medical simulator

Page 448

Zhou Cheng himself had never seen so much money, he just envied: "You have money, this is just an initial investment."

Zhang Zhengquan sighed, and then said: "So, I don't know how to pay you for the time being. As far as I know, there are headhunting companies looking for you, and some companies offer you an annual salary of 5000 w."

"But I dare not make any moves, because you are still a student, Academician Gui Yuanping, you can still suppress some people."

Zhou Cheng's eyes lit up immediately when he heard the words, and he joked, "Don't worry, the annual salary is 5000 million. If I work for one year, I will be able to lie flat in Shashi. When the time comes, I will work behind Teacher Cai's ass. Life will be so beautiful."

To be honest, the annual salary of 5000 million has far exceeded Zhou Cheng's expectations.However, Zhou Cheng had expected that when he released the small incision open reduction and internal fixation, the potential profit would be far more than that.

It's just that since Zhang Zhengquan happens to be engaged in this business, then naturally he won't take advantage of others, and this is only the early stage, and Zhang Zhengquan will definitely not treat him badly in the future.

Mapi, a person with tens of millions of interest a year, can shamelessly take advantage of someone with a monthly salary of several thousand. Such a person is untrustworthy. Where can you find a credible person?

"Cut~~~"

Zhang Zhengquan couldn't deny it: "Don't think I don't know, your girlfriend can make you lie down in minutes. And you must know about it. If you just want to lie down, let her sit on it." Already."

Zhou Chengcheng knew that the dog couldn't spit out ivory, so he really wanted to pour water on Zhang Zhengquan's face, but he held back.

Cursed: "What the hell are you?"

Zhang Zhengquan rolled his eyes: "Who told you to cheat me first. Damn, I've been annoyed recently. There are a lot of junk."

"Why did I cheat you?" Zhou Cheng was stunned and asked.

Zhang Zhengquan sat up directly: "You haven't tricked me yet? Let me tell you, didn't you ask me to play tricks on you last week? I really saw the effect."

"But that bitch has a classmate and best friend, she's a real tiger, and she didn't know why she found out about it. Niang Xipi, you've been bothering me every day lately."

"Here." In order to express his difficulties, Zhang Zhengquan handed the phone to Zhou Cheng.

He also complained: "Besides, this bitch is a student of the director of the Sports Medicine Department of the Ninth Academy, so it's not easy for me to block her directly."

Zhou Cheng looked at the conversation between Zhang Zhengquan and the other party, and then looked at the profile picture, boy, isn't this a little bit?

Oh, well, it turns out that Chen Shengwu's girlfriend is Ding Dian's classmate and best friend.Then Zhang Zhengquan's trickery was caught by Ding Dian, with Ding Dian's temperament and grueling effort?

Zhang Zhengquan took the phone back and murmured: "I called her yesterday and scolded her a few times, and she even cried. Damn it."

"I coaxed me for more than five minutes. I'm not good at doing this kind of thing."

You tiger!

Zhou Cheng silently pretended that he didn't know Ding Dian at all, so he didn't interrupt.

After a while, Zhou Cheng patted Zhang Zhengquan on the shoulder and said, "Let's go to the operating room. Professor Xue Xiude is the only surgeon in this operating room. We still have to go and have a look, especially you."

"That's natural. All my equipment is free, and Professor Xue Xiude didn't ask me for money. This is enough favor for me."

"Oh no, it's Brother Zhou Cheng's face, you are my big brother." Zhang Zhengquan put away the phone and started to lick it again.

Zhou Cheng stood up, ignoring him.

When he returned to the operating room, Professor Xue Xiude was already sitting upright, carefully reading the films again, and then constantly calculating.

Beside, Professor Gu Zhongliang and Shen De's attending physician directly drove Chen Shengwu and other students to the side, leaving only Mao Yuxuan on the stage, and personally began to disinfect and spread the towels.

Xue Xiude is the person who leads the group, they are a team, Professor Xue Xiude is in charge of the new surgery today, naturally he wants the most proud assistant.

"Teacher Xue, we're ready here." Gu Zhongliang stopped laughing and scolding on stage, and his address and wording became formal.

