The surgeon looked at Huang Lao, and he didn't believe Zhou Congwen's diagnosis.

Although Zhou Congwen is in the limelight recently, in the eyes of the 912-team professor, he is a primary school student of Mr. Huang. The reason why he is so awesome is probably mostly due to Mr. Huang’s enumeration.

Moreover, good surgery does not mean that the diagnosis is high. The surgery is full of animals on the streets, and you can just have fast eyes and fast hands, and...

The professor led the group to look back, but he looked at it in vain, and Mr. Huang was not behind him.

He was stunned for a moment, but then he saw a familiar figure holding the prepared chest-closed drainage tube in his hand, lifting the sterile sheet.

For thoracic surgery, the closed chest drainage equipment must be prepared. When the operation is about to end, the nurse travels to the instrument table and handed it to the operator and assistant.

At this time, Old Huang was already squatting beside him, which scared the savage.

"Disin." Huang Lao said in a deep voice.

The surgeon gave up the sterile area and began to disinfect it. Huang Lao squatted halfway and performed closed drainage on the patient.

Zhou Congwen put the stethoscope on the anesthesiologist's table. Seeing that the boss had already taken action, he immediately asked the nurse to pour salt water into the chest bottle with external use.

Connecting the closed drainage of the chest cavity, Zhou Congwen squatted on the ground to observe, "Anesthesiologist, trouble bloating the lungs."

As the anesthesiologist pinched the ball in his hand, a sound of gurgling gas overflowing from the chest vial.

Pneumothorax, indeed pneumothorax!

The craftsman was stunned and then smiled bitterly.

That's a healthy side.

With ventilator-assisted breathing, pneumothorax actually appeared on the lungs when one lung was ventilated!

A similar situation is like wearing new shoes and wearing shit, which makes people feel disgusting.

But he did not complain about his luck, and the professor led the group was stunned by the cooperation of the boss and Zhou Congwen.

"Boss, it's okay." Zhou Congwen looked up and saw that his blood oxygen saturation began to rise rapidly, and said to his boss.

"Yes." Mr. Huang didn't hurry to leave, but picked up the medical record and looked through it again.

Zhou Congwen knew that the boss of the surgery would not see them all.

After all, the number of patients who had surgery in 912 was too large, and the boss was getting older and he couldn't keep up.

Only patients with difficulties will consult their boss.

Before the patient showed intraoperative lateral tension pneumothorax, he was just an ordinary patient with a small lung nodule, and the boss would not pay attention to it.

Mr. Huang looked through the medical records very quickly, and after reading them, he put them down.

"Li Sheng."

"Here, boss." The craftsman said quickly.

"Your patient, tell me what's going on."

Professor Li Sheng from the group was stunned. What's going on? Just wear new shoes and walk on shit, otherwise what else could be going on.

But if I answer the boss’s question like this, what will definitely be a storm waiting for me.

The professor in the group looked worried and lowered his head and said nothing.

The sound of the monitor alarm in the operating room gradually became quiet and returned to normal.

"Redisinfect and have surgery." Seeing that Professor Li didn't say anything, Huang Lao ordered.

"Okay." Professor Li regained his vitality in an instant.

"Zhou Congwen, you have read the medical records, let me tell you what happened." Huang Laodao.

Zhou Congwen heard the sound of completing the task. Although this task looked simple, it was actually extremely dangerous.

When Zhou Congwen heard the boss ask himself, he pondered and immediately said, "Boss, I suspect it was caused by the patient's chemotherapy for parotid malignant tumors ten years ago."

"!!!" Li Sheng was re-disinfecting. After hearing Zhou Congwen's words, he was stunned.

Chemotherapy ten years ago...

Zhou Congwen is sure that he is not kidding.

"Yes, continue." Old Huang looked at Zhou Congwen.

"Chemotherapy drugs are very likely to cause varying degrees of fibrosis in the lungs. Remodeling of the lung fibrosis and cellization lead to reduced lung compliance, thus increasing lung vulnerability. When ventilation is performed on a single lung, high-pressure gases are more likely to damage lung tissue."

"There is the impairment of the elasticity and compliance of the lesion's lung tissue; the high pressure generated by intraoperative ventilation may affect the fragile lung tissue and lead to pneumothorax."

After Zhou Congwen finished speaking, he looked at Huang Lao's four eyes.

"It's probably the reason." Huang Lao said, "I'm very lucky today. Patients after chemotherapy are not likely to develop tension pneumothorax during general anesthesia."

After hearing what the boss said, Professor Li felt like he was amnesty, and a stone fell to the ground in his heart.

"The boss is right." Zhou Congwen continued to please him like a licking dog.

"One-third of the methods for diagnosing tension pneumothorax intraoperatively are determined by auscultation, which is also the simplest and most convenient clinically.

But clinicians and anesthesiologists need to have a deep understanding of this intraoperative complication.

Two-thirds of the judgment is made through imaging examinations such as CT and B-ultrasound, which can greatly interrupt the process of surgery and anesthesia."

"The anesthesiologist handled it well, and there was nothing to be faulted at the rescue steps at that time."

"It's just bad luck."

Zhou Congwen finally said in a positive tone.

Old Huang looked at Zhou Congwen, ignored his words, turned around and bowed his hands and walked out of the art room.

Zhou Congwen followed and went out of the arts. Huang Lao asked leisurely, "Zhou Congwen, although tension pneumothorax is rare in surgery, it is not rare."

"The problem has been solved, it's not good to be too strict." Zhou Congwen said, "The anesthesiologist does have some minor problems in the treatment. He should be auscultivated as soon as possible, but he also had a bronchoscopy, so he missed this."

Seeing that Zhou Congwen was clear, Huang Lao turned his head and looked at him again.

"It is indeed rare to reduce lung compliance caused by chemotherapy, boss." Zhou Congwen knew that the boss was a little unhappy, but insisted.

"What do you think is the work to improve?" Huang Lao didn't worry about Zhou Congwen's attitude, but asked while walking.

"I think intraoperative anesthesia should give low tidal volume, and according to the situation, the PAP is lower than 30cmH2O and PEEP levels, 0~5 or 5~10cmH2O."

"What else?"

"CT and radiation are not suitable, but B-ultrasound is portable. In the future, one is placed in the surgery room." Zhou Congwen said, "But... Boss, there are not many people who can use B-ultrasound to see pneumothorax in our 912 now."

"It's nothing difficult." Huang Laodao, "If lung sliding signs, B lines, lung pulses and M-type beach signs appear in the B-ultrasound image, then it is definitely not pneumothorax. The positive lung point is a sign of the high specificity of pneumothorax."

Zhou Congwen was speechless, the boss wanted to organize the learning rhythm again.

Everything is good in 912, but once the boss discovers some small problems, he needs to organize his studies.

Other hospitals and departments are always organized and studied in nursing departments, but the 912 cardiothoracic surgery department and the boss’s organization must not be ignored.

Zhou Congwen smiled. Is the technology of pneumothorax that B-ultrasound has also been promoted since 912 cardiothoracic surgery?

It is now 2003, and 99% of doctors across the country may not know the existence of technology to diagnose pneumothorax using B-ultrasound.

From this point of view, the boss is always at the forefront of the times.
Chapter completed!