Siheyuan: Rebirth in a prosperous era, great doctors are sincere

Chapter 592: Performing Craniotomy on Xu Damao

He Daniu is a poor boy, and his sister married Gu Yu's brother Gu Lei.

He originally thought that he would never be able to marry and have offspring in this life, but he didn't expect that Guyu actually gave him a son.

The He family has no descendants.

He Daniu is willing to give everything for his son.

There was no hesitation at all when donating bone marrow, and I even donated with a smile.

now.

When He Daniu learned that Xu Damao's decision to stop his son from taking medication indirectly killed him, he was filled with anger.

My son is gone.

What's the point of him being alive?

My son is gone.

Xu Damao, the culprit who killed his son, still wants to live?

There are no doors.

He wants to kill Xu Damao.

He wants to avenge his son!

Even at the cost of his own life.

Even if I lose my life, I have no regrets!

He Daniu began to act.

He quietly went into the city and observed for two days before finally taking action after understanding Xu Damao's daily routine.

When Xu Damao was returning home from get off work, he was targeted as soon as he arrived at the gate of the courtyard.

He Daniu suddenly ran over from behind and stabbed Xu Damao with a dagger.

When Xu Damao turned around and saw the ferocious-looking He Daniu, he was shocked. Before he could react, the dagger stabbed into Xu Damao's stomach.

The dagger pierced into Xu Damao's stomach. He felt an unspeakable pain and blood flowed out along the dagger.

"You, why..." Xu Damao shouted with some difficulty.

"Why? You still have the nerve to ask why? You killed my son and made all my hopes come to nothing. Tell me, do you deserve to die?" He Daniu roared loudly.

He Daniu became more and more angry as he spoke. He used the dagger to stir Xu Damao's stomach vigorously. He really wanted to kill Xu Damao, and he would not be polite at all.

Feeling immense pain in his body, Xu Damao wanted to run but felt too weak to run.

At this point, Xu Damao knew that it was a life-and-death situation. To do nothing would mean death. How could Xu Damao do nothing?

He took a few steps back and pulled the dagger out of his stomach. Xu Damao covered his stomach and turned around to run, wanting to run to the courtyard.

As long as he gets out of his control, he has a chance to survive. Otherwise, He Daniu will kill him. I'm afraid that Xu Damao won't even know how he died in the end.

"Run? Can you run away?" He Daniu was completely furious. He took a few quick steps and chased after him. He grabbed Xu Damao's neck and slammed him against the wall, causing his head to hit the wall.

moment.

Xu Damao's head was bleeding and he fainted.

Even so, He Daniu still didn't want to let it go and wanted to give Xu Damao another fatal blow.

At this time, Liu Haizhong, He Yuzhu and others also got off work. Seeing someone beating Xu Damao like this, they all surrounded him.

Not just people from one courtyard, people from other courtyards gathered around as well.

A guilty conscience.

Under the watchful eyes of the crowd, He Daniu did not dare to continue beating Xu Damao. He fled in fear without even confirming whether Xu Damao was dead or not.

No one chased him, and under the leadership of Liu Haizhong, they sent Xu Damao to the Sixth Hospital.

After Yan Bugui got home from get off work and learned about this incident, he immediately went to the Sixth Hospital.

Urgent situation.

At Zhou's repeated requests, Liu Haizhong and Yan Bugui went directly to the Li family to find Li Ping'an, wanting him to be Xu Damao's attending physician.

Li Ping'an did not dare to delay and immediately went to the hospital with them.

When they arrived at the hospital, Zhou was holding her son's stomach to prevent bleeding, but even so, a lot of blood still flowed out.

Imminent.

Xu Damao must be treated immediately!

After an examination, Li Ping'an believed that the main reason for Xu Damao's fainting was not because of a stab wound in the stomach but because of a collision with the head.

It may be caused by epidural hematoma!

Epidural hematoma is a hematoma located between the inner plate of the skull and the dura mater. It often occurs on the convex surface of the upper hemisphere of the tentorium cerebelli. It is very common, accounting for about 30% of traumatic intracranial hematomas, most of which are acute hematomas, followed by subacute and less chronic.

It is mostly caused by direct external force on the head, resulting in skull deformation or fracture at the point of force, and damaging blood vessels. Therefore, the most common site of extramembranous hematoma is the temporal parietal area, followed by the frontal parietal parasagittal sinus, which can be unilateral or bilateral.

During lunch, the laboratory technicians were not there, so Li Ping'an performed X-ray, B-ultrasound and other examinations on Xu Damao.

Xu Damao had a clear history of trauma, with a short onset and rapid progression.

The symptoms of upper and lower back headache and limb weakness were progressive and rapidly aggravated, and the mental disorder gradually deepened. He entered a deep coma in a short time. Physical examination showed that the right pupil was dilated about 5mm, and the light reflex disappeared. The left pupil diameter was about 3mm, and the light reflex was dull. The neck was stiff and resistant, and the left pathological signs were positive.

Combined with imaging head examinations, it was revealed that there was a large amount of intracranial hemorrhage, the midline of the brain had obviously shifted to the left, the ventricles were compressed, and brain herniation had formed. If surgery was not performed in time, the hematoma would continue to increase and compress the brain stem, which would most likely lead to death.

Therefore, surgery is indicated.

Also.

Xu Damao's intestines are prone to rupture, and there may be more than one rupture.

If surgery is to be performed to remove the cerebral hematoma and to repair the digestive tract, general anesthesia will definitely be required. Li Ping'an asked the nurse to call Jiang Daqiao, and also called Xiao Lu and several other auxiliary nurses from the operating team.

