godfather of surgery

Chapter 946 Upgrading in Place

The next day, Yang Ping went to the CCU for ward rounds to check Karen's postoperative condition.

Professor Yang's ward rounds are destined to be watched by many people, so Yang Ping has just stood beside the bed. Karen's ward is already filled with doctors on three floors, including senior chief physicians and deputy chief physicians. , or young doctors, masters, regular trainees, and interns, surrounding Yang Ping.

Xia Shu reported on Karen's condition after CCU surgery. Currently, his vital signs are stable and he does not need the support of ECMO. Stable vital signs are maintained by Karen's own heart, which is very rare for Mr. Karen.

Before that, in order to reduce the load on the heart and preserve the only cardiac function, Karen had been relying on ECMO to maintain life. Even when he was transported to China by medical plane, Karen still did not leave the support of ECMO.

Now after the operation, the tattered heart has been repaired and rebuilt, has normal functions, and can fully support Karen's life.

After listening to Xia Shu's report, Yang Ping took the tablet PC handed over by Xia Shu and began to look through Karen's latest examination results. The patient's electronic medical record information was always updated faster than the paper information, and all the examination results were the same. The first step is to upload the report to the electronic platform of the internal network. However, sending the paper report to the doctor requires a tedious process: issuing the paper report, delivering it to the department, and the bedside doctor or intern putting the report into the medical record. This process Sometimes it takes several days, so the doctor prefers to look at the information on the computer, which is more timely.

In intensive care units like CCU, there are a lot of various examinations every day. The examinations in one day can often exceed the examinations in the entire hospitalization period in ordinary wards. Yang Ping carefully examined each one, focusing on various blood tests.

Blood routine, biochemistry, liver and kidney function, myocardial enzyme spectrum, procalcitonin, etc., all have been reviewed after surgery. From the examination results, it seems that the infection has been completely controlled. This kind of infection with local lesions has no effect on the surgical operation. It has an immediate effect. After the infection focus is cleared, the general infection can be quickly controlled, and some remaining infections are quickly eliminated under the attack of antibiotics and the body's own immunity.

The most common infection with lesions is various abscesses. Surgical incision and drainage or removal of abscesses can quickly control the infection. If there is no surgical intervention and relying solely on medical treatment, no matter how high-end antibiotics are, it is difficult to obtain good curative effects.

Karen's bacterial endocarditis, infected valves, abscesses and vegetations are all infection lesions. These lesions cannot be removed and the infection cannot be controlled at all. Now the surgery has completely cleared these lesions and then replaced them. A new valve was put in, the infection was under control, and Karen's condition will soon return to normal as long as her heart function returns to normal.

The Swedish doctor who was following him kept writing down something. This doctor made very detailed notes in the form of drawings and text. He even drew Karen’s bed in the CCU, the furnishings of various equipment in the room, and the instruments. Various monitoring data on etc.

Song Zimo took a glance and saw that the Swedish doctor's entire notebook was made like a book of miniature figures. Perhaps in order to pursue the speed of recording, the miniature figures were like the recently popular stick figure paintings, which were very concise.

Yang Ping read the electronic medical record and prepared to do a bedside echocardiogram, which is an examination that needs to be reviewed repeatedly after surgery.

Xia Shu brought in a color ultrasound machine and began to perform echocardiography on the patient. Echocardiography can make a qualitative diagnosis of some heart diseases. It can also quantitatively analyze the heart structure, valve morphology, ventricular wall motion and hemodynamic status, and evaluate the heart morphology, Structure, including heart chamber size, ventricular wall thickness, valve opening and closing, and myocardial movement.

Therefore, color ultrasound is the most commonly used examination in cardiac surgery in many cases. In the perioperative period of cardiac surgery, that is, before, during and after surgery, color ultrasound is an indispensable diagnostic and evaluation tool.

In our country, echocardiography is generally performed by ultrasound doctors. Whether they are cardiologists or cardiac surgeons, few have mastered the principles and operations of echocardiography. Most doctors are laymen.

Different from our country, cardiologists and surgeons in Europe and the United States must do echocardiography by themselves. They receive comprehensive learning and practice in this area from the time of residency training, so cardiac color ultrasound is a must for every cardiologist. Preparation skills must be mastered proficiently.

The founder of echocardiography, Dr. Feigenbaum of the United States, was not a sonographer, but a cardiologist. Cardiac surgeons or physicians with clinical experience can master the principles and uses of color ultrasound and perfectly combine clinical practice with imaging.

A doctor in the ultrasound department will never perform cardiac surgery in his life. He lacks clinical experience in heart disease and only has imaging knowledge. The combination of clinical and imaging is more conducive to the advancement of cardiac color ultrasound.

