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"Attractor, here, hurry up, give me some perspective."
Director Xu estimated that the bleeding blood vessels came from the liver or pancreas, but some of the blood vessels in the liver and pancreas were on the back side. If they were blood vessels on the back side, it would be very difficult. Director Xu could only locate the approximate location of the bleeding point for the time being.
He was an experienced emergency surgeon and responded calmly. With the help of his assistant's suction device, he finally determined that the source of the bleeding was probably the blood vessels at the third porta hepatis behind the liver.
He reached behind his liver and touched it, as if he had found something, and then pinched it. The bleeding actually decreased, which showed that his judgment was correct.
A short steel bar just passes through the liver. The liver needs to be cut anyway, so it is better to cut it now.
"Vascular forceps!"
Director Xu used a vascular forceps to stop the bleeding of the blood vessel with the feeling of his hands. This is a real skill gained through many years of emergency surgery experience, and it is difficult for ordinary people to do it.
But after treating the blood vessels here, the bleeding will only decrease, not stop.
Judging from the direction of the bleeding, the rest of the bleeding should be on the pancreas. Director Xu tried to feel the back side of the pancreas. The pancreas was relatively troublesome because its blood vessels often mutated and its anatomy was unstable.
Moreover, the pancreas was tightly suppressed by the steel bars, and the hand could not dig too deep. No matter from above or from below, Director Xu fumbled several times, but found nothing.
This battle was fought passively and cowardly, but Director Xu had no choice. This was the emergency surgery team of Union Medical College. If it were in a general hospital, such cases would have disappeared long ago.
Several groups of doctors were very fast, but unfortunately there were too many bleeding parts, the bleeding speed was also fast, and there were too many steel bars.
It is impossible to treat so many places at the same time. The abdominal cavity is so big, so it can only be treated one after another.
My blood pressure has shown signs of becoming unstable and has begun to drop.
The pancreas has not been treated yet, and the vascular surgery department is waiting to treat the large blood vessels, but it is impossible to treat the large blood vessels when the pancreas is bleeding like this. If two people treat it at the same time, there is not enough space.
The anesthesiologist paid close attention to the patient's blood pressure. It was obvious that the blood pressure was now on a downward trend. He planned to increase the blood transfusion pressure, but found that it was already the maximum blood transfusion pressure and could not be increased any more.
''My blood pressure is a little unstable!"
The anesthesiologist immediately informed the surgeon of the vital signs he observed.
There is nothing we can do if we can't stabilize it. There are so many bleeding points now, it's like a fire is out of control and the fire brigade is exhausted.
The neurosurgery team is working steadily. They have cleaned up the intracranial hematoma and slowly started to separate the tissue around the steel bars to create a safe channel for removing the steel bars. The surgery on their side is not urgent, so they can only work slowly and slowly.
"The blood vessels of the pancreas are mutated. You see, this one is the bleeding blood vessel of the pancreas now. The bleeding is very violent. This is the blood vessel that must be controlled first. Not only these blood vessels, but also here, you see, these blood vessels are all
It must be controlled quickly.”
Yang Ping pointed out several major blood vessels on the film. These are the blood vessels that he believes must be controlled first, but they have not yet been controlled.
From the location of the injury and the rate of blood pressure drop, Yang Ping can make a rough prediction. These are some of the trauma theories in the papers he published. Judging the rate of blood loss from the injured blood vessels, and then adding the rate of blood transfusion, this can
From a circulatory perspective, predicting how long a patient can support it will be even more accurate if factors such as age are added.
According to my own theoretical prediction, this patient will not last long if he continues at this rate.
"You have to hurry up, otherwise the patient won't last long." Yang Ping was very worried.
Director Long looked at the situation on the stage and began to feel anxious.
"The blood pressure is still dropping!" The anesthesiologist's worry became more obvious now.
"Keep the pressure on!"
Director Xu ordered.
