Hu Xiaotian said: "This warm water is for you to soak your hands, otherwise the blood vessels will shrink later and the blood will not flow out."
Hu Jinniu saw more and more blood in the copper basin, and said with a trembling voice: "My family... how much more do we need?" Now he knew he was scared, and he actually took the initiative to get close to Hu Xiaotian.
Hu Xiaotian said: "Don't worry, generally speaking, the weight of human blood accounts for eight percent of body weight. You weigh two hundred kilograms, right?"
Hu Jinniu shook his head: "One hundred and eighty!"
"Let me do the math, that means you have fourteen kilograms of blood in your body. According to my experience, you will die only if you lose two-thirds of the blood. That means you will die only if you lose nearly nine kilograms of blood. This is the time when you lose two-thirds of your blood."
It won’t weigh more than half a pound, so don’t worry, it won’t die in a while.”
Although Zhou Wenju knew that Hu Xiaotian was teasing Hu Jinniu, he still admired his profound medical knowledge. He didn't expect that he knew so much at such a young age, and could even calculate the amount of blood in the human body. How did he know that Hu Xiaotian studied Western medicine?
, has an extremely solid foundation in human anatomy and physiology.
A normal person's blood usually does not exceed 400 ml at a time, but Hu Xiaotian gave Hu Jinniu nearly two kilograms of blood, which was estimated to be about 1,000 ml. Only then did he stop the bleeding and suture him. At this time, Hu Jinniu's face was pale, and his legs were
They were all soft. When Hu Xiaotian sutured his wound, Hu Jinniu felt as if he had escaped from death. The violence and hatred in his eyes when he looked at Hu Xiaotian were no longer there. Once a person regards the other person as someone who can control his life and death,
No matter what, it will no longer be prestigious.
Hu Xiaotian looked at the blood in the basin and said, "Although it's not enough, we can only make do with it."
After finishing the bandaging, Hu Jinniu staggered out with the support of the middle-aged scribe. He didn't even want to stay here for a moment longer.
At this time, the preoperative preparations were almost complete, and Zhou Wenju, the anesthesiologist, had also used golden needles to prick the acupoints and pour Mafei Powder into the injured person's body.
Everything is ready, all we need is Dongfeng, and all we have to do next is wait for the chief surgeon, Hu Xiaotian, to show off his skills.
Hu Xiaotian looked at the sleeping flower thief. He couldn't help but sneer, "Thief! If you fall into my hands, you will be unlucky for eight lifetimes."
Although he thought so in his heart, when he actually started to operate to save people, Hu Xiaotian had to use his best medical skills and state. Due to habit and medical ethics, when facing a patient, you cannot judge him by good or evil, just like
You have no right to sentence him to death on the operating table.
Cai/Hua Thief's physical condition is pretty good. He has no shock caused by anemia, or an imbalance of water and electrolytes, and he has no serious symptoms of infection. This is a problem that Hu Xiaotian is puzzled by. When he comes here
In one era, it was discovered that people living here generally have strong vitality, and even if they suffer severe trauma, they are rarely troubled by infection. Hu Xiaotian couldn't help but think of all kinds of infections in modern society. Perhaps it is directly related to the overuse of antibiotics in clinical practice.
The relationship between the two is as high as the Dao and as high as the devil. Some things are inherently mutually reinforcing and incompatible.
Due to limited conditions, Hu Xiaotian had to omit the steps of gastrointestinal decompression and enema before surgery. He had just asked a middle-aged scholar about his medical history and found out that the thief had not eaten a grain of rice or drank any water since last night.
Once you take a sip, there shouldn't be much of a problem.
The refraction principle of the copper mirror is used to ensure illumination of the surgical area.
The surgical patient was placed in a supine position. The patient was disinfected and draped as usual. Hu Xiaotian's surgical equipment was now much more complete. Zhou Wenju stood beside him, temporarily acting as an anesthesiologist and assistant. As for others, no one else was allowed.
enter.
Once Hu Xiaotian entered the operating state, he suddenly became serious. His mouth and nose were covered by a mask, and his hair was covered by a hat. Only a pair of eyes were exposed. At this time, his eyes were firm and convinced, and he took a deep breath.
With one breath, the whole person instantly entered the operating state.
Zhou Wenju stood next to Hu Xiaotian. Although he couldn't see Hu Xiaotian's face clearly, he could really feel a completely different temperament from Hu Xiaotian. Hu Xiaotian was holding the narrow lancet, which made Zhou Wenju feel...
He had only experienced this feeling from a few doctors in his life. But all of them were top figures in the apricot forest. Zhou Wenju really couldn't figure it out. A man who was only sixteen years old
How could a young boy of 20 years old have such a master-level aura?
Laparotomy. Laparotomy for abdominal injuries usually uses a midline incision in the abdomen, which can be extended up and down or laterally to both sides when necessary. The incision is about eight to ten centimeters long, with one-third located above the umbilicus and two-thirds located above the umbilicus.
Below the navel. Although Murong Feiyan stabbed the flower thief in the stomach before, the wound was narrow and Hu Xiaotian chose to make a new incision.
While Hu Xiaotian skillfully cut open the skin and muscles and separated the tissues, he introduced to Zhou Wenju: "The conventional detection principle of abdominal trauma is that if there is a large amount of bleeding in the abdominal cavity, the source of the bleeding should be found first, the bleeding should be controlled, and then the bleeding should be controlled.
