medical simulator

Chapter 285 The Ignorant is Fearless! (seeking subscription)

The seats on the plane were quite empty, and there were not many people. Zhou Cheng and Li Chongyue sat in a row, and there was no one in the closest corridor.

Li Chongyue seemed a little nervous, his back pressed against the back of the seat tightly, and he looked at Zhou Cheng, after the plane took off for a while.

Li Chongyue took a breath of relief and asked, "Senior Brother Zhou, the call you received earlier was really a consultation?"

"Are you going to have an operation?"

Li Chongyue felt a little uneasy, feeling that it was too unreal.

Although he hadn't started working yet, it was too appalling for a senior brother to be called to Shanghai for consultation and surgery.

"I didn't know until I went there that I might not be on stage." Zhou Cheng wrinkled his expression at this moment, glanced at Li Chongyue, and replied.

Although Xue Xiude is new to this type of operation, he is a professor himself, and he can understand one by analogy. Even if it is a troublesome operation, according to his experience, he can handle it freely.

Knowing that he is currently in Shashi, if he still wants to call the patient he went to see, it probably won't be very good.

"Oh." Li Chongyue nodded, not daring to speak again, his expression still a little nervous.

However, there was a little more trust in the gaze towards Zhou Cheng.

At least, for now, Zhou Cheng didn't have too many rhetoric, but was thinking about something, which was completely contrary to the tricks he knew.

The more people let you down, the more likely they are plotting against you. Of course, it cannot be ruled out that Zhou Cheng is fishing on purpose.

But he has already contacted his family, and Zhou Cheng also let him not monitor him, so he is not afraid that something will happen.

……

Soon, in fact, there were nearly two hours.

The plane lands.

Zhou Cheng took Li Chongyue out of the airport quickly. When he got off the plane, Professor Xue Xiude called to inform him that someone was waiting outside the airport and found the license plate.

The other party glanced at Zhou Cheng, and then passed Li Chongyue.After the two got into the car, they started immediately.

Zhou Cheng asked: "Master, can I ask, Professor Xue Xiude, where is the surgery done now?"

"Then I don't know. I took the task temporarily. Someone asked me to come to the station just now to pick you up at a designated location. Didn't they tell me which hospital to send you to?" The master said a little strangely.

"Well, okay, it's okay." Zhou Cheng didn't say much.

The other party knew his name, and he must have been sent by Professor Xue Xiude to pick him up. It is inconvenient to explain, it may be difficult to say.

Zhou Chengcheng wanted to search the target hospital to see if it was that kind of place, but the other party's reply made him more sure of one thing.

Some hospitals are relatively special hospitals, and some wards are also relatively special wards.

The Eighth Hospital does not have this kind of ward, but both the Affiliated Hospital of Shonan University and the Second Hospital have it.

There is a more popular way of saying it is the senior cadre ward.

After arriving at the location, Zhou Cheng and Li Chongyue got out of the car first, and then saw an acquaintance.

Professor Li Xuande of Yan Chai Hospital.

Li Xuande was wearing casual clothes at the moment, standing at the destination, and he saw Zhou Cheng when he got off the car.

After Zhou Cheng got off the car, he said again: "Xiao Zhou, I'll take you."

But after finishing speaking, he immediately saw Li Chongyue again, frowned slightly, and stopped talking.

Zhou Cheng hurriedly explained: "Professor Li, this is my junior brother, Li Chongyue. When Professor Xue called me just now, we were having breakfast together. So we came here together."

"Chongyue, this is Professor Li Xuande from the Department of Trauma Surgery at Renji Hospital Affiliated to Shanghai Jiaotong University." Zhou Cheng introduced Li Chongyue again.

"Hello, Teacher Li." Li Chongyue became even more nervous.

Only then did Li Xuande say: "Xiao Zhou, let's go there first, but your junior brother Xiao Li may not be able to enter the place we want to enter."

"Okay." Zhou Cheng really didn't think of this in advance.

