This is a patient who underwent radiofrequency ablation for liver cancer today.
Late-stage liver cancer has multiple intrahepatic metastases. With this diagnosis, ten years ago, the patient could be declared to have no therapeutic value and die after a survival period of three to six months.
However, with the clinical development of interventional surgery, this kind of disease can not only be delayed for a period of time, but also the cure rate has increased from 0 to about 25%.
In addition, 912 has carried out research on three-dimensional reconstruction of 64-slice CT surgeons, which has once again improved the cure rate of liver cancer.
Embolization + radiofrequency ablation is indeed an effective method to treat liver cancer. No matter how much Zhao Wenhua denounces Zheng Ren, he has to admit that it is indeed of great benefit for the surgeon to perform 64-slice CT three-dimensional reconstruction on his own.
The patient in front of me had liver cancer resected a year ago and had recurrence after surgery. Because the left hemihepatectomy was performed and the recurrence of the disease after surgery was contraindicated by surgery, interventional treatment was the only option.
Zhao Wenhua admitted the patient to the hospital at the outpatient clinic. After interventional embolization, he performed radiofrequency ablation this morning.
The lesion was close to the diaphragm, so Zhao Wenhua chose transthoracic radiofrequency ablation.
This is just a common operation method. Both Zhao Wenhua and Director Kong have done it thousands of times.
The effect is also very good. As long as you pay attention to burning the needle tract, there will be no complications of implant transfer.
Clinical data show that implant metastasis is rare.
But the patient in front of me had another complication, bleeding.
Zhao Wenhua was in a frenzy. He was really screwed. When he withdrew the needle, he carefully burned the blood vessels and the needle track, but he even suffered from bleeding.
What a bummer.
The only thing I hope now is that the bleeding will stop on its own.
I tried three sets of hemostatic drugs, and even used a micropump to pump vasopressin into the pituitary gland, but the bleeding still couldn't be stopped.
During the thoracic surgery consultation, Fang Lin came to order a chest bottle.
In just one moment, the chest bottle was almost full, and Fang Lin had no choice but to clamp the chest tube with hemostatic pliers. He judged that this patient would most likely need a thoracotomy. However, after explaining to Zhao Wenhua that it was the thoracic department's judgment, Zhao Wenhua refused the suggestion of thoracotomy.
In fact, Zhao Wenhua's idea is also very simple. How thick can the radiofrequency needle be? However, the thickness of an ordinary needle will not cause much damage to blood vessels. Moreover, there are no major blood vessels at the location where the needle is inserted, and the needle is carefully cauterized when it is removed.
I've done everything I can, even if it's bleeding, it should probably be stopped. Opening the chest at this time would at least be a medical accident.
Wouldn't it be better if we could stop the bleeding on our own and everyone would be happy in the end
Nowadays, doctor-patient disputes are so serious that normal complications are regarded as medical accidents. I am really distressed. Zhao Wenhua is so worried that he is pulling strands of his hair down.
Fang Lin had no choice but to sigh and go back. He is just a consulting doctor, making decisions related to himself. As for whether the patient should be transferred to general chest surgery for treatment, it is up to Zhao Wenhua to make the decision.
This is a medical rule. Fang Lin can't just drag the patient onto the operating table and do it.
Zhao Wenhua watched the movie and felt sad. He carefully recalled the operation process, and found that there was nothing that could be improved. He was also very nervous, and his skills were pushed to the limit.
As long as it is surgery, there will be complications, no matter how high the level, they are unavoidable.
Zhao Wenhua tried his best to avoid it and waited for Zheng Ren to make a mistake first. That guy was like walking a tightrope. No matter how difficult the operation was, he had to try it to make sure he didn't make a mistake.
But something unexpected happened. Zheng Ren didn't make a mistake, but he did.
It wasn't a mistake, it was just bad luck and complications arose. (Note 1)
If Zheng Ren did not exist, the patient Zhao Wenhua would have admitted defeat. He was sent to the thoracic surgery department for thoracoscopic hemostasis. A small operation could solve the problem quickly. But after Fang Lin made the suggestion, Zhao Wenhua felt that it was a conspiracy.
Everyone in the hospital knew about the relationship between Fang Lin and Zheng Ren.
Zhao Wenhua knew about that accident and that rescue. This is Zheng Ren's dog, looking at him fiercely, waiting for him to make a mistake, Zhao Wenhua thought to himself, and rejected Fang Lin's suggestion without hesitation.
Just waiting for Fang Lin to leave, Zhao Wenhua began to hesitate and become anxious again.
What should I do if the bleeding doesn't stop? He checked the patient's blood pressure almost every few minutes, for fear that the blood pressure would not stop falling. When that happens, I have to go on stage to say anything.
Hope it doesn't happen.
Every time the arterial blood pressure monitor fluctuates by one or two values, Zhao Wenhua's heart will beat continuously. As he ascended, he saw hope. When he came down, it was like falling into hell.
It was already half past three in the middle of the night, and he was still anxiously observing and making judgments.
Zhao Wenhua never reopened the hemostatic forceps. He gradually came up with an idea. The bleeding occurred because there was negative pressure in the patient's chest, and the bleeding from the ruptured blood vessel could not be stopped at all.
If you want to change the negative pressure state, there is only one way to let blood accumulate in the chest.
After that, the blood vessels were occluded and the bleeding stopped, which seemed to be a way to slowly solve the problem of atelectasis.
After hesitating for a long time, Zhao Wenhua decided to adopt this approach.
Even so, he still looked after the patient very carefully. Eventually I stopped walking around and took care of her bedside. At this time, he didn't trust anyone. Only when he was in front of the patient's bed could his anxious heart feel more at ease.
Things haven't gotten better, they haven't gotten worse, they just haven't changed. Under the premise of continuous blood transfusion, the blood pressure was maintained at 80/40 mmHg. It was considered a hemorrhagic shock, but it was not serious.
In addition, the patient's preoperative basal blood pressure was low, and this blood pressure was acceptable.
It's just that such a night is so difficult.
Almost every doctor has a night like this, more or less.
If it hadn't been for Zheng Ren, Director Wei would probably still be performing extremely complicated surgeries on the operating table... No, if it hadn't been for Zheng Ren, the patient would have died when he came on stage, and he wouldn't have had to suffer long ago.
Zhao Wenhua watched the film again, returned to the patient's bedside, sat on the bench, and stared blankly at the monitor.
The patient's family was grateful and told them before the operation that there would be complications, but they unexpectedly encountered them.
This was bad luck, and the patient's family was reasonable and recognized it.
Professor Zhao has been at the bedside since the onset of the condition, and the patient’s family members also expressed their gratitude. Only Zhao Wenhua himself knew in his heart what the best choice was.
It's just that he couldn't make that choice.
Although it was just a common complication that no one could avoid, Zhao Wenhua still wanted to avoid entering the palace for the second time and not give Zheng Ren a reason to attack him.
Fortunately for Zheng Ren, Zhao Wenhua couldn't help but feel bored when he thought of Su Yun who looked like a boy band star next to him.
That person has the worst intentions!
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Note 1: Try your best to increase the luck value of Boss Zheng in order not to make any mistakes. Being a doctor, luck is really important.