Sisi's MRI scan came back one week after the surgery. It showed that the liver metastasis had shrunk a bit, and the edema was more obvious than before. It was evenly distributed and the edge just followed the outline of the original tumor.
This magnetic resonance performance shows that the focused ultrasound bombarded the tumor entity in all directions, without missing anything or exceeding the scope of the tumor, achieving the purpose of precise bombardment.
However, even so, there will still be residual tumor cells. These cells will slowly divide and eventually come back. This is the fate of late-stage malignant tumors. Once distant metastasis occurs, there is almost no way to eradicate it.
Therefore, the "three early" treatment principles are advocated for cancer - early detection, early diagnosis, and early treatment. When cancer cells have not spread and are gathered in a local space, they can be completely removed in one go.
Duan Xiaoming from the Haifu Surgery Department has also been paying attention to this patient. Because this patient had surgery in their department, he also has the authority to access the medical records.
He was very curious. On the day of Yang Ping's surgery, he casually bombarded dozens of times, and even adjusted the parameters in a serious way. The accuracy of the parameters reached the limit of the machine. Is it just a show, or is it the real thing?
Duan Xiaoming wanted to know the answer. Sisi also had an MRI that day, but she had just completed the surgery and the imaging results were not very obvious, so she could not draw a conclusion yet.
Now Duan Xiaoming believes it. Three sets of magnetic resonance films were compared before the operation, on the day after the operation, and one week after the operation. The effect is clear. No one knows the effect of this operation better than Duan Xiaoming - it is very good, too good to be believed.
.
From the magnetic resonance pictures, it can be seen that all liver tumors have been hit by focused ultrasound, and due to the influence of high temperature, most of the tumor cells have been killed and are being disintegrated and absorbed.
As an expert in Haifu knife, he has never been optimistic about this equipment. He applied to be transferred back to the ultrasound department several times, but was rejected by the hospital.
How could the equipment that the hospital spent so much money to buy at that time be idle? At least now it can treat patients with uterine fibroids.
In this way, this department is half-dead, and Duan Xiaoming has nothing to do all day long, staring at the rise and fall of stocks on his mobile phone.
"Do you think Dr. Yang is strange? For an orthopedic surgeon, he can also perform Haifu surgery?"
Anyway, there are no patients now, so we all gathered together to chat for a few words. One of my assistants, a resident doctor, asked.
Duan Xiaoming pointed it out to him: "Look, in the MRI of the little girl in their orthopedics department last time, the liver tumor was so cleanly removed by the Haifu knife."
If Haifu Dao has such an effect, then he will have a lot of potential in the future, and he will not be like now just waiting to die.
Duan Xiaoming thought that if he could learn such a unique skill from Dr. Yang, not to mention other diseases, just treating uterine fibroids would make him famous and wealthy.
In a situation like yours, if you want to become famous, you can only take a different approach, focus on a niche area, and maximize it.
It is too difficult to deal with liver cancer, lung cancer, etc. I will become famous for uterine fibroids in the future, and I will also have a place in G city.
Duan Xiaoming was thinking about how to open up the relationship, and he was afraid that he would trouble Song Zimo again.
If the machine is idle, it is idle. If there is any patient in the future, please ask him to operate it and take it with you. Don't stare at the stock all day long and make your eyes swollen. You are still losing money.
To cheer up and get down to business, Duan Xiaoming rubbed his bald head.
---
"Does it still hurt here?" Yang Ping pointed at the location of the liver area on the right side.
"There was a bit of pain on the day of the operation. It doesn't hurt now and I feel much better. Thank you, big brother." Sisi looked much better because she got rid of the pain in the liver area.
There is a copy of "Human Anatomy Atlas" on her desk, a People's Health Edition, and there are some anatomical drawings on the draft paper next to it.
"I asked Sister Feifei for this. I also want to be a doctor. I will start preparing now. This is the liver. I drew it. Sister Feifei said that I need to learn anatomy well and be able to draw pictures."
Sisi saw that Yang Ping noticed the book on her desk, took the initiative to explain, and even showed Yang Ping her drawing.
Although this picture is a bit cute, it is well drawn. Yang Ping took a closer look and found that the drawing is quite detailed: left and right halves, 5 lobes, 8 segments, gallbladder, hepatic duct, common hepatic duct, common bile duct, and proper hepatic artery.
, the hepatic portal vein, are all drawn.
This little guy might be a good material for studying medicine in the future. Yang Ping's nose suddenly felt a little sour.
"You draw so well!" Yang Ping praised her.
The little girl said proudly: "I will draw every part of the human body, and then I will also draw a complete human anatomy diagram."
The pain in the liver area disappeared after the operation, which also proved the effect of the operation from the symptoms. The tumor was generally killed by the heat energy and began to absorb and shrink. The stretch on the pain nerves of the liver capsule was gradually reduced, and the pain was naturally relieved.
It is the first time to use the simulated surgery function of the system space, and the effect is very good. Yang Ping has already conducted complete simulations on several tumors of Sisi. Currently, it is only used for liver surgery, and in the future, it will be completed step by step for tumors in several other parts of the body.
Treatment.
This simulation function is very good for difficult surgeries. You can use replicas to conduct a large number of research and experimental surgeries, obtain data, and then apply the data to real cases.
This ability to copy cases can also be used flexibly. For example, by dissecting the copied cases, you can find lesions that cannot be detected by medical instruments.
---
Fang Xiaoyun's muscle strength is still declining. Now it has dropped to level 2. He can only move on the bed and cannot even lift his legs.
The parabolic span of this spinal cord edema is a bit large, which is not consistent with the condition. Yang Ping asked Zhang Lin to review Fang Xiaoyun's magnetic resonance imaging and perform vascular imaging.