"Xiao Zhou, Boss Zhang, wash your hands and go on stage together."

"Especially Xiao Zhou, you have to stop thinking that your words are expensive and give more pointers." Xue Xiude himself was in a good mood, joking with Zhou Cheng and Zhang Zhengquan.

Zhang Zhengquan smiled apologetically, while Zhou Cheng said, "Mr. Xue, let's wash our hands."

He heard so much flattery that Zhou Chengcheng didn't bother to respond anymore. He should do things well first, and it would not be too late to do these things later.

Washing hands, dressing, and on the stage, Zhang Zhengquan immediately spread out the corresponding instruments one by one. Professor Xue Xiude could only order them. In fact, the appropriate size of the instruments was measured on the plain film long before the operation began.

However, Zhang Zhengquan still prepared four more models of instruments for emergencies, although he still had to take these instruments back for disinfection, wasting time and cost.

Professor Xue Xiude continued to be in charge, still following the principle of fracture treatment, first reset and then fix.

Method reset!

However, to be on the safe side, Xue Xiude didn't pursue speed, so he cleared and reset three times in a row!Every time, the alignment of the broken ends can be made more appropriate.

After the last time, Professor Xue Xiude said: "That's all right. I'm not you, Xiao Zhou. If you think it is barely suitable, then you can fine-tune the reset by placing the equipment. I have to make all the favorable factors more in place. Row."

Professor Xue Xiude's cautiousness made Zhou Cheng's heart tremble: "It should be so, Mr. Xue. It's because I'm too aggressive in my daily life."

Xue Xiude shook his head and said, "You have made so many sets, what is there to say about menglang and not menglang? With all the favorable factors, it is a lookout from the platform."

"You are looking down, so naturally you care about it. There is no high or low level of learning, but the skills are uneven. My experience does not apply to you. If you apply it, it is a bondage to you."

"You don't have to follow my train of thought."

Zhou Chengcheng smiled: "The principle of prudence still needs to be learned a lot."

In fact, now is more suitable to flatter Xue Xiude, but Gu Zhongliang and Shen De didn't say a word. This is the critical moment of the business, who is going to laugh?

The jokes on weekdays were because Xue Xiude knew what he was doing, and he was sure of everything. He could drive very fast on the operating table, but it was obviously not suitable for him at this moment.

Zhou Cheng said: "Professor Xue, at this moment, we still take the four to five centimeters above and below the fracture line, after the opening to the fascia layer, after breaking the fascia layer, enter the intermuscular space to the surface of the periosteum, take the same axis, different It can be achieved by punching holes in the axial position, separating the instruments and putting them down, and then collecting the instruments above and below the fracture naturally."

Xue Xiude is not Zhang Zhengquan, so there is no need to talk about the anatomical level and which muscle gap, so the teaching will naturally be very simple.

Xue Xiude closed his eyes slightly, and then ordered: "Give me the round knife. Prepare blood vessel forceps and opener."

The round knife is held in the hand, and the standard pen-holding style is used to make two incisions. The incisions are not large, and the skin and subcutaneous fat are directly incised, and the fascia layer is not easily injured. Then Zhou Cheng uses tweezers to assist, and the power of electrocautery is used for electrocoagulation. Slowly stop the bleeding.

Controlling the vision is the most important thing.

After the electrocoagulation broke through the fascia layer, the muscle layer was exposed. Xue Xiude quickly used the hemostatic forceps to slightly open the muscle, exposing the gap between the muscles. Among them, the ranking is at the top.

Moreover, Xue Xiude's technique is very sophisticated, he quickly drilled through the intermuscular space and reached the periosteum layer. After clamping the periosteum with vascular forceps, he felt the blunt rupture with his hand, and then inserted a 2.5mm diameter tube The Kirschner wire was fixed at the end of the bone under the exposure of the vascular clamp.

This is a line that serves as the gag to the end of the bone and also serves as a marker for the second incision.

Zhou Cheng is very familiar with it and doesn't need this operation, but Xue Xiude needs it. If the upper and lower Kirschner wires are parallel, they must be on the same axis.

Borrowing all favorable factors to perform surgery is what Xue Xiude must do for the first time.

