Chapter 632 Surgery that is simpler than first-level surgery
In real life, interns have no status.
The virtual world is not much better. The virtual world is just as cruel as reality.
As soon as I started, I was deducted 10% of the completion score.
Zhou Yi never dared to make any mistakes again.
Follow Lao He honestly and submissively to practice.
He Congshuang crossed Zhou Sheng's side, walked to the back of the desk, pulled up a chair, and sat down.
With her legs crossed, she looks like a goddess.
Lao He is about to sit in for a consultation.
Zhou Sheng was still standing. Seeing that Lao He didn't pay attention to him, Zhou Sheng knew that he had to be self-reliant.
He looked around, except for the chair where Lao He was sitting.
This clinic only has one consultation bed and one waiting chair.
You can't move the waiting chair to sit on it yourself. I guess if you do that, your internship points may be deducted immediately.
have no choice!
Zhou Shengsheng could only stand beside He Congshuang like a follower.
He Congshuang didn't even glance at Zhou Sheng, and started calling directly.
In a moment, a patient pushed open the door and entered.
The patient was a young man, clutching his chest and looking in pain. His condition was very similar to that of the patient with esophageal rupture that Zhou Yisheng rescued.
But the situation is not that serious.
The young patient entered the consulting room and saw the man in a white coat.
He sat down directly on the waiting chair.
After He Congshuang said, "What's wrong with you?"
The patient began to complain.
After a while, Zhou Sheng understood the basic condition of the patient.
Patient Liu, male, 21 years old, suddenly felt right side chest pain during exercise, shortness of breath, occasional cough, no obvious phlegm, and fever. No special treatment was given at first, but the symptoms gradually worsened over half a day, and he came to the outpatient department.
It was chest pain again, Zhou Yisheng thought to himself. Could it be that the esophagus was also ruptured?
It's very possible, after all, this system can read the participants' memory information.
However, because it is in a virtual copy, Zhou Sheng's various system artifacts cannot be deployed.
At this moment, he could only honestly guess at the patient's condition.
The patient over there had just finished complaining, and He Congshuang began to consult.
Mainly asking people if they have any history of food or drug allergies.
The patient's answer was no.
After the questioning, it’s time for a physical examination.
The body temperature was measured, 36.6°C, normal.
Heart rate measured, 97 beats/min. Normal.
Blood pressure, 125/85mmhg. Normal.
Next comes visual inspection and auscultation.
He Congshuang murmured while inspecting: "Short breathing, no jaundice on the skin, right lung percussion sound, and the breath sound on the right side disappeared during auscultation. Abdominal physical examination showed no abnormality..."
The physical examination is almost done.
Zhou Sheng felt that the patient probably did not have a ruptured esophagus.
Because the patient's blood pressure is normal and the breath sounds on the right side have disappeared during auscultation.
This proves that there is something wrong with the patient's right lung.
After the examination, He Congshuang had time to talk to Zhou Sheng. She turned around and asked Zhou Sheng beside her: "What examinations does this patient need now?"
Listen to it on Monday.
He Congshuang wants to test herself!
Although there is no black technology, I have been working in the emergency center for so long.
I am not an intern who knows nothing at all.
At that moment, Zhou Sheng was unambiguous and immediately answered: "Blood routine, electrocardiogram, and chest X-ray are necessary examinations."
Zhou Shengsheng's answer made He Congshuang very satisfied.
She nodded approvingly.
Then she turned back and asked the patient to go for an examination.
The patient responded.
In a blink of an eye, he pushed the door open again.
Normally, these three inspections would take two to three hours.
If it is slow, it may take more than half a day.
But a copy is a copy, and everything is about saving time.
Once the door opens, once it closes.
The inspection is done.
The patient sent the three test reports of blood routine, electrocardiogram, and chest X-ray to He Congshuang.
He Congshuang read the pictures very quickly, almost every picture in a few seconds.
Then she handed the report to Zhou Sheng beside her without looking back.
Monday understood this from heart to heart.
Take the report and read it one by one.
The electrocardiogram reported everything was normal.
The blood routine report is densely packed, but if you look carefully, every item is within the normal range.
It was only on this chest X-ray that something was obviously strange: the right lung texture disappeared and the right lung was compressed by about 50%.
This is consistent with the result of auscultation, and there is something wrong with the patient's right lung.
The lungs are compressed by half. Their function decreases, and of course they will become short of breath.
Zhou Sheng immediately understood at a glance that this was a common pneumothorax in thoracic surgery.
Why are the lungs compressed?
This situation is usually caused by air entering the chest cavity, causing the lungs to be squeezed due to pressure.
Then why does air enter the chest cavity?
The biggest cause is the rupture of the bullae.
Generally speaking, lung tissue shrinkage below 30% is considered a small pneumothorax, which has little impact on breathing and blood circulation. More than 30% to 60% is considered a large pneumothorax, which will cause chest tightness, chest pain, shortness of breath, palpitations, and tracheal displacement to the healthy side.
wait.
Treatment: A small amount of pneumothorax does not require treatment and can be absorbed by itself in 1 to 2 weeks.
Massive pneumothorax requires thoracentesis to extract the accumulated air to promote early expansion of lung tissue. Antibiotics are also used to prevent infection.
After Zhou Sheng read it, he immediately gave the answer: "Teacher He..."
With previous experiences and lessons learned, Zhou Sheng did not dare to call He Congshuang his wife, so he said. It would be safer to call him "teacher" honestly.
"...I think it's a pneumothorax."
"What's the next step in treatment?"
"With 50% compression, a moderate pneumothorax does not require surgical treatment, but it is difficult to recover on its own. Consider thoracentesis to remove the pneumothorax."
He Congshuang nodded, "Arrange!"
Give an order.
This time there is no animation for opening or closing the door.
Zhou Sheng's eyes lit up, and when he recovered, he directly entered the scene of thoracentesis.
When answering He Congshuang's question just now, Zhou Shengsheng did not regard thoracentesis as a surgery. In fact, thoracentesis is indeed an entry-level first-level extrathoracic surgery.
However, this operation is too simple and too common for surgeons, so doctors do not regard it as surgery.
Its status is not even as good as a first-level appendix surgery.
To put it simply, thoracentesis surgery is to use a puncture needle to make a small hole in the patient's chest, and then extract the accumulated fluid or air.
In addition to its clinical role in treating pleural effusion and gas accumulation, it also plays an important role in diagnosis.
After the effusion is aspirated, pleural fluid smear, culture, cytology and biochemical tests can be done to identify other causes.
Therefore, although this thoracentesis surgery is a first-level thoracic surgery.
But it is an operation that almost every surgeon can perform. Emergency centers also often use this thoracentesis to check for pleural effusion.
Not only surgeons, but also interns often perform this operation because this operation is part of the clinical practice test in the doctor's qualification examination.
Of course, for interns who lack clinical experience, this operation still has teaching significance.
But for Zhou Sheng, this is no different than taking his blood pressure.
However, no matter how small the operation is, it must be taken seriously, not to mention that it also involves the issue of copy completion rate.
Zhou Sheng opened the puncture bag and prepared to take out the instruments for operation.