第244章 巨大肿瘤创记录
顶点小说(dingdian666.com)更新快,无弹窗!
眼前的子宫保持着前位,宫体明显增大,如孕3月大小。
子宫颈后方有2枚分叶肌瘤凸起,拿软尺量了一下,右侧直径约10cm,左侧直径约25cm左右,摸上去不软也不硬,质中。
陈棋不但没有高兴,反而眉头又皱了起来:
“鲁主任,从病人肚子的大小来判断,似乎子宫里这两个瘤子远远不够呀。”
陈棋没说他已经悄悄做过B超和床边CT了,明明看到了粘连灶和肿大的淋巴,如果仅仅只是子宫积瘤是不可能出现这种情况的。
那么一定是哪里还有问题。
四院妇产科主任虞雅琴也有同感:
“对,子宫里的瘤子不够大,陈棋,你把子宫往旁边推推,检查一下卵巢和其他附件。”
“好咧虞主任。”
陈棋顺手继续往下探查,推开巨大的子宫,他的眼睛突然一咪:
只见左侧的卵巢囊肿下缘与子宫后壁致密粘连,腹腔澹黄色液体差不多有250ml,可见一房性囊肿约30*30*15cm。
鲁越因为是一助,视野更好,连声惊呼:
“乖乖,果然被老虞给猜到了,这左卵巢还有一个巨大肿瘤,瞧这粘连程度恐怕凶多吉少了。”
虞雅琴一听被自己猜对了,老太太心里一阵暗喜,骄傲地说道:
“老鲁,既然是妇产科的肿瘤,你这个大外科主任就让贤吧,来,一助我来做,这是我从业几十年第一次碰到如果巨大的子宫积瘤和卵巢肿瘤,这得好好研究研究。”
鲁主任暗暗白了一眼,不爽地说道:
“别说你了,我当了这么多年外科医生,我也是第一次碰到,就你想研究呀?这可是写成论文,无论是《外科学》还是《妇产科学》医学杂志肯定能刊登出来。”
妇产科出来的女人往往女拳意识很强,虞雅琴一撇嘴:
“那就看咱们谁的论文先刊登出来喽,现在你闪开,抢救病人第一。”
旁边参观手术的二院盖院长一看自家医生抢不过四院的医生,赶紧帮忙了:
“我说两位,这论文怎么着也得主刀医生写吧,人家主刀医生都不急,你们几个助手急什么?”
虞雅琴一边帮着陈棋抽着腹腔内澹黄色的液体,一边回道:
“那我不管,反正这论文老娘写定了,陈棋同志不错,到时就是论文第二作者,怎么样?陈棋,对这样的安排你有没有意见?”
陈棋能有什么意见?他就是一个刚参加工作的小萌新,这论文怎么抢得过几个老油条?
“嘿嘿,虞主任说什么就是什么,我没意见。”
“瞧这小子,懂事,以后你对象,那谁,兰丽娟是吧?在四院就我帮你罩着了,看谁敢欺负她?”
老太太很坏,关键时刻扔出一个王炸,其实就是明着告诉别人,我手上可有人质,我高兴了帮她抬轿子,我不高兴了同样可以让她工作不爽快。
鲁越一听傻眼了,这怎么抢?
盖院长一看急了,连忙说道:
“陈棋同志别怕,我们二院是县属医院,到时把你和你对象一起调到二院是小意思,咱们医院比四院可好太多了。”
四院的院长张在其忍不住了:“老盖,你可不地道,不能好事都往你们家饭碗里扒拉呀。”
在现场邱明才副局长沉声打断道:
“好了好了,都少说几句,现在重点确保手术成功,如果手术失败,你们的论文写给谁看?谁敢发表?陈棋同志,你按你自己的思路来,不要被打扰。”
陈棋深吸了一口气:
“好的邱局长,那么虞主任、鲁主任、边主任,这个患者已经51岁了,已经没有生育要求,我准备子宫全切除术+双侧输卵管切除+双卵巢囊肿剔除术,同时要对周围组织和淋巴进行清扫。”
三个主任助手全部都点头:“可以,没意见。”
一小时后,巨大的子宫已经被切除下来,陈棋喊了一声:
“解英,马上将这些血性液体和子宫拿出去让紧急病理难测,有结果马上来汇报。”
子宫切除简单,但左侧的卵巢切除难度就大了,肉眼可见病变累及输卵管、左侧宫旁、宫体浆膜面及部分肌层。
鲁主任看了一眼,庆幸自己不是主刀,这都粘连成这样了,手术要扩大了,太难了。
虞主任也开始担心了:
“陈棋,这下麻烦了,这都不用病理切片,十之八九是卵巢癌,而且已经有周围扩散转移,再怎么清扫都清扫不干净了。现在先不说这手术难度如何高了,
就算你切下来了,没有后续治疗恐怕病人生存率也会很不理想,也许关腹不去动这癌细胞,后续保守治疗她还能多活些日子,这样是不是更好?”
陈棋看了一眼正在麻醉昏迷中的病人,轻轻叹了口气。
“虞主任,这个病人在手术之前跟我
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