Chapter 133 I actually just want to grow up (please subscribe!)
After hanging up the phone, Bu Chaodong felt that the old man opposite was inexplicably weird!
He turned to look at Yan Haihan and others, and asked angrily: "What is the background of this old comrade opposite? Is he a doctor?"
I feel very angry but I can’t let it out. Is this what a doctor should say?
Yan Haihan hurriedly explained: "This is Professor Ding from the Orthopedics Department of the Affiliated Hospital of Xiangnan University, and he is also Dr. Yang's teacher!"
Then he turned to look at Huang Shinan and said, "Director Huang, our orthopedics department may not be able to do anything about this matter. You can find another way. I will take Yang Yifeng down to rest first."
Yan Haihan was drumming in his heart at the moment, fearing that Ding Changle would come to trouble him again later!
Through the few words just said, Yan Haihan could probably tell that there was a deep-seated reason why Yang Yifeng left the Affiliated Hospital of Xiangnan University and came to the Eighth Hospital without undergoing surgery.
It may even be that for this reason, even Professor Ding would not be able to interfere.
However, Yan Haihan could only take one step at a time. He didn't do anything to Yang Yifeng. He was called by Huang Shinan from the Department of Vascular Surgery. Even if Ding Changle lost his mind, he would definitely not let him go.
of blood.
When taking Yang Yifeng downstairs, Yan Haihan was still making some insinuations, preparing to find out the secrets hidden in Yang Yifeng.
But Yang Yifeng had no intention of talking to Yan Haihan at this moment. He didn't ask or answer anything, leaving Yan Haihan unable to find any way to break through.
…
On the other side, family members communicate with each other outside the operating room.
Bu Chaodong looked at Huang Shinan again and asked seriously: "Director Huang, what Professor Ding just said, is it true that you know the law and break it?"
Huang Shinan nodded and said with a wry smile: "Yes, doctors have specific scope of practice."
"The authority for surgery must also be classified and approved by the medical department. Dr. Yang is an orthopedic surgeon, and if he crosses the line to perform vascular surgery, strictly speaking, it violates the Practicing Physician Act."
"Even though Dr. Yang was granted surgical authority in the vascular surgery department at Shonan University Hospital, he is now in our Eighth Hospital. If his practicing certificate has not been transferred, he will not be willing to perform the surgery, which means he is abiding by the law."
"It would be fine if no one said anything about this matter. But Dr. Yang himself was unwilling, and he was reported after being forced to take office."
"I don't know what the plot of this is," Huang Shinan said with a helpless smile.
On weekdays, everyone just wants to complete the operation in a peaceful manner. Occasionally, there is an extra-level operation to practice, but it is done secretly and they dare not tell anyone.
This is a major obstacle for newcomers to learn surgery.
But now, it has become the best life-saving talisman for Yang Yifeng, who should not be on stage.
He is refusing to violate the law...
Bu Chaodong's face was twitching. For the first time, he felt that this shabby rule that he used to think that doctors should be strict in management was now so annoying!
After finally finding Yang Yifeng, only to watch him leave——
Do nothing to save him.
only.
Special professions such as lawyers and doctors have their own special legal scope.
Yang Yifeng himself is unwilling to perform the surgery. If you force him to practice medicine in a wrong place, the original intention is to save people, but in fact, Yang Yifeng can report them in return for forcing him to practice medicine illegally.
Bu Chaodong doesn't know how to discuss this point, and he doesn't know whether the lawyer knows about it.
But for sure, no matter whether it makes a big fuss or not, as long as it breaks out, no one will gain anything good.
From the conversation with Professor Ding Changle just now, Bu Chaodong also learned something, that is, it seems that this Yang Yifeng may have been treated unfairly in previous encounters, and he really suffered from psychological stress.
This is not an act.
That's why I didn't dare to go in at the door of the operating room.
However, Bu Chaodong had no intention of caring about Yang Yifeng and Ding Changle at the moment. He just asked Huang Shinan: "Director Huang, can you find someone else? Or urge Professor Shu?"
"Although the situation is not optimistic now, we still have to find a way."
Bu Chaodong didn't want to make a hasty decision about his own limb amputation, but he finally found someone who was free and around and could perform the surgery. As a result, the other person was still a little stressed.
Unwilling.
Moreover, his teacher knew about it and refused to help persuade him to take risks to save people. The teacher said that they would call the police if he got him on stage.
This kind of bullshit made Bu Chaodong feel very miserable.
And I just read about it. Yang Yifeng is a student. His practicing certificate is at the Affiliated Hospital of Xiangnan University. He came to the Eighth Hospital to study. He has never been on stage, which is equivalent to an internship.
