Chapter 377 Mother and baby are safe, the role of teachers
Zhou Can doesn't care about other people's strange looks.
There are two main types of aortic dissection. Type A is highly dangerous and requires open-chest surgery. The risk is extremely high, and the entire surgical process is very complicated, requiring extremely high surgical experience and skills from the doctor.
Even so, the mortality rate of type A dissection surgery is still as high as over 30%.
There are also some very powerful surgical teams that specialize in this type of surgery and can reduce the mortality rate to around 10%.
Relatively speaking, if one in ten patients dies, the mortality rate is still extremely high.
The other is type B dissection, which can usually be treated with interventional therapy by placing a covered stent.
That is, endovascular aortic repair, through femoral artery puncture, the aortic covered stent is implanted at the rupture, completely closing the rupture and closing the dissection, so as to achieve the purpose of clinical treatment.
Traditional surgery is rarely performed nowadays.
Because of the high risk and technical requirements, not many surgical teams can complete the operation.
Unfortunately, the pregnant woman was diagnosed with aortic dissection during her pregnancy, and it was type A. Seeing that one person would die and two lives would be lost, the hospital experts discussed multiple surgical options and finally decided to perform a cesarean section and dissection surgery at the same time.
Before entering the operating room, a critical illness notice was issued to the family.
To be honest, now everyone is saving lives based on the conscience of doctors.
If the pregnant woman can be saved, the baby born by cesarean section will be able to grow up under the care of maternal love. Otherwise, the baby will be left without a mother right after birth, which is very pitiful.
Why is the mortality rate of type A dissection surgery so high?
Because it is an open-chest surgery, the heart needs to be stopped during the operation, and artificial blood vessel replacement or bypass surgery must be performed. The operation is complicated and time-consuming, and there are also many postoperative complications.
Every patient who undergoes type A dissection surgery is basically in danger of death.
Some patients still die after the operation even if the operation is successful.
This operation is performed under ECG monitoring and hemodynamic monitoring throughout the process, and blood pressure needs to be strictly maintained at around 120/80 mmHg.
The above surgical conditions and basic steps show how difficult the operation is.
During the operation, the left and right brachial arteries, the left external carotid artery and one femoral artery are separately freed. Then four guide wires are inserted from the femoral artery on one side of the lower limb into the corresponding catheter. After observing the specific situation under radiological conditions, the specific surgical plan is decided.
This patient required an aortic replacement.
Director Xueyan’s surgical skills are still a little lacking after all. After working for so long, she is still stuck at the most critical and difficult step.
After Zhou Can took over, he made the two obstetricians and gynecologists feel that there is no scarier thing than getting scarier.
I saw him talking to the patient quickly and violently.
Compared with Director Xueyan's gentle, soft and slow approach, these are two completely different surgical styles.
"alright!"
More than thirty minutes later, Zhou Can breathed a sigh of relief. He had finally accomplished his mission and successfully completed the aortic replacement.
"Sister Yan, you should perform the rest of the operation!"
After Zhou Can completed the most difficult surgical steps, he was ready to give up his position.
He addressed Director Xueyan in a way that he no longer needed to hide, from behind the scenes to the front of the stage.
In front of everyone, she was directly called Sister Yan.
"You are very fast at surgery, and time is of the essence. You should do the operation! I will help you."
Director Xueyan has always treated him very well.
Whenever there is an opportunity to practice surgery, she will give it to Zhou Can as long as he is capable of doing it.
This is an intentional effort to train Zhou Can so that he can quickly become a core member of the cardiothoracic surgery department who can shoulder important responsibilities.
Today, Zhou Can's surgical skills are getting better and better, and he is basically capable of performing most of the difficult operations in cardiothoracic surgery. His status in the cardiothoracic surgery operating room is also getting higher and higher.
Gradually, a new surgical team centered around him was formed.
In fact, this trend has existed for a long time, but it is more obvious now.
Everyone is a wise person. With their abilities and talents, it is impossible for them to take over the important task of Director Hu Kan in a short period of time. Only Zhou Can can give everyone hope.
Cardiothoracic surgery is now in turmoil and full of crises.
If a new core figure fails to take over before Director Hu Kan falls, the cardiothoracic surgery department is likely to see a significant decline in business in a very short period of time and be ruthlessly eliminated from the list of first-class departments by the market.
In the past year or so, this sign has become very obvious.