Is the spinal artery embolized again? Or is there hematoma compression? The surgery interfered with the blood supply of the spinal cord?
Does surgery interfere with spinal cord blood supply? Impossible!
Yang Ping was very confident in his operation. Not a single intercostal artery was broken, so how could he damage the blood supply?
Hematoma can also be ruled out. If there is a hematoma, it is impossible that the magnetic resonance imaging does not show it.
It is entirely possible for arteries to become embolized again. The diagnostic accuracy of magnetic resonance imaging for these subtle lesions is 95%, which means there is still a 5% chance of missed diagnosis and misdiagnosis.
For others, there is a 5% possibility, but Yang Ping does not have such a high error.
He has recently carried out auxiliary examination training in the system space, and his MRI reading ability has improved to several levels. He can identify artifacts, interference, imaging deviations, etc. If there is any doubt, he can further examine it, or supplement it with other methods.
Check to identify.
"The peak of edema should have passed. How come it lasts for so long and the muscle strength is getting worse and worse?" Song Zimo was puzzled.
"There will be no problem with the identification of edema by magnetic resonance imaging. This patient is very surprised why the edema has not subsided at all and has entered a plateau." Yang Ping was also a little confused.
"If it's just caused by spinal edema, it doesn't matter much. It doesn't matter if we wait. I'm afraid there are other reasons." Professor Zhang also came up.
"Doctor Yang, Fang Xiaoyun's mother is here. She was brought up by the security guard. She wanted to see her daughter. The security guard asked if it was allowed?" Cai Qiaojun, the head nurse, came to inform.
Two security guards took Fang Xiaoyun's mother with them. She didn't make any noise or make a fuss this time. She was quiet and seemed very honest. She kept apologizing: "Last time I was too emotional. This time I figured it out."
, I just want to see my daughter. Isn’t she hospitalized for surgery? I am her mother and I want to take care of her."
There was no reason to let her take care of her daughter since they were not noisy. Yang Ping told Head Nurse Cai, "Ask the patient what she wants. If she agrees, let her in."
There is no time to bother with her. Everyone is busy analyzing the condition. In this kind of case, if you are not careful, it may lead to permanent paraplegia. Therefore, once there are signs of abnormality, it must be analyzed and dealt with in time.
"I've used methylprednisolone and 20% mannitol, but the edema still hasn't been reduced. Is there no reason?"
Zhang Lin is the doctor in charge of the bed, and he also participated in the discussion.
"There are only two reasons. One is related to the condition of thoracic tuberculosis, and the other is not related to this condition. There are other reasons. Although the diagnostic idea emphasizes unity, try to use one disease to explain the symptoms, but when the unified explanation fails, just
We need to consider diversity and whether this patient may have other problems." Yang Ping analyzed.
The doctor's analysis of the condition is a process of logical reasoning. He uses his own knowledge and experience to comprehensively analyze the patient's medical history, physical examination and auxiliary examinations to get to the truth directly.
However, in many cases, the truth cannot be revealed at all and can only be treated symptomatically. Some diseases heal themselves without figuring out the cause. There are many such things.
Just like when the image on a TV is always unclear, if you take a picture, it will be clear. I don’t know what the reason is.
"There is no sign of ischemia in the spinal cord. Don't worry too much. You can wait. If it really cannot recover, then check other aspects. It is too early to start the examination now, and the patient cannot afford it financially." Professor Zhang suggested that again.
Wait.
Yang Ping thought for a while and went through the possible causes in his mind. Fang Xiaoyun's magnetic resonance imaging currently showed no signs of spinal cord ischemia, and there was no embolism in the arteries supplying the spinal cord.
At least in the main arteries that can be seen on magnetic resonance imaging, no embolism is seen; the arteries that are not visualized have little impact on blood supply, and even embolism does not pose a threat.
D-dimer was rechecked several times and showed a downward trend, which did not support spinal artery embolism, indicating that the clot in the body was only limited to a small amount of bleeding caused by surgery.
It is indeed a bit premature to launch inspections now, because troubleshooting requires a large number of inspections, and some inspections have certain side effects.
"Professor Zhang is right. You can wait and observe closely. I agree." Yang Ping made a decision.
"I'll go see her too!" Professor Zhang took everyone to ward rounds.
Fang Xiaoyun was sitting on the bed, very calm. She believed in the doctor very much. Her colleague was massaging the muscles of her lower limbs. Fang Xiaoyun's mother, Teng Guihua, was sitting on the escort's chair, smiling at everyone, a little reluctantly.
Everyone is still a little uncomfortable with her change of attitude. Could it be that their conscience has discovered it? They owe their daughter a debt and now they have to make up for it.
Maybe you deal with objective conditions every day, and when you analyze the condition, you won’t be involved in any emotions. One is one, and two is two. Just because you hate one, one will become two. You may also stay in the system space for a long time.
Now, people’s temperaments have also changed.
In short, Yang Ping doesn't believe that this shrew has changed so quickly, but he doesn't have to deal with her. He just needs to treat Fang Xiaoyun seriously.
Professor Zhang personally checked his body and found that his muscle strength is currently Level 2. It is also Level 2, which is slightly worse than yesterday’s Level 2. Yesterday, he moved his limbs faster in bed, but today he moves very slowly and weakly.
It is now progressively declining. Professor Zhang frowned. Decades of experience told him that the situation was not optimistic.
"Professor, my daughter was able to walk before the operation. Why can't she walk now and is paralyzed?" Teng Guihua asked carefully.
Professor Zhang glanced at her: "We are observing closely and will conduct further inspections if necessary."
"Did the operation go wrong?" Teng Guihua blurted out.
