Chapter 138: A Powerful Newbie
Dr. Zhang Suo outside the door was surprised and astonished. Xu Ze naturally wounded his mouth and prepared the puncture part. Holding the syringe in the other hand, he stably and accurately injected the small medicine bottle in Director Zhai's hand. Five milliliters of lidocaine was withdrawn, ready to start local anesthesia.
From Xu Ze's point of view, since Director Zhai said to let him do it himself, then of course Director Zhai will be an assistant to assist him in completing the lumbar puncture when there are only two people.
But Zhang Di was astonished that Director Cheng didn't do it himself, but also served as an assistant. From their point of view, this was almost impossible. , in addition to the weekly ward rounds; generally, to see patients, they have to be applied by the general doctor in charge of the patient, and they will spare time to come out for consultation.
It is impossible to waste time and do such a small operation in person, but today Director Zhai not only came to do it, but also worked as an assistant for a new doctor, which made people feel strange.
At that moment, Zhang Yi hurriedly put on his mask and hat and went in, smiled at Director Zhai and said, "Director, why don't you rest, I'll be Dr. Xu's assistant.
Director Zhai knew what Zhang Suo meant, shook his head with a light smile, and then continued to watch Xu Ze do his work. He was an assistant for nothing else, just to see Xu Ze's true ability, and of course he would not let others to replace myself.
Xu Ze didn't think so much at this time, he was doing his own operation wholeheartedly, carefully inserted the syringe into the puncture point obliquely, injected some anesthetic into the bottom layer of the skin, and then changed to insert the needle vertically, from the skin to the puncture point. The interstitial ligament was carefully infiltrated with local anesthesia layer by layer.
After the lidocaine had been completely injected into the ligament, Xu Ze took a breath, calmed down, picked up the puncture needle about ten centimeters long and carefully fixed the skin at the puncture point with the thumb and index finger of his left hand. The puncture needle is inserted vertically from the intervertebral space slowly, and the lumbar puncture is officially started.
Seeing that Xu Ze started the formal piercing, director Zhai also had a flash of curiosity. At this time, he basically did not doubt Xu Ze's ability. He was just wondering if Xu Ze could succeed in one attempt. It shows that Xu Ze must have a lot of clinical experience, and his theoretical and hands-on ability is very strong, so I can let Xu Ze do things in the future.
At this time, Zhang Li saw that Director Zhai refused, so she watched carefully from the sidelines, looking at Xu Ze, who can make Director Zhai pay so much attention to him, what is he doing? It should not be a silver wax-headed gun...
At this time, Xu Ze was also a little nervous. Although it was said that the lumbar puncture was not successful once, and there were many cases where it was done once or twice; but Xu Ze still wanted to be perfect. When he was in the virtual space, But after doing it many times, you can only succeed once you get familiar with the feel. This time, in reality,
It made him a little nervous.
Xu Ze recalled the feeling when operating in the virtual space, and slowly pushed the puncture needle forward according to the feeling. When it was pierced like this, Xu Ze's hand froze slightly. After a while, he felt a little resistance. After he pushed forward lightly, he quickly broke through. He couldn't help but frowned at the moment. This should be the breakthrough of the first layer of ligament, and the next step is the most critical Well, whether it succeeds or not depends on what happens next.
Continued to puncture for two centimeters, Xu Ze really felt the resistance again, this time the resistance was much greater, Xu Ze raised his eyebrows lightly, then took a light breath, clenched the puncture needle, pushed forward, and felt With this push, his hand was free, and the resistance to needle insertion disappeared obviously. Only then did Xu Ze heave a sigh of relief, knowing that the puncture needle had passed through the ligament and dura mater smoothly, and reached the spinal canal smoothly.
Although it is estimated that it has reached the spinal canal, it is still not completely sure that the puncture will be successful. This can only be counted if the cerebrospinal fluid is seen.
Xu Ze let out a sigh of relief, and slowly pulled out the needle core. Success or failure was once again determined. If the cerebrospinal fluid was still not seen, then the puncture had to be done again.
However, it was obvious that Xu Ze's training in the virtual space was very effective. As the needle core slowly withdrew, under the eyes of the three of them, a drop of colorless transparent liquid gently dripped together.
Seeing this drop of transparent cerebrospinal fluid dripping out, Xu Ze couldn't help heaving a sigh of relief, but director Zhai and Zhang Suo at the side both had a flash of approval on their faces, this Xu Ze is really good
Xu Ze slowly pushed the needle back again, temporarily stopping the cerebrospinal fluid from flowing out of the needle tube, then took out a manometer from the waist puncture bag, carefully inserted the lower end of the manometer tube into the needle tube, and began to measure Intracranial pressure, which is also an important diagnostic method of lumbar puncture, can rule out some cases of intracranial hypertension through manometry.