Internships or traineeships are just a quick tour without having to move the practice location of the professional qualification certificate.
Therefore, there is no such thing as refusing to save someone.
On the contrary, he abides by the law...
Huang Shinan immediately smiled bitterly, looked at Bu Chaodong and said, "I'm afraid this is not appropriate. Now that Professor Shu is on the operating table, disturbing him again and again, the other party will lose his temper."
Bu Chaodong said angrily: "Is losing your temper more important than saving lives?"
"Professor Ke Shu, the one lying on the operating table now has a life." Huang Shinan muttered to Bu Chaodong, feeling that he was unlucky enough to meet these two patients today.
If Yang Yifeng's teacher really went to have trouble with Professor Jin Kaishi from the Affiliated Hospital of Xiangnan University, Professor Jin would definitely hate him and Huang Shinan. After all, it's because you encountered difficulties, and I want to solve them for you.
This is how Ding Changle got into trouble.
You may have offended someone secretly, so how could you possibly do something that would displease Professor Shu?
Although Huang Shinan says he is not proficient in vascular surgery, after all, the department carries this brand, and he will still have to hang out in the circle in the future. The bosses on both sides have offended, so you are still messing around.
"Looking at the situation, the only quickest way to solve the problem now is to amputate the limb first to save life."
While Huang Shinan was still talking, Chen Liwei walked out and whispered a few words into Huang Shinan's ear.
Huang Shinan's expression immediately changed, and he asked in shock: "What?"
"The patient has a ruptured liver and may need partial liver resection and liver repair. The intestines are also ruptured. The current situation is very complicated."
"The thoracic surgery department said that the knives on the chest did not go very deep because they were blocked by the ribs..." Chen Liwei said bravely.
As a result, this patient is basically left to the hepatobiliary and pancreatic surgery and gastrointestinal surgery departments to determine whether he can survive.
It only depends on Huang Shinan's decision.
This made Huang Shinan feel extremely stressed, and the fine sweat on his head continued to seep out——
Huang Shinan immediately said to Bu Chaodong: "Bu Bureau, we can't waste time now. The amputation must be carried out immediately!"
"The patient's condition is now changeable and his vital signs are unstable. If the delay continues,"
"It may be too late to amputate the limb. If you can't save your life, what can you do? Now, for amputation, you have to deal with the trauma in other places in parallel to have a glimmer of hope." Huang Shinan said anxiously, wanting very much to go back to the operating room.
See patients early.
Otherwise, the patient may die at any time.
Although Bu Chaodong was extremely reluctant at the moment, he could only sigh helplessly.
He hammered the table in the family communication room of the operating room with his fist, causing the table to vibrate and his fist to turn red.
Then you scratched your hair hard and said, "Save your life first, then let's talk."
Obviously, it was extremely difficult for him to make such a decision, and he made a lot of determination!
Limbs!
Life.
These are two aspects that are extremely difficult to choose, but he has to make the choice.
Fang Yu is the name of the patient currently lying on the operating table. He is a descendant of his sacrificed comrades, and he is now the logical successor to his father's sealed alarm.
Huang Shinan now wants to beat Yang Yifeng to death and turn him into a lunatic.
However, the Eighth Hospital where Huang Shinan is located is also...
After getting Bu Chaodong's informed consent, Huang Shinan and Li Changhong rushed directly to the operating room. They saw Yan Haihan meeting Dong Qiansheng who was hurriedly walking out of the operating room.
Then Dong Qiansheng came to Yan Haihan and asked anxiously: "Director Yan, how did the family decide?"
In fact, I have the answer in my heart.
Yan Haihan sighed: "The family has decided to amputate the leg. Have Huang Yu and Xu Yanlin arrived? If so, prepare immediately. We will start the show at the same time."
Huang Yu is a trainee from another department who is undergoing orthopedic training this month, and was assigned to the Yan Haihan group.
The person on duty was Min Chaoshuo, which meant that both of them had to be prepared to go on stage at any time to participate in emergency surgery.
If it was an ordinary emergency surgery, just one person would come to the operating room, but today was special.
Double lower limb amputation, also called double lower limb limb separation surgery, is not difficult to perform. It is not a problem if both Yan Haihan and Dong Qiansheng need to perform surgery at the same time, but each will definitely need an assistant to help.
Because amputation is not just about sawing off the leg, it also requires the storage of blood vessels, nerves, muscles and other tissues, which cannot be done by one person.
As if he had expected it, Dong Qiansheng rolled his eyes and explained to Yan Haihan: "Director Yan, the situation is like this. Gang Luoyun called and said that another patient with an open fracture came to the emergency department.
patient."
