The "lifelong enemy" that Jin Yaowu never forgets is not as immersed in TIPS surgery as he imagined.
Zheng Ren has already gone to the obstetrics department, explained the relevant conditions to the patient with hyperemesis gravidarum who had just been admitted to the hospital, and the patient's family, and found the endoscopic room to prepare for surgical treatment.
A sketch was placed on the table, clearly showing the operation process.
"That's basically it." Zheng Ren put down his pen, looked at the patient's family, and said, "The principle is to solve the problem of severe vomiting caused by stimulation of autonomic nerves after eating.
For most patients, it is enough for the tube to remain in the stomach. But for patients with hyperemesis gravidarum, we also need to send the tube into the jejunum. "
"Is the risk great?" the patient's lover asked.
"It's not big." Zheng Ren said: "But there is still a possibility of discomfort, resulting in the postoperative failure to meet our surgical expectations."
"Didn't you mean..." the patient's lover asked in a particularly troubled manner. He was a little timid, but the doctor in front of him looked too young and didn't look like a professor. So he took courage and kept asking.
"I just said that if you use a gastric tube, it will be very irritating. And even if chyme is injected into the stomach tube, it will cause severe vomiting as a side effect."
"If you use a jejunal tube, use intravenous drip, and there are related nutritional drugs, which can support your lover until the expected date of delivery. After the baby is born, the nutritional tube can be removed." Zheng Rendao.
The patient's family members were a little confused, but Zheng Ren's explanation was simple and the sketches made it clear at a glance.
"Even if there is no vomiting, the nutritional solution can provide sufficient nutrition, but it may also have side effects. For example, if the nutrition tube is removed after delivery, your lover's gastric function will be affected because he has not eaten for a long time, etc."
"Then... what should we do?" The patient's lover's hands were a little numb.
"You can only recover a little bit, or during the jejunal nutrition period, you can drink a small amount of water and eat, and gradually try it near the threshold that causes discomfort." Zheng Rendao: "This is just a general idea, and the specific situation varies from person to person."
The patients' families were silent.
They all understood what Zheng Ren said.
But when we think about pregnant women not only being unable to eat, but also having to rely on nutritional fluids to survive for several months, everyone is a little panicked.
Coupled with a series of side effects, there are a total of 23 pre-operative instructions. How can anyone not panic
But there was nothing the family could do.
Pregnant women have severe pregnancy reactions from the 3rd week of pregnancy until the 24th week of pregnancy. She had had two miscarriages before, but she didn't keep the baby. So even if she has hyperemesis gravidarum this time, she will persist.
The most frightening thing is that her mental state is somewhat unstable.
The patient herself has made it very clear that she should never induce labor. Even if she vomits to death, she still has to give birth to the child.
If she was given anesthesia and induced labor without telling her, she would jump off the building after the operation.
Words like this leave family members and obstetricians at a loss.
The method provided by Zheng Ren is the only way to solve the problem. The director of the obstetrics department contacted Xiehe’s classmates, who provided relevant medical records.
Although the number is not large, similar attempts have been made over there.
Just like Zheng Ren’s approach, nutritional support was provided through jejunal nutrition, and the postoperative results were quite good.
Therefore, Director Du of the obstetrics department asked the hospital chief to consult and ask Boss Zheng of the interventional department to come and take a look.
She also didn't expect that Boss Zheng would draw a sketch that was comparable to a textbook picture. She also didn't expect that Boss Zheng had considered all the side effects and listed 23 pre-operative instructions.
"Can we... think about it?" In the end, no one in the patient's family could make up their mind and asked hesitantly.
"No problem, you can try intravenous vitamin B6 and intramuscular injection of vitamin B1 first." Zheng Ren smiled, trying to ease the tense atmosphere in the office.
But no one noticed his smile. The family was gloomy, each thinking about different things.
"Director Du, let's do this for now." Zheng Ren said, "If my family agrees to the surgery, you can inform me at any time. If there is no surgery on my side, I can do it as long as I have enough time to fast and drink."
"Okay." Director Du didn't waste any time and nodded directly, "Can I take a look at the endoscopy room first?"
Zheng Ren thought for a while. Although he had undergone surgery in the system operating room, he had never been exposed to the endoscopic room of 912. It would be best to take a look.
"Okay, Director Du?" Zheng Ren asked tentatively.
"I'll go watch it with you," Director Du said.
The patient's family was still very polite and a little embarrassed to apologize to Zheng Ren. Zheng Ren sent them out with a smile and went to the endoscopy room with Director Du.
"Boss Zheng has heard of you for a long time, but I didn't expect that the opportunity to cooperate with you would come like this." Director Du said as he walked away.
"I used to work with obstetricians a lot." Zheng Ren said with a smile: "Postpartum hemorrhage and other things were all done through intervention."
"Well, it's a pity that I can't ask you for a consultation. Boss Zheng, is this kind of surgery reliable?"
"The operation is not difficult, but the postpartum gastric recovery will take a long time. By the way, the jejunal feeding tube may be blocked in the middle, and the tube may need to be replaced. But this is not troublesome, it is just a minor operation."
"It's also a way." Director Du said: "There are many patients with hyperemesis gravidarum. If successful, we can cooperate for a long time."
Zheng Ren pondered for a moment and then asked: "Director Du, please go back and ask the patient if he can accept the live broadcast of the surgery."
"Xinglinyuan's surgery live broadcast?"
"Um."
"That side spreads faster and the technique is simple, so you're not afraid..." Director Du paused mid-sentence.
"This is just an idea. It can solve the pain of many patients. What's the use of keeping it in hand? Surgery should solve the problem." Zheng Ren smiled.
Director Du felt a little emotional. Boss Zheng is so majestic. No wonder people have become visiting professors at Mayo.
At the office meeting that day, Director Du saw with his own eyes Director Kong resisting Director Mao and finally making a comeback.
At that time, I still didn’t understand why Director Kong put so much effort into a “little” doctor.
When I look at it now, if I don't say anything else, I feel comfortable just because of this person's generosity.
I need to cooperate more with Boss Zheng in the future.
"The endoscopy room in our hospital was not big at first, but Director Luo held it up with one hand." Director Du did not mention the jejunal feeding tube and began to introduce it to Zheng Ren.
This is the past and present life of the endoscopic laboratory.
There are some specialist doctors in domestic endoscopic laboratories, but in some hospitals the department of gastroenterology controls the endoscopic laboratories.
After all, the vast majority of patients who undergo gastrointestinal endoscopy are in the Department of Gastroenterology. A proper upstream department, absolutely no suspense.
Without the support of the Department of Gastroenterology, it would be difficult to carry out the work of the endoscopic laboratory.
It turned out that 912 was in this mode. Zheng Ren smiled and nodded.
Director Luo is also very supportive of me. It should be a pleasure to work with him.