I can see the status bar

Chapter 364 Dr. Cao (3)

Under the shadowless lamp, the operation is still in progress.

Dr. Cao's surgery turned into an unsurprisingly combined thoracoabdominal surgery.Tong Chunlai, director of the Cardiac Surgery Department, is in charge of the heart, while the handling of the liver is handed over to Chen Hua, the deputy director. Do a good job in the separation of the peritoneum and hemostasis.

"The blood bank has provided a reserve of [-] milliliters, and the stock may not be enough... Just now the blood bank called and said that the hospital still has a reserve of [-] milliliters..." The itinerant nurse in the operating room told Chen Hua The director whispered, "They have transferred blood from the city blood center, and it will be delivered in about half an hour."

There are many bleeding ports on Dr. Cao's body, and there are more than ten wounds on the body surface, but half of them are not too deep, and the amount of bleeding is acceptable.Even if the portal vein of the upper extremity is broken, the bleeding volume so far is only about 400 ml.The rest of the blood was almost all concentrated in the chest cavity and abdominal cavity.

A pericardial effusion, which means the heart is bleeding.Sun Lien's injection in the emergency room saved Dr. Cao some time, but the situation is still not optimistic.He had damage to the lateral myocardium of the left ventricle, as well as damage to both the left anterior interventricular branch and the left anterior descending artery.These three damages alone caused more than 1 ml of bleeding in about 100 minute.And what's more troublesome is that when in the pericardium, the bleeding volume of these wounds is not too large due to the pressure of the pericardium itself.But after Director Tong Chunlai cut open Dr. Cao's pericardium with a scalpel, a large amount of blood gushed out.Blood quickly covered the surface of the heart, obscuring all surgical views.

Although he lost his vision, Director Tong was still calm.After cleaning up the blood stains on the surface of the heart with a suction device, he dictated to his assistant, "Record, there is a wound about 4.5 mm deep on the outside of the left ventricle, about one centimeter in length. The left anterior interventricular branch and left anterior descending branch are damaged. The damage was about one millimeter. No other obvious wounds."

The thickness of the left ventricle of an ordinary adult is about 11-16 mm. Although the 4.5 mm wound does not directly penetrate the myocardium, the trauma caused is already very serious. If it directly penetrates the myocardium and causes the heart to rupture, I am afraid Dr. Not on the operating table.

"Intubate the ascending aorta and inferior vena cava, prepare for cardiopulmonary bypass." Director Tong quickly gave instructions to the physician in charge of perfusion after his assistant said that the recording was completed. "Stop beating as soon as possible."

Although from a technical point of view, director Tong can also suture the myocardium and blood vessels directly on the beating heart.However, both the coronary artery and the coronary vein are damaged, and the cut myocardium is also within the blood supply range of the anterior descending artery.If more applications are used to block the superior and inferior vena cava, and the heart is empty-beating, the damaged myocardium will inevitably accumulate waste and become hypoxic due to empty-beating.The use of high K+ depolarization arrest program can minimize the damage to the myocardium and create good conditions for further surgery.

"Let's go, let's go!" The ascending aorta and inferior vena cava were being intubated nervously on the operating table, and Director Zhao Chongxi, who rushed over, finally arrived at the operating room.He struggled through the doctors waiting for news in the corridor, and rushed into the operating room, "What's going on?"

"Grade four liver injury, penetrating injury of the left liver lobe, rupture of the proper hepatic artery and hepatic vein." Director Chen Hua, who was in charge of the early separation and hemostasis, replied with his head down. His hands were buried in Dr. Cao's abdominal cavity, and the The liver is pressed down toward the operating bed, and at the same time, the first hilum of the liver is blocked with the auricle forceps, the subhepatic inferior vena cava is blocked with the vena cava anastomotic forceps, and the superior and superior hepatic vena cava is compressed with fingers.At this moment, Director Chen Hua wished that he had three heads and six arms, two fingers oppressed two veins, and a large amount of hemoperitoneum made his gloves slippery, making oppression very difficult.

