"Take a look at the umbilical cord. Is there any leakage in the umbilical cord? It is likely that the umbilical cord is entangled with the amniotic membrane."
Professor Zhang gently picked up the little guy's hand. He was holding the umbilical cord in his hand, just like he was touching his neck.
Professor Zhang checked the umbilical cord very carefully and with delicate techniques.
"Come on, Xiao Yang, check the umbilical cord."
Yang Ping received Professor Zhang's order and began to explore the umbilical cord. Looking at it bit by bit, there seemed to be no problem on the surface. Yang Ping gently touched the umbilical cord with his hand.
It is true that there is something wrong with one part of the umbilical cord, and Yang Ping is going to open the outer membrane to take a look.
"Micro-shear!"
Yang Ping wanted to use microscissors to gently cut a part of the umbilical cord, but Director Mei stopped him: "Don't move, the umbilical cord cannot be moved!"
The umbilical cord is the source of oxygen and nutrition for the fetus. How can it be moved casually? Let alone an orthopedic surgeon. How can you move the umbilical cord? Director Mei's movements were very gentle and blocked Yang Ping's hand.
Yang Ping was quite embarrassed. He looked at Professor Zhang. Professor Zhang looked down at the umbilical cord, then reached out and touched it again: "There is a hidden constriction ring here. Let him open it for you to see."
With Professor Zhang on the platform, Director Mei could still not believe it. He retracted his hand, and Yang Ping gently cut the surface of the umbilical cord lengthwise and separated it gently. Yes, there is a narrowing ring inside.
"That's the problem!" Professor Zhang pointed it out to Director Mei and Director Ke.
The two directors took turns to take a look at the assistant's eyepiece and were shocked. Not only was there a constriction ring inside, but the umbilical cord was also partially necrotic. The necrosis may not have reached the blood vessels, so the blood vessels could still transport blood smoothly. p>
After the narrowing ring is inserted, the gap is very small and the tissues at both ends are fused, so it looks exactly the same as normal.
Just like an apple, give it a hoop. When the apple grows, the hoop sinks into the flesh. The hoop creates a circle of gaps. This gap slowly disappears at the level of the apple skin. It cannot be seen from the outside, but there is a hoop inside. p>
"To cut off this part and re-anastomose the umbilical cord, first loosen the constriction ring and take a look." Professor Zhang told Yang Ping.
Yang Ping loosened the constriction ring, and the blood vessels inside were also a little necrotic. Professor Zhang came over and took a look at the microscope.
"Feel the fetal heart!"
Director Mei touched it and saw an immediate effect. Sure enough, the fetal heart rate went up. This old man was really miraculous. He was not an obstetrician and gynecologist, so how did he know that the problem was with the umbilical cord?
"There are still patients waiting in my outpatient clinic. What you do is to cut off all the necrotic sections and then re-anastomose them. If they are left in place, the necrosis will expand and the umbilical cord blood vessels will become necrotic and embolized."
Professor Zhang started to take off his clothes and gloves. Director Mei quickly asked before he left: "Professor Zhang, how did you know that the problem was the umbilical cord?"
"The mysteries of human beings are far more complicated than we imagine. This behavior is the self-protection instinct of the human body. Didn't you see that his hands are always at the umbilical cord, trying to grasp the umbilical cord. People, whether after birth or in the mother's belly
When he is in a desperate situation or isolated, his latent instincts will be stimulated and he will do some incomprehensible behaviors. He is saving himself and wants to live. You have not dealt with the key issue for him, which is to close the uterus. How can he be willing to do so?
."
After Professor Zhang finished speaking, he hurried away, leaving behind a half-informed Director Mei. Director Ke wanted to ask a few questions but didn't catch up.
People in the room are in a daze. Can such a small fetus save itself? What theory? Let’s tell a bedtime story.
"I don't understand, it's like a supernatural incident." said the anesthesiologist.
Director Mei came back to his senses: "That's what happened. There was a case like this in the United States. It caused a sensation in the United States at the time. There are many human codes that medicine cannot decipher for the time being. Let's continue with the operation."
"The old man is a genius?" Director Ke exclaimed.
"Otherwise, why would he be the leader of the expert team?" Director Mei also admired him.
Experience is something you sometimes have to accept. As you are older and have more experience, what you have thought about for a long time can be solved in a few minutes.
Yang Ping exposed the entire section of the umbilical cord that was necrotic. It was not much, about one centimeter, but the fetus was only thirty centimeters long, so this centimeter was quite a lot. He also carefully touched other parts, and it should be fine.
"It would be complicated to cut off the umbilical cord and then anastomose it. Let's talk to the family about it."
This time it was Director Mei's turn to go out and communicate. Today's operation is complicated.
Zhong Mingfang stood guard outside, his heart burning, and he looked at the door of the operating room from time to time, hoping that his wife would push out. Every time one was pushed out, he rushed forward, no!
Some family members thought he had any malicious intentions. When other family members pushed her out, he rushed up to her, especially a woman who had a cesarean section in the obstetrics and gynecology department. When she was pushed out, he rushed faster than her husband and was almost beaten. p>
Zhong Mingfang and his wife both graduated from Southwest Political Science and Law. When he graduated, he wanted to continue his studies, but family conditions did not allow it. His wife gave up graduate school and started working. With his wife's support, Zhong Mingfang studied for graduate school and later opened a law firm with his wife.
So, he is also a figure in G city.
