第一百三十八章 厉害的新手
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第一百三十八章厉害的新手
在门外张琦医生惊诧和讶异的目光中,徐泽很自然地一手按住准备穿刺的部分,另一手拿着注射器,很稳很准地从瞿主任手中的小药瓶中抽取了五毫升的利多卡因,准备开始做局麻了。更多小说ltxs520.com
在徐泽看来,既然瞿主任说让自己动手,那么在只有两个人的情况下,瞿主任当然是会当助手,辅助自己将这个腰椎穿刺术做好,倒是不用太过忌讳什么身份问题,
而张琦惊愕的是,瞿主任竟然不是自己动手,而且给人当助手,这在她们看来,这是几乎不可能的事情,作为一个科室事务繁忙的主任,又是全国知名专家,除了每周一次的查房之外;一般看病人,都是得由管病人的普通医生申请,他们才会抽时间出来会诊。
而根本不可能会浪费时间,亲自来做这样的小手术,可今儿瞿主任不但是来做了,而且竟然是给一个新医生当助手,这才让人觉得奇怪。
当下张琦赶紧戴上口罩帽子走了进去,对着瞿主任笑道:“主任,要不您休息吧,我来给徐医生当助手。”
瞿主任知道张琦的意思,轻笑着摇了摇头,然后继续在一旁看着徐泽动手,他当这个助手可不是别的,只是为了看看徐泽的真正能力而已,当然不会让别人来代替自己。
徐泽这时可没有想那么多,正全心全意地做着自己的手术,小心地将注射器斜斜刺入穿刺点,在皮肤的底层注入了一些麻药,然后再改为垂直进针,自皮肤至椎间韧带一层一层小心地作局部浸润麻醉。
当利多卡因已经完全注入韧带中之后,徐泽轻吸了口气,定了定神,便拿起那根十来厘米长的穿刺针,小心地以左手拇、示二指固定穿刺点皮肤,右手持穿刺针以垂直背部方向,从3、4腰椎间开始缓慢刺入,正式开始进行腰椎穿刺了。
见得徐泽开始正式穿刺了,瞿主任眼中也闪过了一丝好奇,他这时基本上已经不怀疑徐泽的能力了,只是在想不知道徐泽能不能一次成功,如果这个也能一次成功,那么说明徐泽在临床方面肯定有十分丰厚的经验,理论动手能力都极强,自己以后也就可以放手让徐泽去做事情了。
而张琦这时见得瞿主任拒绝,便也在一旁小心地看着,看着这个能让瞿主任这般重视的徐泽,到底手头如何,应该不是个银样蜡头枪才是……
此时,徐泽却是也稍稍地有些紧张,虽然说这做腰椎穿刺,一次不成功,多做一两次的情况很多;但是徐泽依然想做到尽善尽美,当初自己在虚拟空间的时候,可是做了好多次之后,熟悉了手感才能一次成功,这次可是现实中,不由地让他有一点点的紧张。
徐泽一边回忆着当初在虚拟空间时操作时的手感,一边缓缓地凭着感觉,推行着穿刺针向前前进,这样刺入的大概3、4厘米的时候,徐泽的手轻轻地滞了一下,感觉到了一点小小的阻力,当他轻轻往前一推之后,很快地便突破了,当下不禁拧了拧眉,这应该是突破了第一层韧带,接下来就是最关键的了,成不成功就看等下的情况了。
继续穿刺了两厘米,徐泽果然再次地感觉到了阻力,这次的阻力要大的多,徐泽轻扬了扬眉,然后轻吸而来口气,握紧了穿刺针,往前一推,感觉随着这一推,然后手下一空,那股进针地阻力明显消失,徐泽这才松了口气,知道穿刺针已经顺利地穿过韧带与硬脊膜时,顺利地到达了椎管内。
虽然估计着已经到达了椎管内,但是还是不能完全确定穿刺就成功了,这个必须要见到脑脊液才算数的。
徐泽轻吐了口气,将针蕊缓慢拔出,成败就再次一举了,如果还是没有见到脑脊液,那么就必须再次重新穿刺。
不过很明显徐泽在虚拟空间中培训的效果很不错,随着针蕊地缓缓退出,在三人希冀的目光中,一滴无色透明液体随之轻轻滴出。
见得这滴透明的脑脊液滴出,徐泽不禁地松了口气,而一旁的瞿主任和张琦脸上却是都闪过了一丝赞许之色,这徐泽果然是不错的……
徐泽又缓缓地将针蕊推了回去,暂时地止住脑脊液从针管中流出,然后从腰穿包中摸出一个测压管,小心地将测压管的下端套入针管处,开始测量颅内压力,这也是腰穿术一个重要的诊断方法,通过测压,可以排除一些颅内高压的情况。
随着测压管的套住,测压管中显示的脑脊液刻度缓慢地上升,渐渐地在150毫米水柱处停住,徐泽也放下了心来,正常值是180,现在才150,看来颅内压力并没有增高,应该没有其他什么颅内或脑脊液的病变,这下确诊格林巴利综合症又多了一分把握。
测完压之后,徐泽小心地将测压管取了下来,然后将针蕊插入针管中,堵住脑脊液使它不再流出;然后伸手从腰穿包中摸出三根试管,准备留脑脊液标本做化验。
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