Since 1981 Health School
Chapter 604 The Surgeon's Help
The morning is the day when Chen Qi sits in the "expert clinic".
Anyway, Chen Qi is the dean, and he can do whatever he wants, so he specially opened the first "endoscopic expert clinic" in China, where he attends one morning a week.
In addition, he also goes to the Fourth Hospital of Yuezhong University once a week for a "cleft lip and palate specialist clinic", which is also half a day a week.
In addition, Chen Qi arranges one day every month to go to the Huangtan Health Center for an outpatient clinic, which can be regarded as going to all the tertiary hospitals in cities, counties and towns.
After all, he was the one who shouted the slogan of "two-way referral" at the beginning, and he couldn't turn his face and deny people after making money from the government, and stop going to lower-level hospitals to see a doctor right away, right?
If you want to join Chen Qi's expert account, you need to queue up overnight with a quilt a week in advance, and it takes seconds.
Basically, Chen Qi and Lan Lijuan's numbers are almost hard to get now, and this is Chen Qi's insistence on preventing the appearance of scalpers.
Patients came from all over the country. Those who could come from other places in the 1980s were actually intractable diseases like Yu Sisi, so Chen Qi's personal medical level is also constantly improving.
No, today Chen Qi sat in the specialist clinic, and the scene was quite spectacular.
There were two students sitting next to him, one was writing the medical records, the other was in charge of writing checkups or prescriptions, and Chen Qi only needed to be in charge of seeing the doctor.
This is the proper treatment of a big professor, and only the old experts in top hospitals can enjoy it.
In addition, behind Chen Qi, there are 8 graduate students sitting, and the teacher is in the outpatient clinic. They must follow. In addition, 5 master students are studying with Lan Lijuan.
Chen Qi and Lan Lijuan are the first husband and wife in China to lead students together, and they are also majoring in internal medicine and surgery. It is conceivable what kind of level these 15 master students can achieve after graduation.
Next to the master students, there is a visiting group composed of 20 doctors from Xijing Hospital.
The doctors at Xijing Hospital were coming in, mainly because they wanted to see Chen Qi's best endoscopic surgery, to see if it was as magical as it was said in the legend, and could replace surgery.
Doctors in gastrointestinal surgery are obviously more concerned about this issue.
In the end, good fellows, they saw a few cases of difficult and miscellaneous diseases after they came to Yuezhong, which can be regarded as gaining knowledge, either epilepsy-type abdominal pain, myocardial infarction-type abdominal pain, or abdominal pain without the major of gastroenterology.
So today, knowing that Chen Qi has an endoscopy clinic, all 20 doctors from Xijing Hospital got up early and waited for the clinic.
Anyway, the doctors are used to getting up early and going to the outpatient clinic.
Even Professor Tong, who is in his 70s and almost 80, sat there in good order, watching how "Ms. Chen" carried out endoscopic diagnosis and treatment like a student.
Chen Qi has a lot of rules when he sees a doctor. He doesn't allow a large group of patients to gather around there. This not only lacks personal privacy, but also affects the doctor's mood.
Therefore, when Dean Chen went out to the clinic, there must be a nurse holding a table to stop him at the door, and then the manual call system was adopted.
For example, now, Yang Xiuxiu is already shouting: "No. 15, Yuanquanlin, is Yuanquanlin there?"
At this time, a middle-aged and elderly man in his 50s came from behind the crowd. He wore glasses and looked like an intellectual. He smiled and said:
"Little comrade, my surname is not Yuan, but my surname is Qi. The pronunciation of this word is the same, it is the Qi in "Qi and Ji are the same, after the official in charge of Ji."."
Yang Xiuxiu blushed when she heard it. She only had a technical secondary school diploma and was unfamiliar with such uncommon words, so she quickly apologized:
"Sorry, I'm sorry, I mispronounced your name because of my low level of education, now it's your turn."
"Hehe, it's okay. Anyway, my surname is always mispronounced. I've been used to it for a long time."
The nurse outside was calling the patient's name, and the director of the gastroenterology department of Xijing Hospital, Liang Jingwen, who was sitting inside, muttered:
"Hey, listen, why is Qi Quanlin's name so familiar? This voice also sounds familiar."
Zhou Qifa, director of gastrointestinal surgery, said casually:
"In the First Affiliated Hospital of Jiaotong University, there is also a surgeon named Qi Quanlin. His surname is relatively rare and is often pronounced Yuan. It is strange, but his voice does resemble him. Could it be that Lao Qi has come to Yuezhong?"
Director Liang was at a loss:
"I can't, why did Lao Qi come to Yuezhong? The train will take three days and three nights, besides, what disease they can't cure in the First Affiliated Hospital of Jiaotong University, why do you want to come to Yuezhong?"
