Chapter 494: Doctors cannot just treat illnesses
In the operating room, anesthesiologist Qu Zi and the anesthesia nurse were performing general anesthesia on the patient.
Since the last time she talked to Zhou Can, she has been appearing in the emergency department more and more frequently. Whenever she needs to be given general anesthesia or spinal anesthesia, Zhou Can will consult her.
Sometimes, she felt that the surgery was too risky and did not agree to take the risk.
Zhou Can could only try his best to persuade her.
Fortunately, she had a high degree of trust in Zhou Can's surgical ability, and the two had worked together many times, so they had a certain foundation of trust between each other. So in most cases, Zhou Can successfully persuaded her.
After the patient was given general anesthesia, Zhou Can began to perform a laparotomy on the patient.
As the patient's physical condition was very weak, like a lamp that could go out at any time in a rainy night, Qu Zi was already nervous as soon as the operation began.
Fortunately, Zhou Can’s surgery was not only fast but also extremely stable.
During the cesarean section, there are six levels of incision, coupled with the support of quick and steady knife techniques, it is as smooth as flowing water.
Open the abdominal cavity and go straight to the ileocecal region where the bleeding source is located.
A large mass with a diameter of more than 9 cm was found in the ileocecal region.
The wall of the mass is very thick.
"My goodness, why did you grow such a big lump?"
Doctor Xu was standing nearby and examining his apprentice. He was quite surprised to see such a large lump.
"It doesn't look like a tumor. It's probably just blood clots inside!"
Zhou Can’s level 6 debridement technique is not given for nothing.
He stared at the lump for a few seconds, pressed it lightly with his fingers, and he already had an idea in his mind.
"Teacher, do we need to drain the fluid from the mass first?"
"It's okay! This lump is not easy to aspirate. It will probably burst if touched."
Dr. Xu’s surgical experience is definitely many times richer than Zhou Can’s.
He said it was okay and that he basically wouldn't make mistakes.
In terms of surgical caution, Dr. Xu ranks second, and I'm afraid no one dares to claim to be first.
After all, he had an accident that ruined his future and life. Once bitten by a snake, one will be afraid of the rope for ten years.
When performing surgery, Dr. Xu is not only strict with his doctors, but even stricter with himself.
Even if he liked Zhou Can to the extreme, if he dared to be careless during the operation, he would be scolded so badly that he couldn't even raise his head.
Zhou Can tried to move the lump with his hands in order to separate the adhesion between the lump and the surrounding tissues.
Crash!
I didn't expect it to break as soon as I moved it.
Blood immediately flowed out.
"Yang Zhi, suck out the accumulated blood!"
"good!"
In fact, Yang Zhi was already prepared without Zhou Can's instructions.
"If your team could have one more scrub nurse, it would be more complete."
Anesthesia nurse Qin Yue said nearby.
She didn't talk much before, but since Qu Zi said she wanted to join Zhou Can's team last time, she would always smile and nod when she saw Zhou Can. During the operation, if she found some problems or deficiencies, she would take the initiative to point them out.
"Alas, I would like to hire another surgical nurse to help Qiao Yu share the work pressure, but you also know that the surgeries I currently perform are still mainly level one and level two surgeries, and I can't support so many people!"
Zhou Can's statement is quite modest.
With the horrific number of surgeries his surgical team performs every day, he can easily support them by hiring one more scrubbing nurse.
However, this will definitely lead to a reduction in the income of Qiao Yu and Ma Xiaolan.
Both of them come from poor families and want to make as much money as possible.
Although the work was a bit tiring, the two had no complaints.
For the time being, Zhou Can had no intention of hiring any more surgical nurses.
As he spoke, Yang Zhi had already drained the fluid from the mass.
"It seems that there is not only blood in this mass, but also necrotic tissue that looks like rotten flesh. I'm afraid I have to remove this section of intestine completely."
Zhou Can looked at the aspirated fluid and found that the patient's ileum was worse than he had imagined.
If it could be discovered earlier, maybe less intestine could be removed.
It may not even require surgery and can be cured by direct medication.
After careful examination, he found that not only did the patient's ileum segment where the mass was located show signs of necrosis, but the mesenteric lymph nodes were also significantly enlarged and thickened.
“Cut it!”
After examining the patient, Dr. Xu agreed to remove this section of intestine and the mesenteric lymph nodes.
After carefully cutting off this section of ileum and mesenteric lymph nodes, Zhou Can felt extremely relieved. It was not because he had obsessive-compulsive disorder, but every time he helped patients cut off the lesion tissue, he felt a sense of accomplishment.
[Experience points for fast knife skills +1, experience points for steady knife skills +1. ]
It was at this time that he felt that his swordsmanship seemed to have made a major breakthrough. He couldn't tell how the breakthrough happened, it seemed to be a natural result.
In the past, when he used the steady knife technique, it felt like a mountain was pressing down on the scalpel.
