"Today is Saturday?" Zhou Cheng took a look at the time before checking the ward, and felt that the time was a little confused, as if he didn't know day and night.
Zhou Cheng hasn't been home for three days, and he only squeezes in time to sleep.
"Oh, so it's a shift." Zhou Cheng followed in Cai Dongfan's footsteps, followed by Du Yanjun and Li Zhongyue.
Originally, there was nothing special about the patients in the ward. The only special thing was the two beds where the operation had just been performed the day before yesterday. He secretly said to Cai Dongfan: "Director Cai, my baby's activities are very good, but I don't dare to let him."
"Move around."
"I'm afraid that other people will be jealous, so he does functional exercises secretly at night. He's very happy."
It was probably because of Li Keke's incident that they also knew that the patients in the ward also had lemon essence.
Cai Dongfan smiled and said, "It doesn't matter. You have to exercise on time and don't overdo it. Functional exercise is your own. There is no need to stop doing it because of other people's thoughts and opinions."
"The operation has been completed, and the best opportunity has been laid for you. But how you will train later depends on your own efforts."
"If you don't cooperate with functional exercises, no matter how good the surgery is, it won't actually help."
Cai Dongfan was in a good mood when he heard this.
There were no interns around, so several residents in charge of the beds felt a little relaxed.
I thought that Cai Dongfan, the most junior professor in the group, would have a lot of things to do. After the senior doctor completed the operation, he would focus on the bedside doctor's ability to communicate with the patient.
But in fact, there were very few things going on. The patient and his family saw that his functional recovery was excellent. Under Zhou Cheng's strict painless medication principle, the patient's pain was well controlled and he was willing to cooperate with the exercises.
There are also some children who are pampered by their families, or people who are very afraid, so there is nothing they can do. This cannot be forced.
Soon, the ward round team arrived at the ward where the first diabetic foot patient was located.
As soon as Cai Dongfan entered, a family member came up to him and said, "Professor Cai, you are finally here. My husband has had a cold in the past two days, and the air conditioning in this ward is not good."
"I went to the nurse to change the bed, but they asked Professor Cai to go to them and tell them. Professor Cai, can you be considerate and think of a way for us?" The speaker was a woman in her thirties, well-groomed
Quite refined and polite in speech.
Anyone who had been in the hospital would know she was lying.
Cai Dongfan said hurriedly: "What you said is wrong. All bed allocation and bed replacement matters in our hospital are coordinated by the Nursing Department. Don't blame me."
"The head nurse doesn't agree. Even if Director Ding comes, it's useless."
This is true. The Nursing Department and the Medical Department are two parallel departments. The hospital has clearly defined the distribution of responsibilities.
The reason why the nurse is called the head housekeeper is actually that all beds and wards are in charge of the head nurse.
"But, Professor Cai, my husband has a cold. I'm afraid that he will get serious and cough and tear the wound again, which will affect his recovery." She said this, her eyes rolling.
The young man lying on the bed also coughed a few times very cooperatively, as if to prove that he really had a cold.
"There is really nothing we can do about this. As you know, the beds in our department are very tight. Once a patient is discharged, one will become available, and then new patients will come in immediately." Cai Dongfan also continued to explain.
"Professor Cai, is anyone discharged from the hospital today? Can you transfer them?" the woman asked again.
"Yes, it's bed 23." Cai Dongfan nodded towards the back of the room. This patient was in bed 21, just in the same room.
"That?"
"Then we are also discharged from the hospital? Can we be discharged from the hospital?" The woman asked again with an idea.
Du Yanjun quickly said: "Master, this patient had the operation last Friday. It is already the eighth day after the operation. He is unwilling to be discharged from the hospital on Monday."
"Okay, your husband is recovering well. I also see how this young man usually behaves.
The activities are not bad. Just be careful about the wound after you leave the hospital. It won't be a big deal. "Cai Dongfan knew that this patient was a fracture patient brought in by Professor Wang and Professor Ding to take care of him.
It is a high-quality disease that is easy to manage and basically does not have too many sequelae, so he can handle it smoothly.
"Then we will be discharged from the hospital..." the woman said immediately.
There was disgust in his tone.
There is no way, to be honest, no one wants to live in such a ward except for family members or people with the same disease, especially now that it is winter.
The air conditioner here is cold and they turned it off, but I just think the smell is amazing!
But there is no way, this is a gay man, and the other two diabetic foot patients are lesbians. In principle, men and women do not live in the same ward, just for fear of inconvenience.
The Orthopedics Department of Shonan University Affiliated Hospital basically has no vacant beds for turnover.
