Start From Emergency Doctor
Chapter 246
Chapter 246
Zhou Yuan moved very quickly.
Carefully lifted the spleen out, placed it outside the incision, and plugged the large gauze pad into the splenic fossa with the other hand.
This method can stop bleeding on the one hand, and can also fill the space after the missing spleen, and prevent the spleen from sliding back into the abdominal cavity-the surface of the spleen that has run out of the body carries a lot of bacteria.
“What are you doing, come and help!” Zhou Yuan shouted to Zhang Ling.
Zhang Ling hurried over and helped Zhou Yuan support her spleen.
“Scalpel.”
“Tissue shears.”
Zhou Yuan quickly cleaned the disintegrated tissue around the spleen pedicle, ligated and cut the splenic portal arteries and veins respectively.
Splenectomy is not a difficult operation. Mastering double lung transplantation allows Zhou Yuan to excise and transplant difficult lungs. Mastering total gastrectomy allows Zhou Yuan to have perfect organ removal skills.
Coupled with the structure of the spleen, Zhou Yuan himself is very clear. With the skills and abilities brought about by other operations, Zhou Yuan has no problem doing a splenectomy with a very low degree of difficulty.
Zhang Ling stood by, still in a sluggish state.
“Zhou Yuan, don’t take this risk in the future…26…If the patient’s family knows that you have had the operation rashly, some malicious people will take the opportunity to blackmail…” Zhang Ling said worriedly.
Zhou Yuan nodded and said: “I know, but it was too late at the time. The patient experienced heavy bleeding, and the penetrating part of the spleen was still losing a lot of blood. If the operation is not performed immediately, there will be a dead end!”
“Then you have to think of yourself too!” Zhang Ling shouted subconsciously.
Shenyuanjing is the best counterexample.
He is a master of hand surgery and a figure with a strong voice in the field of replantation of severed limbs. However, he was revoked his doctor’s license for some reasons and could not be used on the operating table for life.
It is said that because he performed an operation without authorization, he was finally sued by the patient’s family and lost the case.
Zhou Yuan sighed and said, “The patient is a traffic policeman. Without him, there are probably more than 20 wounded people who came to the emergency department. I don’t believe what he would do to us.”
The two stopped talking and concentrated on removing the spleen.
…
Outside the operating room, Lin Wen quickly pushed a person to the rescue room.
“There is a woman here! She is holding a comatose child in her arms!”
“Come to the rescue, the hug is too tight, we can’t separate!”
No one dares to question how powerful a person will be in a crisis.
There was a piece of news that a child was crushed under the truck. His father was in a hurry and he lifted the truck directly—this is not a fantasy, but something that actually happened.
Several people ran up quickly, trying to separate them.
Soon, some parents recognized the wounded.
“She is Teacher Zhao Han! It was she who pushed my child away. Otherwise, my child would not be as simple as bruising, and he would definitely be hit by a car too!”(Read more @ wuxiax.com)
“Teacher Zhao saved four children! At that time she also pushed my son away, and then the little girl in the middle was too late. Teacher Zhao could have run, but she went back and hugged the little girl!”
Lin Wen was taken aback for a moment.
I thought it was the mother protecting the children, but the teacher was protecting the students…
“We must save it!”
Lin Wen and other medical staff are not emotionless machines. After hearing about Zhao Han’s deeds, they immediately became more cautious.
“Will there be an accident with the child in her arms? She is hugging too tightly…”
“CT of the brain is here! The patient suffered a head impact and his skull was injured!”
After a while, everyone finally succeeded in separating the two.
Other doctors quickly rushed Zhao Han to the rescue room.
Lin Wen is going to check the injury of the child in her arms and mark the red, yellow and green zones.
As soon as she turned the little girl over, Lin Wen was frightened by the blood-stained face.
“In the beginning?!!!”
…
“Vascular clamp.”
Mao An’s spleen pedicle is relatively thick. Zhou Yuan clamped the spleen pedicle in parallel with three large hemostatic forceps at the spleen door.
Then, the splenic artery and splenic vein were ligated separately.
“Remove the spleen.”
Zhou Yuan put the spleen on a sterile funnel, and allowed the blood in the spleen to flow naturally into the blood storage bottle containing the anticoagulant maintenance solution for autologous blood transfusion.
Mao An’s spleen was injured by his ribs, so the blood in the spleen was not contaminated, and in theory it could be autologous.
If a foreign body invades the body and damages the spleen, the blood in the sinusoids of the spleen cannot be reused.
After the spleen was removed, Zhou Yuan began to stop bleeding and check.
After splenectomy, there are often torn varicose veins oozing blood in the retroperitoneum, splenophrenic ligament, spleen-kidney ligament, which can cause postoperative hemorrhage, secondary infection and subphrenic abscess. These bleeding points must be carefully examined , One by one ligation to stop bleeding.
The last step is drainage and suture.
Because the patient’s spleen was removed, and the liver is next to the spleen, which is also affected by the spleen, Mao’s blood clotting function will decrease.
Even if the bleeding is completely stopped during the operation, the patient’s blood coagulation function is not good after the operation, and hemorrhage on the wound may occur. Therefore, a drainage tube should be placed in the splenic fossa.
“Dual-lumen silicone tube.”
Zhou Yuan carefully inserted the drainage tube into the splenic fossa. The double-lumen tube can be placed for three to five days. After the operation, suction can be continued, and the risk of bleeding and effusion will be greatly reduced.
After completing the placement of the drainage tube, Zhou Yuan began to suture each layer of the incision with silk thread.
“Not enough blood…”
While stitching, Zhang Ling, who had been staring at the venous channel, said suddenly.
Zhou Yuan said in a deep voice: “The blood in the sterile funnel is autologously refluxing!”
“Understood, I am worried that the patients outside will not be able to perform surgery…”
There is not enough blood, which means that the blood bank is in a hurry…
In the emergency department alone, there were five or six people who were seriously injured, and there were a lot of other wounded people. At this time, the blood bank was in a hurry, and the operation could not be performed at all, and they had to wait for death!
Zhou Yuan’s face changed.
Although he has a small blood bank, he can only lose a thousand milliliters of blood at most…not to mention so many people, Mao An’s operation alone used three thousand milliliters of blood!
There is nothing he can do.
“Don’t worry, at least I rescued Mao An… By the way, did you see Chuchu when you first went out?” Zhou Yuan rescued Mao An and finally had the opportunity to ask Chuchu.
“Chuchu? Is Chuchu also there?!” Zhang Ling was shocked.
“I don’t know, I was in Yanjing Elementary School at the beginning. This point is when they are out of school.”
“I didn’t see it!” Zhang Ling was somewhat thankful.
“Okay, the stitching is over. You take care of the next steps, and I will continue to go out and save people!”
After Zhou Yuan finished speaking, he glanced at Mao An’s vital signs. During the emergency rescue process, Mao An gradually recovered, at least the fatal injury was dealt with.
As for fractures and so on, these are all things on the orthopedics side.
Zhou Yuan is an emergency doctor, and his mission “to save his life” is always the most important. .
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