At this moment, I have a new understanding and breakthrough in the method of steadying the knife.
When he holds the scalpel and touches any part of the patient's body, he can feel the landing feeling extremely subtle.
The tip or blade of a knife is extremely sharp. When it touches the skin or organs of the body, it will immediately cut the part where the blade is.
Using a scalpel as a 'foothold' is simply a crazy idea.
I'm afraid no doctor would dare to use a scalpel as a fulcrum for the body when performing surgery.
Even if the force is only 0.1 kg, it is enough to cause fatal harm to the patient.
To treat the scalpel as a foothold, the surgeon needs to have the strength and ability to use the knife to a level that is difficult for ordinary people to achieve.
Zhou Can couldn't wait to check the medical attributes.
[Steady Knife Technique, current experience value: proficient level 1/100000, steady as a mountain, nimble as a swallow, with the knife and the feet as the fulcrum, like a tripod. Can be integrated into all surgical techniques involving knife handling. ]
If you work hard enough, you can grind an iron rod into a needle.
After years of practice, his steady sword technique was finally promoted to the second level - skilled level.
When wielding a knife, the knife becomes a fulcrum of the body, forming a tripod with the feet.
According to the laws of physics, triangles can form the most stable physical structure.
The wisdom of the ancients was extremely advanced. As early as the time of Dayu, they had already cast a giant three-legged tripod to suppress floods and ferocious beasts.
There are nine statues of the famous Jiuzhou Ding, all with three legs.
Zhou Can had never expected that the second level of Steady Blade Technique was to use the blade as a foot, forming a tripod with the feet. This high level of comprehension of blade techniques was simply beyond the imagination of the brain.
You can only practice over and over again, practice makes perfect, and you will naturally figure out the knife-handling skills through practice.
This is also a profound understanding of the use of power.
I wonder if Director Hu Kan’s second level of steady knife technique is also a three-legged tripod?
Director Hu Kan has passed away, so I'm afraid there is no way to verify it.
Steady knife technique and fast knife technique are both the knife techniques that Zhou Can values most, and each has its own merits.
Now that the steady sword technique has been promoted to the proficient level, and the quick sword technique has also been promoted to the proficient level, will it cause an imbalance in power between the two sword techniques, affecting his unique sword technique that is a fusion of the quick sword technique and the steady sword technique?
After testing, he found that there was no effect.
On the contrary, because of the successful advancement of the steady knife method, the self-created knife method has become more stable and flexible.
After removing the diseased intestinal segment and swollen mesenteric lymph nodes, Zhou Can cleaned the surrounding tissues and removed suspected secondary lesions.
It's not just cancer that spreads.
If ulcers are not treated in time, they can also cause the bacteria to spread rapidly.
For example, the most common gastric ulcer is usually self-limiting, but if the patient is in poor physical condition or is not treated promptly and correctly, the ulcer area may increase.
The intestinal lining of the patient's ileum segment that was removed was 100% rotten.
It is not cancer, but its dangerousness is no less than that of cancer.
If the patient had not been hospitalized due to shock caused by blood loss, his intestines might have ruptured if he had delayed treatment a little longer.
By then, just an intestinal perforation would be enough to take his life.
After intestinal perforation, intestinal contents enter the abdominal cavity and peritonitis will definitely occur.
Zhou Can's help in the surgery was definitely equivalent to saving the patient's life.
During the debridement process, the newly-promoted steady knife technique must naturally be put into actual combat to fully satisfy your skill.
The biggest feeling is that debridement has become easier, faster, safer and more perfect.
In the past, even though his debridement skills had been promoted to level six, he never dared to use the word perfect when performing debridement on patients.
At best, it is just right, with excellent debridement.
At this moment, he used the word "perfect" for the first time.
Even though it is only used to clean ordinary surgical wounds now, I believe it would be equally capable of clearing out dense lymph node tumor clusters.
This is just one of the benefits of the Steady Knife Method after its advancement. I believe that whether it is dissecting difficult body parts, or removing extremely difficult lesions, or separating extremely difficult adhesion tissues, etc., the Steady Knife Method can help his surgical ability reach a higher level.
When Zhou Can finished the operation and closed the cavity, the patient's vital signs had stabilized. Doctor Xu stared at Zhou Can in surprise and said, "Xiao Zhou, I saw you clean the wound just now. Your surgical ability has obviously improved. You are not only as nimble as a tongue, but also as steady as a mountain. It seems that you have worked hard in the past two years!"
"Hehe, the teacher's eyes are sharp. Nothing can be hidden from you. Your swordsmanship has indeed made a breakthrough."
Zhou Can's strength has reached a new level and he is in a very good mood.
Completing this partial ileum and mesenteric lymph node resection is nothing.
At least many deputy chief doctors and chief physicians of surgery have the ability to perform this operation.