After inserting a Kirschner wire in parallel with the same method, Xue Xiude let out a long sigh of relief, and said, "It can be regarded as successful. When you actually practice, you will realize how stable your hand is, Xiao Zhou, and you don't need a Kirschner wire." As an auxiliary line for the opening."

Zhou Cheng smiled stupidly, he didn't think so thoroughly before, so he used too much force.At this moment, Xue Xiude re-disassembled the awesomeness of this hand feeling, which made Zhou Cheng blush a little.

He never thought of being so pretentious...

At this time, Associate Professor Gu Zhongliang and others intuitively recalled Zhou Cheng's seemingly careless operation before, but in fact there were so many details and difficulties hidden. After careful consideration, they still felt that they were learning. Still have to follow the path that Xue Xiude is taking now.

Then came the opening.

With the auxiliary approach, the opening is not difficult, followed by the placement of two tubes similar to arthroscopy.

After this, Professor Xue Xiude introduced the mirror to one end through the mirror tube, and the tube at the other end is the way to place the instruments, which can be operated intuitively under the mirror.

The instrument is unique, suitable in size, like an umbrella, and it is not difficult to place into the bone marrow cavity.

However, next, there is another difficulty. The mirror tube at one end has been occupied, so one end needs to be operated blindly. In fact, the best backup method is to open a third hole, and then see the instrument placement process intuitively. .

This is also an alternative, but it's still hard!

Under the blind operation, the difficulty of the operation is doubled. It is at this step that Jingxing Xing and others are in Waterloo. As a result, the instruments at the two ends cannot be folded in the lumen, and the placement fails. They can only withdraw and repeat the operation.

Moreover, they placed the third mirror tube, which is equivalent to seeing the entry of the second instrument, but it is still not easy to align.

Seeing this step, Zhou Cheng hurriedly said again: "Professor Xue, when the second instrument is reinserted, it can be placed slightly at the distal end of the fracture, and does not necessarily need to be placed in the center of the catheter."

"After inserting the device into the lumen, first pull out the back holder of one device, then put the mirror in, operate the operable device end, and open a segment of the mushroom after the devices at both ends are anastomosed."

"After the last end is shaped and fixed, the tail end of the instrument is naturally in the center of the bone marrow cavity, then the mirror is withdrawn, the back holder of the fixed instrument is put in, the mushroom is opened, and finally the mushroom end is naturally grasped into the bone marrow cavity Inside, you can achieve a fixed effect!"

Xue Xiude smiled: "I'm afraid this is what you have hidden, Xiao Zhou?"

While talking, while doing so.

Zhou Cheng just kept silent, not intentionally, but for self-protection, he only knew its shape but not its quality, so it was naturally difficult to copy, Zhou Cheng didn't do it on purpose.

However, it is simple to say, but short to say, the process of operation is still not easy.

All the professors with the same skills are in Waterloo, therefore, Xue Xiude's first operation still failed to combine the two ends of the equipment.

It is not easy to operate under direct vision, let alone blind operation.

Seeing this, Zhou Cheng said, "Professor Xue, you don't need to worry about whether your hands are shaking or not. Just imagine the feeling when you close your eyes and operate the two ends of the instrument. It's not difficult."

Before Xue Xiude operated, he had already made a lot of preparations, and Zhou Cheng also used auxiliary training methods.

Closing eyes is also a kind of blind exercise. Xue Xiude has practiced countless times, and one failure does not mean anything.He is hanging on the body!

And for this step, he has been practicing blind exercises for more than ten years in the simulated world!

That's why he has the power he has today.

Xue Xiude breathed a sigh of relief, and continued to follow Zhou Cheng's instructions slowly.

At a certain moment, Xue Xiude suddenly felt that the two ends of the equipment were attracted to each other. Seeing this situation, he immediately exerted a little force with his hands, feeling a click.

Xue Xiude opened his eyes: "Push the C-arm, see through once!"

Zhou Cheng also passed it through, but it was the first time, and it was for everyone to see.Later everyone knew that Zhou Cheng basically didn't need perspective.But Xue Xiude still does everything for the sake of safety and prudence.

