To the astonishment and astonishment of Dr. Zhang Suo outside the door, Xu Ze naturally opened his mouth and prepared the puncture part. Holding a syringe in his other hand, he steadily and accurately inserted the syringe from the small medicine bottle in Director Zhai's hand. Five milliliters of lidocaine was extracted and local anesthesia was started. wWw.QuAnBen-XIaoShuo.CoM
In Xu Ze's view, since Director Zhai said that he would do it himself, then of course Director Zhai would be an assistant to assist him in completing the lumbar puncture when there are only two people. There is no need to be too taboo about identity issues.
What surprised Zhang Di was that Director Cheng did not do it himself, but acted as an assistant. In their view, this was almost impossible. As the busy director of the Women's Office and a well-known expert in the country, , in addition to weekly ward rounds; generally, to see a patient, the general doctor in charge of the patient must apply, and they will take time to come out for consultation.
It is impossible to waste time and perform such a small operation in person, but today Director Zhai not only came to perform it, but also worked as an assistant for a new doctor, which made people feel strange.
At that moment, Zhang Yi quickly put on his mask and hat and walked in. He smiled at Director Zhai and said, "Director, why don't you take a rest, and I'll be Dr. Xu's assistant.
Director Zhai knew what Zhang Suo meant. He chuckled and shook his head. Then he continued to watch Xu Ze take action. He was serving as an assistant for no other reason than to see Xu Ze's true ability. Of course, he would not let others to replace myself.
Xu Ze didn't think so much at this time. He was concentrating on his operation. He carefully inserted the syringe into the puncture point diagonally, injected some anesthetic into the bottom layer of the skin, and then changed to inserting the needle vertically, from the skin to the Local infiltration anesthesia is carefully performed layer by layer on the interfacial ligament.
When the lidocaine had been completely injected into the ligament, Xu Ze took a breath, calmed down, then picked up the puncture needle about ten centimeters long and carefully fixed the puncture point skin with the thumb and index fingers of his left hand. The puncture needle is inserted vertically in the direction of the back, starting from the 3rd and 3rd intervertebral areas, and the lumbar puncture is officially started.
Seeing that Xu Ze started to formally puncture, a trace of curiosity flashed in Director Zhai's eyes. At this time, he basically no longer doubted Xu Ze's ability. He just wondered whether Xu Ze could succeed in one attempt. If this could also be successful in one attempt, then It shows that Xu Ze must have very rich clinical experience and strong theoretical and practical skills. I can let Xu Ze do things in the future.
When Zhang Li saw Director Zhai's refusal, she watched carefully from the sidelines. Seeing what Xu Ze, who could be so valued by Director Zhai, had at his disposal, he probably wasn't just a silver wax-tipped gun...
At this time, Xu Ze was also slightly nervous. Although it was said that the lumbar puncture was not successful once and had to be done one or two more times, Xu Ze still wanted to do it perfectly. When he was in the virtual space, But after doing it many times, he got familiar with the feel before he could succeed once. This time it was in reality, which made him a little nervous.
While Xu Ze recalled the feel of the operation in the virtual space, he slowly pushed the puncture needle forward according to his feeling. When it was inserted for about 3 meters, Xu Ze's hand stagnated slightly. After a while, he felt a little resistance. When he pushed forward slightly, he quickly broke through. He couldn't help but frown at that moment. This should have broken through the first layer of ligament. The next step is the most critical Yes, whether it succeeds or not depends on what happens next.
After continuing to puncture for two centimeters, Xu Ze felt resistance again. This time the resistance was much greater. Xu Ze raised his eyebrows slightly, then took a breath, held the puncture needle tightly, and pushed it forward. With this push, and then his hand was released, the resistance to the needle insertion disappeared obviously. Xu Ze breathed a sigh of relief, knowing that the puncture needle had successfully passed through the ligament and dura mater and reached the spinal canal smoothly.
Although it was estimated that it had reached the spinal canal, it was still not completely certain that the puncture was successful. This would only count if the cerebrospinal fluid could be seen.
Xu Ze let out a breath and slowly pulled out the needle. Success or failure would be determined again. If cerebrospinal fluid was still not seen, the puncture would have to be re-punctured.
However, it was obvious that Xu Ze's training in the virtual space was very effective. As the needle slowly withdrew, a drop of colorless and transparent liquid gently gathered in the hopeful eyes of the three people.
Seeing this drop of transparent cerebrospinal fluid dripping out, Xu Ze couldn't help but breathed a sigh of relief. Director Zhai and Zhang Suo on the side both had a look of approval on their faces. Xu Ze was indeed good.
Xu Ze slowly pushed the needle core back to temporarily stop the cerebrospinal fluid from flowing out of the needle tube. Then he took out a manometer from the lumbar puncture bag and carefully inserted the lower end of the pressure tube into the needle tube and began to measure. Intracranial pressure is also an important diagnostic method for lumbar puncture. By measuring pressure, some conditions of intracranial high pressure can be ruled out.
