I Spent Those Years In the Operating Room Fighting Monsters

When Qu Hongsheng praised Fang Nixin, the patient's family members rushed up and asked, "Professor Qu, how is my father's situation now?"

"The wound is still oozing pus. I've been hospitalized for more than a month."

It was the patient's son who was talking, with a short head and slightly dark circles under his eyes. He looked a little sleepy, as if he hadn't slept for a long time.

The patient himself is currently dozing, not speaking, but it can be seen from the gap between the upper and lower eyelids that he is not asleep.

Qu Hongsheng was also a bit difficult to answer this question, and said, "Your father's current situation, he told you about it before the operation. It's very hard to do, and he is not too young. He is sixty-eight this year."

"And the long-term tuberculosis infection before the hospitalization has led to the current weight loss. Moreover, the infection of Mycobacterium tuberculosis itself, coupled with malnutrition, increases the chance of tuberculosis recurrence and bacterial infection after surgery. This is difficult to avoid. matter."

"Before, we considered the risk to be relatively high, so we postponed the date of the operation. I have told you this in detail."

When Qu Hongsheng said this, the middle-aged man nodded, but he kept scratching his hair and said, "Professor Qu, I can understand what you said. It's just that you also know my father's situation."

Speaking of this, the man made a high-profile: "He has been in good health before, I have an older brother and two younger sisters, the four of us are out all year round, and every time I call to ask him if he is in good health, he says yes. "

"I also found that he was getting thinner every year, but he didn't say where he was in pain, he just said that he was in good health, and he took painkillers every year when he came back for Chinese New Year. It wasn't until a few days ago that my mother suddenly gave We made a phone call and said my dad couldn't move."

"You said this?"

The man's eyes were a little sparkling, "My dad has really worked hard for us all his life, and when he gets old, he is reluctant to let himself spend our money. It's just that there is not only one father. My dad is not too old. Certainly not young."

"We still hope that he can stand up by himself in the future, and it won't hurt so much. Even if he doesn't walk, it's fine if it doesn't hurt. Based on this consideration, the four of us have a strong willingness to operate."

"Well, I don't blame him, nor do I blame you. Even now, when I see such a situation, I suddenly feel unacceptable."

"Professor Qu, you are all great experts, great professors, you must think more about ways. It doesn't matter if you spend more money."

The middle-aged man put his hands together and kept asking Qu Hongsheng.

These words, Lu Chengcheng felt a little empathy, and it is estimated that his parents had the same mentality.

The tree wants to be quiet but the wind doesn't stop. Sometimes the elderly just want to avoid being a drag on their children. When they are about to die, some childishly run away from home, dragging their illnesses into disability, and even commit suicide. .

The generation of parents, in our life, is only a journey to accompany, but in their life, since they have children, it is a lifetime...

Professor Qu Hongsheng may have more experience, so although he was moved, he said calmly: "You may have misunderstood me, I am not thinking about money. Now I am thinking about the problem. In my father's case, one or two more debridements may be required to control the infection."

"You can actually choose one-stage surgery for joint tuberculosis. We have already chosen a conservative method to do it in two stages. We will give a solution soon. It's just quite troublesome, and I have to take care Think carefully."

Qu Hongsheng also had his own plans. If it wasn't for the strong willingness of the patient's family to undergo surgery, he begged him to make his father stand up again before the surgery. Qu Hongsheng would not be willing to take this trouble.

Now that it is infected, it is almost one of the worst outcomes. Qu Hongsheng has not made a final decision on how to solve this problem in the future.

In fact, the easiest is to directly fuse the joints to completely solve the problem. It's just that after the joint fusion, he loses his own function, and he is destined to be paralyzed for the rest of his life.

However, the treatment of tuberculous arthritis, especially multiple tuberculous arthritis, is itself a rather complicated problem. Coupled with malnutrition...

Qu Hongsheng then introduced: "This is Dr. Xie, and he will be your father's doctor in the future. If you have any questions, you can talk to him at any time. If I have any ideas, I will immediately discussed with you."

"If we don't get to the last step, we still don't think about joint fusion, okay?"

"It's not that infection is an uncontrollable problem, but I just hope to find the best way to keep the function, right?"

