This doctor has a system

Chapter 543 606. It’s over, it’s over, this patient has arrived
"Baidu said that some children with the flu will have a fever for at least a week." The mother said, "Son, hold on."

"But he looks so miserable." Zhu Ping'an's father was worried. "I think we should go to the hospital and have a look."

"Look, you're just being impatient."

"What do you know? Who doesn't feel uncomfortable when they are sick?" said the wife. "Disease comes like a mountain falling, and goes away like a thread being pulled out. Everything has a process!"

Two days passed quickly, and Zhu Ping'an still had a fever and also developed symptoms of chest tightness after activities.

"No, you have to take the child to the hospital now! I'll be there later." Zhu Ping'an's father said on the phone.

"Look, he's in a hurry."

"Mom, love me again!" Zhu Ping'an began to save himself.

This sentence successfully evoked the glory of maternal love, and Zhu Pingan's mother took a special leave to take him to the hospital for treatment.

When I arrived at the clinic, the doctor still asked me to take a chest CT scan.

"Can't we just not take the photo?" she asked the doctor. "This thing has radiation!"

"The sun also has radiation. Don't you get sun exposure every day?" the respiratory doctor said. "Besides, didn't you notice that the child was a little short of breath?"

"I want a CT scan," Zhu Pingan shouted, "I feel uncomfortable!"

His shouting attracted the attention of other patients waiting for treatment, and everyone gathered around to see what was going on.

"It should be the stepmother." An old lady analyzed, "Did you notice that this woman looks a bit fierce?"

"is a bit"

"You are so heartless! A CT scan only costs a few dollars, but you are not willing to spend it on your child. You have a very bad conscience!"

Zhu Ping'an's mother was very embarrassed, and she quickly fled with her son taking the check list.

The results of the chest CT scan were shocking. It could be clearly seen that Zhu Pingan's left bronchus was completely blocked and his left lung was in a completely deflated state, like a deflated balloon.

"Have you been choked by anything recently?"

Zhu Ping'an thought about it carefully and shook his head.

"That's a big problem. We have to go to the city." The doctor felt something was wrong. It didn't look like a good thing.

Tumor?

But the patient is so young, so logically speaking, the probability of a tumor should be relatively low.

But sometimes it’s really hard to say.

Zhu Ping'an's mother was obviously unable to accept the result. She repeatedly asked the doctor for confirmation, and in the end the doctor became a little impatient.

"Don't worry! This won't go wrong!" He tried to explain, "I know it's hard for you to accept it at first, but now we have to hurry up and get the child treated."

“I’m not saying it’s necessarily a bad thing.”

"Maybe it's blocked by a phlegm plug or something."

How could a young person have such a large sputum plug in the left bronchus? However, this was all the doctor could say at this time. It was really difficult to communicate with the family members.

In the end, it was Zhu Ping'an's father who came to the hospital and he made a decision immediately: go to the Provincial People's Hospital.

"The child's father is a distant relative of mine." Director Tian said to Gao Feng.

In fact, they had met before, and Director Tian even came out to entertain Zhu Pingan's parents when they came to Z State.

But it was after that that the two families lost contact. The main reason was that Zhu Ping'an's mother was a very difficult person to describe. She often forwarded some small articles that Director Tian didn't like.

For example: a young girl died due to a black-hearted doctor, or a 60-year-old man lay on the cold operating table forever in the hope of making money without regard for the safety of the patient.

Director Tian was so upset that he simply blocked the other family.

This time, Zhu Ping'an's father went through many twists and turns before finally getting in touch with him.

"Let's do a bronchoscopy." Gao Feng said after looking at the film. Judging from the imaging, the probability of malignancy is very high.

"Isn't this doctor a little young?" Zhu Ping'an's mother was a little worried. "Talk to Director Tian and ask him to find an experienced expert to take a good look."

"Oh, you shouldn't say so much at this time." The husband said dissatisfiedly, "If we continue to make trouble, Director Tian will be even more dissatisfied with us!"

Although the beginning of autumn is approaching, the weather is still very hot. At seven o'clock in the morning, the sun is already radiating heat unscrupulously, like the sun at seven or eight o'clock.

Gao Feng did not go to hand over the shift, but went directly to the bronchoscopy room. The moment he came in, the sunlight shone on his face, as if it was covered with a layer of Leica classic filter.