"I need to go on stage. Chaoshuo is currently having a pre-operative conversation with the patient."
"I don't know what time the operation will end. Should I go over there to do it? Call Luo Yun down to do the amputation surgery? Or let Luo Yun start the operation first, and I'll do it after the amputation is over?"
If the family decided to undergo limb salvage surgery, Dong Qiansheng would not dare to say that he would have to change the person midway.
But limb separation surgery is just a simple level II surgery. Luo Yun can do it, and even Zhou Cheng and Min Chaoshuo can do it. It doesn't require much technical content.
However, this new open fracture surgery in the department requires someone to perform it, and we don’t know what the situation is.
"Call Luo Yun to come down and amputate the leg. Amputation doesn't take a lot of time. He's already tired enough from being on duty."
"Take Xu Yanlin over, and ask Luo Yun to call someone down."
"Open fracture surgery is impossible without an assistant." Yan Haihan made arrangements, and then walked towards the operating room, presumably because he didn't want to waste time.
Each group's emergency surgeries should be arranged and planned in advance within their own group, and they should first select people from their own group to do the work.
There were originally only two surgeries today, and Yan Haihan's team had enough manpower. Yan Haihan led one and Dong Qiansheng led one, forming two sets of preparation teams, which is usually enough.
Today I can only borrow Luo Yun, and let Luo Yun borrow a subordinate.
Min Chaoshuo is on duty and cannot move!
Dong Qiansheng nodded and called Luo Yun, and also called Xu Yanlin and said: "Yanlin, please help Luo Yun and Director Yan do some chores first. I will call you over after I have made preparations for the opening of the stage."
.”
Xu Yanlin naturally praised it.
Finally, Min Chaoshuo couldn't leave while he was on duty, and Pang Dingkun went to the Department of Orthopedics. The newly arrived Huang Yu couldn't beat him when he got the chance. After Pi Bian Pidian agreed, he took the initiative and actively helped to lift his legs.
Because it is an amputation, the distal end of the limb does not need to be sterilized in a strict sense.
Xu Yanlin therefore took the initiative to ask for help with disinfection.
Huang Yu was new here and was not clear about the scope of disinfection in the Department of Orthopedics. Yan Haihan originally planned to do the disinfection himself and asked Huang Yu to lift his legs, but when he saw Xu Yanlin come in, he asked Xu Yanlin to complete the disinfection.
…
At the same time, in the dressing room of the operating room, Yang Yifeng was talking on the phone with Ding Changle.
Yang Yifeng first explained what happened to Ding Changle in detail.
Ding Changle said: "Yi Feng, come back."
"The Eighth Hospital is not suitable for you now. They are all old foxes who have been in the workplace for many years."
"If there is no profit, I can't afford to be early."
Yang Yifeng replied in a low voice: "It's okay, Master, I think it's actually okay."
"I just wanted to walk in, but my parents couldn't help but think about their expressions and faces."
"I may really never be able to hold a scalpel again."
"Those are my dad and my mom!"
"Those are my dad and my mom."
"I could have saved my dad. My dad could have saved his life." Yang Yifeng was in the corner and said to Ding Changle on the other end of the phone.
To be honest, Ding Changle felt extremely distressed when he heard this!
But after all, he could not fully understand that Yang Yifeng watched his mother die on the operating table where he was the surgeon, and at the same time, his father could not be saved because of his own choices.
What exactly will you go through in your heart, but it will definitely be very uncomfortable, very uncomfortable.
Don’t advise others to be kind without doing their own thing!
In this life, there are four words: loyalty, filial piety, benevolence and righteousness.
Who can tell clearly?
Ding Changle advised: "If a doctor does not heal himself, he will not heal his family members!"
"Yi Feng, it was Jin Kaishi who made a mistake in the program. He shouldn't have let you come on stage. I don't blame you."
"Where in the world would anyone let a patient's biological son stand on the operating table and do the fucking thing of his parents?"
"He himself has been suppressed for too long by Shu Changfa, who is attached to the Second Department. He wants to get you to push up their department. He is doing it out of selfish motives!"
"If you don't use it, you will try to take the wrong side of the sword!"
Ding Changle cursed.
Shonan University has three affiliated hospitals, namely A1, A2 and A3.
External relations are possible, but in reality, competition between them is still very fierce.
If it is said that neurosurgery and neurology in Appendix 1 are overwhelming to the point of suffocation in Appendix 2, then in cardiovascular surgery, it is the other way around.
Shu Changfa ran so fast that he even led his department to the top five in the country, and it would not be an exaggeration to even go further.
