Only the answers of this kind of practical medical student can make the seniors feel the danger of the younger generation. Sometimes, it is only a matter of being surpassed by the younger generation for a few years.

Dr. Cheng Yuchen looked serious and asked her: "Have you ever had a closed chest drainage?"

Closed thoracic drainage is a secondary surgery, a minor surgery that can be completed by a daily resident. It is difficult or not, but simple. In clinical practice, there are usually two methods of this surgery.

One method is a very traditional method, which requires local anesthesia and a scalpel to cut the skin and muscles between the ribs. Finally, a hole is opened with a bent forceps in the patient's chest cavity and then the drainage tube is inserted for suture and fixation.

Another method is to use a trocar to directly puncture the penetration into the drain tube without surgery.

Last year, when an intern was involved in the emergency rescue of a car accident, she was asked by chance to perform chest puncture and emergency surgery to help patients with tension in the respiratory department. She assisted Teacher Xin in pleural effusion puncture. In fact, the puncture surgery she had and the drainage bottle was almost the second method of chest puncture and drainage surgery just mentioned.

In addition to this, Xie Wanying has performed many other clinical punctures, including subclavian venous puncture.

The focus of various clinical puncture surgeries is to master accurate operation anatomy and keep in mind the operating procedures. It is far less complicated than surgery. It is just that since puncture surgery is classified as a secondary surgery, it is not the simplest primary surgery, in order to fully illustrate its risk. If the puncture is wrong, it will cause serious complications such as heavy bleeding.

Dr. Cheng Yuchen asked her if she had done it, and she was quite questioning. Obviously, she thought that she, a medical student who might have not done such an operation, might be talking about it on paper.

You know there are two types of puncture methods, so do you know which puncture method is suitable for this patient?

The first method was previously called thoracostomy. It was made into a hole, which was very similar to the condition where the tube was left in the thoracic open surgery. The tube was very thick. The advantage of thick drainage tubes is that it was not easy for drainage substances to block the tubes. It was very suitable for patients with complex and severe conditions such as empyema and hemopneumothorax.

The disadvantages are also obvious. The length of the patient's chest cavity is two or three centimeters, and the patient will feel pain. This will cause a relatively traumatic surgery to the patient, which the patient will not like.

In the second way, the puncture needle used in clinical practice is a central venous catheter needle. The needle is small and the drainage tube brought in is thinner and softer, which brings an extraordinary sense of comfort to the patient. In comparison, the tube is thin and softer and is easily blocked by the drainage substance, which is not suitable for patients with complex drainage substances.

Also, there is a difference between simply puncture and drainage of tubes. Otherwise, there would be no choice between puncture or tubes.

To apply specific clinical cases, a simple summary: if you keep the tube, it is because a puncture cannot re-extension. For example, the young man who was rescued last time, he returned to the hospital and had to undergo drainage surgery to keep the tube. If the tube is not left, the tube will always exist. The pneumothorax will soon cause difficulty in breathing.

The patient in the respiratory department is not, because of the enclosed pleural effusion. The clinical extraction of pleural effusion is to clarify the diagnosis of infection. The degree of dyspnea does not require long-term respiration, but more importantly, the source of infection is treated.
Chapter completed!