The best hospital in Xi'an is Xijing Hospital, followed by the First Affiliated Hospital of Xi'an Jiaotong University.
The level of the two hospitals is not much different, and they are located in the same city, so the doctors are quite familiar with each other.
At this time, the door of the clinic was pushed open, and a gentle patient came in, holding a briefcase with a red envelope, with a polite but neither humble nor overbearing attitude:
"Dean Chen, hello, I am patient No. 15."
Before Chen Qi could speak, he heard screams from behind him: "Old Qi? Is it really you?"
Qi Quanlin was still calm just now, but when he was called out like that, he was completely stunned, thinking that he had already run to Yuezhong thousands of miles away, how could anyone recognize him?
Take a closer look, "Hey, isn't this Teacher Tong? Why are Lao Liang and Lao Zhou also in Yuezhong?"
Liang Wenjian and Zhou Qifa stood up, the surprise on their faces could not be stopped:
"That's the right question for us to ask. We are here to visit Yuezhong. Why did your old guy come to Yuezhong? You even registered. Are you here to see a doctor?"
"Old Qi, you ran over to see a doctor? What's the matter?"
Liang Ping'an and Zhou Qifa asked a lot of questions in one go, which was really surprising to them.
Although Professor Tong didn't remember Qi Quanlin very much, it sounded like he was his fellow villager and colleague, so he nodded with a smile.
Qi Quanlin looked at these 20 fellow villagers and colleagues, and suddenly couldn't laugh or cry:
"This world is so small. I never thought that I would meet you when I came to Yuezhong. This is really meeting old friends in a foreign land. Hehe, yes, I came to Yuezhong to see Dean Chen for medical treatment."
Qi Quanlin said it easily, but he couldn't hide the loss and embarrassment on his face.
After Liang Wenwen and Zhou Qifa calmed down, they also asked with concern: "Old Qi, what's your situation? Xi'an can't be cured, so you have to go to Yuezhong."
Qi Quanlin smiled wryly: "Xi'an is really incurable, you look at these, it is estimated that only Dean Chen has hope."
When Chen Qi heard that he was a colleague, he was still the chief physician and professor of Xi'an Jiaotong University in his 50s. Although he was equally surprised in his heart, he still nodded politely:
"So it is, it is..."
"Qi Quanlin, surnamed Qi..."
Chen Qi yelled in embarrassment:
"I'm sorry Director Qi, it's the first time I've seen this surname, thank you for trusting me, I came all the way from Xi'an, I heard Professor Tong said that they spent three days and three nights on the way to Yuezhong.
So I think Director Qi must have encountered a huge difficulty. Everyone is in the same industry, and you are also my senior. Anyway, if I, Chen Qi, can cure it, I will do my best. I will definitely not hold back, and I will not let you down. my trust. "
As soon as Chen Qi's voice fell, it was determined that he was either a professor or a director. Even the students were all masters and had sufficient IQs. Everyone knew that things must not be that simple.
Qi Quanlin would rather abandon Xi'an and go to Yuezhong thousands of miles away to treat his illness, which shows that he does not want the outside world to know what illness he has or where he is going.
Today, it was really a coincidence that Ah Qiao's mother met Ah Qiao's father.
Qi Quanlin smiled wryly:
"Originally, I really wanted to come and go quietly alone. I didn't expect you to meet so many fellow villagers. Anyway, you are all gastroenterologists. I am a patient today. Please help me find a way."
After speaking, Qi Quanlin took out his medical records and related checklists.
Intellectuals do things carefully, and put each piece of paper in chronological order, and hold it with clips, so that people who look through it can see it at a glance.
After the medical records were circulated, Zhou Qifa, the director of gastrointestinal surgery, frowned. He is a professional intestine cutter, and he is quite expert and proficient in Qi Quanlin's disease.
"Old Qi, you have a laterally growing tumor. Don't you know how to treat it if you are a surgeon? It needs to be surgically removed."
Lateral spreading tumor, or LST for short, is a special type of colorectal tumor that originates from the intestinal mucosa.
Because intestinal tumors can easily enter the intestinal lumen if they develop laterally, and after entering the intestinal lumen, they will grow crazily without the restriction of other tissues, which will lead to blockage of the intestinal lumen, and then develop into intestinal obstruction.
Such tumors have a higher risk of locally invasive growth and dysplasia than ordinary adenomas.
Therefore, tumors with lateral intestinal development should be surgically resected as soon as possible.
When Qi Quanlin heard Zhou Qifa's question, he smiled bitterly:
"Old Zhou, I understand what you said. You see, I also removed part of my intestines last year. I thought the matter was over, but the growth of the tumor obviously exceeded my expectations and developed too fast.
