Since 1981 Health School

Ma Xiaona was presenting her medical case on the podium, and all the doctors below were busy taking notes.

When they heard that a small gastroesophageal reflux disease caused such serious consequences, everyone was stunned.

Then ask yourself one by one, what would you do if you encountered such a patient? How to diagnose? And then a lot of doctors find out, I'm afraid they might be doing worse.

Especially the few directors of surgery who were clamoring before, all of them were frowning.

A patient involves the digestive system, respiratory system, immune system, facial features system, nervous system, etc., where to start?

Why are surgeons called rough men, and why are orthopedic surgeons called carpenters? The reason is that these doctors who use knives seldom think about why this disease is caused? What is pathophysiology?

They deal with patients in a simple and rude way, treating the head with a headache and cutting the foot with pain.

If a surgeon is thinking about etiology and pathology, then this doctor has the potential to become a famous doctor, such as a certain dean surnamed Chen.

The doctors off the field now admire this young Dean Chen very much. Such a complicated disease can be prepared to be diagnosed, and he really lives up to the name of a miracle doctor.

But obviously Dean Chen is unwilling to let them go, let go of this opportunity to hit people.

"Everyone has heard Dr. Ma's case report, and the answer to the mystery has been revealed, so now the question is, how should we treat this case of refractory gastroesophageal reflux disease?

Director Jin Peilin, Director Yan Chengzhi, Director Liu Chuanpin, and Director Shen Zhemin from the surgery department are all here today, right? Okay, I see it, I would like to ask these directors of surgery to talk about this patient transferred to your surgery, how are you going to treat it? "

After being named by Chen Qi, these surgical directors were all embarrassed, and each of them began to shrink their necks.

Jin Peilin was the oldest and the oldest, so he was pushed out by several other directors:

"Old Jin, you go!"

"That's right, Lao Jin is very qualified, hurry up and help us win the battle and defeat the dean."

Jin Peilin really wanted to kill these bastards with a gulp of salt soda, but he couldn't help it, because he was the one who started the fuss in advance.

Jin Peilin stood up, took the microphone and thought for a while:

"Well, since the problem is in the stomach, it is because of so many complications caused by the contents of the stomach, then we simply cut the stomach completely, the stomach is gone, the contents of the stomach are gone, and the root cause of the disease is solved. hehe."

Several surgical directors beside him also laughed along with them:

"Yes, yes, stomach cutting, we are experts in this."

"After gastrectomy, the root cause is cured, and only our surgeons can handle it."

Other surgeons also agreed with this treatment method, only a few surgeons blushed, including little doctors like Lu Yuehua.

Lao Guo and Zhu Huoyan shook their heads when they heard this.

Sure enough, as expected, the surgeon's suggestion was immediately booed.

Jia Liangcai, the director of internal medicine, was the first to fire.

"Old Jin, are you kidding me? Let's not talk about other side effects after total gastrectomy. For this patient alone, it is because of gastroesophageal reflux that he has so many complications and caused so many adverse consequences.

If you cut the stomach and lose the two switches of the cardia and pylorus, the small intestine will directly connect with the esophagus, and the contents of your stomach will be gone, but without these two switches, the intestinal contents and digestive juices will be released unscrupulously reflux.

Think about it, everyone. After the stomach is removed, the reflux disease will not be solved, but will become more and more serious. Good guy, the patient came to treat the disease. No wonder. "

Hehehe~~~

The physicians in the venue all burst into laughter. It was a rare opportunity to hit the rough surgeons, and they would definitely spare no effort.

"Director Jia is right, teach surgery a lesson..."

"The surgeon knows everything, but doesn't care if it's right or not. What a bunch of reckless people..."

"How can a total gastric resection be so simple, how many years will the patient live?..."

Indeed, total gastrectomy will not only aggravate esophageal reflux disease, in fact, other serious consequences cannot be ignored at all.

The stomach has the functions of storage, digestion, and transportation. When a person's stomach is completely removed, the food cannot be decomposed and digested by gastric acid, and directly reaches the intestinal tract, which will affect the body's absorption of food nutrients.

It is easy to make the body lack of nutrition, lead to low immunity, induce iron deficiency anemia, and osteoporosis.