As the pressure measuring tube was clamped, the cerebrospinal fluid scale displayed in the pressure measuring tube slowly rose, and gradually stopped at ten millimeters of water column. Xu Ze also felt relieved. The normal value was 1,000, and now it has dropped. It seems that the intracranial pressure is not high, and there should be no other intracranial or cerebrospinal fluid lesions. A higher diagnosis gives you more confidence in myocardial syndrome.
After measuring the pressure, Xu Ze carefully took out the pressure measuring tube, then inserted the needle core into the needle tube to block the cerebrospinal fluid so that it would not flow out; then reached out and took out three test tubes from the lumbar puncture bag, preparing to retain the cerebrospinal fluid. Specimens for testing.
Carefully line up the test tubes in your right hand and place them under the needle tube on the patient's spine. Then gently hold the needle core with your left hand and carefully pull it out slowly and slowly. As the needle core comes out of the needle tube, Withdrawing, the colorless and transparent cerebrospinal fluid slowly dripped from the needle into the test tube in Xu Ze's hand.
When the three test tubes in his hand were filled with half of the cerebrospinal fluid, Xu Ze quickly pressed the fingers of his left hand against the bowl tube to stop the cerebrospinal fluid from flowing out temporarily, and then placed the test tubes in his hand on the treatment tray aside. Then insert the needle core into the needle tube to block the cerebrospinal fluid so that it will no longer flow out.
After everything was done, Xu Ze reached out and quickly pulled out the puncture needle, sealed the needle hole with a piece of gauze, then changed the patient's position from side lying to supine, and then asked the patient if there was any special discomfort. , and told him to lie on his back for four hours before he could sit up. After that, he packed up the surgical instruments, took three test tubes filled with cerebrospinal fluid, and left the ward with Director Que.
Back in the office, Director Que quickly wrote out the test orders and handed three test tubes to the nurse. Let them send it to the laboratory for testing immediately.
Zhang Zhuan saw Director Que being so cautious and couldn't help but asked curiously: "Director, is there something wrong with this patient?"
"Well, when Xu Ze went to see the patient just now, he found some abnormalities. After detailed analysis, we considered that this patient may not have simple myasthenia gravis, but may be a recently discovered disease, so we must treat it as soon as possible. Make a diagnosis to avoid delaying the patient's treatment!" Director Zhai nodded, looked at Zhang Yi and said.
"Newly discovered disease? Did Xu Ze see it?" Zhang Yan couldn't help but say in astonishment after hearing Director Que's words.
"Yes, Xu Ze is a very good young man. He has a wide range of knowledge and has done extremely in-depth research on some new diseases. If he hadn't discovered the abnormality this time, I wouldn't have thought of this!" Director Zhai said with a smile.
It was almost twelve o'clock. Qian Xuebin opened the door and walked in. He smiled at Director Que and said, "Director, please get off work. I've already eaten!"
Seeing Qian Xuebin come in, Director Huang waved and then said: "Xiao Qian, come here."
Seeing the solemn look on Director Zhai's face, Qian Xuebin couldn't help but feel his heart skip a beat, then he walked over with a smile and said, "Director, what's the matter?"
Director Cheng nodded and told him to sit down, then handed the medical record in hand to Qian Xuebin and said, "Xiao Qian, you need to rewrite this medical record. I just went to see this patient and found something abnormal. It may not be a simple case." Myasthenia gravis may be a recently discovered disease called Guillain-Barre syndrome!"
"I will find out the information for you later. You first ask the patient's medical history again, and then do a physical examination carefully. Then write down the medical history and some subtle physical examinations in detail, and don't say anything else. Question. Do you understand?" Director Que explained cautiously and somewhat sternly.
Hearing Director Que's critical words, Qian Xuebin's face darkened. Although it was not a shameful thing to be criticized by the director, Qian Xuebin still felt hot on his face after being criticized in front of other doctors. .
Although I don’t know what went wrong with my medical records. But Qian Xuebin still nodded humbly and said seriously: "Okay. Director, I will conduct a comprehensive consultation and physical examination on the patient again, and I will never miss anything again!"
"Well, go now. Xu Ze and I have already performed a lumbar puncture on the patient and are waiting for the test results to come out. You first ask about the medical history and do a physical examination, and then I will find the information for you!" Director Huo clicked. He nodded, then got up and went to his director's office.
After Director Que left, Qian Xuebin began to analyze the matter. His physical examination should have always been good, and there were usually no big problems when asking about medical history. So where could the problem lie
Qian Xuebin was thinking about it, and suddenly he remembered the strange and seemingly unrelated medical history of Xu Ze when he went to see this patient two hours ago. greetings
Xu Ze probably saw some problems, but he didn't say anything. Instead, he told the director directly, allowing himself to be criticized by the director.
Thinking of this, Qian Xuebin's eyes couldn't help but reveal a trace of resentment.
Defense: Do you guys still have monthly tickets on hand? Please give Tiannan a few more votes to encourage him. If he adds thirty more, if Tiannan is not too busy working the night shift, he will definitely try his best to code another chapter and add an update before twelve o'clock!
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