The patient's age is not very old. Now that he is 68 years old, he can still fight for an operation to preserve his function. If he is 86 years old and the lifeline itself is not very long, Qu Hongsheng may have done joint fusion directly. .

"Hello, Doctor Xie." The middle-aged man shook hands with Xie Jian quite politely.

This made Xie Jianlue a little uncomfortable, but he could also see that, at least for now, this family member was still a very empathetic and filial person.

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Qu Hongsheng then took off the patient's gauze and looked at the drainage tube, and found that the inlet and outlet of the drainage tube were slightly dissolved. This is due to the long-term compression of the drainage tube, but the patient's own malnutrition is caused, and the secretions from the drainage tube orifice are taken, and there is also bacterial infection.

"This patient, let's take some time today to discuss it in detail."

"Little Lu, what do you think of this?" Although Qu Hongsheng felt that Fang Nixin had reached the limit, he still wanted to see if Lu Cheng had any better opinions.

Lu Cheng frowned slightly and said, "Professor Qu, in fact, if you want to talk about new ideas, I think the most important step in tuberculosis and infection is thorough debridement. Especially the infected tissue in the joint cavity, It has to be cleaned up thoroughly."

"For other adjuvant treatment options, I still agree with the current medication. It is this debridement, I think I can try to find more closed spaces."

"And this second debridement must be arranged as soon as possible."

If infection occurs after surgery, debridement must be done in the fastest way, and sensitive bacteria must be found as soon as possible, which are two particularly important points.

"Okay, then, let's make arrangements for tomorrow. Tomorrow is Thursday, which happens to be the operation day of our group. We will strive to completely eliminate the infection after tomorrow's debridement."

"Oh, by the way, Xie Jian, remember to review the liver and kidney function of the patient at any time. The patient has been receiving anti-tuberculosis treatment. Pay attention to the results." Qu Hongsheng ordered again.

Qu Hongsheng has a lot of troublesome patients in charge of himself, so he does not pay attention to the examination results of each bed every day, which must be reminded by the doctor in charge of the bed at any time. The previous doctor in charge of the bed has left, but the task still needs to be handed over.

"Okay, Teacher Qu."

"Invite another person from the nutrition department to come to the consultation and prepare a nutritious meal. For oral protein powder, family members should go out and buy that kind of domestically produced ones. The ones offered by our hospital are all imported, which may be a bit expensive."

"Others, in particular, pay attention to the changes in the patient's body temperature and electrolytes. Also, remember to take samples for bacterial culture at least every two days, the drainage tube orifice, and the bacterial culture of the drainage fluid."

"The thrombus should also be reviewed. After the review, call the vascular surgery department for consultation at any time." Qu Hong arranged the event in great detail.

For complicated patients, the regulations in charge of management should be meticulous, especially for patients with tuberculosis and infection, which is a wasting disease, and nutrition and electrolytes must keep up.

"Thank you, Professor Qu. My father has worked hard for you." The middle-aged men thanked Qu Hongsheng and others one by one, which made people feel a little sad.

…

Then the group came to the second bed.

Xie Jian once again reviewed the simple medical history of the second bed: "The second bed, a patient with septic arthritis, had previously undergone a cannulated screw internal fixation operation for a femoral neck fracture in a prefecture-level city hospital, and an infection occurred after the operation."

"Before the debridement in this hospital, I was infected with multi-resistant bacteria, high blood pressure, and mild diabetes. The blood sugar level before surgery was well controlled. On the second day after surgery, the blood sugar level soared to 13.2mmol/L."

"Especially the blood sugar level after dinner, the highest one was 17.2mmol/L."

"At present, there is no trace of pus in the wound, but the bacterial culture results of the drainage fluid in recent times are a bit messy. It seems that the results of the bacteria cultured each time are different, and there are some inconsistencies in the sensitive antibiotics."

"So the current antibacterial regimen was changed from cefuroxime to piperacillin, and now polymyxin is used. However, the bacterial culture results sampled two days ago show that among the currently sensitive antibiotics, polymyxin is Average sensitivity, vancomycin sensitive."