After confirming the discharge, Cai Dongfan took someone to bed 22. He was a man in his forties. He was very thin and dark, with very dark feet. He was wrapped in a thick layer of gauze, but it still couldn't be covered.
The smell of living ***.
Even though Zhou Cheng and others were wearing masks, they could still smell the smell, mixed with the smell of complexed iodine.
The accompanying family member was his wife. She had an expressionless face and helped him sit up. She was not impatient, but she was not very happy either. She did not have any objections to the family members in bed 21, and showed no particular displeasure or irritability.
Hello, how are you feeling today? What's your blood sugar level in the morning? "Ji Lefan asked.
Diabetic foot patients are all diabetics, so they must ask about their blood sugar.
"I took a test in the morning and it was 8.8. My blood sugar is under control, but my feet are still the same. When I go to bed at night, they are very swollen and painful." The family member replied.
The man was used to being tortured. He shook his head and said, "Doctor, if my foot really doesn't work, just have it amputated. I can't stand it anymore."
As he spoke, he slowly straightened his body.
Xie Wenhua, a bedside doctor, hurriedly said: "Professor Cai, the patient's current treatment plan is still using the treatment plan of the burn department. He has also consulted the endocrinology department many times. He is currently awaiting surgery and his blood sugar control is better now.
.”
"What are the drugs used to promote microcirculation?" Zhou Cheng asked Xie Wenhua. He didn't have time to look at these carefully. He was too busy yesterday to sort them out.
"Alprostadil is currently used for treatment." Xie Wenhua also used it.
"What about antioxidants?" Zhou Cheng continued to ask. Antioxidants are the most commonly used ones, so they should be correct, but Zhou Cheng was also afraid of missing them.
"Lipoic acid." Xie Wenhua answered fluently.
"Add gabapentin to relieve pain and let the patient rest better at night. Then add methylcobalamin to nourish the nerves. Diabetic foot will damage the nerves to a certain extent." Zhou Cheng added.
"Methylcobalamin has been prescribed in the burn department." Xie Wenhua remembered the arm machine and wrote gabapentin in his notebook.
"Pay attention to protecting the stomach. Alpha-lipoic acid and alprostadil all have certain gastrointestinal tract irritation. Remember to use preventive anticoagulant drugs, low molecular weight heparin sodium, and do not use Natrex." Zhou Cheng specifically explained.
Low molecular weight heparin sodium is the most classic anticoagulant drug, and nadroparin calcium is rumored to be a better anticoagulant drug, and this is also written in the guidelines.
Although Naqu is more expensive, low molecular weight heparin sodium has been used for many years and has a very good safety factor.
The most important thing is that Zhou Chengyou discovered that low molecular weight heparin sodium can promote the recanalization of the internal microcirculation of diabetic feet to a certain extent, and it can also prevent venous thrombosis. It is a dual-purpose drug, which is perfect.
"Okay!" Xie Wenhua wrote.
"Use half the dose before surgery. The most important thing is to pay attention to the patient's pain response, be sure to strictly analgesia, and let the patient rest well." Zhou Cheng explained again.
When diabetic foot ulcers develop, they are often accompanied by nerve and blood vessel damage, and the pain is particularly unbearable.
If you don't get a good rest, it will definitely be very painful before the next surgery.
This kind of disease requires special care in surgery and medication. If the medication is used properly, the rotten smell can be eliminated.
lost.
"Okay!" Xie Wenhua nodded.
Cai Dongfan said nothing during this process, and even the specific use of the medicine mentioned by Zhou Cheng and others was not particularly clear.
He was a trauma surgeon, but he suddenly developed diabetic foot disease, and his progress was still slow.
Then, Bed 23 had planned to be discharged from the hospital in advance. Especially after Bed 22 was transferred in, his desire to move out became even more urgent.
After completing the ward rounds, Zhou Chengcai said to Du Yanjun: "Yan Jun, please remember to remind me in the future that all diabetic patients in our group must take low-molecular-weight heparin from the beginning of admission. This should be stopped the night before the operation and the second day after the operation."
Use it again from the beginning of the day.”
"Just stop on the day of the operation!" Zhou Cheng ordered.
He is now the attending physician and has absolute prescribing rights. As long as Cai Dongfan doesn't stop him, he can change the patient's treatment plan at any time.
"We will talk about other drugs based on the specific situation. You can check the information and literature yourself. Our team will formulate a general treatment framework so that all resident doctors will be aware of it."
"They will be able to use it in their work and study in the future."
"We try our best to use medication mainly and surgery as a supplement. If we can solve some cases without surgery, it can alleviate a large part of the pressure on hospital beds." Zhou Cheng said in the simulated world, half of the patients can be treated with surgery, and half can be treated with medication.