But now it is the ultimate pressure, and there is no more pressure to add.
"It's already the biggest pressure."
The anesthesiologist said.
Director Xu raised his head and looked at the bags of blood hanging on the infusion pole. No, it’s not possible. The bleeding is so fast and the injury is so complicated. Not to mention the steel bars that damaged so many blood vessels and the bleeding from so many fractures. The amount of bleeding is huge.
.
At this time, Director Xu began to feel that he lacked confidence. This case was indeed beyond his previous experience and was very difficult to handle.
I don’t know what happened, maybe one of the blood vessels broke through the thrombus formed by the body’s self-coagulation function, and blood started to gush out again.
Where is this bleeding again?
The enemies in front of me are still too much to deal with, and now there are new enemies.
Director Xu felt a little nervous, but this was only on a technical level. Emotionally, Director Xu remained calm as usual. He was a senior emergency surgeon, not a rookie who had just picked up a knife.
Not every patient can be saved, we just try our best.
The anatomy here is inherently complicated, otherwise combined pancreaticoduodenectomy would not be a very large operation.
The short steel bars haven't been pulled out yet, and now we have to dissect the pancreas. It's too busy, and it's all in vain even if we have three heads and six arms.
Treating a dead horse as a living horse doctor is the only way.
"Director Xu! The heaviest bleeding is behind the head of the pancreas!"
"Take a large curved forceps, open the forceps a little, and insert it from the underside of the pancreatic head. The bend is to the right. The direction of entry of the forceps is straight upward. Extend the forceps to the hinge position and clamp."
"Give me a big bend and I'll show you."
Yang Ping shouted loudly, and Director Xu immediately stopped and turned to look at Yang Ping. Qiu Nuo gave Yang Ping a handful of clean large curved blood vessels. He immediately used his hand as a pancreas to demonstrate to Director Xu.
After the demonstration, Yang Ping approached the operating table and prepared to guide Director Xu to stop the bleeding.
Director Xu hesitated for a moment and immediately followed the instructions. However, even with the demonstration, Director Xu could not have done it so accurately. He carefully inserted the blood vessel clamp.
Everyone gave up their positions. Yang Ping, regardless of the sterility principle, tried to get as close to the operating table as possible and looked inside:
"Go a little to the right, yes, go in a little further, go a little further, don't be afraid."
"The opening of the pliers is too small, please make it bigger."
"Turn the pliers a little clockwise, yes, stop!"
"Keep this position, move forward a little, and don't move!"
"folder!"
Under Yang Ping's remote control command, Director Xu finally completed the action. He clearly felt that he had clamped some tissue. After the suction device cleaned up the bleeding in this area, something magical happened. Really, there was no more bleeding here.
"Clamp with upper teeth first!"
Yang Ping could only order Director Xu this way, because the next step of ligating the blood vessels by hand was impossible for Director Xu to do.
Director Xu followed the instructions, set the teeth on the vascular forceps, and then released the vascular forceps, feeling relieved.
If it were anyone else, even with Yang Ping's remote control, it would be impossible to complete the hemostasis action, because this requires a wealth of experience.
Next, under the remote control of Yang Ping, Director Xu actually completed the hemostasis of several blood vessels, and these were all the more difficult bleeding parts.
After hemostasis of several relatively large blood vessels, the condition of the surgical area improved significantly, and Director Xu breathed a sigh of relief.
You can't always let others direct you to perform surgeries, right?
Director Xu said to Yang Ping, "How about you come on stage to help?"
Yang Ping was not polite. There was not much push and pull when rescuing people, so he immediately went out to wash his hands.
When you go out, don't forget to say: "Qiu Nuo! Wash your hands!"
The surgery he was waiting for was very fast, and the nurse on the stage could not handle the equipment. He needed a nurse who could adapt to his own pace.
PS: I wish everyone a happy New Year, good health, a happy mood, and all the best! Thank you for your support over the past year, salute!