Li Xuande didn't say much, and led Zhou Cheng into a commercial vehicle, and the car continued to drive. After detours, Zhou Cheng couldn't tell the direction at all, and went into the underground parking lot.

On the way, after Li Xuande communicated with Professor Xue Xiude, he still decided to let Li Chongyue stay in the car and continue to wait, and only let Zhou Cheng get on by himself.

Zhou Cheng had no choice but to confess a few words to Li Chongyue, then got out of the car with Li Xuande.

After the two got out of the car, the driver took the initiative to talk, "Do you want to go up with me and find a place to rest, Dr. Li? There is a coffee shop inside the hospital."

"No, there's no need, teacher." Li Chongyue didn't dare to agree. He was new here and unfamiliar with the place. He was really afraid of being betrayed right now.

Turned around the car several times.

"Don't be nervous, Doctor Li. I'm just a driver. Then I'll go down and bring you some bottles of water. You can rest in the car for a while."

"It is estimated that Dr. Zhou and several professors will take a while."

"Okay." Li Chongyue held the phone nervously, hesitating whether to make a call or not.

However, he has been sharing his real-time location at any time.

……

When going upstairs, Zhou Chengcai asked, "Professor Li, what's so special about this patient?"

There are two special ones, one is status, and the other is illness.

"They are all special, mainly because of the special circumstances."

"The injured person was a veteran cadre. His request was to be able to walk and participate in a more important poverty alleviation activity preferably in a week later."

"This gentleman is quite pragmatic. Although he is not well-known, there are quite a few people who respect him. Even after retirement, he is still walking for poverty alleviation."

"He traveled a lot, and finally had such a meeting, so he hoped that he would not be absent." Li Xuande said solemnly.

"Then how did the old gentleman get injured?" Zhou Cheng continued to ask.

"During the inspection, I accidentally stepped on it and fell down. I was sent to the local hospital and said that I needed surgery. The old man disagreed, so I was transferred to Shanghai. But I still don't want to miss it."

"The place he went to was a bit remote and the transportation was inconvenient." Li Xuande didn't describe it in depth.

"Intertrochanteric fracture. After being sent, I was the first one to seek consultation. I suggested Professor Xue Xiude and Professor Jingjingxing. After seeing it, Professor Jing found it quite troublesome."

"I just arrived in Shanghai this morning, so we decided to ask you to come up with a solution, which happens to be after your defense is over."

After saying this, Li Xuande said again: "Professor Xue also discussed this matter with Mr. Zeng, and Mr. Zeng agreed, so I called you."

Well, come to think of it, this must really be a respectable old gentleman, and what he did was also very meaningful.

Otherwise, there wouldn't be so many resources for him. In Zeng Lao's current situation, although he still needs human relations, he doesn't need to bend down to serve the powerful.

Coming from the mountains in western Hunan, Zhou Cheng really knows the poverty in many places, which is unimaginable.

"How old is the old man?" Zhou Cheng asked again, don't tell me I'm in my nineties.

"At 85, the body is still in good health on weekdays. The military is transferred to the military. The basic physical condition is not bad, otherwise, even if the situation is special, we will not consider it based on the current situation." Li Xuande said.

Naturally, he won't promise anything indiscriminately. At an advanced age of more than 80 years, the biggest influencing factor for being able to withstand surgery and predict the effect of surgery is the physical condition before the injury.

No matter how complicated the intertrochanteric fracture is, it is not a problem for Li Xuande and Professor Xue Xiude.

It’s just that the traditional surgery requires a large incision, and no matter how bad it is, it is an intramedullary nail. After the intramedullary nail fixation, although it is possible to stand in time, there is a deep incision after all. (There are variants of intramedullary nailing at intertrochanteric fractures, with different names, but the essence is similar.)
Soon, the two changed into their hand washing clothes and entered the operating room.

It's just that the operating room here is quite different from the usual operating room. Next to each operating room, there is a relatively closed space, which may be used for discussion.

After Li Xuande walked in, he directly dragged Zhou Cheng into a simple conference room next to a certain operating room with lights on.There were quite a few people sitting inside, all in green hand washing clothes and hand washing pants.

