godfather of surgery

Chapter 257 Did the operation fail?
The MRI of Sisi's re-examination one week after the operation came out, and the liver metastases shrunk a little, and the edema shadow was more obvious than before, evenly distributed, and the edge just followed the outline of the original tumor.

This magnetic resonance performance shows that at that time, the focused ultrasound bombarded the tumor entity in all directions, without any omission or beyond the scope of the tumor, and the goal of precise bombardment was achieved.

However, even so, there will still be residual tumor cells. These cells divide slowly, and finally come back again. This is the fate of the advanced stage of malignant tumors. Once distant metastasis occurs, there is almost no way to eradicate it.

Therefore, the treatment principle of "three early" is advocated for tumors - early detection, early diagnosis, and early treatment. When cancer cells have not spread and gathered in a local space, they can be removed in one go.

Duan Xiaoming of the Haifu Knife Department has also been paying attention to this patient, because he has the authority to review the medical records of the operation performed by this patient in their department.

He was very curious. Yang Ping had an operation that day, he bombarded it dozens of times casually, and adjusted the parameters in a pretentious manner. The accuracy of the parameters reached the limit of the machine. Is it just pretending, or is there something real?

Duan Xiaoming wanted to know the answer very much. Sisi also had an MRI that day, but she had just finished the operation at that time, and the imaging performance was not very obvious, so no conclusion could be drawn.

Now Duan Xiaoming believed it. Before the operation, on the day after the operation, and one week after the operation, the three sets of MRI images were compared, and the effect was clear. No one knew the effect of this operation better than Duan Xiaoming—it was so good, it was too good to believe.

From the magnetic resonance images, it can be seen that all liver tumors have been beaten by focused ultrasound, and under the influence of high temperature, most of the tumor cells have been killed and are disintegrating and absorbing.

As an expert in Haifu Knife, he himself has never been optimistic about this equipment, and applied for transfer back to the ultrasound department several times, but was rejected by the hospital.

How could the equipment that the hospital spent so much money to buy be idle? At least now it can treat patients with uterine fibroids.

In this way, this department is half dead, and Duan Xiaoming also has nothing to do all day long, staring at the ups and downs of stocks on his mobile phone all day long.

"Do you think Dr. Yang is strange? An orthopedic surgeon, he can also do Haifu Knife?"

Anyway, there are no patients now, everyone gathered together to chat for a while, and a resident doctor, his assistant, asked.

Duan Xiaoming pointed it out to him: "Look, last time the MRI of the little girl in their orthopedics department, the liver tumor was so cleanly beaten by Haifu Knife."

If Haifu Knife had such an effect, then he would have a lot to do in the future, and he would not be like this now.

Duan Xiaoming thought, if he could learn such a unique skill from Dr. Yang, not to mention other diseases, just having uterine fibroids would make him famous and rich.

In my situation, if I want to be famous, I can only take a slanted approach, focus on a subdivided field, and make it the ultimate.

It's too difficult to deal with liver cancer and lung cancer. I will make a name for myself in the future with uterine fibroids, and I will be able to occupy a place in G City by then.

Duan Xiaoming was thinking about how to open up the relationship, and he might trouble Song Zimo again.

If the machine is idle, it is also idle. If there is any patient in the future, please ask him to operate it and take care of yourself. Don’t stare at the stock all day long. If your eyes are swollen, you will still lose money.

To cheer up and do something serious, Duan Xiaoming touched his bald head.
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"Is it still painful here?" Yang Ping pointed to the location of the right liver area.

"I had a little pain on the day of the operation, but now it doesn't hurt, and I feel much more comfortable, thank you big brother." Sisi looked much better because she got rid of the pain in the liver area.

On her desk was a copy of "Atlas of Human Anatomy", the human health edition, and there were some anatomical drawings on the draft paper next to it.

"I asked Sister Feifei for this. I also want to be a doctor. I'm starting to prepare now. This is the liver. I drew it. Sister Feifei said that I should learn anatomy well and be able to draw pictures."

Seeing Yang Ping, Sisi noticed the book on her desk, took the initiative to explain, and showed Yang Ping her drawing.

Although this picture is a bit cute, it is well drawn. Yang Ping took a closer look and found that the drawing is quite delicate: left and right halves, 5 lobes, 8 segments, gallbladder, hepatic duct, common hepatic duct, common bile duct, proper hepatic artery , Hepatic portal vein are all drawn.

This little guy might be a good material for studying medicine in the future, Yang Ping's nose suddenly felt a little sour.

"You draw really well!" Yang Ping praised her.

The little girl proudly said: "I will draw every part of the human body, and then I will draw a complete human anatomy."

The postoperative pain in the liver area disappeared, which also confirmed the effect of the surgery from the symptoms. The tumor was generally killed by the heat energy, and began to absorb and shrink. The stretch of the pain sensory nerve in the liver capsule was gradually relieved, and the pain naturally relieved.

It is the first time to use the simulated operation function of the system space, and the effect is very good. Yang Ping has already carried out a complete simulation of several tumors in Sisi. Currently, he is only using the operation on the liver. In the future, he will complete the tumors in other parts step by step. treat.

This kind of simulation function is very good for difficult operations. You can use replicas to conduct a lot of research and experimental operations, obtain data, and then apply the data to real cases.

The ability to replicate cases can also be used flexibly. For example, dissection of replicated cases can find lesions that cannot be detected by medical instruments.
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Fang Xiaoyun's muscle strength is still declining, and now it has dropped to the second level. He can only move on the bed, and he can't even lift his legs.

The parabolic span of the spinal cord edema is a bit large, which is not consistent with the condition. Yang Ping asked Zhang Lin to give Fang Xiaoyun another MRI scan and an angiography.