In addition, the stomach is an important digestive organ of the human body. If a person's total gastrectomy will reduce the digestive function, the digestive function will be disordered, which will easily cause indigestion and gastrointestinal diseases, resulting in chronic diarrhea, abdominal pain, and loss of appetite.

The most important thing is that if a person's stomach is completely removed, it will affect the body's digestion and absorption of nutrients, which will lead to the body's gradual weight loss.

At that time, only semi-liquid or liquid food can be used for life.

Although it has been reported in the literature that patients with total gastrectomy live up to 20 years, this is only a small number of people.

In fact, the 5-year survival rate of most patients with total gastrectomy is only 20%, that is, 4 out of 5 patients will not survive 5 years.

Therefore, total gastrectomy is generally limited to gastric tumors with a relatively high degree of malignancy, large volume, and wide range.

After the physician explained this, they coaxed Jin Peilin into the fire and roasted him. The little old man blushed and turned his head to play a rascal.

"Old Jia, since you said that our surgery plan is wrong, then tell me, how does your internal medicine treat it? Let us learn from it."

"Yes, Director Jin said well, please ask the physician to help us solve our doubts..."

"I don't know much about internal medicine. I can only talk about it. I say one thing, but I don't accomplish anything..."

"Director Jia, what are you talking about, the patient can live in your internal medicine department now, how is your internal medicine department going to treat it?..."

Now it was the turn of the surgeons to start booing, and then Jia Liang realized that he was about to drip down in cold sweat, and now it was all right, the hole he dug would bury himself.

"Uh, um, um, we still need symptomatic treatment, such as antacid, promoting gastric motility, regulating gastrointestinal flora, and anti-inflammatory and anti-infective treatment..."

Jin Peilin chuckled and asked back:

"The one just said on stage that this patient has been treated in your internal medicine department for more than a week. He has used all kinds of medicines, even doubled the dose of omeprazole from abroad. As a result, his condition has not improved at all. wrong?

What's the matter, Lao Jia, dare to love your internal medicine, only bragging is left? If you laugh at others even if you can't cure your own disease, I think it's better to come to our surgery and try it out, maybe vigorously can do miracles, don't you think so? "

"Yes~~~~"

The surgeons booed one after another, and then the audience burst into laughter. Even Director Zhu was sitting there smiling, with a relaxed expression.

Lao Guo looked back at these old subordinates and scolded with a smile:

"Damn it, you guys can't do this to cure the disease, it's the number one booing."

Lan Lijuan sat under the stage, unable to lose face. After all, this patient was taken over by their sixth internal medicine department. After a long time of treatment, not only did it not work, even the cause of the disease was found by her husband.

She has to admit that the overall level of the six internal medicine and her personal level is still flawed, and there is still a big gap from the top level of internal medicine.

Sitting on the rostrum, Chen Qi looked at the surgeons and surgeons "attacking" each other below, and he was also happy to see the results.

Seeing that everyone was making a fuss, he knocked on the table to signal everyone to be quiet.

"Just now the surgeons represented by Director Jin and the physicians represented by Director Jia have put forward their own treatment plans, but unfortunately, none of them is feasible and effective. I don't think we have any objection to this. Bar?

What does this mean? Does it mean that the level of doctors in our Yuezhong People's Hospital is too poor? I can't even handle a stomach bug. Or is it that the disease itself is terminally ill and there is no cure, so let's just give up and let the patient go back and die at home? "

As soon as Chen Qi finished speaking, all the doctors in the audience lowered their heads in shame, and even Lao Guo blushed a little.

Because after thinking about it for a long time, he found that if he was the attending doctor, he seemed to be helpless, and he would really let the patient be discharged early, so Jia Jia waited for the banquet.

Chen Qi saw that the atmosphere was getting better, so he spoke slowly.

"Actually, there is another possibility. The knowledge you have learned before is outdated and backward. Should we eliminate it? International medicine is improving day by day, but our country is still complacent. If you fall behind, you will be beaten, comrades."