Epidural hematoma evacuation is a neurosurgery procedure.

The Sixth Hospital does not have a neurosurgery department.

in fact.

Jie Fang: In the past, some large hospitals in China had neurosurgery departments, and the first successful craniotomy was performed in the country in the second year after the founding of the People's Republic of China.

just.

Even today, more than a decade later, the success rate of neurosurgery is still very low.

The Sixth Hospital has never performed craniotomy and does not have any special surgical equipment, such as medical milling cutters and drills.

Make bricks without straw.

How can Li Ping'an perform surgery without surgical instruments?

However, at this time it was impossible to transfer Xu Damao to other hospitals.

Not to mention whether time permits, there is no way to guarantee that it will not be damaged again during transportation.

If the injury worsens during transportation, especially the brain injury, it can cause death at any time.

Li Ping'an meant to ask someone to go to Jingcheng University Hospital to borrow a set of surgical instruments.

There is a neurosurgery department in the Beijing University Hospital.

Li Ping'an specifically called them to inform them of Xu Damao's illness and wanted to seek their help.

The people at Jingcheng University Hospital agreed.

When a nurse was ordered to go over there to get the surgical instruments, Zhou had to follow.

In fact, he wanted to know what the chances of success of his son's operation were and whether he could be saved.

Li Pingan naturally would not object.

Although he didn't understand whether Zhou really went there purely to help, there was no need for him to refuse.

Zhou and a nurse went to Jingcheng University to get medical equipment.

After the nurse went back, Zhou did not leave. She thought that they could not only listen to Li Ping'an's one-sided words, and they could not just listen to whatever Li Ping'an said.

Since this concerns his son's life, he must find an authoritative expert to ask about the situation.

After constant inquiries, Zhou heard that the most authoritative neurosurgeon at Jingcheng University Hospital was Professor Liu.

Professor Liu has been working in neurosurgery for several years and is said to have performed a craniotomy before.

When neurosurgery was still a new term, even at the Capital University Hospital, there were only a few neurosurgery operations a year.

Professor Liu had actually performed craniotomy, which meant he was a very experienced doctor.

Zhou had to meet with Professor Liu no matter what.

The nurse at Jingcheng University Hospital didn't say anything and asked Zhou to wait. After all, Professor Liu was working in the outpatient department and she couldn't see him whenever she wanted.

One of the nurses went to see Professor Liu.

The other nurses were chatting.

Zhou was in a daze and heard what they were talking about.

"Strictly speaking, any surgery has risks, and any drug has side effects. Even a minor surgery can lead to the patient's death!"

"There was a very minor operation a few days ago, and the patient died due to severe bleeding during the operation!"

"A few days ago, a patient with a benign tumor came for surgery. Somehow the tumor suddenly ruptured and the hypothalamus was accidentally touched. He died!"

"And the issue of the bed in your ward. Do you know why there is a bed? Because when the patient was sent to the operating room, it was found that the vascular malformation in the brain could not be cured, so they sutured it and pushed it out!"

The more Zhou listened, the more frightened she became.

Only a dozen minutes later, Professor Liu came over led by a nurse, but Zhou felt as if he had been there for several days. He was in great torment and sweat was coming out of his forehead.

Professor Liu is a very nice person. After listening to Zhou's story, he decided to go to the Sixth Hospital with Zhou.

He knew Li Ping'an's surgical skills.

He had only heard that Li Ping'an was skilled in general surgery, but he had never heard that Li Ping'an could actually perform catastrophic surgery.

Professor Liu also promised that if Li Ping'an needed it, he would be willing to help with the neurosurgery part of the operation.

Zhou thanked him repeatedly and begged Professor Liu to go with her to take a look.

If in later times trepanation could be used to remove epidural hematomas, it would be a very common procedure.

During the operation, a cone hole or drilling hole is first made to drain some of the liquid hematoma.

The indications are relatively stable condition, bleeding volume of about 30 to 50 ml, clear positioning by CT examination, midline shift of more than 0.5 cm, and no continued bleeding.

The method is to make a cone hole or drill a hole at the thickest part of the hematoma shown on CT, and then insert a suction needle or a broken suction needle with a twisted wire.

After draining some of the blood, urokinase is injected again, or urokinase plus hyaluronidase is injected to dissolve the remaining blood clot. This is repeated several times, and the drainage tube is left in place for 3 to 6 days until CT scan shows that the hematoma has been completely drained.

During puncture treatment of acute epidural hematoma, the patient's condition should be closely monitored and CT scans should be performed promptly. If the hematoma is reduced by less than 1/3 after aspiration and initial liquefaction or if there is no significant relief of symptoms, craniotomy with bone flap should be used to remove the hematoma.

This operation is simple and easy, which helps to quickly save the patient's life. It is used for emergency rescue of extremely acute epidural hematoma. It can temporarily partially relieve intracranial hypertension. In order to gain time, it is often used for pre-hospital or pre-operative emergency treatment.

Li Ping'an did not wait for external assistance from Jingcheng University Hospital. In fact, he started the operation right after sending the nurse and Zhou away.

Li Pingan's surgical team and Jiang Daqiao's anesthesia team participated in the operation together.

After Xu Damao was disinfected before the operation, Xiao Lu, Zhao Wanrong and others pushed him into the operating room.

Anesthesia.

Use a heart-lung machine.

Li Ping'an first performed intestinal repair surgery on the patient. In order to minimize the surgical trauma, Li Ping'an used Xu Damao's wound and helped him suture the three broken wounds as carefully as possible.