Is the spinal artery embolized again? Or hematoma compression? The operation interferes with the blood supply of the spinal cord?
Surgery interferes with spinal cord blood supply?impossible!

Yang Ping was very confident in his operation, not even a single intercostal artery was broken, how could it damage the blood supply.

Hematoma can also be ruled out. If there is hematoma, it is impossible for MRI to not show it.

Arterial reembolization is entirely possible, and the diagnostic accuracy rate of magnetic resonance imaging for these subtle lesions is 95%, which means that there is still a 5% possibility of missed diagnosis and misdiagnosis.

For others, there is this 5% possibility, but Yang Ping does not have such a high error.

He has recently conducted auxiliary inspection training in the system space, and the ability to read MRI images has been improved several times. He can identify artifacts, interference, imaging deviations, etc. If there is any doubt, further inspections can be done, or supplemented by other methods. inspection to identify.

"The peak of edema should have passed, how did it last for so long, and the muscle strength is getting worse?" Song Zimo was puzzled.

"MRI's identification of edema will not be a problem. This patient is very strange, why the edema has not subsided at all, and has entered a plateau." Yang Ping was also a little puzzled.

"If it's just caused by spinal cord edema, it's not a big deal. It's okay to wait a little longer. I'm afraid there may be other reasons." Professor Zhang also came up.

"Doctor Yang, Fang Xiaoyun's mother came up and was brought up by the security guard. She wanted to see her daughter, but the security guard asked her permission?" The head nurse Cai Qiaojun came to report.

The two security guards took Fang Xiaoyun's mother. She didn't make any noise this time, she didn't make a fuss, she was quiet, she seemed to be very honest, and kept apologizing: "I was too emotional last time. , I just want to see my daughter, isn’t she hospitalized for surgery? I am her mother, and I want to take care of her.”

There is no reason not to let her take care of her daughter. Yang Ping told head nurse Cai: "Ask the patient what he wants, and if he agrees, let her go in."

I don't have time to bother with her. Everyone is busy analyzing the condition. If you don't pay attention to this kind of case, it may lead to permanent paraplegia. Therefore, if there is any sign of abnormality, it must be analyzed and dealt with in time.

"Methylprednisolone and 20% mannitol have been used, but the edema still hasn't been relieved. Is there any reason?"

Zhang Lin is the doctor in charge of the bed, and he also participated in the discussion.

"There are no more than two reasons. One is related to the condition of thoracic tuberculosis, and the other is not related to this condition. There are other reasons. Although the diagnosis method emphasizes unity and tries to use one disease to explain the symptoms, when the unified explanation does not make sense, it is Consider diversification, whether this patient has other problems." Yang Ping analyzed.

Doctors' analysis of the disease is a process of logical reasoning, using their own knowledge and experience, comprehensively integrating the patient's medical history, physical examination and auxiliary examinations, and peeling off cocoons to reach the truth.

However, in many cases, the truth cannot be revealed at all, and only symptomatic treatment is available. Some diseases recover on their own, but the cause of the disease has not been clarified. There are many such cases.

It’s like the picture on a TV is always unclear. You take a picture and it becomes clear. I don’t know why.

"There is no sign of ischemia in the spinal cord. Don't worry too much. You can wait. If you really can't recover, you can go to other aspects for inspection. It's too early to spread the inspection now, and the patient can't afford it financially." Professor Zhang suggested further wait a minute.

Yang Ping thought for a while, and ran through the possible reasons in his mind. Fang Xiaoyun's MRI shows no evidence of spinal cord ischemia, and no embolism has occurred in the supplying arteries of the spinal cord.

At least in the main arteries that can be seen on MRI, no embolism is seen; arteries that are not visualized have little effect on blood flow, and even embolism does not pose a threat.

The D-dimer was rechecked several times, and it also showed a downward trend, which did not support the embolism of the spinal artery, indicating that the blood clot in the body was only formed by a small amount of bleeding caused by the operation.

It is indeed a bit premature to spread out the inspection now, because the investigation requires a lot of inspections, and some inspections have certain side effects.

"Professor Zhang is right, you can wait and observe closely, and I agree." Yang Ping made a decision.

"I'll go see her too!" Professor Zhang took everyone to rounds.

Fang Xiaoyun sat on the bed, very calm, she trusted the doctor very much, and her colleague was helping her massage the muscles of her lower limbs.Fang Xiaoyun's mother, Teng Guihua, sat on the escort's chair and smiled at everyone, a little reluctantly.

Everyone is still a little uncomfortable with the change in her attitude. Could it be that conscience has discovered it?I owed my daughter, and now I have to make up for it.

You may deal with objective diseases every day, and when analyzing the disease, you will not carry any emotions. One is one, and two is two. You will not turn one into two just because you hate one.It is also possible that after staying in the system space for a long time, people's temperaments have also changed.

In short, Yang Ping doesn't quite believe that this shrew has changed so quickly, but he doesn't need to deal with her, he just treats Fang Xiaoyun seriously.

Professor Zhang personally checked the body, and the muscle strength is currently at level two, which is also level two, which is worse than yesterday's level two. Yesterday, I moved my limbs faster on the bed, but today I moved very slowly and weakly.

Now it is a progressive decline, Professor Zhang frowned, decades of experience told him that the situation is not optimistic.

"Professor, my daughter was able to walk before the operation, why can't she walk now, paralyzed?" Teng Guihua asked carefully.

Professor Zhang glanced at her: "We are observing closely and will conduct further inspections if necessary."

"The operation went wrong?" Teng Guihua blurted out.

(End of this chapter)