"Or it's better to do this first and observe for two days. If it grows up, it might be possible." Fang Lin had no choice. Seeing that Boss Zheng was not speaking for a long time, he whispered to suggest.

"Do you still have the face to say that you are a thoracic surgery department? Just you are hospitalized, one year is not enough, it will take at least three years. Squat in the department and have surgery every day." Su Yun said coldly.

"Brother Yun, let me say good things well, and I will do it again if I don't take it. In just this year, I feel disgusted." Fang Lin said with a frown.

For him, there is nothing more troublesome than doing another hospitalization.

If Fang Linning was not going to be a professor in the group, it would be better to quit his job and go to a private hospital just like Su Yun said.

Fang Lin is still resistant to the disease. When many doctors hear that they want to be hospitalized, they will choose to resign without hesitation.

"What does the guide say?" Su Yun looked at Fang Lin with contempt, "The primary spontaneous pneumothorax still leaks after 7 days of intercostal drainage; the secondary pneumothorax still leaks after 14 days of intercostal drainage; it is essentially a persistent bronchial pleural fistula."

"Brother Yun..."

"The 2015 European Respiratory Society Spontaneous Pneumothorax Diagnosis and Treatment Statement states that patients whose drainage time is more than 3-5 days and who still have continuous air leakage should be taken further treatment." Su Yun looked at Fang Lin, as if he felt that the stethoscope on his shoulder was too dazzling. He turned his head and said to Lin Yuan: "Xiao Linzi, tell him what he said in other guidelines."

"Oh, OK." Lin Yuan watched the film with Zheng Ren and said: "The 2010 British Thoracic Science Society's Spontaneous Pneumothorax Management Guidelines point out that if there is conservative air leakage for 48 hours, it is necessary to consider whether to have surgical intervention."

Fang Lin looked at the monster in Boss Zheng’s medical team with a frown.

Everyone knows these things, but who would memorize so many details? In addition to talking about the treatment guides in the whole hospital, can they have even a little effect on the patients in front of you?

It was simply impossible. Fang Lin sighed in his heart. He looked at the video reader sadly and was about to speak, but was directly interrupted.

Because there is a topic about the guide that is not over yet.

"The 2018 German Spontaneous Pneumothorax Management Guidelines propose: Whether it is spontaneous or secondary pneumothorax, if the drainage still leaks for 48 hours, you must consider changing the treatment plan." Lin Yuan continued.

"Stop!" Fang Lin saw that she wanted to say something, so he begged directly, "Surgery? I have to ask the director for instructions. Even if this patient is submitting an emergency form, the anesthesiologist dare not anesthetize."

"Boss, can you do it?" Su Yun approached Zheng Ren and asked in a low voice.

Zheng Ren didn't say anything, he tried to undergo interventional treatment under bronchoscopy in the system operating room.

Generally speaking, there are several treatment methods for pneumothorax.

First of all, the most common chest open surgery ten years ago. The benefits of this surgery are just like Su Yun said, Huo Liang is drastic. The disadvantage is that the trauma is huge and the patient recovers slowly after surgery.

If the old patient who had already "disassociated" had undergone such an operation, Zheng Ren was not sure whether he could step down. After all, he had already undergone relevant surgical training in the system operating room, and the completion rate of the operation was not high at all.

The low completion of the operation means that there are many postoperative problems, which was ruled out by Zheng Ren.

Secondly, it is minimally invasive thoracoscopic surgery, which is the first choice for thoracic surgery in major hospitals. Not only general chest, but also cardiothoracic doctors like Zhao Yunlong, who are very enthusiastic, have begun to prepare to perform type 1 aortic arch dissection surgery with laminoscopy.

Major guidelines recommend the first choice for refractory pneumothorax. However, this patient in front of him is not suitable. He has poor overall basic condition, poor cardiopulmonary function, and widespread lung lesions. The completion of the surgery performed with a thoracoscopy is still very low.

Besides, the patient has a severe thoracic adhesion, and the field of view when entering the thoracoscopy is quite limited, so hemosexual surgery is required first. If you are not careful, the blood vessels will be broken, and the bleeding will be stopped first. If you do a ball operation without a surgery field, this is also ruled out.

Next is the pleural fixation procedure adopted by local hospitals.

It is actually a very simple operation.

The principle is to rub the pleura through chemical drugs or surgical procedures to form uniform and consistent sterile pleural inflammation and complete atresia atresia. The patient injects 50% high sugar 50ml in the chest cavity in the local hospital, which is this procedure.

Talc and tetracycline can be used as the first choice drugs, and other commonly used ones include autologous blood, eleanene, hypertonic glucose, iodophorol, etc. (Note 1)

Another is argon ion coagulation. Some doctors attribute this treatment to internal medicine treatment, which Zheng Ren disagreed.

But this technology is also not suitable for patients in front of you.

The last one, which is the only treatment method that Zheng Renneng thought of - bronchoscopic interventional treatment.

Use bronchial plugs, stents, one-way live flap, autologous blood, biological protein gel, and gelatin sponge to block the airway to achieve the treatment purpose.

Among them, autologous blood and biological protein glue can be absorbed by themselves, but it is easy to cough up. At present, major guidelines are not recommended as the first choice.

Zheng Ren tried it 20 times before he found a feasible solution.

No matter how serious or minor illnesses are, as long as they get worse, it is very difficult. The peak intervention, the peak general surgery, and the top level of cardiothoracic surgery master, Boss Zheng, faced with a small pneumothorax, actually underwent more than 30 surgical training.

Zheng Ren expressed helplessness in this regard.

"You can try interventional treatment." Zheng Ren said, "Anaesthesia...it's better to find Lao He."

"With a bronchoscope, it is very risky." Su Yun reminded.

"But there is no other good way," Zheng Ren said, "I use a laryngeal mask to be used for anesthesia, and I will block the bronchoscope."

Su Yun hesitated for a long time and asked, "Boss, if there is a little bit of excitement, there may be problems."

Zheng Ren nodded, "There is no way to do this, I'll try to be lighter. Fang Lin, are you thinking about it?"

In fact, Fang Lin had no considerations. He didn't dare to give any traumatic treatment to the patients in front of him.

Not to mention anything else, severe COPD in old patients is enough to scare 99% of doctors, and 99% of the remaining 1% are the kind of stupid, bold, and ignorant.

In other words, Zheng Ren used the system space to make cheats, kept trying, and finally figured out the right way to dare to perform surgery on him.

The superior hospital has difficulties with the superior hospital, otherwise Fang Lin would not have asked Boss Zheng to solve this problem.

...

...

Note 1: Before 2011, Professor Didu was asked to perform a lung cancer surgery. The patient had pneumothorax after 2 weeks. On the second day of the Lunar New Year, I injected the patient with high sugar and then it was cured. This is a very common method, with many disadvantages, but it is also very useful.
Chapter completed!