As the pressure measuring tube was hooked, the cerebrospinal fluid scale displayed in the pressure measuring tube rose slowly, and gradually stopped at the water column of Tian mm. It seems that the intracranial pressure is not just there, and there should be no other intracranial or cerebrospinal fluid lesions. The diagnosis criteria of the public have added a little more certainty to throw away the inducer syndrome.
After measuring the pressure, Xu Ze carefully removed the pressure measuring tube, and then inserted the needle core into the needle tube to block the cerebrospinal fluid so that it would not flow out; then he reached out and took out three test tubes from the lumbar puncture bag to prepare the cerebrospinal fluid samples Do a test.
Carefully arrange the test tubes in a row in the right hand and place them below the needle tube of the patient's spine, then gently hold the needle core with the left hand, carefully pull it out slowly, and follow the needle core from the needle tube After exiting, the colorless and transparent cerebrospinal fluid slowly dripped drop by drop from the needle into the test tube in Xu Ze's hand.
When the three test tubes in his hand were all dripped with a small half tube of cerebrospinal fluid, Xu Ze quickly pressed the finger of his left hand against the bowl to stop the cerebrospinal fluid from flowing out temporarily, and then put the test tube 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 does not flow out.
After everything was settled, Xu Ze reached out and quickly pulled out the puncture needle, sealed the needle hole with a piece of gauze, and then changed the patient's position from the side lying position to the supine position, and then asked the patient if there was no special discomfort , and told him to lie down on the pillow for four hours before he was allowed to sit up, he packed up the surgical instruments, took three test tubes filled with cerebrospinal fluid, and the three of them, Director Que, left the ward.
Back in the office, Director Que quickly prepared the test form and handed it to the nurse with three test tubes. Let them be sent to the laboratory for testing immediately.
Seeing Director Que's seriousness, Zhang Zhuan couldn't help asking 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 a detailed analysis, we considered that this patient may not be simply myasthenia gravis, but may be a newly discovered disease, so it must be diagnosed as soon as possible. Make a diagnosis so as not to delay the patient's treatment!" Director Zhai nodded, looked at Zhang Yi and said.
"A new disease? Did Xu Ze see it?" Hearing Director Que's words, Zhang Yan couldn't help being stunned.
"Yes, Xu Ze is a very nice young man with a wide range of knowledge, and his research on some new diseases is also very in-depth. If he hadn't discovered abnormalities this time, I would not have thought of this!" Director Zhai said with a smile.
It was almost twelve o'clock, Qian Xuebin opened the door and walked in, and smiled at Director Que: "Director, please get off work, I have eaten!"
Seeing Qian Xuebin coming in, Director Huang beckoned and said, "Xiaoqian, come here."
Seeing Director Zhai's serious face, Qian Xuebin couldn't help but his heart skipped a beat, then he walked over with a smile and said, "Director, what's the matter?"
After director Cheng nodded to signal him to sit down, he handed the medical record in hand to Qian Xuebin and said, "Xiaoqian, you need to rewrite this medical record. I went to see this patient just now and found something abnormal. Maybe it's not a simple case. Myasthenia gravis, may be a recently emerging disease called Guillain-Barre Syndrome!"
"I will find out the information later and show you the information. You first ask the patient's medical history again, then do a physical examination carefully, and then write down the medical history and some minor physical examinations in detail. 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 for a moment. Although being criticized by the director is not a shameful thing, but being criticized in front of other doctors, Qian Xuebin still felt hot on his face. .
Although I don't know what's wrong with my medical records. But Qian Xuebin still hurriedly nodded his head humbly, and said seriously: "Okay. Director, I will conduct a comprehensive questioning and physical examination on the patient again, and there will never be any omissions!"
"Well, let's go now. Xu Ze and I have already performed a lumbar puncture on the patient, and we are waiting for the test results. Please ask about the medical history first, and after the physical examination, I will find the information for you!" Director Huo clicked Nodding, he got up and went to his director's office.
After Director Que left, Qian Xuebin began to analyze the matter. His physical examination should be considered good, and there is usually no big problem with the medical history. So where could the problem be?
Qian Xuebin was thinking about it, and suddenly remembered the strange and seemingly irrelevant medical history when Xu Ze went to see this patient two hours ago, and his heart skipped a beat at the moment. Say hello
This Xu Ze may have seen some problems, but he didn't say anything, but directly talked to the director, letting himself be criticized by the director,
Thinking of this, Qian Xuebin's eyes could not help revealing a trace of resentment
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