Jin Kaishi moved slowly, seeing that he couldn't catch up. As a result, he couldn't find the right person, so he grabbed Ding Changle's student to challenge him.
It's so shameless.
In the past, Ding Changle only had opinions but didn't say anything out loud, but since then, he and Jin Kaishi have been on equal footing and have never interacted with each other again.
It's just that today, Jin Kaishi hasn't given up yet, and is going all out to harm Yang Yifeng.
It really made Ding Changle angry.
After he settled the matter on Yang Yifeng's side first, he was going to deal with Jin Kaishi over there!
If you break your face, you will tear your face.
The reason why Yang Yifeng didn't dare to go to the operating table again, and the reason why his most valued apprentice had to drop out of school, was because of Jin Kaishi's help!
If he had not allowed Yang Yifeng to come to power, no matter how much Yang Yifeng regretted it, how could Yang Yifeng change his career and drop out of school?
In his heart, Ding Changle actually hoped that Yang Yifeng would take that step and let go of this knot!
But this knot is too difficult to solve!
At least Ding Changle couldn't solve it.
Yang Yifeng can only solve it slowly by himself. Ding Changle actually hopes that Yang Yifeng can directly overcome the inner demon just now and walk into the operating room.
But he backed down.
On the other side, after Yang Yifeng heard this, he did not reply to Ding Changle's words, but asked: "Master, is it not illegal to kill someone with a mental illness at any time?"
After Ding Changle heard this, sitting in the car, he felt that all the nerves in his body were suddenly twitching!
It seemed as if all the questions in my head were suddenly cleared up.
Yang Yifeng is Ding Changle's most valued disciple, and Ding Changle's understanding of Yang Yifeng is unimaginable.
Yang Yifeng does not smoke or eat betel nut.
But occasionally he drank some wine. At the reception banquet when he first came to orthopedics, Yang Yifeng drank so much that his face turned red. How happy was Ding Changle to see that?
However, Yang Yifeng's parents were hit by a drunk driver.
Yang Yifeng vowed never to drink again.
He did it.
However, at first it was clear that he was a drunk driver who killed someone, but later it was proven that he did not drink much, and somehow he developed a history of mental illness...
Ding Changle's scalp felt numb for a moment——
Because since then, Yang Yifeng has always been normal and sometimes abnormal, and he often consults the psychology department of the Second Affiliated Hospital of Xiangnan University...
Ding Changle had been worried for a while.
I chatted with Yang Yifeng countless times and asked for help from someone.
When I went to find Yang Yifeng, his condition was always normal.
But what if?
Ding Changle once again thought of a possibility.
Is Yang Yifeng deliberately pretending to be mentally ill in front of other people?
Stress——
My parents died on the operating table, and I was the chief surgeon. This is an objective fact.
"Yi Feng, what are you thinking about?"
Ding Changle's scalp was numb at this moment: "I tell you, don't go astray!"
"If your parents knew what you were thinking right now, they would never die in peace!"
"I won't die with my eyes in peace!"
Is Yang Yifeng smart?
Although he is very smart, Ding Changle has not seen many people who can compare with Yang Yifeng.
If he were to secretly lay out his personality, and it was in the field of medicine, and if he even put effort into studying what mental illness is like, even the professor of psychiatric surgery might not be able to detect that he was pretending.
After the character design was created, the night turned dark and windy, killing people and setting fires...
Such distant and unfamiliar images and scenes that only appeared in martial arts novels he had read suddenly popped into his mind.
Yang Yifeng said: "Master, I'm just talking casually."
"I will definitely not do such stupid things. My parents just want me to live well and live happily."
"This is more important than anything else."
"I know it very well myself."
Ding Changle was not sure whether Yang Yifeng was clear at this moment.
I don't dare to be sure.
In this world, there is only a thin line between genius and madness.
Yang Yifeng's title among his classmates is "madman", which is another name for genius.
But it is unclear whether Yang Yifeng will take this title seriously.
Moreover, Ding Changle paid attention to every word Yang Yifeng said. He would definitely not do such a stupid thing.
What about others?
What does Yang Yifeng want to do?
Before Ding Changle could reply, Yang Yifeng said: "Master, please don't come over now. I have already decided."
"I want to find a quiet place now and be quiet."
Ding Changle was still worried: "Send me the location of where you want to go, and I'll be there soon!"
After hanging up the phone.
Ding Changle became very nervous, and then urged the taxi driver to speed up.
But it was almost time to get off work at this time, and the Second Ring to Star Link line from the Affiliated Hospital where he started to go to the Star District was blocked to death!
