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第一百二十四章 再挑重担(1 / 2)

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总住院医师沈甜甜也闻讯赶来。那天的失败,令她甚是郁闷,她也觉得,这种体型的病人,做腰穿应该不难,可当天,自信心满满的沈甜甜,和其他人一样,以失败告终。

陈浩让谭三少协助,将病人的体位摆好,便动起手来。定位、消毒、打开腰穿包、戴好手套、铺巾、麻醉、进针......动作流畅自然,毫不拖泥带水,更没有丝毫的停滞。

站在身边的廖梅,看见陈浩的针,一直缓慢往前推进,暴露在皮肤外面的针越来越短。

廖梅心里打起鼓来:我前天进到这样的深度就不敢进了,这个陈主任,为什么这么大胆,还将针往里送?

是的,陈浩手中的腰穿针进针的深度,已经超过教科书的范围,但陈浩还是一脸淡定地,缓慢地将针向前推进,所有围观的医生们,都屏住气,紧紧地盯着陈浩的手。

突然间,陈浩推进的手停了下来,并伸直了腰,此时的腰穿针露出外面的部分,大约剩下2厘米左右。

只见陈浩一只手将针固定,一只手缓缓地将针芯往外拔。陈浩不敢完全排除蛛网膜下腔出血,也就不能不防范高颅内压的可能。

随着缓慢拔出的针芯离开针体,无色的脑脊液随即缓慢流了出来。测完压力,留取适量的脑脊液送检,陈浩才迅速拔出腰穿针,并叮嘱患者,必须在床上平卧六小时后,才能起床活动。

走出病房,廖梅他们一直跟着陈浩来到课室,陈浩示意他们坐好,陈浩正准备借此机会,强调基本技能的重要性。

廖梅还没等陈浩开口,便抢先说道:“陈主任,我打心眼里佩服您!前天我也做了,但我不敢进针这么深,我知道我失败的原因了,还是基本功不够扎实啊。”

这是陈浩一直很敬重廖梅的原因:有错就承认,不逃避,不为自己找借口,并在错误中不断学习和进步。

“大家都要向廖教授学习。每个人都有自己的不足,这不可怕,可怕的是不敢承认自己的不足,甚至找各种借口为自己辩护,这样的人,是没有什么发展前途的,希望今天在座的各位,好好记住这一点。”

“请大家到课室来,是想和大家说一说基本功的重要性。当一个病人的诊断不清楚时,当这个病人的诊断,需要你用最基本的方法去获取证据时,如果基本功不过关,你就拿不到你想要的证据。”

“就像今天这个病人,如果腰穿做不了,不知道脑脊液的情况,那蛛网膜下腔出血的诊断就成立了,治疗的方向也就完全错了。”

“刚才廖教授也说了,她不敢进针这么深。一般而言,腰穿时的进针深度为4~6厘米,这是标准的说法”

“但大家也知道,进针的过程中会遇到两个阻力点,一个是韧带,一个是硬脊膜。”

“当腰穿针穿过这两个阻力点的时候,会有明显的落空感,当然,前提是你必须缓慢进针,才能感受到这两个落空感。”

“我今天为什么敢进这么深?因为我进入到5厘米左右时,才遇到第一个落空感,我知道,针还没有进入到脊髓蛛网膜下腔,所以我才继续进针。”

“当遇到第二个明显的落空感时,我相信,我成功了,最后的结果,大家也看到了。”

“其实我今天的进针深度并不是很深,大概是7厘米左右。我知道,我的中指一横指的宽度大约1.5厘米,所以我对进针的深度,心中有数。”

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