This doctor has a system

Chapter 520 583. I understand!
"My life is so miserable!" Zhang Meiniu started howling in the ward after waking up, "I have never enjoyed a single day of happiness in my life!"

A nurse was mopping the floor inside, and I felt sorry for her.

"I guess it's because the family is poor." She said to another older sister who was working with her.

"I've seen the son in bed 8, and he seems to be dressed quite decently," said the older sister.

"That's disobedience."

Zhang Meiniu's son happened to pass by. He felt helpless when he heard what they said. He wanted to scold them, but suddenly felt it was unnecessary.

"Mom, just endure the hardship for a few more days," he said to his mother. "Director Gao said there is great hope for recovery."

"Mom, this suffering will never end." Zhang Meiniu cried loudly, "God damn it, you are catching me in trouble!"

God is so unfair, the son thought.

"Mom, don't cry. It will be okay this time." He comforted her.

"If you cry and get any problems again, you'll probably have to suffer other things."

Zhang Meiniu calmed down immediately. She was really scared.

Gao Feng discussed tomorrow's surgical method with Zhengyang and the others. In fact, it was mainly him who was talking and a group of people were listening below.

General practitioners basically do not perform bronchoscopy; this is a skill that only respiratory physicians and critical care physicians need to master.

Of course, there's no harm in listening.

"How about it? This should be able to solve the problem." Gao Feng was very satisfied with the PPT he made.

"There will definitely be no problem if the director takes action." Bu Zhengyang said with a smile.

"The director explained it so clearly that I understood it even though I have never done it before." said a knowledgeable guy.

"Me too." Mao Wen quickly said.

"I got it!"

"Me too!"

Gao Feng was very happy that so many people understood it. That means he should at least get a dozen skill points.

"Invalid teaching, you gained 0 skill points." The system prompted.

Very good, a good atmosphere has been formed in the department.

When you stand high enough, you won't hear any unpleasant sounds.

Zhang Meiniu was pushed into the bronchoscopy room early in the morning. The anesthesiologist was afraid that she would be nervous, so he whispered a few words of comfort to her.

"Stop talking, we've done it dozens of times." She said impatiently, "Hurry up and take the medicine, I want to sleep."

With the injection of anesthetic, Zhang Meiniu soon fell asleep.

With the help of the soft endoscope, Gao Feng picked up the hard endoscope and pushed it in. Soon, he saw the previously placed self-expanding coated metal stent under the endoscope. This stent should have been inserted recently and looked very new.

There was some white sticky sputum on it, and a small amount of granulation tissue grew on both ends of the stent.

This is a very optimistic situation. Gao Feng simply used argon gas to burn the granulation tissue on the body, and then used forceps to pull out the stent along the hole of the hard mirror. There was only a small amount of bleeding during the process.

After the stent came out, Gao Feng looked again with a mirror and found that there was some granulation tissue hyperplasia under the stent.

People with scar-prone constitutions really cannot afford to be hurt. A minor injury can actually cause such a big trouble.

Gao Feng decided to perform cryosurgery on these newly grown granulations. The principle behind this is actually very simple.

It is to use a small freezing probe, carbon dioxide or nitrous oxide, etc. to significantly reduce the local temperature of the probe, and through the extremely low temperature, the local tissue cells inside and outside the crystals are dehydrated, the cell proteins are denatured, and the tissues are ischemic and necrotic.

This technology is very mature, highly safe and has few complications. It generally does not damage the airway cartilage or cause airway perforation, and is less dangerous.

Most newcomers usually practice cryosurgery when they first start using bronchoscopic treatment. It is not like argon or electrosurgical surgery, which will fill the whole house with barbecue smell, so it is relatively environmentally friendly.

Gao Feng quickly dealt with these places one by one.

The next step was to insert the silicone stent. Gao Feng used pliers to clamp the stent and inserted it. After the silicone stent popped out, he found something wrong.

The customized stent doesn't seem to match this section of trachea very well, as the diameter is a little too large.

Most patients will not bother with it, there is no problem using it.

But Zhang Meinui can't do that. She has a very bad scar-prone constitution. If the stent puts too much pressure on the surrounding tracheal mucosa, it is hard to say whether the pressure stimulation will lead to tissue hyperplasia.

Gao Feng operated very carefully to reduce damage to the tracheal mucosa, and he eventually removed the stent that had just been inserted.

The person from the manufacturer was also there. After a brief communication, the two began the on-site pruning and polishing work.

"Director Gao, I haven't seen you put in a stent recently." The young man said, "I heard that you went to Beijing."

"Yes, now we are running between the two sides." Gao Feng replied. This young man from the factory is very perceptive and good at flattering. He can also cooperate with him on the stage. He is a promising talent.

"Please support us more," the young man requested. "Sales have been poor in the past few months, and my boss has been scolding me."

"I just want to support you, but there's nothing I can do." Gao Feng said, "You have to have a sick person."

"Can we expand the indications here?" the young man asked, "I see some hospitals use quite a lot of stents."

Gao Feng ignored him. After all, silicone stents were also foreign bodies. They could not be placed randomly without clear surgical indications. It was not as simple as eating a candy.

Like Zhang Meiniu, many patients will encounter endless troubles, especially cancer patients.

Gao Feng had previously seen an elderly patient, who was 81 years old and had advanced squamous cell lung carcinoma. Tumor infiltration had caused large airway stenosis, and an airway stent had been placed.

Then problems would occur every now and then: poor airway humidification would lead to sputum blockage, and tumor growth would block the stent.

The patient spent his last days in the hospital.

This stent did not play any beneficial role, but instead prolong the patient's pain.

When encountering such an elderly patient with no quality of life, Gao Feng is unwilling to discuss measures such as stent placement with the family.

After being trimmed and polished, the silicone stent was put back into Zhang Meiniu's airway. This time the size was just right and the fit was very satisfactory.

"Watching you do it, I always have an illusion that placing the stent under a hard mirror is very simple." Liang Congyue, who was watching from the side, couldn't help but sigh, but when he really tried it himself, he realized it was not easy.

I don’t know how much effort it will take to make every step so efficient and perfect.

After Zhang Meiniu woke up, she was sent back to the ward by the nurse. She felt that this time seemed different from the past.

After every bronchoscopy, she would cough violently for a while, but not today.

This couldn't help but give her a sense of anticipation.

"It's still early. We'll have to do it again next week." Gao Feng poured cold water on her. Next time, it will mainly depend on whether there is new granulation tissue. If there is, cryotherapy and submucosal injection of drugs will be required.

"Mom, hold on a little longer." The daughter-in-law comforted her, "You like to endure hardships anyway."

"How can you talk like that?" the son said dissatisfiedly, "Mom is like this, can't you just say this in private? Really!"

Soon one week passed, and during this period Zhang Meiniu's condition was very stable, which undoubtedly gave her family more expectations.

The results of this bronchoscopy also made them very happy, as no stubborn granulation tissue was seen.

"It may be that the time is too short." Gao Feng said, "Come back one month after you are discharged from the hospital."

At that time, another assessment will be done and the silicone stent can be removed if possible.

(End of this chapter)