The master said: "Boss, it's not that I don't want to go fast, but if I step on the accelerator too fast, we won't be able to go at all."
Ding Changle's heart was like an ant on a hot pot, and he could only wait quietly to move forward at a rapid pace.
I feel a little regretful. I should have taken the subway if I had known better...
Yang Yifeng.
…
When Luo Yun and Zhou Cheng rushed to the operating room!
Li Changhong and Wang Yaoxiang had already disinfected their upper limbs. Yan Haihan also arranged for Xu Yanlin to complete the preoperative disinfection actions, while Huang Yu held the patient's legs with both hands.
Because the patient's body is quite strong, the weight of both legs is quite heavy.
Huang Yu had never experienced such high-intensity leg-raising movements before when he was doing rotations in departments such as the Department of Neurosurgery. He looked like he was overwhelmed and could barely hold on.
Seeing this, Zhou Cheng first put on a pair of sterile gloves and asked Huang Yu for a leg so that Huang Yu could interchange his left and right hands as a buffer.
Luo Yun washed his hands directly with Yan Haihan, and the two of them were still talking about something in the middle.
When Luo Yun heard that Yan Haihan said with great pity that Yang Yifeng actually had a way to complete the patient's limb-sparing surgery, but he was unwilling to go on stage. Luo Yun felt particularly surprised, but he immediately remembered what Yang Yifeng had told him.
I have been to the annual academic meeting of SVS.
It suddenly dawned on me.
Luo Yun turned to Yan Haihan and asked: "Director Yan, in other words, this patient can actually avoid amputation, but no one dares to complete this operation now?"
Yan Haihan glanced at Luo Yun, his eyes and tone were strange: "Luo Yun? Why are you asking this? Don't make matters worse."
"This patient's situation is quite special and his status is also special."
Although Yan Haihan knew that Luo Yun's background was quite high, and he and others had underestimated Luo Yun, Luo Yun was obviously from the Department of Orthopedics. If he wanted to get involved in vascular surgery, he would also be with this patient.
Yan Haihan would absolutely not allow it to be done on his body.
Luo Yun quickly explained: "No, Director Yan, I just asked casually out of curiosity. Naturally, I won't rush into limb-sparing surgery."
"I am not a graduate student in vascular surgery. Since Director Huang has said that I want to amputate the leg, I must listen to him. He is a knowledgeable person in this field."
Then Luo Yun said again: "Director Yan, Zhou Cheng in our team has now obtained Level II surgery authority. Limb dissection is an authentic Level II surgery. I will let him come on stage and I will be my assistant. It's okay, right?"
It will not delay the patient's condition."
"What do you think?"
Amputation is simple and is a level II operation. Zhou Cheng can do it just right. To obtain authorization for level III surgery, he needs a certain amount of level II surgeries. It is impossible that the amount of level II surgeries is not enough. Ding Changle
Just go and make arrangements for him.
As for the amount of surgeries, Zhou Cheng has to accumulate them slowly. There will only be one more surgery.
The patients in the department are not only Zhou Cheng's, nor Cai Dongfan's, Du Yanjun and Zhang Zhengquan also need to learn.
"It's okay. Just tie the artery later. The most important thing now is to solve the problem of blood loss caused by blood vessel damage." Yan Haihan reminded the important point.
Zhou Cheng received Level II surgery because the entire department made a concerted effort to ask the medical department for it, so naturally they trusted Zhou Cheng's ability.
Amputation is not difficult, limb salvage is difficult.
Nowadays, the most critical thing for patients is multiple wounds and severe blood loss. Hemostasis and blood transfusion are the key.
However, after the bleeding has been stopped for a long time, the blood in the arteries and veins will coagulate. If amputation is not possible, the muscles of the limbs will gradually become necrotic, and the creatine produced by muscle dissolution will be fatal.
Therefore, this amputation can actually be performed in two steps.
Tie arteries, stop bleeding, and save lives in emergency situations.
Then amputate the limb to save your life!
The amputation can even be done slowly after six hours, it doesn't matter, it won't put any burden on the body.
"Okay!" Luo Yun and Yan Haihan walked in again.
They saw that Li Changhong and Wang Yaoxiang had opened the gauze on their upper limbs and began to expose the brachial artery.
The purpose and procedures of their surgeries are the same as those of Yan Haihan.
Stop the bleeding first. After the bleeding is stopped, Li Changhong can step down. Just let Wang Yaoxiang complete the amputation slowly...
The first department of osteopathy is responsible for the upper limbs, and the second department is responsible for the lower limbs.