Several new nurses who were in training were washing mirrors in the disinfection room and their eyes widened when they saw this scene.

Mom, this is simply life-threatening.

"Who is this?" Someone couldn't help swallowing.

"It's our Director Gao." The nurse from our hospital replied, "Stop drooling, he's already married and had kids."

"Let's take a look." The young nurses said with a smile.

'Looking like this, it doesn't matter if he gets married.' A mentally unhealthy woman thought, 'I'll suffer a little, sometimes it's okay to call him dad.'

The first patient was a middle-aged man who had been coughing for more than half a year and was admitted to the outpatient clinic. He still looked miserable. People who saw him at first glance would subconsciously think that they might owe him 100 yuan or that his wife had run away with someone else.

"Can I let my wife come in and watch while we do it?"

Obviously, the middle-aged man's wife did not run away.

"No." The nurse rejected him flatly.

"Then I won't do it!"

"Okay, I'll cancel it for you right away," said the nurse.

"No! What's your attitude?!" The man was angry, "I'm just talking, how can I really not do it!"

Everyone
"It hurts!" the man screamed again.

"I'm injecting the medicine. Just bear with it." The anesthesiologist said, "It won't hurt after a while."

"I'm going to complain to you when I wake up!"

Seeing the patient fall asleep, the anesthesiologist felt speechless. He even had an idea just now, which was to prevent the patient from waking up again.

"Who admitted this strange patient?" "Bu Zhengyang, a general practitioner, admitted him from the outpatient clinic." After Gao Feng said this, he picked up the mirror and poked it in.

When the mirror moved to the right upper lobe of the lung, the main object appeared in everyone's field of vision. It could be clearly seen that there was a round mass at the opening of the tube growing into the bronchial cavity. It had a capsule and a pedicle at the bottom that was connected to the bronchial wall.

"Is it malignant?" An intern took out his cell phone and took a picture.

"It should be benign, and the probability of it being a leiomyoma is higher." Gao Feng said after looking at it carefully. The surface of the lump is covered with normal mucosal epithelium, which is generally not the case with malignant ones.

He picked up the biopsy forceps and clamped a few pieces. There was almost no bleeding. The nurse excitedly said that what Professor Gao had obtained was big and good, and thus declared the operation over.

The next patient was Zhu Pingan. The child was obviously a little nervous, and his hands were shaking as he lay there.

"Stop shaking. If you keep doing this, I will also shake when I give you the injection." The anesthesiologist deliberately scared him.

"You are really sick!" The nurse scolded him and turned to comfort the patient, "Don't be afraid, you will fall asleep soon. It won't be uncomfortable at all."

Because the patient's left bronchus had been blocked by an unknown object, he now only had single-lung ventilation. The risk of anesthesia in this situation was still relatively high, so the anesthesiologist called in another person to help.

No matter what time it is, having more people is always a good thing. Even if the patient really has a fatal condition, it will be easier when carrying him to the morgue.

Of course, in this situation, the probability of being beaten by family members is also quite high.

Generally speaking, a person's lung function reaches its peak in their 20s and then starts to decline around 40 years old. Zhu Pingan is still a greenhorn, so his lung function must be good. Even with single-lung ventilation, his blood oxygen saturation reached 99%.

This made everyone relax.

There was no abnormality found in the main airway, and there was no special situation found in the right main bronchus and its segmental bronchus. But when the mirror reached the lower segment of the left main bronchus, Gao Feng frowned and the onlookers exclaimed in surprise.

"Oh my god!"

"It's over, it's over. The patient has arrived."

It can be clearly seen that an ugly neoplasm has grown in the lower segment of the patient's left main bronchus. It is covered with white moss and looks uneven. Dilated blood vessels and ulcerated bleeding can be seen in some areas.

The probability of malignancy is almost 100%.

Gao Feng simply touched it lightly with the bronchoscope, and immediately, blood began to ooze out of the surface of the neoplasm.

This indicates that the blood supply is very rich.

After careful consideration, Gao Feng asked the nurse to bring a puncture needle and decided to puncture the lesion directly.

Compared with directly using biopsy forceps, this method has two advantages. First, the risk of bleeding is lower. The aperture of the puncture needle is not large, so even if it pierces a blood vessel, the amount of bleeding will not be large.

Second, the puncture needle can reach deeper tissues, which helps to improve the positive rate of diagnosis.