Nobody has an opinion.

The fluoroscopy results were quickly displayed on the C-arm display screen, and it can be seen that the mushroom instruments inside just fit together in the bone marrow cavity.

"It's done!" Gu Zhongliang was excited.

This step is the most difficult, and there are tricks in it. If it wasn't for Zhou Cheng's guidance, most people would think that the placement process must be centered, and that the alignment process must be meticulous.

But actually?

Professor Xue Xiude breathed a sigh of relief and asked Zhou Cheng: "Xiao Zhou, do you think so, can you proceed to the next step?"

He trained for seven or eight days, almost no surgery, and he trained at home, but he still didn't know what to do.

Zhou Cheng nodded: "Professor Xue, it is already possible. It is still the previous set of theories. First unfold one end. Fix the equipment at one end. In fact, if this end does not fit well with the other end, you can also unfold one end first. fixed."

"Then operate on one side and fix the two ends to reduce the difficulty of operation."

After Xue Xiude finished, Zhou Cheng told him a spare trick.

Xue Xiude looked at Zhou Cheng with some resentment for a moment, as if to say again, didn't you say this earlier?

"However, high-difficulty exercises will further temper the hand feel and proficiency. If you just choose an alternative plan, then if there is an unexpected need, it will be more stressful."

"Professor Xue, if it is not necessary, it is better to align the two ends first, because this will allow you to operate the radius, ulna, and tibia and fibula more easily."

"The femur and the humerus belong to the large lumen in the long bones." Zhou Cheng expressed his thoughts.

Only then did Xue Xiude nod slowly: "Teaching people how to fish is worse than giving them fish. I can understand that you are teaching surgery, not how to do it."

Then Xue Xiude took a deep breath, smiled, and eased his mood: "But do you know how nervous I was just now? I almost lost face in front of the students."

At the same time, I secretly said in my heart, and the operating room is not a law that does not spread to everyone. If it fails this time, Hu Xian and the old man will definitely know tomorrow, and they may call to greet one or two, just like me.

So, luckily, I happened to be able to call them tonight.

This is a completely different story.

After the two ends were joined together, Xue Xiude still slowly fixed one end, then fixed the other end, and after tightening at the same time, Xue Xiude nervously looked through again.

"Success!" Although Professor Xue Xiude was in his fifties, he still couldn't hide his inner joy.He clenched his fist hard and hammered it, and then blew his chest loudly.

"Congratulations, Professor Xue." Gu Zhongliang breathed a sigh of relief.

The success of Xue Xiude's operation as the chief surgeon is not just a simple operation, it represents that the trauma surgery of the Ninth Hospital of Shanghai is about to reach a new level, and!

This also means that Huaguo's trauma surgery is about to usher in a new sub-specialty. This prelude, regardless of whether others accept it or not, is coming.

"Congratulations, Master." Mao Yuxuan and others also congratulated Xue Xiude.

Xue Xiude did not get carried away by the momentary success or failure. After calming down, he said calmly: "Sew up, place a small drainage piece, and prepare for the turnaround of the next operation."

"In addition, for this operation, it is necessary to strictly review the inflammatory indicators after the operation, and review the plain film on the first and fifth day after the operation."

"Confess to the patient and his family members that the plain film should be reexamined regularly one week, two weeks, one month, two months after the operation. We will bear the cost of the reexamination by ourselves, and the registration fee will be paid by the patient himself, and we will register with Shende when the time comes."

"Everyone in the group should make detailed records. When a patient comes for a follow-up examination, they can notify Mao Yuxuan and Shen De's attending physician at any time, or associate professor Gu Zhongliang, or directly notify me."

"Record the blood draw indicators for each re-examination, and measure the changes in the fracture line each time..."

Xue Xiude is a professor. His understanding and in-depth understanding of clinical topics are much more proficient than Zhou Cheng, who is in the first half of the research, and there are more people available. Therefore, he ordered a series of contents.

Then he said: "Mao Yuxuan, Shen De, Lin Yousheng, Xiao He, the four of you are each responsible for a scoring scale, and every time you see a patient, you must re-score all the scoring scales within three days. And mark and record the raw data, don't be careless."