Therefore, Luo Yun and Yan Haihan didn't even look at what Li Changhong and others were doing. They just told Zhou Cheng and Xu Yanlin to wash their hands quickly and then go on stage to help.
Zhou Cheng nodded, and after leaving his position as a pure tool, he went to look at the patient's other conditions.
The knife was stabbed in the right upper abdomen, probably directly on the liver. The edges of the wound were neat, so it should be fairly easy to repair.
The edges of the openings in the jejunum and ileum are also neat. It seems that the person who injured the person did not stab the person cruelly and then stirred it up.
If you really do this, I'm afraid it's really hard to save the gods——
But even so, there was still an extremely pungent smell in the abdominal cavity.
The intestinal tract is ruptured, and the smell is ecstasy.
Zhou Cheng frowned involuntarily...
When Zhou Cheng and Xu Yanlin washed their hands and walked in, they saw that Yan Haihan was already cooperating with Luo Yun to peel off the femoral artery of one lower limb, and the four people from the Department of Orthopedics had divided into two teams and started to search separately.
Arteries, hemostasis.
Because the limb needs to be amputated, the brachial artery and femoral artery can be directly found and tied off.
Zhou Cheng put on sterile surgical clothes and wandered around Luo Yun.
Luo Yun turned around and said, "Zhou Cheng, take Xu Yanlin to do the other side. The femoral artery exploration and ligation is just a simple Level II operation, which is part of the amputation. It shouldn't be difficult for you to complete it, right?"
Zhou Cheng nodded and looked at Yan Haihan.
Exploration of the femoral artery is only a level II operation and is also a component of amputation. This is naturally not difficult. Zhou Cheng has perfect level of anatomy experience and can do it with experience.
Ligating the artery is much simpler, just tie it off with a silk thread.
Yan Haihan said: "You and Yan Lin should do the femoral artery exploration over there. Remember to be careful. After you find the breach, press the proximal end of the femoral artery firmly and firmly."
Blood vessels are similar to water pipes, but they are not exactly the same as water pipes. They are similar in that they can pass liquid.
The difference is that water pipes can be on the surface of the body, while blood vessels are generally buried deep.
If there is a break in the water pipe, you can stop the water first and then slowly look for the hole. But the blood vessels are not good. The main switch for blood in the blood vessels is the heart. If it stops beating, the person will die.
Therefore, it is necessary to quickly find the proximal end of the blood vessel and then compress it to control bleeding.
Everyone in the department knew about Zhou Cheng's Level II surgery, so Xu Yanlin didn't say much, but looked at Zhou Cheng with a little envy.
He even stepped forward and said, "Brother Zhou Cheng, let me help you suppress it first."
Zhou Cheng nodded.
Then while slowly tearing the gauze apart with his right hand, his left hand went to the abdomen. After touching it flatly for a while, he pressed it firmly and deeply!
This is on the surface of the body. Press according to the shape of the blood vessels to stop the bleeding!
It comes naturally from knowledge of anatomy and is not a very advanced skill.
The application of manual pressure to stop bleeding during surgery is on another level and is not the same.
However, by compressing the proximal end of the artery break, the amount of bleeding can be greatly reduced.
Because the patient's blood pressure was not high, and Zhou Cheng's pressure was strong, there was not a lot of blood oozing after Zhou Cheng removed the gauze!
Then Zhou Cheng unexpectedly grabbed the proximal end of the femoral artery before Yan Haihan could.
"silk!"
The right hand was transformed into a loach-catching style, and a section of the femoral artery was quickly and neatly pulled out. It was pinched tightly between the thumb and index finger.
Then switch to the thumb and index finger of your left hand that was originally pressing the groin and pinch it tightly!
Lift it out slightly, then immediately take the two silk threads prepared in advance and quickly go around the blood vessel, tie it tightly and tie it into a semi-dead knot (refer to tying shoelaces, which are tighter than shoelaces).
Then the femoral artery was lowered! I flicked the stump of the blood vessel a little and saw no bleeding, so I let out a long sigh of relief.
He said to Xu Yanlin: "Relax your strength first, and I'll see if there's any bleeding elsewhere."
Yan Haihan's brows suddenly raised, and he couldn't help but speed up the movements of his hands slightly after discovering that Zhou Cheng had actually done the surgery in front of him.
However, Yan Haihan was so frizzy that he didn't have time to grasp the stump of the artery!
Suddenly, the arteries began to bleed!
Bunde Laogao!
Then it sprayed down, and part of it hit Yan Haihan's eye lenses directly.
Zhou Cheng was still looking for other blood vessel openings. When he saw this, he immediately reached across the operating table and grabbed the contralateral femoral artery stump with his thumb, index finger and middle finger.