But finding out the cause of this patient's illness, completing the surgery quickly, and successfully saving the patient's life, all in all, is pretty amazing.
"It was Lao Hu's steady knife technique that broke through, right? You also need to work harder on the fast knife technique I taught you!"
There was a hint of sourness in Dr. Xu's tone.
Seeing that his beloved disciple had made a major breakthrough in steady knife skills, but his quick knife skills had remained lukewarm, he was obviously a little jealous.
"I haven't fallen behind in the fast knife technique either. I've been practicing it all the time! But if you want to make a breakthrough, besides hard practice, chance is also very important. You never know when you will make a breakthrough, and I will definitely make you happy when that happens."
Zhou Can’s quick knife skills had long been promoted to the proficient level. If he wanted to advance to the next level, the experience points required would increase tenfold. How could it be so easy?
"By the way, have the cut intestines been sent for examination?"
Zhou Can asked Dr. Pu.
At present, he is the only one who can do such miscellaneous tasks as sending samples for inspection.
"It has been sent for pathological examination. The report will probably be available a little later."
Dr. Pu replied.
…
The patient's pathology report came out when I was about to get off work in the afternoon.
The intestinal wall of the intestinal segment submitted for examination was thickened, and the texture was soft and fish-like when cut open, with necrosis. Microscopically, a large number of reticuloendothelial cells proliferated in the intestinal lymphoid tissue to form macrophages, with phagocytosed lymphocytes, red blood cells, and nuclear fragments visible in the cytoplasm, and ulceration and necrosis of some intestinal walls.
Seeing this, Zhou Can couldn't help but secretly admire Director Shang of the Department of Gastroenterology. The patient was indeed suffering from typhoid fever.
As long as macrophages are formed, it can be basically confirmed as typhoid fever with 100% certainty.
He then looked down and sent the lymph nodes for examination and found enlarged lymph nodes, with typhoid cells visible under the microscope.
The above changes are consistent with typhoid fever.
Now, the reason for the patient's persistent high fever has finally been solved, the largest source of bleeding has been successfully found, and the bleeding has been successfully stopped through surgery.
The necrotic intestinal segment was also completely removed.
As long as the lesion progresses to the typhoid stage, it means that the lesion site enters the necrotic stage.
Zhou Can learned a lot from this case.
It is also a very rare cause of disease among the many difficult cases he has encountered.
Typhoid fever has been difficult to cure since ancient times.
Traditional Chinese medicine even developed a typhoid school based on typhoid fever.
He summarized his diagnostic experience and decided to write a diagnostic report after get off work. He believed that next time he encountered a similar case, he would be able to avoid many detours.
Since it has been clearly diagnosed that the patient has typhoid fever, it will be easy to deal with.
The bleeding has stopped and only anti-infection and anti-typhoid treatment is needed.
On the third day, the patient's body temperature had returned to normal and his vital signs had stabilized. He no longer had symptoms such as a continuous drop in blood pressure or shock.
Considering that this patient also has gastric ulcers and old bleeding, it means that the patient's usual diet and daily routine are very poor.
A 20-year-old boy is in the golden age when his body is in the best condition.
The entire digestive tract is already in danger and has even developed to the point of typhoid fever.
Zhou Can felt it necessary to have a good talk with the patient's family.
Unexpectedly, the child's father saw that his son's condition had improved and had returned to work. The love a father has for his child is as heavy as a mountain, yet extremely silent.
He is the financial pillar of the family. His son's medical treatment cost a lot of money, so he has to work hard to make money to support the family expenses.
The child's mother obviously couldn't control her son. She obeyed him in everything and treated him like an emperor.
Seeing this scene, Zhou Can couldn't help but fall into silence.
Doctors can cure patients' diseases, but they cannot change patients' family education environment, let alone change patients' bad living habits.
Out of his sense of responsibility as a doctor, Zhou Can still decided to talk to the patient himself.
In terms of age, Zhou Can is only a few years older than the patient.
After get off work, after checking the ward, Zhou Can sat down in front of the patient's bed.
The patient's mother was very polite to him.
After all, it was Zhou Can who cured her son's illness.
Seeing her son's condition improving day by day and being pulled back from the brink of death by the doctor, she was full of gratitude to every medical staff who participated in treating her son.
"What grade are you in now?"
Zhou Can didn’t know how to get close to others, because usually others took the initiative to get close to him.
You can only find conversation to start with the patient.
"Freshman!"
"It's great to be a freshman. I've just been freed from the pain of the college entrance exam and entered the university campus. I can relax and live a comfortable life. If I'm lucky, I might even get a beautiful girlfriend."
"Hehe, that's right! Compared to my high school life, I also think college life is simply heaven."
The patient was struck by his words.
"Have you talked about girls?"
Zhou Can asked.
The patient subconsciously glanced at his mother standing next to him and said nothing.
In this kind of situation, no matter whether men or women, they will avoid their parents.