"I asked for a consultation from the pharmacy department yesterday. The consultation opinion said that polymyxin should be stopped, vancomycin should be changed, levofloxacin should be added, and rifampicin should be taken orally. The patient did not see tuberculosis. Yesterday's tube bed The doctor hasn't prescribed it, and I don't know if I should follow the consultation advice for the time being." Xie Jian explained his views on the consultation advice while introducing.

However, after Xie Jiancai finished speaking, Fang Nixin said: "In addition to rifampicin used for Mycobacterium tuberculosis, it is also commonly used in the antibacterial treatment of Staphylococcus aureus. Oral rifampicin is very effective in joint infections. It is not for the purpose of Anti-tuberculosis is a broad-spectrum antibiotic."

Fang Nixin also saw Xie Jian casually comment on the consultation opinion of the associate professor of pharmacy, so she warned him in advance not to think too much.

Xie Jianjian obediently shut his mouth, and honestly wrote the corresponding doctor's order.

"The current anti-infection plan should be changed according to the consultation opinion of the pharmacy department. For patients with septic arthritis, if the bacteria develop multi-resistance, the effect of vancomycin is relatively good."

"If the current drainage tube is unobstructed, we will observe it for a few more days. If bacteria can still be cultured in the subsequent drainage tube, we may have to do a debridement. However, the current bacterial species are changing, and it may not be a real infection. lesions."

When the patient heard this, his face brightened and he asked, "Professor Qu, is my infection cured? No more bacteria?"

The patient heard it differently. He was young. Moreover, his wife also looked at Qu Hongsheng with great hope, and hoped that Qu Hongsheng could give a positive answer.

Qu Hongsheng hurriedly explained: "It's not good either, it's just a temporary observation."

"If you continue to cultivate and there are bacteria, then the situation is quite complicated..."

"Ah? Not yet." The patient was immediately disappointed.

He was a minor operation at first, and the incision was only a few centimeters. He thought it would be fine soon, but who knew that after going around, he turned into infectious arthritis. Now the femoral head is directly taken out and bone cement is made. The desertion is still not good.

It's been several months, not to mention missing work, medical expenses, these are a big pile, and there are children at home who want to study, he has long been anxious, and wants to go back to do business as soon as possible.

"In your situation, the unit that you performed the operation on before dared not accept it again. It must be very troublesome."

"Bacteria infected before are like wearing armor. We have to find the Achilles' heel so that we can really kill them, and then give you joint replacement so that you can get out of bed and walk again." Qu Hongsheng continued to explain .

"Alas. If I had known, I would have come to the big hospital to see it." The patient was a little dejected.

In fact, his road to seeking medical treatment is not easy. He has been transferred from a prefecture-level city to several tertiary hospitals in Shashi, UU reading www. No one dared to accept uukanshu.com. Finally, he finally went to the Second Xiangya Hospital to find a doctor who dared to deal with his condition.

But it didn't go well. After several days of surgery, the news the doctor brought him every day was not very optimistic.

"Relax in peace, we will try our best to find a way for you. You need to move your feet more and exercise your muscle strength, otherwise, when you can move in the future, your muscle strength will be gone, and you won't be able to walk." Hongsheng continued to explain.

Although the situation of this patient is changeable, it is actually much more optimistic than 1 bed. Youth is his capital.

Infections always come under control.

"Okay, Professor Qu." The patient listened, then eagerly watched Qu Hongsheng and his group leave, with an inexplicable look in his eyes.

Prosperity and wealth are all life, life, old age, sickness and death are inexorable.

This statement is true.

Qu Hongsheng and others continued to walk towards the three beds, still Xie Jian's, Xie Jian stood beside the bed and explained the patient's medical history.

About an hour and a half later, Qu Hongsheng and the others slowly passed the dozen or so patients. The speed of the rounds this time was obviously much slower than when they were in the trauma center.

However, no slowness is no good. Basically, the patients you encounter need to be carefully dealt with and considered.

After checking the room, Xie Jian and other lower-level doctors dispersed in a hurry and started to grab the computers to deal with the patients. Qu Hongsheng called Lu Cheng and Fang Nixin to the doctor's office separately and said, "Little one. Lu, Xiao Fang, Xiao Cao, come here, let's discuss the specific plan for tomorrow's surgery patients." Click to download the APP of this site, massive novels, free to read!