It can be said to be stable, accurate and ruthless!
The bleeding stopped immediately.
But the blood sprayed out continued to fall down, falling on the floor of the operating room and on everyone's heads and shoulders.
But even so, everyone just glanced at Yan Haihan and saw that there was no more bleeding.
He did not walk away, but turned a blind eye to this scene and continued to operate.
What are you afraid of if you are sprayed with blood during the operation? As long as the scalpel is not placed on the neck and the patient does not have any infectious diseases, the operation will still be necessary.
This is the routine that surgeons should have.
Naturally, Yan Haihan couldn't be so calm anymore, and immediately took a few steps back, and then said: "Xiu Xing, come here and help me take off my glasses!"
The lenses were blurred, and the blood in the air immediately oxidized and turned black, blocking Yan Haihan's sight.
After Yan Haihan's glasses were taken off, he approached again. He didn't feel embarrassed, but his ears and cheeks were a little red. He took the proximal end of the artery pinched by Zhou Cheng's right hand, and then started ligating!
I cursed in my heart, today is simply a bad luck day.
Although the others did not move, Li Changhua and Wang Yaoxiang from the Department of Orthopedics looked at each other, and they could see ridicule in their eyes!
Yan Haihan actually made such a mistake, I don’t know what he was thinking!
But I didn't really take it to heart.
The femoral artery in the lower limbs is no smaller than the brachial artery in the upper limbs. One person can find the right place by pinching the armpit.
After Yan Haihan strictly tied the two silk threads, he couldn't help but look at Zhou Cheng who had helped him.
I discovered that after not seeing each other for a while, I saw that after Zhou Cheng opened the wound and exposed the femoral artery injury, he was still 'playing' with the femoral nerve and the accompanying femoral vein...
In fact, I was checking whether these two gadgets were injured.
It's just this skillful technique that made Yan Haihan become a monk.
MLGB, I'm undergoing surgery now, you're tossing and turning.
Only then, Yan Haihan saw again that the vascular forceps in Zhou Cheng's hand seemed to be fine. He pried it from nowhere and seemed to take out the inner great saphenous vein from the wound, and then removed the wound.
After the compression, blood gurgled out.
Zhou Chengcheng said: "Are there any sutures in vascular surgery? Open a few."
"Yes!" the circulating nurse replied immediately. Although she didn't know which surgeon in which department asked for it, she just wanted to follow the order now and didn't bother to care about it at all.
Yan Haihan and others immediately glanced at Zhou Cheng after hearing this.
This patient is going to have his leg amputated. What are you doing with the vascular sutures?
Of course, this also includes Li Changhong from the Department of Orthopedics.
Zhou Chengcheng said: "Director Yan, I think the plane of amputation can be moved slightly downward and closer to make it easier to install a prosthetic limb in the future. The arterial and venous breach here is not large and can be sutured."
Although it is an amputation, how much is left and how much is amputated are completely different.
Amputating a leg from the base of the thigh is an amputation, and amputating a leg from the ankle is also an amputation. The degree of functional preservation is completely different.
Yan Haihan heard this and felt it made sense.
Without saying much, Luo Yun secretly gave Zhou Cheng a thumbs up.
Although amputation is cruel, it is for the benefit of the patient to retain as much limb as possible. I'm afraid that's all that can be done now.
People in orthopedics are not very proficient in vascular surgery. Vascular surgery cannot solve the problem of blood vessels, so orthopedics can only try to leave as many stumps as possible to make up for it.
After Zhou Cheng got the vascular sutures, he quickly sewed up the great saphenous vein. There was only a small opening in the great saphenous vein. There was no need for the three-point vascular suture method of amputated limb replantation, and he quickly sewed up the great saphenous vein.
The saphenous vein was repaired.
The same goes for the femoral artery…
After hearing Zhou Cheng's words, Yan Haihan felt secretly in his heart. If Zhou Cheng had not said this, then he really planned to amputate the limb from the injured place. It was simple and crude, but Zhou Cheng said this.
As the director, Yan Haihan was embarrassed to say that the scope of the amputation here was shorter than Zhou Cheng's, so he also asked for vascular sutures and then began to sew them up.
However, when Yan Haihan finished suturing, he was about to see what Zhou Cheng was doing.
Suddenly I discovered something not quite right——
Because Zhou Cheng is currently operating on the patient’s posterior tibia!
And his movements are skillful——
What is he doing?
After Zhou Cheng used a round knife to break the skin, he did not use a sharp knife to penetrate deeply. Instead, he used a vascular forceps to bluntly break open the muscle layer as if entering his own house, and went straight to the posterior tibial artery...