Apart from other things, the total number of operations in cardiothoracic surgery has been steadily declining. Although it has not plummeted, compared with the peak period, both the number of outpatient and emergency visits and the total number of operations have dropped by almost one-third.
The huge drop in the number of medical consultations is directly reflected in everyone’s income.
I believe many people can feel the decline in income.
…
Nearly an hour later, the operation was over, and the woman's life was finally saved after so many people's efforts.
But she was afraid she wouldn't be able to breastfeed the baby.
Because she needed to stay in the ICU of the cardiothoracic surgery department, the baby was born by caesarean section because it was less than 37 weeks, which was barely considered premature. In addition, the baby's nutrition was a little weak, so he might have to stay in an incubator for about a week.
The operation was generally successful.
The lives of both adults and children were saved, and a human tragedy was avoided.
"Dr. Zhou is a very capable surgeon! I'm Zhao Jie, a surgeon in the Department of Obstetrics and Gynecology, and this is my assistant Qin Feifei. It's an honor to meet you."
The obstetrician and gynecologist took off his mask and greeted Zhou Can with a smile.
This is a female doctor in her forties with an ordinary appearance.
But her surgical skills are very strong. She and her team performed the cesarean section on the woman just now.
Her medical assistant was a very tall male doctor. He nodded at Zhou Can in a friendly manner as a greeting.
"Thank you for the compliment! I am also very happy to meet you and Dr. Qin."
Zhou Can took off his gloves and took the initiative to shake hands with the other person.
Dr. Zhao was able to perform cesarean sections alone, so he must be at least an associate chief physician. When someone took the initiative to make friends with him, he, a resident who had just completed his training, had to lower his posture and be more enthusiastic and friendly.
"I look forward to cooperating with the Department of Cardiothoracic Surgery again if there is a chance in the future. Thank you so much today! Director Hu, if there is nothing else here, we will withdraw first."
After Zhao Jie and Zhou Can met, they did not talk much in the operating room.
That is to say, just make yourself familiar with the crowd first.
This is because she saw the powerful surgical skills displayed by Zhou Can, and she also heard many of Zhou Can's reputations, which made her so enthusiastic about Zhou Can.
It is no longer the era when doctors work alone. When faced with difficult cases, they often need to ask doctors from other departments for advice, or even invite them to join a joint consultation.
Now that we are familiar with an excellent doctor like Zhou Can, it will be easier to ask him for help next time.
Therefore, behind everyone’s interactions, it is essentially all for the sake of interests.
After the mother was sent to the specialist ICU, a new patient was soon brought into the operating room.
Not every patient is wheeled into the operating room.
Patients who need to lie on a cart are basically critically ill patients who have lost their ability to move.
For patients who can walk on their own, nurses will usually take them into the operating room.
The patient was able to walk, but he moved with great difficulty and appeared to have severe breathing problems.
The patient was lying on the operating table and was quickly anesthetized.
During the patient's anesthesia, Zhou Can did not help the anesthesiologist to perform anesthesia, but took the patient's information to understand it first.
"Xiao Zhou, you will perform this operation! Repairing a bronchopleural fistula is a level 4 major operation, so you must be extremely careful during the operation. I will be there to guide you through each step of the operation. Xueyan has basically mastered this operation, but Director Le is still a little short of mastery, so it's just right for her to be Zhou Can's assistant and learn it again."
Director Hu Kan made the main arrangements for the operation.
"OK!"
Director Le readily agreed.
At present, their surgical team, including Director Xueyan, him, and Zhou Can, should be the three main forces.
Everyone has his or her own strengths, and in terms of comprehensive surgical capabilities, Zhou Can is the strongest.
Both he and Xueyan had to admit this.
Talent can easily make up for the age gap.
Director Le is slightly older than Director Xueyan, and both of them have more than 15 years of surgical experience, which is considered to be a veteran. However, compared with Zhou Can, his overall strength is obviously weaker than Zhou Can.
You have to know that, all you have to say, it has only been three years since Zhou Canman started using a scalpel.
In just three years, he was able to surpass these chief physicians who had studied hard for fifteen years. Talent must be an important factor.
…
I worked until around nine in the evening and then called it a day.
Zhou Can looked at his experience points in multiple surgical skills and saw that they had increased a lot. His heart was filled with joy and a sense of accomplishment.
This feeling of making a little progress every day makes him feel very secure.
After such a long period of practice and actual combat, and after a period of time, the quick knife technique will soon be upgraded.