Look at this colonoscopy checklist. It says that almost the entire rectum is covered with tumors. Now I have not only changed my bowel habits, diarrhea, constipation, blood in the stool or abdominal pain, but also incomplete intestinal obstruction.
We are colleagues, and we all know that the only way to get rid of this disease is surgery, but if we want to remove the tumor, it also means that I need to remove the entire rectum and anus. If there is no rectum and anus, what's the point of living in the future? "
When Qi Quanlin said these words, it was as if the person in the dream had been awakened. Every doctor present suddenly realized, and then they could understand why Qi Quanlin refused to remove the rectum and anus.
The length of the rectum is about 12 to 14 cm. Its main function is to absorb water and electrolytes, and another function is to store stool.
In addition, the rectum is anatomically connected to the anus, and is fairly close to muscular layers such as the anal sphincter.
After the traditional segmental resection, it is very likely that the muscle layer of the sphincter will be damaged, which will affect the defecation function to a certain extent, and the patient may have sequelae such as fecal incontinence.
Not to mention, if a person's rectum and anus are all removed, the stool will no longer be controlled, and it will be pulled out when it is said to be pulled out.
The best way is to wear a dung bag, and wear a dung bag for life.
This dung bag is not the birdcage of the old BJ people. He carried it in his hand for a walk until he met someone who asked: Did you pull it?
In addition, excision directly and the anus are also prone to infection.
The anus is a door that blocks the connection between the human intestinal tract and the outside world. After resection, the area of the intestinal tract communicating with the outside world will increase, which will increase the risk of intestinal infection, and even external viruses and bacteria will enter the blood through the gastrointestinal circulation, thus cause systemic infection.
Therefore, for an intellectual, if he becomes incontinent when he defecates at any time, and lives with a dung bag every day, he is really as good as dead.
Everyone in the office is a doctor, so they immediately understood why Qi Quanlin didn't want to see a doctor in Xi'an, but traveled all the way to Yuezhong.
Apart from liking Chen Qi's medical skills, I'm afraid it's more because he doesn't want his acquaintances to see his miserable situation.
It's a pity that things backfired, the more he didn't want people to know, but he met so many fellow villagers and colleagues, which made Qi Quanlin feel helpless in his heart.
After hearing Qi Quanlin's words, Zhou Qifa patted the shoulders of these colleagues:
"Old Qi, there is nothing to be ashamed of. You are a surgeon yourself. Why do you want to use internal medicine for treatment? In this way, when I return to Xi'an, I will perform the operation on you myself, and I will definitely not let others know."
Qi Quanlin smiled: "No, Lao Zhou, I really want Dean Chen Qi to help me find a way to come to Yuezhong this time."
After finishing speaking, Qi Quanlin looked at Chen Qi who was sitting there:
"President Chen, I heard that you are excellent at performing endoscopic surgery. Whether it is early cancer, achalasia, or refractory gastroesophageal reflux disease, these difficult and miscellaneous diseases can be easily solved. Is it possible to help me and cure me of lateral growth tumors?"
Chen Qi was studying the medical records in his hand.
The inspection reports of later generations all use color printers to print out high-definition anatomical screenshots, so that doctors can see them clearly at a glance.
In the 1980s, there was no such printing, and the hospital didn't even have a computer, and all the inspection reports were handwritten, which made it impossible for Chen Qi to judge and evaluate the severity of the disease, and whether there was a possibility of surgery.
This is also the reason why those experts in later generations do not like to read the imaging reports of lower-level hospitals, but prefer to read the films by themselves.
See for yourself, you know what you are doing, and you are more intuitive. Others’ judgments are not necessarily prepared, which is directly related to the level of doctors.
"Director Qi, I read your reports. Although the above diagnosis is clear, but because I don't know what's going on in the intestine, I need to do some further tests before I can tell you whether the operation can be done, but Don't worry, as long as there is a chance, I will definitely perform this operation."
Qi Quanlin breathed a sigh of relief when he heard Chen Qi's assurance, "Then please leave it to Dean Chen."
However, the gastroenterology surgeons headed by Zhou Qifa all turned ugly.
Some surgeons were a little annoyed, thinking that Qi Quanlin himself was a surgeon and asked a physician for help? (Chen Qi asked, is endoscopy internal medicine?)
Some surgeons expressed uneasiness. In the future, physicians can do the surgery, so why should they be surgeons?
Some surgeons questioned that if you dig a tumor and cut a polyp, endoscopy may be okay.
Now, the tumors in the intestine are not a matter of one or two, but may be dozens or even hundreds of large and small tumors. How do you cut them with endoscopic surgery?
The best way to treat lateral growth tumors is to directly remove the entire intestine and anus, so that it can be cleaned up. This is a radical operation.
At this moment, the contradiction between internal medicine, surgery, and endoscopy emerged.
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