The father of echocardiography in my country is Professor Wang Xinfang of the Ultrasound Department of Wuhan Union Hospital. He has made great contributions to the ultrasound profession and is recognized as the world's first person in fetal heart ultrasound monitoring.

In the 60s, obstetricians in my country could only rely on listening and touching to understand the condition of the fetus in the womb, but could not hear the fetal heartbeat. In 1963, while performing an ultrasound examination on a pregnant woman, Professor Wang found that the waves displayed on the ultrasound machine jumped a bit, and speculated that this should be the fetal limb movement. He immediately thought: Since he can understand body movements, can he use it to monitor fetal heartbeat? So Professor Wang began to try and used two ultrasound probes, one connected to the mother's heart and one connected to the fetal heart, to obtain two wavebands with different speeds. After many observations, he discovered the fetal heartbeat reflex. That year, Professor Wang published an article in a domestic medical journal and drew the world's first fetal heartbeat fluctuation frequency curve. In 2002, based on this article, the world ultrasound community finally confirmed that China was the first to discover fetal heart ultrasound reflection.

In fact, Xia Shu was not very familiar with echocardiography when he was in Fuwai Hospital. He had little exposure to both the principles and practical operations. He usually relied on the help of sonographers to complete echocardiography examinations. After arriving at the Institute of Surgery of Sanbo Hospital, Xia Shu began to learn to do echocardiograms and make diagnoses by himself. Now Xia Shu has mastered the principles and operations of ultrasound, and is very skilled in the operations.

Yang Ping watched from the side, while Xia Shu started to operate. The color ultrasound probe began to examine Karen's heart, making a comprehensive evaluation of the size of the heart chambers, ventricular wall thickness, valve opening and closing, myocardial movement, etc., without missing any details. , especially in the case of valves, must be carefully evaluated to detect subtle potential risks.

The doctors around them quietly watched Yang Ping and Xia Shu perform cardiac ultrasound. No one made a sound, they were all very focused.

The Swedish doctor continued to draw his "stick figures" while watching, because he wanted to restore the respective positions, postures, etc., of the doctor and the patient during this kind of examination, so that some things that he did not understand could be analyzed slowly later. Things cannot be described in detail and accurately by relying on words.

Judging from the color ultrasound examination, no problems were found, indicating that Karen's operation was very successful. The cardiac color ultrasound showed that all parameters of the heart, whether static or dynamic, were normal. The implanted valve was of appropriate size and had open and closed functions. Normal, no closure or incomplete opening.

Karen's surgery involved thousands of stitches on the heart. As long as these stitches can be stopped for the healing period, there will be no problem. The fixation of the sutures is only temporary and ultimately depends on the tissue on the heart to heal.

The healing time of an incision on the heart is very short, because the heart itself has a very rich blood supply. The richer the blood supply, the stronger the healing ability. The poorer the blood supply, the worse the healing ability.

For example, wounds in diabetic patients take a long time to heal, and may even be prone to non-healing, because diabetes can cause changes in peripheral blood supply, resulting in poor blood supply, so the wound heals slowly or does not heal.

"Extubate him today!" Yang Ping felt that Karen was in good condition and could be extubated.

Secretary Xia took note of Yang Ping's words. After the ward rounds, he would pull out the tracheal intubation inserted before yesterday's operation and allow Karen to breathe normally.

The Swedish doctor was very surprised by Karen's recovery. He participated in Karen's entire perioperative treatment and observed the entire operation at close range, allowing him to see what the world's most powerful cardiac surgery is like. His little notebook It recorded Mr. Cullen's entire treatment process. With permission, he copied Cullen's surgery. This information is undoubtedly valuable to Swedish doctors.

After checking the ward, Yang Ping had to rush back to the surgical institute, as there were still many surgeries waiting for him. Outside the door of CCU, Ning Qi and Karen's family members have been waiting for a long time. Mr. Karen was introduced by Ning Qi, and Ning Qi arranged his family's accommodation and life in China, so Ning Qi often comes here to see him. Yang Ping understood the condition.

Most of Karen's family members speak Swedish. Yang Ping, with the help of a translator brought by Ning Qi, briefly introduced Karen's condition. He heard that the postoperative period was very smooth and that the tube can now be extubated and transferred back to the general ward in a few days. , and then slowly got out of bed and moved around. Karen's family members were very excited. His wife and several children kept saying thank you.

"Thank you!" Ning Qi also looked at Yang Ping gratefully.

Yang Ping said with a smile: "I am a doctor, this is my duty."

"Whenever you are free, I'll treat you to dinner. Don't just say you're busy - I'm not treating you alone, but also inviting Xiao Su and my godson. You decide the time. Come to my house and I'll cook for myself." Ning Qi said in a gentle voice.