A minute later, the sharp knife punctured the blood vessel wall of the posterior tibial artery, and pulled out a thrombus strip the size of a little finger from the blood vessel cavity like a carrot, like a black loach...
Obviously, this is the arterial emboli that Zhou Cheng found in the downstream arterial branch of the femoral artery!
He's doing an arteriotomy and thrombectomy!
The expressions of Yan Haihan and Luo Yun changed immediately, and even the expressions of Li Changhong and Wang Yaoxiang were a little unnatural.
Zhou Cheng is performing arteriotomy and thrombectomy. How does he know where the thrombus is?
This is the first point.
The second point is, if Zhou Cheng now extends the scope of limb salvage to below the knee joint, what will they do?
Can the limb be amputated above the knee joint or above the elbow joint?
Doesn't this mean that you and others are worse than Zhou Cheng?
But what can we do if we don’t amputate the limb here? Will they be able to do what they are doing now?
Won't.
Yan Haihan regretted very much, regretted why he asked Luo Yun to come down, and also regretted why Luo Yun brought Zhou Cheng.
Zhou Cheng found Yan Haihan and Luo Yun looking at him.
Femoral artery thrombectomy is a branch of level II surgery, so Zhou Cheng can really do it!
Among the surgical authorities, arteriotomy and thrombectomy are also authorized within the orthopedics category.
Luo Yun took a deep breath and asked, "Do you know how to perform arteriotomy and thrombectomy?"
This is not asking, this is affirming.
Zhou Cheng was suturing the incision of the posterior tibial artery to remove the thrombus. He nodded and replied naturally: "Yes, Teacher Luo, after I obtained the Level II surgical authority, I watched the video to learn this surgery."
"Arteriotomy and thrombectomy is the 22nd item in the 2011 surgical classification list in my country, the orthopedic classification II surgical classification list..."
"So I thought I might encounter such an operation, so I went to learn from the video."
Although Zhou Cheng's words were very straightforward, direct, and even well-founded.
Even the National Health Commission was not called this name back then. The content was stated in official documents issued by the Ministry of Health.
I’ve told you a few of them.
Creak!
While Zhou Cheng was speaking, he clearly heard several harsh sounds of rubber slippers rubbing against the ground!
Such a refreshing and refined reason!
It really caught Yan Haihan, Li Changhong and others off guard.
My heart muscle almost died.
After you obtained the Level II surgery authority, you followed the Level II surgery list of the Ministry of Health and learned it one by one?
Is this too much?
Actually it's not too much.
It's just that I don't know how to say it.
…
The muscles at the corners of Yan Haihan's and Li Changhong's mouths became whole like cardiac muscle, and began to twitch at the same time.
Either twitching or not twitching, very uniform.
Luo Yun took a step back, not quite able to stand still.
Zhou Cheng really dares to say——
Then excuse yourself and speak out on this occasion.
Then they saw Yan Haihan and Li Changhong glance at Huang Shinan intentionally or unintentionally, their eyes full of weirdness and complexity...
Brother, why don't you come over and see if this is your surgery?
Huang Shinan felt that today must be the end of him. First, a lot of bad luck fell from the sky like no money.
Then, an orthopedic surgeon named Yang Yifeng appeared in the middle and played the role of savior for half a minute.
After asking him to be the surgeon, he forcibly refused.
Now a little orthopedic surgeon has come out to make a fuss!
Oh my god, which god did I clash with today?
I learned it from online surgery videos, so I know how to do it.
Does it mean that I, Huang Shinan, didn’t follow the surgery videos on the Internet, so I don’t know how to do it?
Then, Zhou Cheng continued the next step of the operation, which was to sew up the opening of the artery!
Then he released the ligation thread and saw that the posterior tibial artery began to fill and there was no blood leakage.
Immediately follow the course of the posterior tibial artery with your hands and feel the beating of the artery from top to bottom!
The course of the femoral artery is from the outer superior to the inner inferior, while the beating of the posterior tibial artery extends posteriorly toward the lateral malleolus.
Therefore, when Zhou Cheng's hand reached down to the dorsalis pedis artery, he was immediately startled.
Then he retracted his hand in disbelief and tried again with his left hand.
I also felt the pulse of the dorsalis pedis artery!
Now Zhou Cheng began to get entangled, and whispered to Luo Yun: "Teacher Luo, I actually just want to stay longer."
"But now the dorsalis pedis artery is already pulsing."
"Can this still be amputated?" Zhou Cheng asked Luo Yun sincerely.
But after hearing this, Luo Yun rolled his eyes almost to the top of his head...