Then his incision skills had been promoted to level five more than three months ago, and he was now at the junior level of deputy director. The important medical skill of pharmacological differentiation was also promoted at an astonishing speed.
He is also at level five now and is moving towards the intermediate level of deputy director.
However, after being promoted to level 5, the experience points required to upgrade increased to 100,000, which was not something that could be completed in a short period of time. Even though he could often earn extra experience points during the operation, some of which were large rewards of 100 points.
But accumulating one hundred thousand is still a long process.
In general, his current knowledge of many important medical skills is at the level of deputy chief physician, which is enough to deal with general situations. He only feels tired when challenging some difficult cases.
As for extremely difficult cases, there are many that he is still unable to handle so far.
"Teacher, you are gasping for breath very heavily. Why don't you rest at home for a few days?" Director Xueyan looked at Director Hu Kan with concern.
"I'm so happy! Seeing that you have successfully completed difficult surgeries such as type A arterial dissection and bronchopleural fistula repair, the strength of our cardiothoracic surgery department is guaranteed to a certain extent. As long as you continue to grow at this rate, I believe that within five years, the cardiothoracic surgery department will be able to return to its peak level when I was in charge of the surgery."
Director Hu Kan's face was full of joy.
He was happy from the bottom of his heart to see that there was someone to take over the department.
"Xiao Zhou, you must make a summary of today's two important operations when you go back. I have encountered more dangerous cases like the type A arterial dissection operation. At that time, the patient's blood vessels ruptured because the blood pressure was not well controlled. That time, more than a dozen medical staff members rescued the patient for more than four hours, but in the end they were unable to save the patient..."
Director Hu Kan values Zhou Can the most.
Zhou Can would be taught every time to guard against arrogance and impatience, summarize more and think more.
"You've been busy so late, you must be hungry, right? We are surgeons, and our job is the hardest. I ordered fried egg noodles for you today. I'm old, and I'm afraid I'll get angry, so I'll eat with you."
Director Hu Kan slowly scanned the dozen or so medical staff of the surgical team as if he was looking at his own child.
These people are basically the core members of the cardiothoracic surgery team.
Zhou Can took a bottle of pure milk, heated it up, inserted the tube, and brought it to Director Hu Kan.
"Director Hu, if you are afraid of getting angry, drink some milk to supplement your nutrition! You are the mentor and backbone of all of us. Only if you are in good health can you always guide our work. I don't know how others feel during the operation. Anyway, as long as you stay by my side, even if you don't say a word, I will feel at ease. I subconsciously think that if a fistula is poked or an emergency situation is encountered that I can't handle, the teacher is sitting there and will definitely help me solve it."
Zhou Can's words made many people laugh.
"You know what, I feel the same way. Even though I've been doing surgery for 15 or 16 years, I become a child again when I do a major surgery. When Director Hu is by my side, I feel very brave."
Director Xueyan also said this seriously.
"You all have this feeling. I was too embarrassed to say it out loud before. After all, I'm already 45 years old. What if others laugh at me and say I'm still a child? How embarrassing it would be!"
Director Le's words made everyone burst into laughter.
The three of them are Director Hu Kan’s direct disciples and have received the most guidance.
After all, Director Hu Kan has limited energy and time, so it is impossible to treat them equally. He can only focus on training the three of them. Jin Mingxi has also received a lot of training in the past year.
"You are just like my children in my eyes. I have watched you grow up and encountered various setbacks. All I can do is to give you the necessary help and guidance like a parent. Xueyan, do you still remember the first time you took a knife to participate in an operation and cut a patient's blood vessel? Did you cry out of fear?"
Director Hu Kan was reminded of the past by them, and a nostalgic expression appeared on his face.
"Teacher, please give me some face! That happened so many years ago. I didn't expect you to remember it so clearly!"
Director Xueyan is as shy as a little girl.
"Haha, what's the big deal! Everyone will encounter various setbacks and embarrassments on the road to growth, but as long as we can continue to grow, we can become more and more outstanding. Didn't I collapse on the operating table two years ago? I tell you, don't compare yourself with others, learn to compare yourself with yourself. As long as you are better than your past self, that's enough."
Director Hu Kan taught them some insights into life.
Comparing yourself with others will only make you angry.
Comparing yourself with others is the easiest way to generate negative emotions, and even discouragement and despair. Comparing yourself with your past self is a very good way.
