A spleen that was broken like watery tofu. Xie Wanying recalled the test questions that Senior Brother Tao gave to the surgical students. The real-life surgery scene was much more severe than the test questions that Senior Brother Tao had given. This kind of spleen could not be re-sewed back together with a few needles.
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For grade three or four spleen rupture, total spleen resection is the only option.
If the entire spleen, including the splenic hilum, is removed, doctors need to consider it more carefully, considering the child's young age and future growth space.
Xie Wanying remembered what she had said to Wen Gui. Although she and her family members spoke very rationally, they were emotionally unbearable.
"Teacher Nie. The OPSI of children is very high, higher than that of adults. This may be due to the complete removal of the spleen. If the spleen is preserved, it will be of greater significance to the child. The spleen not only stores blood, but also has
Hematopoietic function and irreplaceable immune function for a period of time, as well as anti-tumor function in the future." After Xie Wanying said these words, she also knew that she only had this little time for the teacher to consider. Now it can only be decided by the teacher. The teacher's decision
I have more experience than she does, so I believe I can make the best choice for the child.
Total resection is a one-and-done solution. If the spleen is to be preserved, the only way to preserve the spleen in this case is autologous spleen tissue transplantation. The biggest problem with autologous spleen tissue transplantation is the postoperative period.
It is true that children need to pay more attention to OPSI than adults, but autologous spleen tissue transplantation also has the risk of necrosis and infection. Moreover, long-term postoperative dynamic observation is required to see whether the children have recovered their spleen function. This requires professional doctors to keep an eye on
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If the patient had the surgery in their own hospital, it would be easy to predict the follow-up. But it is not the case now. It is hard to say whether it is possible to ensure that professional doctors will be responsible for the follow-up treatment of this child. With the conditions of the county hospital, he saw what happened tonight with his own eyes.
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Taking this into consideration, Nie Jiamin had already made a decision before the operation. If the problem could not be solved, he would have to perform a total resection.
Unexpectedly, the student opposite suddenly mentioned this to him.
"Didn't you consider other issues?" Nie Jiamin asked her deliberately. Because he knew that she was capable, he hoped to guide her to be more considerate and careful as a doctor in the future.
"Teacher Nie." Xie Wanying cooperated with the teacher's manual operation without stopping. The teacher-student cooperation is to free the splenic pedicle. This step must be done regardless of whether the spleen autologous tissue transplantation is done. On the other hand, she continued: "If it is a postoperative
I personally don’t think you need to worry too much about the problem. It’s not far from the capital, and it’s okay to let them come to the National Association for follow-up treatment.”
It seemed that she knew what he was worried about. He was not sure how domestic patients could be transferred to another hospital or whether they could be transferred after surgery. He asked, "Do you think she can be transferred to the National Association?"
"She was a patient in a car accident, and the driver responsible for the accident has to pay for her medical expenses."
The first criterion for whether domestic patients can be transferred to another hospital is whether they have enough money. Nie Jiamin understood what she said and said to her: "Overseas, you need to check insurance."
Maybe Teacher Nie was touched after hearing Qian, felt deeply about it, and started talking to her about the situation abroad.
After the obstacle is resolved, the patient will be given a splenic autologous tissue transplant. Three vascular clamps are placed close to the splenic pedicle of the splenic hilus, the splenic pedicle is cut between the two hemostats near the spleen, and the splenic pedicle is disconnected with the vascular clamps.
The spleen was placed in a balanced solution prepared at 4 degrees Celsius outside the body.
First, the blood vessels of the splenic pedicle were double-ligated to fully stop the bleeding. The blood finally stopped flowing like a fountain. The abdominal cavity was checked to find no rupture and bleeding of other organs. The child's blood pressure stabilized.
