-by-step principle of tumor analgesia, this patient has been on morphine for three months. During this hospitalization, morphine was used at an extreme amount, 30mg/time, twice/day, but it could only relieve the pain in the liver area, and the pain in the front chest was still severe. The chest pain caused, according to the location of the nerve, the area of ​​the anterior chest pain is the area dominated by the anterior branch of the thoracic 2 nerve. According to the CT and MRI images, the thoracic 2 nerve root just happened to be violated and compressed, so we think it is caused by the thoracic 2 nerve root, unfortunately , Spinal anesthesia is not available here, once respiratory depression is caused, the consequences will be serious, so we have encountered difficulties and need your help.”

"Have you considered using an implantable analgesic pump, implanted into the spinal canal, using morphine as the main drug of the analgesic pump formula, and releasing it regularly, so that it can relieve pain without causing anesthesia on the plane, and does not affect breathing? ” said the director of the pain department of the Second Attachment.

After the director of Attachment [-] finished speaking, the director of the Pain Department of Attachment [-] said: "It is not realistic to implant an analgesic pump in the spinal canal, and a very large amount of morphine has been used to suppress the pain in the liver area. According to our experience, this kind of radicular pain , Morphine is almost ineffective. We have used it before at a lower level. If the nerve root is healthy and there is no tumor invasion, it will be effective. If the nerve root has been invaded by tumor tissue, morphine is ineffective, and anesthesia must be used for nerve blockade. lag."

The director of the Pain Department of the Second Attachment had a different opinion: "Nerve block is too difficult, and it is almost impossible to do it. Usually, our nerve block is placed around the sheath, and even if it is punctured into the sheath, the anesthetic will leak out. To block, you must ensure that all the anesthetic is in the nerve sheath and cannot leak out, otherwise it will cause anesthesia on the plane and inhibit breathing, so you can only use a ventilator to assist breathing."

After a brief silence, the professor of the Cancer Hospital spoke: "Whether to consider limited surgery, don't move other places, go in from the back, just remove the tumor tissue that oppresses and invades the nerve root, relieve the oppression, liberate the nerve root, and the pain will naturally disappear. "

"The family members refuse the operation, even if it is limited!" Director Kong explained.

"We don't want to operate, but we have to solve the problem. This is a problem for us." said the director of the orthopedics department of the Second Attachment.

The Orthopedics Department of the Second Attachment is ranked second in Southern Metropolis Province. A long time ago, the Orthopedics Department of the Second Attachment was evenly matched. Since Professor Su Qingyun became the director of the Orthopedics Department, the Orthopedics Department of the First Attachment began to take the lead, from overwhelming to throwing away.

The surgery that symbolizes the highest risk in orthopedics, scoliosis correction, has an annual operation volume of more than [-] in the first attachment, ranking in the first echelon in the country, while the second attachment has only close to [-] operations, ranking in the second echelon.

For bone tumors, there is an independent large-scale bone tumor ward in Attachment [-], but there is no independent large-scale bone tumor ward in Attachment [-].

So naturally, Fu Er's orthopedics department bowed down and regarded Fu Yi as the big brother.

Neuraxial analgesia was not available, nerve block was not feasible, and the family members refused the operation.

This discussion can't go on?

The discussion fell silent again.

(End of this chapter)