Can be solved.
He has not yet determined which patients can be treated with surgery and which can be treated with drugs.
He has to slowly classify and deal with it. If he can classify the diabetic foot and come up with a treatment plan, this alone will be enough for Zhou Cheng to safely bring this disease to the title of national key diagnosis and treatment center!
Because no one does it, Zhou Cheng does it well, and the number of patients is huge!
"Okay, Brother Cheng, I'll check it out right away when I get back." Du Yanjun's heartbeat also started to accelerate.
Now that Zhou Cheng is working, he is finally going to start leading a project at his own place. Moreover, he just built such a big living room and drank some soup, which is enough for him to stay in the hospital!
Cai Dongfan left the ward, turned around and asked, "This diabetic foot can be treated with simple medicines?"
"It can be cured, at least 40% of the time, and it will be effective in about five days!" Zhou Cheng estimated conservatively and did not want to give too high hopes.
"That's enough for a large batch. Come on, let's continue checking the wards."
Half an hour later, Li Zhongyue immediately came to him and asked Zhou Cheng: "Brother, why do the three diabetic foot patients take different medicines?"
"Of course the medication is different, and everyone's situation is different," Zhou Cheng said.
"I haven't clarified the difference myself yet. You can also check the literature for me."
"Oh, okay, senior brother." Li Zhongyue's mood became a mixture of disappointment and excitement.
Zhou Cheng couldn't even figure out what kind of disease it was? In Li Zhongyue's vision, Zhou Cheng was almost invincible in orthopedics.
Of course, Zhou Cheng himself had never thought this way. He just had a plug-in, but he was not able to control all orthopedic diseases.
After he solves this disease, he will ask someone to open a separate department, and he doesn't know who is willing to take over.
"That's it, I have to squint for a while. I'm too sleepy." Zhou Cheng said.
"Okay, senior brother, you go and rest first." Li Zhongyue saw Zhou Cheng's green hand-washed clothes and hurried away.
Zhou Cheng fell asleep as soon as he got into bed.
Wang Huan and others returned from the ward rounds with the instructor and wanted to report to Zhou Cheng, but they were stopped by Du Yanjun.
Then Peng Lingli and several interns got together and were analyzing several diseases that they had led the ward rounds today, and then looking for similarities and differences and exchanging opinions.
The learning motivation and learning methods of top academics, and even the way of finding happiness, are different from ordinary people.
When Zhou Cheng was in the Eighth Hospital before, there was no such test.
Zhou Cheng was woken up by Cai Dongfan who knocked on the door and knocked him out.
"Xiao Zhou, get up quickly! Come and see Professor Ning." Cai Dongfan shouted loudly after slamming the door.
Zhou Cheng was sleeping in a daze. When he heard this, he rubbed his eyes and opened the door. The circles under his eyes were very red.
Then he saw two people standing at the door. Needless to say, Cai Dongfan, the other person turned out to be Ningling from the first ward of the Department of Orthopedics, which surprised Zhou Cheng.
"Xiao Zhou, we meet again." Ningling has a good figure, looks very kind, and has a gentle voice. It sounds like a spring breeze, with an indescribable flavor.
"I understand. I told Professor Cai and we'll talk tomorrow, but Professor Cai insists that we meet now." Ningling said helplessly.
"Xiao Zhou, Professor Ning specially transferred to our group after applying with Professor Chen Tingye. From now on, we will all be part of it."
"Tonight, let's honor Professor Ning together." Cai Dongfan warmly invited the wine party.
Before Zhou Cheng could speak, Ningling said, "Professor Cai, this won't work. We have agreed that I will treat you today, and I will never refuse Professor Cai your treat in the future."
"This time, I have to thank Dr. Zhou for his help. My sister-in-law is recovering well now. Today, I have to compete with Professor Cai. You can't refuse." Ningling's momentum is very strong and cannot be refused.
"Is there anything else like this?" Cai Dongfan turned to look at Zhou Cheng, who had not heard about it.
Zhou Chengcheng said: "Master, Professor Ning and I performed two operations together and learned from each other. It was an emergency operation, so I didn't bother you."
"What time is it now, oh, Master, I have to go for a consultation, and then I have to complete the intern's ward rounds record. Master, how about you and Professor Ning chat more?"
The total hospitalization time is all squeezed out, there are no emergency consultations, and there are also ordinary consultations.
"Go ahead, Professor Ning, Xiao Zhou is the chief resident now, so?"
Ningling said: "We all understand, we are all our own people, it doesn't matter. Thank you for your hard work, Xiao Zhou."