The biggest regret in life is that both of them have infertility. After a lot of effort, they used their own sperm and my wife’s eggs to have a child through artificial insemination, but now they are faced with this situation again.
Hey, I don’t have this in my life, there’s nothing I can do about it.
The door finally opened: "He Liru's family!"
Zhong Mingfang immediately went over: "Here, Director Mei!"
Listening to the voice this time, he recognized that it was Director Mei.
"Now a new situation has emerged. Your child's umbilical cord also has a hidden constriction ring, and it is necrotic. Now it needs to be removed and re-anastomized."
"Sir, are you okay?" Zhong Mingfang was very nervous.
"The adult is temporarily stable and can tolerate the operation. If you don't do this step, the fetus will give up. It will take another hour to do this step of the operation. Are you willing to continue? The patient is still stable. There are risks, but you can try hard." Now I can only make my own decision. As long as the adults are fine, let's do it. My wife is determined to have this child, and she wants it too. Now that things have come to this, I have fulfilled my wife's wish and I have to risk my life.
"Okay! Thank you for your hard work."
"Yes, wait until the doctor in charge of the bed comes to see you to sign a new informed consent. We will do it while the surgery is going on, without any delay."
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Things are really full of twists and turns. Now Zhong Mingfang finally realizes how helpless a person is when he is sick and how strongly dependent he is on the doctor. His mood is contradictory. He doesn't want anything to happen to his wife, but he also wants a child.
If he had to choose one of the two, he would choose his wife; if he could choose both, that would be great, but I don’t know if God would give him this opportunity.
Now I heard that my wife is still stable, but the baby is in trouble. The doctor is working hard to cut off and connect the umbilical cord. It makes my head hurt just thinking about it.
A young female doctor came out and asked Zhong Mingfang to sign the informed consent form for the operation, because he had not considered cutting the umbilical cord and re-anastomizing it.
Changing or adding surgical procedures requires re-communication and signature, otherwise the doctor will not dare to do anything except to save lives.
These doctors seemed to have been preoccupied with his wife's affairs, and they hadn't had lunch yet. He asked cautiously: "You haven't had lunch yet, right?"
"Oh, no, your wife's matter is urgent, and the director said you should eat after finishing it." The young doctor said casually.
It was really hard work. Zhong Ming felt a little ashamed. If he invited the doctor to have a meal, he didn't know if he would go, but he didn't have time. He had to spend time with his wife later, so he would feel confused anyway.
I usually think quickly and have clear logic, but now my mind is like a pot of porridge, or boiling porridge.
Director Mei returned to the operating room: "Let's cut off the anastomosis and re-anastomize it."
This small umbilical cord is similar to the tail of a white mouse, but for Yang Ping, it is very easy.
Director Ke was glad that he had managed to get his brother from the Department of Orthopedics to come on stage. Otherwise, if things were like this today, he would close the abdomen and go straight back after the operation. In a few days, the fetus would die in the womb, and there might even be an intrauterine infection. Thinking about it,
Afraid.
"Cut?" Yang Ping confirmed again.
Your patients, if you don’t open your mouth, the knife won’t dare go down.
Director Mei agreed: "Cut it!"
The necrotic part is cut off, and the umbilical cord arteries and veins are re-anastomized under the microscope. The fetus has a strong healing ability, which is not comparable to that of adults. After the anastomosis, there is almost no need to control the blood vessels, and there is almost no vascular crisis.
Otherwise, once a vascular crisis occurs and the fetus is in the uterus, it needs to be treated, the uterus needs to be opened, and the operation needs to be done again.
Anastomizing blood vessels is a starting method, and it only takes two blood vessels and it can be done in just a few clicks.
"Is the fit complete?"
"Okay!"
Despite his reputation, Dr. Yang is really good at orthopedics, and he is indeed an experienced driver.
Director Mei felt the fetal heartbeat, and it was very good. The fetal heart rate was normal, which indicated good blood circulation. After observing for a few minutes, Director Mei felt reassured: "Close the uterus,"
"Artificial amniotic fluid!"
Because part of the amniotic fluid will be lost when the uterus is opened, artificial amniotic fluid must be added to maintain the amount of amniotic fluid. Otherwise, the fetus will be in danger due to oligohydramnios after surgery.
Director Mei was observing the reaction of the fetus while suturing, and she already had a psychological shadow.
Really, the little guy is no longer restless.
Is what Professor Zhang Zongshun said about the fetus’ survival instinct true?
Director Mei felt that it was necessary to check the information carefully, ask classmates and friends, and ask formal questions to do some research.
After all, this kind of thing is too profound. When everyone sees it, it is just an interesting thing and they will not delve into it.
Director Mei saw that Professor Zhang's words were serious and did not sound like a joke, and he also found the problem and solved it.
Didn’t the fetus touch its neck with its hands before? Is this the same reaction?
Director Mei is becoming more and more interested in whether this reaction is unconscious or conscious.
He decided to visit Professor Zhang when he had time to find out and find out.
The little guy no longer protested with force, and before he knew it, the uterus was closed.
He started to close his stomach, but Director Ke was still thinking about it: "Lao Mei, is what the old man said true? You have a lot of experience in this area."
"I want more experience, so I don't need to trouble the old man. Let's go and ask together when we are free." Director Mei is quite skillful.
Layer by layer, from the inside to the outside, the abdominal skin is also sutured.
The vital signs of the pregnant woman were normal and nothing happened.
Being able to get on the operating table and get off the operating table with confidence is really not a high requirement.
