Many cases of synovial chondromatosis of the knee joint have been seen, but so many cases are rare.
Xiaowu took off the film to prevent the secret phobe from feeling any more discomfort. He admitted the patient to the hospital and completed the preoperative examination and surgical arrangements.
Yang Ping continued to study the punctures of Huaqiaolou patients, and repeatedly simulated punctures with the help of images constructed in his mind to adjust the angle of punctures in order to hit the target with one hit.
Song Zimo didn't take a break at noon and stayed in the laboratory practicing arthroscopy. Tang Fei called him lunch from the cafeteria. He ate it in the dining room of the department and continued practicing in the afternoon.
It is said that in the past, at the orthopedic trauma department, he would practice until after ten o'clock every night, and sometimes until twelve o'clock, as long as there was nothing special to do.
The three-dimensional CT and MRI reconstructions of the Huaqiao Tower patients have been completed. Thin-layer scanning showed that the reconstruction results were very clear. Director Han compared Yang Ping's paintings with the reconstructed images on the electronic reader. There was almost no big difference in the spatial structure. Yang
Flat pictures are more expressive.
Director Han looked at the time and saw that it was already half past four. He put down what he was doing and took Yang Ping to the Overseas Chinese Building to attend the conference.
In the conference room of the Internal Medicine Department of Huaqiao Building, several directors have already arrived, as well as Director Zhao of the Medical Department. Everyone gathered around the oval table to discuss Mr. Ning's condition privately in advance.
Director Kong asked Director Han and Yang Ping to sit down. Each seat on the table was equipped with a high-definition tablet computer. This is the terminal of the mobile medical record system. The patient's medical records and auxiliary examination results can be accessed on the tablet computer. The screen of the tablet computer
The resolution is much higher than ordinary ones, just to be able to see the details of the image clearly.
Director Kong's phone calls continued, and people came in one after another, including the major directors in the hospital and several professors from outside the hospital. Director Zhuang from the Department of Internal Medicine also came to help accompany the experts from outside the hospital.
"This is the second courtyard attached--"
"This is from the First Affiliated Hospital--"
"This is from the cancer hospital--"
Several directors came over and took their seats one by one. Director Kong and Director Zhuang made arrangements with ease and without a trace of neglect or omission. The two brothers from the Overseas Chinese Building were also considered figures on the scene.
The consultation naturally involves seeing the patient. Someone has already proposed to see the patient first. Director Kong takes people to the ward to see the patient, and Director Zhuang helps accompany the patient.
Everyone used this time to reminisce about old times. These experts are familiar with the directors of relevant departments of Sanbo Hospital. They often get together during meetings, and some of them are even senior brothers.
We are usually very busy, so it is rare to see each other. Except for academic meetings, it is this kind of big medical meeting where we can chat for a few words and talk about our current situation.
Only Professor Su Qingyun from Appendix 1 has not arrived yet. He is the main expert of this association. Although the patient has liver cancer, the problem to be solved now is caused by spinal metastasis. Su Qingyun is the chairman of Orthopedics of Nandu Province and an academician.
The popular candidate is naturally the most important expert in this consultation. The meeting was postponed from three o'clock to five o'clock just to wait for him.
Su Qingyun was still the dean of the first affiliated school and was very busy with work. It was a great honor to be able to take time out to come here. Everyone was talking privately about who this patient was. Professor Su was invited to come forward in person. Normally, for consultations with other hospitals, even if he was invited, students would be sent there.
Participate.
There are still a few minutes left, and Professor Su has not yet appeared. Yang Ping has met Professor Su before. There was an academic conference held at the Municipal People's Hospital. Professor Su went there. It was from a distance, not as close as now.
Professor Su has published more than a dozen articles in top international orthopedic journals such as AJAM and **JS. The impact factor is extremely high, so he is at the top level in China and has a place internationally.
Some people raised their wrists to look at their watches, some looked at the door, and some whispered to each other, but they all waited patiently.
"Speak boldly later. Don't be frightened. In academic matters, one is one and two is two. There is nothing to be modest about." Director Han told Yang Ping in a low voice.
At five o'clock sharp, Professor Su came in under the guidance of Director Kong, followed by a young doctor who looked very similar to Professor Su.
As soon as Professor Su came in, he greeted everyone with a smile: "Sorry! Everyone has been waiting for a long time!"
In fact, he was not late, he came in just on the hour, but others came earlier.
Professor Su is in his fifties and does not look old at all. He wears glasses and a Chinese tunic suit with a white shirt. He has an elegant temperament and shows off his elegant demeanor. His strong aura comes from his long-term high academic position. p>
Everyone came up to shake hands with him. When shaking hands with Director Han, Professor Su stayed longer: "Brother Han, long time no see."
Seeing Yang Ping next to Director Han, Professor Su asked: "Who is this?"
"Doctor Yang, my student!" Director Han introduced.
Yang Ping shook hands with Professor Su.
"The young man has an extraordinary temperament, and Professor Han is famous for his sharp vision. He has not recruited doctors for many years, but he would rather be short-term than inexperienced. It seems that he has picked a good candidate." Professor Su said with a smile.
"This is Dr. Su!" Director Han introduced the young man next to Professor Su.
"Su Nanchen!" The young man next to Professor Su shook hands with Yang Ping.
"Yang Ping!" Yang Ping could feel his confidence and calmness.