There are acquaintances there, such as Jing Xing, Xue Xiude, Hu Xianhe and a few other people that Zhou Cheng doesn't know, but they are all quite old.

To be able to invite so many heavyweights, this old gentleman is not an ordinary person.

When Zhou Cheng walked in, Li Xuande said in a low voice: "Xiao Zhou, the medical records and preoperative examination results are all there, you should go and browse them first."

"Okay." Zhou Cheng nodded, and then slightly clasped fists with the other teachers as a signal.

He didn't say much, but went straight to the medical records office.

Open it up.

Except for gender, other information is all numbers.

Well, this is the first time Zhou Cheng has seen such a medical record, so he didn't struggle too much, and roughly sorted out the current medical history and medical records.

The history of present illness is mainly the limitation of movement of the right lower limb after a fall. The history of past diseases is also quite simple, only high blood pressure, but it may not be true.

The results of the preoperative examination were nothing special. The blood pressure was well controlled. It was measured several times in a row, and it was all between [-] and [-]. There were no obvious contraindications to surgery. The inflammatory indicators were high, but the white blood cell count was not Not particularly high.

Then I read the films again, there were plain films and CT scans, Zhou Cheng was slightly taken aback after seeing them.

He knew why Professor Xue Xiude and others came to do minimally invasive surgery in person, which was a bit tricky.

This fracture is a bit violent. It is not just a simple intertrochanteric fracture. The fracture line extends upward to the femoral neck and downward to the middle of the femur. It is an ultra-long oblique fracture.

Looking at the CT again, the bone quality is fairly good, and there is no bone defect, but the fracture line is a bit too long, and it is difficult to find a focus point for small incision open reduction and internal fixation.

Thinking that Zhou Cheng was about to finish reading, Professor Xue Xiude spoke first, and said calmly: "Xiao Zhou, do you care whether this case is suitable for small incision open reduction and internal fixation?"

Zhou Cheng turned his head to look at it, and shook his head: "It is extremely difficult to use small incision open reduction and internal fixation for such an ultra-long fracture line type, and the possibility of loosening of the internal fixation device after the operation is extremely difficult. very high."

"If it is prudent, it is better to use the traditional fixing method, plus titanium mesh or steel wire binding."

Hearing this, Professor Xue Xiude breathed a sigh of relief: "Director Zheng, you also heard that after Zhou Cheng saw the patient himself, he also felt that the risk of small incision open reduction and internal fixation is relatively high, so our opinion , or, it is better to adopt traditional fracture surgery.”

"We have tried it once before. You can see the fixed effect, and there is nothing we can do."

The person named Professor Zheng sighed after hearing the words: "It's hard work for you, Professor Xue, and it's also hard work for Dr. Zhou, who is exhausted from traveling around, and came here personally from Shashi."

"The main reason is that the situation is rather special. Since Professor Xue, Professor Jing, and Professor Hu all have quite the same opinions, then I can only discuss it with the patient's family."

"Thank you, Director Zheng." Xue Xiude and others said to the person who spoke.

After a while, Director Zheng walked in with an uneasy expression, his face full of embarrassment.

Seeing Director Zheng's expression, Xue Xiude froze slightly.

"Dr. Zhou, I met the patient's lover and the patient's son. They all begged to try again. They said that this can be said to be the last trip and last wish of the old man in this life."

"Before entering the operating room, he confessed that no matter what the price would be, he was willing to give it a try. He was the one who provoked the head first, and he was the one who ignited the fire of hope. He could not retreat halfway at this time. "Director Zheng said.

"Couldn't we find someone to replace him? Such an important matter doesn't necessarily require him to show up in person?" Xue Xiude actually didn't want Zhou Cheng to take another risk.

The old man is not worth doing this. If it is true that even if the activities are resumed, it is not worthwhile to sit down for a while during the meeting, and the people will just sit down.

Director Zheng said in a low voice: "The old man's wife is very old, and his son is about to retire, and he has not entered politics."