There are disadvantages as well. The puncture needle is relatively expensive, costing more than 2000 yuan each.

The puncture process went smoothly and it only took 7-8 minutes to complete.

The family members waiting outside surrounded him when they saw him come out. "Director Gao, how is it?" Zhu Ping'an's father asked.

"The tissue has been taken. Now we just need to wait for the pathology results."

"Is the probability of it being malignant high?" he asked.

Gao Feng was silent for a while, and finally said comfortingly: "It's meaningless to think too much now, just wait for the result."

The result was naturally no luck. After the results of immunohistochemistry came out, the pathology department quickly issued a report: it was consistent with adenoid cystic carcinoma, moderately differentiated.

Zhu Ping'an's luck is obviously not very good, or should I say, very bad. Adenoid cystic carcinoma is a rare type of clinical malignant tumor with an incidence rate of only 3/1000000. The age of onset is mostly between 45 and 70 years old, and it is more common in the minor salivary glands, sublingual glands, etc., and rarely occurs in the bronchi.

It has been reported before that the youngest patient in the country was 11 years old.

This malignant tumor is not sensitive to radiotherapy or chemotherapy. If the tumor is not completely eliminated, recurrence is only a matter of time.

Currently, the tumor is only growing in the left main bronchus. Once the main airway is completely blocked, the patient will soon suffocate to death.

"What should we do? Can we have the surgery?" Zhu Ping'an's father was very anxious.

Surgery can certainly be done. In fact, thoracic surgery offers the greatest benefit for adenoid cystic carcinoma, but also carries the highest risk.

But surgery also faces many problems.

Because according to traditional surgical methods, in order to cure the tumor, a thoracotomy is required, the surgical incision must be at least 25 cm, and the entire lung on the diseased side must be removed.

In other words, the surgery involves removing the left main bronchus together with the left lung.

Zhu Ping'an is only 13 years old and he is going to lose one lung at such a young age. This will have a huge impact on his future life.

You will understand it in just one sentence. From now on, when you make love, he may only be able to lie down and wait for others to move.

"If there is a problem with the trachea, can't you just cut out the trachea? Why do you have to cut out the lungs together?" Zhu Ping'an's father couldn't understand.

In fact, many doctors couldn’t figure it out before, and they made many attempts, but most of them ended in failure, and the patient ended up having to have one side of the lung tissue removed.

You should know that the average length of the human trachea is 10-13cm, and there is currently no artificial material that can replace it.

If the trachea needs to be removed due to disease, the only option is to splice the remaining trachea together to reconstruct the airway.

However, due to the particularity of the lesion location, the trachea and the remaining part of the right lower lung bronchus are of different sizes after resection, which leads to mismatched anastomosis. At the same time, after part of the trachea is removed, the anastomosis is repeated again, which also faces the problem of insufficient length.

If these problems are not resolved, the only option is to completely remove the bronchus and lung tissue on one side.

"It's not that one lung can't be used," Director Tian consoled. It's just that it's definitely not enough, especially when you're older. But now you can't worry about that. It's better than losing your life.

Just when Zhu Ping'an's parents had accepted it, Gao Feng came over because the system had issued a task.

“Breathe Freely: I wish Ping An will soon celebrate his 14th birthday. It would be a bit cruel for this junior high school student to lose one lung at this time. Please think of a way to help him breathe freely. You will get 30 skill points by completing the task.”

Gao Feng hadn't received any tasks proactively issued by the system for a long time. He became excited upon hearing this. He looked through a lot of information and immediately had an idea in his mind.

"Director Tian, ​​can you lift the lower section of the trachea up?"

"I don't think that's possible." Director Tian explained patiently. If possible, he would definitely try it. "All the surrounding tissues, blood vessels, ligaments, and nerves must be freed. This is too difficult!"

Scholars from Western countries have previously conducted clinical research on this issue. They first experimented on mice, and later changed the subjects to gorillas.

But the results were not satisfactory. The failure rate of mice was almost 80%, and that of gorillas was even higher.

Two years ago, a patient with esophageal cancer and tracheal infiltration tried this surgery. At that time, the patient was helpless because his other lung had severe bronchiectasis and almost no function. If he lost the lung on this side, the patient would die immediately.

In order to prevent him from dying, the doctor in charge at the time thought of many ways and invited multiple departments to consult and develop a surgical plan.

(End of this chapter)