When Director Han was in Shanghai, he and Professor Su were both outstanding figures in the young generation of orthopedics. However, when Director Han moved from Shanghai to Nandu, he wanted to start his own business again. Naturally, he could not compare with Professor Su academically. However,
The foundation is still there.
The two of them cherished each other, exchanged a few simple greetings, and then took their seats.
"That's Professor Su's son. He graduated from the Eighth-year Union Medical College and is a young talent with a first degree in orthopedics. After graduation, he studied at the Twin Cities Spine Center in Minnesota and the Hospital for Special Surgery in New York. He will be your strong force in the Southern Division of the Golden Knife Award.
opponent; in the national competition, he is one of the few super powerful opponents, and he is also an all-around player." Director Han said in Yang Ping's ear.
A tiger's father has no dog's son. This Dr. Su is not only a talented person, he also graduated from the 8-year program of the PUMC. The difficulty of passing the 8-year program of the PUMC is no worse than that of Tsinghua University. Those who can get into the examination are basically top academic figures, among the top few in the province's college entrance examination.
Famous.
Professor Su must have high hopes for his son, otherwise he would always carry such meetings with him. Carrying him with him would allow him to see the world, participate in more exchanges, and even help him build a reputation and connections.
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Everyone sat down, and the consultation began. Director Zhao presided over it, and the doctor in charge of the bed reported the medical history.
After the medical record report was completed, Director Kong added: "Dear experts, respected Professor Su, please take time out of your busy schedule for consultation today. The problem that this patient currently needs to solve is the severe pain in the chest. Thank you all!" p>
"Is it convenient for us to see the patient first?" Professor Su suggested.
Director Kong took everyone to the ward to see patients. Professor Su personally asked about the medical history and performed a physical examination. Other professors also selectively asked about the medical history and performed a physical examination according to their own needs.
After seeing the patients, everyone washed their hands and returned to the conference room.
Director Xu of the Sanbo Pain Department first spoke: "This patient was admitted to the hospital the day before yesterday. From admission to now, we have been following up on pain management. According to the ladder principle of tumor analgesia, this patient has been taking morphine for three months.
During this hospitalization, I used an extreme amount of morphine, 30 mg/time, twice/day, but it could only relieve the pain in the liver area, and the pain in the chest was still severe. After admission, a comprehensive examination was performed, and the heart, lungs and aorta were ruled out.
According to the nerve location, the chest pain caused by the chest pain ranges in the area innervated by the anterior branch of the thoracic 2 nerve. According to the CT and magnetic resonance images, the thoracic 2 nerve root happened to be violated and compressed, so we think it is caused by the thoracic 2 nerve root. Unfortunately,
, spinal anesthesia and analgesia cannot be performed here. Once respiratory depression is caused, the consequences will be serious, so we are encountering difficulties and need your help."
"Have you considered using an implantable analgesic pump, implanted into the spinal canal, using morphine as the main drug in the analgesic pump formula, and releasing it regularly, so that it can provide analgesia without causing anesthesia in the plane and not affecting breathing?
." said the director of the pain department of Annex 2.
After the director of Appendix 2 finished speaking, the director of the pain department of Appendix 1 said: "It is not realistic to implant an analgesic pump in the spinal canal. Extreme amounts of morphine have been used to suppress pain in the liver area. This kind of radicular pain, according to our experience,
, Morphine is almost ineffective. We have used it before at lower levels. If the nerve root is healthy and there is no tumor invasion, it will be effective. This kind of tumor tissue has been invaded and stretched. Morphine is ineffective. Anesthetics must be used for nerve block.
stagnation."
The director of the pain department in Appendix 2 had a different opinion: "The nerve block is too difficult and almost impossible to do. Usually we perform nerve blocks around the sheath. Even if the nerve is punctured into the sheath, the anesthetic will leak out. This kind of
To block, you must ensure that all the anesthetic is in the nerve sheath and cannot leak out, otherwise it will cause anesthesia in the plane and inhibit breathing, and you can only use a ventilator to assist breathing."
After a brief silence, the professor from the cancer hospital spoke: "Would you consider limited surgery, without moving other parts, entering from the back, and only removing the tumor tissue that is compressing and invading the nerve roots, releasing the compression, liberating the nerve roots, and the pain will disappear naturally.
”
"The family refuses the surgery, even if it is a localized one!" Director Kong explained.
"We are not willing to have surgery, but we also want to solve the problem. This poses a problem for us." said the director of the Department of Orthopedics of Appendix 2.
The Department of Orthopedics of the Second Department ranked second in Nandu Province. A long time ago, the Orthopedics Department of the First and Second Department were equally matched. Since Professor Su Qingyun became the director of the Department of Orthopedics, the Department of Orthopedics of the First Department began to take the lead, from being overwhelmed to being left behind.
Symbolizing the highest risk orthopedic surgery, scoliosis correction, Appendix 1 has more than 300 surgeries per year, ranking first in the country, while Appendix 2 only performs nearly 100 surgeries, ranking in the second tier.
Regarding bone tumors, Annex 1 has an independent large-scale bone tumor area, while Annex 2 currently does not have an independent large-scale bone tumor area.
So naturally, Fu-II Orthopedics is resigned to being the underdog and regards Fu-I as its big brother.
Spinal analgesia was unavailable, nerve block was not feasible, and the family members refused the surgery.