"You cook for yourself?"

This eldest lady usually has many things to do, but she still cooks by herself?

Ning Qi said slightly annoyed: "I know how to cook when I'm ten years old. My cooking skills are very good. Don't look down on others. This is just the first time I've made cookies."

"I'll ask Xiao Su to make an appointment with you." Yang Ping replied.

Ning Qi straightened her hair in front of her forehead and nodded: "Okay, I'll make an appointment with Xiao Su."

Yang Ping was busy and had many operations, so it was not easy to chat with Ning Qi for too long, so he left and rushed to the operating room immediately. On the way, he heard Song Zimo say that Bao Junhao had been sentenced, and his father Bao Yulou spoke in a low-key manner. Establishing a charity fund specifically for the education of young people. If Song Zimo hadn't mentioned it, Yang Ping almost forgot about it. If it weren't for the two brothers Dashun and Ershun who were protecting him at that time, he might have hurt those bastards, or even lost him. This kind of person should be punished by law. This incident also served as a warning to Yang Ping himself that he must pay attention to his own safety issues.

Dean Xia called and said he wanted to chat with Yang Ping. Yang Ping said, "I'll go to your office."

Dean Xia quickly said: "No, no, I'll go to the dressing room of your operating room. Let's chat for a few words in the dressing room. I won't waste your time. I'm already in the dressing room now. Why didn't I see you?"

Yang Ping immediately explained: "I just went to CCU for ward rounds, and I'm just going back now. Please wait for a while."

In the dressing room of the operating room of the Institute of Surgery, Yang Ping met Dean Xia, who had been waiting for a long time. His tall body was so conspicuous that the bench in the dressing room seemed too small and thin. When Yang Ping came in, Dean Xia Chang Li stood up and said: "Let's chat here for a few words without taking up your time. You are very busy now and will have an operation soon."

"I just thought you had entered the operating room, so I found a visiting clothes to put on."

Dean Xia didn't need to go to the operating room to find anyone now, so he took off his visiting clothes. The visiting clothes were too small for him. It felt like an adult wearing children's clothes and it would burst immediately.

The two were sitting on the bench in the dressing room chatting. Dean Xia said: "Our hospital will be restructured soon. It will no longer be managed by the provincial department. In the future, it will be directly managed by the Imperial Capital. However, the management and employees of the entire hospital will remain unchanged. Don’t reduce staff, don’t increase staff, don’t replace people, do whatever you have to do. I originally thought I would be acquired by Imperial City 301, but now it seems that this is a bigger deal. You see how much our country values ​​talents. This is all for you. Do you like it? In the southern city, I like to be in Sanbo Hospital, so Sanbo Hospital was upgraded on the spot without change. I also took advantage of it and upgraded together. With this upgrade, my administrative level as the director has also been upgraded a few levels. The pension will definitely be higher in the future.”

Yang Ping had already heard about the acquisition by 301. It was the original plan to turn Sanbo Hospital into 301's Southern Clinical Center. Now it seems that this plan has also been rejected, and Sanbo Hospital will be upgraded in place instead.

"This is all for you. In order to maintain the hospital's environment and vitality without being affected, we upgraded in place. That's what I'm talking about today. In the future, except for a higher status and more resources, other things will remain the same. In the future, your scientific research funds will be even greater. It is sufficient. It not only allows you to raise funds by yourself, but also the country will provide strong support, so you can rest assured to carry out your research in the future. Money is not an issue. The superior leaders have said that in principle there is no upper limit. The superior leaders have also said that there is no psychological pressure. , there won’t be any indicators or anything like that, you can plan everything by yourself and develop freely.”

Dean Xia knew that the superior leaders fully respected Yang Ping's choice and put a lot of thought into providing Yang Ping with a good platform.

''There's nothing else but this. If you have any other ideas or requests, you can put them forward. "

Dean Xia was afraid that Yang Ping had other demands.

"There are no requirements, everything remains the same anyway."

Yang Ping and Dean Xia chatted for a while. Dean Xia still had many things to do, and Yang Ping also had many surgeries. When Dean Xia left, he said, "I think your place is good. If I need to come to you for anything in the future, this is the place. It won’t waste your time, it’s better than the office.”

"Don't, please don't come here often. If you come here often, we doctors won't even dare to change clothes here."

Yang Ping reminded Dean Xia.

Dean Xia thought about it, yes, this is a place where doctors change clothes. How can it be used to talk about work? He looked around the dressing room and said, "Why don't you see anyone coming in to change clothes?"

"Seeing you here, everyone hid in the duty room to change clothes." Yang Ping said matter-of-factly.

Dean Xia looked troubled: "Am I so unpopular? So out of touch with the masses?"