"And not all of them are old gentlemen, making people trustworthy. There are many people who want to take over this sweet pastry, but those who invest may not be willing to trust the person who takes over!"

Zhou Cheng's expression changed when he heard the words.

This topic is quite sensitive.

Director Zheng asked: "Doctor Xiao Zhou, what do you think?"

Zhou Cheng said: "Even if you can walk, the sitting posture is not conducive to recovery. After the intertrochanteric fracture, it is better to keep the lower limbs upright as much as possible."

"Moreover, such a risk is very high. If there is any accident at the venue, the medical facilities are not well prepared?!"

This is a desperate thing, Zhou Cheng was actually a little touched in his heart.

At the age of more than 80, there is no need to put on a show anymore, this is purely the pursuit of life.

In his 80s, he can still gain people's trust. This old man must have been quite popular when he was young.

"These risks are beyond our consideration. Everyone has their own choices and things to do."

"Doctor Xiao Zhou, if you are sure, I personally beg you to come forward."

"The old man is kind to me personally and to my family. The reason why I invited so many professors this time is actually my private request, because the old man convinced me."

"Well, today's operation was carried out, to a certain extent, it was mixed with my personal grievances, and I won't be on stage later."

Hearing this, Zhou Cheng was sincere when he saw Director Zheng.

Everything can be explained, why Xue Xiude still called him.

In such a place, with such troublesome patients and such unreasonable demands, as Director Zheng inside the hospital, he still has to continue the operation.

"Then? Professor Xue, let's go over the surgical plan first. I have a suggestion for a surgical approach. Teachers, please help me to review the feasibility."

Someone took the responsibility away, and he was just a doctor. To a certain extent, the patient's condition and personal request were personal choices, and he was strongly willing to bear the corresponding risks. At the end of the operation, Zhou Chengcheng completed the treatment itself.

What will happen next, Zhou Cheng can only give him sincere blessings.

"Professor Xue, may I ask where your incision is now?"

"1cm below the greater trochanter, about 18cm below." Xue Xiude accurately reported the location.

Zhou Cheng's thoughts turned quickly, and he nodded: "Okay, then we will continue to take these two positions, but our operation method needs to be slightly changed."

"The current difficulty in fixation of patients is that the fracture line is too long and the fixation is unstable. We need to add some binding and fixing props and auxiliary binding equipment."

"For example, we use Kirschner wires to cross the position 1cm and 18cm below the trochanter of the femur, and then we use steel wires to bind them in a figure-eight shape to complete the first fixation."

"Then, we use the extended internal fixation device to fix the upper and lower Kirschner wires a second time, and then extend the device for the third fixation."

"In this way..."

"After the fixation is completed, I will provide a special wheelchair with one pedal, which is very suitable for patients with fractures to get out of bed after surgery..."

"Teachers, what's your opinion?" Zhou Cheng finished speaking and looked around.

Jing Jingxing, Hu Xianhe, and Xue Xiude were just stunned, but the others, including Director Zheng, all opened their mouths wide and stared round their eyes.

Zhou Cheng can understand what he said.

Zhou Cheng's idea of ​​fixation is nothing more than the combination of traditional intramedullary nail fixation and steel wire binding internal fixation. However, the combination is a combination, and it is carried out in an open state.

When it is closed, you have to complete the bundling operation of the steel wire, or bundling in a figure-eight shape.

Brother, why don't you go to heaven?

Within the theory, outside of the operation, have high eyes but low hands?

However, Professor Xue Xiude has seen Zhou Cheng's operation before, so Xue Xiude nodded: "Triple fixation has reached the pinnacle of the internal fixation method. If there is still an accident, then there is really no other way." Good idea."

"I agree with Xiao Zhou's opinion."

"I agree too." Landscape Star and Hu Xianhe said one after another.

The three top bosses all spoke, and the others didn't dare to speak any more. They could only nod and walked out of the temporary conference room.

It is not difficult to complete this operation, but it is difficult to complete it to the point where it can go to the ground early without complications.

It's just that this little Zhou, although it sounds nice, can he really do this?
The ignorant are fearless!
(End of this chapter)