Director Zhao Chongxi came over, took a serious look at the injury on the liver, and immediately asked the equipment nurse for a suture needle and a needle holder, and at the same time said to Chen Hua, "Hold it still, I will suture it."

The accumulated blood in the abdominal cavity was sucked into the blood recovery purifier by the straw held by the assistant, and after purification, it was reinjected into Dr. Cao's vein.But his blood pressure kept dropping.Of the [-] milliliters of blood sent by the blood bank, only [-] milliliters remained.

No one spoke in the operating room, and the air was oppressive as if it were a real entity.No one is still in the mood to joke and chat. Even with the capabilities of the Fourth Central Hospital, this kind of trauma is still extremely dangerous—thanks to Dr. Cao being in the hospital when he was stabbed. Even if most of the patients can't survive the laparotomy, they are likely to die of massive bleeding before the doctors finish the blood vessel suturing.

A normal adult has about 4000 milliliters of blood in his body.And now the doctors have transfused about 5200 milliliters of blood into Dr. Cao's body.The blood in his whole body has almost been completely changed.

The operation on the liver must not only be fast, but also ensure the quality of the completion.Looking at Tong Chunlai's opened chest, Director Zhao, who was in charge of the operation, knew that Dr. Cao had no chance for a second operation.Either fix it all at once, or watch him die from issues that were not addressed in the first surgery.There is no third option.

How likely is it that a patient with a blood transfusion of more than [-] milliliters will survive surgery?Zhao Chongxi shook his head, and drove all these irrelevant thoughts out of his mind.There was only one patient lying on the bed, a patient with severe liver trauma.Keep calm and just complete the operation as before.

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Sun Li'en accompanied Shen Yue to stand outside the operating room without saying a word.

Xu Yourong and the others stood a little further away, but also remained silent.Dr. Pascal looked at Sun Lien worriedly, and whispered to his colleagues, "He looks so abnormal."

Zhou Ce nodded and said nothing, Yuan Ping'an responded, "When encountering such a thing, we should only worry if it is still the same as usual, right?"

Xu Yourong said in a low voice, "Dr. Cao is his roommate, and the relationship is a little closer than ordinary colleagues."

Zhou Ce rolled his eyes, "What you said is meaningless. If one of us gets stabbed, will he feel better?"

"If you have time to bicker, why not think about what you should do later." Dr. Pascal glared at the two of them.He is the oldest, and his qualifications are also the first in the treatment group. It is perfect to play the role of a stabilizer at this time. "I remember that there is a special psychological treatment consultation department in the hospital, right?"

Yuan Ping'an nodded, "I've heard of this department, but I've never seen anyone."

"Then they will be very busy during this period." Dr. Pascal sighed, "I hope the operation goes well. If there is bad news when the door is opened, it will be in big trouble."

Outside the operating room, Shen Yue lowered her head and trembled twice from time to time, then quickly and subtly wiped away her tears, raised her head again and looked at the monitor screen on the wall.The situation in the operating room is simply displayed in a few lines above, "in operation".

"It's been almost an hour." Shen Yue finally couldn't hold it anymore, she asked Sun Lien in a low voice, for fear that her voice would affect the doctors who were doing surgery inside, "Is this normal?"

Sun Lien nodded after being silent for a while, "Brother Cao's injured organs are more complicated to deal with. The longer the operation takes, the better the effect of the operation will be." If it's over, I'm afraid there will only be bad news accompanying it.The longer it takes for the doctors to operate, the more likely it is that Dr. Cao will survive.

Although he looked quite calm on the surface, Sun Lien's heart was already in a mess.About ten minutes ago, two nurses from the central nurse station pushed two freezer boxes with the logo of the central blood station into the operating room.Sun Li'en knew at a glance that it contained urgently called blood from the blood bank.

Even the blood bank of the Fourth Hospital is not enough to prepare blood.When Sun Lien realized this, he felt his heart tremble suddenly.

He stared at the door of the operating room, thinking nothing of it.

　Push a book "I Really Can't Cook", if you are short of books, you can take care of it, the quality of the dishes is guaranteed, you will be hungry after reading it, and I will not be responsible for it!
　　
　
(End of this chapter)