Chen Qi picked up a "Internal Medicine" teaching book, and said to hundreds of doctors in the audience:

"In this medical case, I gave the final diagnosis as refractory gastroesophageal reflux disease, but this disease does not appear in the latest textbooks in our country, and there is no such knowledge point, which shows that this is a brand new disease.

Although this is a possible new disease, we already know what the cause is and are familiar with the anatomical structure, so think about it, the treatment idea is actually very simple. Since the switch of Huimen is loose, then we can treat it For the cardia.

Don’t think about total stomach resection, it’s not considered at all, the patient’s stomach is fine, why do you cut it? Internal medicine treatment is also ineffective, which has been confirmed so far, so we can adopt a new technology.

That is endoscopic surgery. "

As soon as Chen Qi said this, the venue exploded again and again.

In 1988, for the doctors of Yuezhong People's Hospital, or for domestic doctors, endoscopy was a relatively unpopular thing.

Most hospitals do not even have such advanced gadgets as endoscopy, because this gadget has to be imported, and it is not something a small and medium-sized hospital can handle.

The People's Hospital used to have gastroscopes, but there was only one set, and the eyes were still used to look directly at the gastroscope tube, which is a backward endoscope.

The function is also limited to inspection, which is to see if there are any lesions in the esophagus or stomach and duodenum. Minor diseases can be treated internally, and serious diseases can be directly surgically removed.

Later, it was not until Chen Qi and Lan Lijuan received a sponsorship of 2 million US dollars from Sweden, and Aslila Company kindly sponsored two sets of new gastroscopes for the research group, that a small number of people have seen what endoscopy is. .

But now Chen Qi directly said that he would use a gastroscope for surgery? It is still a relatively difficult operation, which has to surprise everyone.

Because most doctors can't imagine.

For surgical operations, there must be dozens of surgical instruments spread out there, and then three or four surgeons need to be on the stage together.

Now a small and long tube can be operated on?

Just like a severed limb without fingers, with a bare top, how do you eat with chopsticks? How do you serve food?

At least the vast majority of doctors in the People's Hospital don't believe it.

Jin Peilin smiled and said from the audience: "Dean Chen, don't be joking, how can this tube be used for surgery? How to cut it? How to suture it? I can't imagine it."

It was rare for Jia Liangcai to side with Jin Peilin at this time:

"A few days ago, Dean Chen used a gastroscope to stop the bleeding, which has already amazed us, but that is just using a function similar to an electric knife on the top of the gastroscope, that is, turning on and off the electricity, everyone can understand.

Now it is said that this gastroscope tube will be used for a gastric surgery, and gastroesophageal reflux disease can be cured without removing the stomach. Oh too much. "

Many senior doctors below laughed lightly.

Regardless of whether everyone was benevolent or malicious, there was laughter anyway. Obviously, these people had voted no confidence in Chen Qi, the dean.

Instead, some young doctors were sitting in the back row, discussing the possibility of endoscopic surgery and its operating principles.

Chen Qi's reputation was obtained through one operation after another, and he directly became an international double director. This is convincing, especially since Chen Qi has invented too many new surgical methods in the past.

Therefore, the young doctors have confidence in Chen Qi. They think that Dean Chen can create miracles, and they are willing to learn from him.

Chen Qi saw the reactions of everyone in the audience, Chen Qi even exchanged glances with Lao Guo and Zhu Huoyan in the audience.

The meaning is obvious, look, this group of old guys not only can't become advocates of new technologies, but also won't take the initiative to learn new technologies, they just hang around with the same old ways, and they are stubborn.

On the contrary, young doctors are willing to accept new things and learn new things, so don't blame Chen Qi for not bringing old comrades to play.

If you want to say that the biggest supporters of Chen Qi in People's Hospital are Lao Guo and Zhu Huoyan, (wives are counted separately).

So the two old comrades nodded slightly, expressing that they had received the signal and would not oppose Chen Qi's future reform measures.

When Lao Guo and Zhu Huoyan didn't object, Chen Qi felt confident, so he tapped the microphone again:

"Everyone, be quiet. We are doctors. It's useless to say more. You can see the real skills in your hands. It's fine if it's a mule or a horse. In this way, I will perform this endoscopic surgery myself tomorrow, so that you can see it." Know what new technology is."