The bleeding organs begin to gradually explore other organs. If there is no bleeding in the abdominal cavity and gastrointestinal contents and gas overflow, the gastrointestinal tract is explored first, and then the substantive organs are explored. The general sequence is,
First explore the stomach, duodenum, bile duct, pancreas, jejunum, ileum, colon, rectum, bladder, etc., then examine the liver and spleen, and finally explore the pelvic organs and retroperitoneal organs."
Some of these medical terms Zhou Wenju had heard of, and some he had never heard of at all. He knew the internal organs. As for the subdivision of the small intestine and colon, that was all a matter of modern medicine. How did he know? As for these organs inside the human abdominal cavity
, he has only seen it a few times and has never dissected it himself, so he has no way of being familiar with these internal organs.
It was impossible for Hu Xiaotian to instill all the anatomy knowledge into Zhou Wenju in a short period of time. He just talked about what came to mind. However, it had completely changed Zhou Wenju's view of medicine and allowed him to see a whole new field.
When Hu Xiaotian cut outside the peritoneum, he observed carefully that the injured person's peritoneum turned dark blue. This phenomenon proved that the patient had intraperitoneal bleeding. Gas escaped when incising the peritoneum, which proved that the injured person should have perforated hollow organs.
.Cut the abdominal muscle layer and let Zhou Wenju help separate the rectus abdominis with a retractor to expand the surgical field of view as much as possible.
Looking at the large piece of blood in his stomach, Zhou Wenju felt his scalp numb. Hu Xiaotian was not surprised. He smiled like a normal person and said, "It's full of bad blood."
After preliminary observation and judgment, Hu Xiaotian began to remove blood and exudate from the abdominal cavity. Due to the lack of a suction device, not long after arriving in Qingyun, he specially asked a craftsman to make an iron tool similar to the shape of a needle tube, which was more like a child's pump.
Gun, this simple suction device can suck blood, gastrointestinal fluid and exudate from the abdomen.
During the suction process, Hu Xiaotian discovered the bleeding point. He asked Zhou Wenju to compress the bleeding point with his hands, then took out the hemostat, clamped the bleeding point with the hemostatic forceps, and quickly performed blood vessel ligation and suturing. Preliminary removal of intra-abdominal fluid or
After the blood accumulated, Hu Xiaotian began to explore the intra-abdominal lesions. The principle of exploration was to explore the normal areas first and the diseased areas last. The exploration techniques were kept gentle and meticulous.
After ruling out lesions in the liver, esophageal hiatus, spleen area, stomach, and pancreas, we focused on the small intestine, pulled the transverse colon and its mesentery upward, and after confirming the duodenal suspensory ligament, we lifted out the duodenum.
The jejunal flexure is inspected in sequence from the beginning of the jejunum. While inspecting the small intestine, check the corresponding mesentery for blood circulation disorders and other conditions. After the inspection, return the inspected intestinal segment to the abdominal cavity in a timely manner.
The jejunum is connected to the duodenum, accounting for two-fifths of the small intestine, and is located in the upper left part of the abdominal cavity. The patient's problem occurs here. Murong Feiyan's sword pierced his abdomen and also pierced the jejunum.
part of the intestine.
After determining the location of the affected area and making a clear diagnosis, Hu Xiaotian decided to perform partial intestinal resection and perform intestinal anastomosis.
He first determines the scope of the intestine that needs to be removed and carefully lifts it out of the incision. The usual surgical principle is to cut off the intestine three to five centimeters near and far from the diseased site.
Hu Xiaotian carefully lifted the injured intestine out of the incision, and used a large warm saline gauze pad to separate the intestine from the abdominal wall. Two pieces of dry sterilized gauze were placed under the gauze pad to completely separate it from the incision, which could minimize the risk of
Damage to the small intestine and prevents intestinal contents from contaminating the abdominal cavity.
Watching Hu Xiaotian pull the organs and intestines of the injured person's abdomen back and forth, Zhou Wenju couldn't help but break out in a cold sweat. Fortunately, he was mentally prepared for this. If he were an ordinary person, he would probably regard Hu Xiaotian as an idiot.
The demon with broken intestines was so frightened that he fainted.
One of the first key steps in resection of the intestine is to deal with the mesenteric blood vessels. Divide a gap on both sides of the main mesenteric blood vessels supplying the resected segment to fully expose the blood vessels. Clamp the blood vessels with two curved hemostats and cut the blood vessels between the forceps. When cutting,
Close to the distal end, use silk thread to ligate the distal end first, and then ligate the proximal end. After the first ligation, do not loosen the proximal end hemostatic forceps, and use silk thread to make a figure-8 shape on the distal side of the ligation line.
Suture and tie. Finally, the mesentery is cut in a fan shape.
Before cutting off the intestine, you must first separate the mesentery at both ends of the retained segment of intestine by half a centimeter. Then check the blood supply of the retained intestine. Use straight hemostatic forceps to clamp both ends of the segment of intestine to be resected, with the tip facing the mesentery.
It is tilted at an angle of about 30 degrees with the longitudinal axis of the intestine. The purpose of this is to enlarge the anastomosis and ensure blood supply to the anastomosis. Then use intestinal forceps to clamp the intestine three to five centimeters away from the incision edge. The clamp should not be too tight.
If it is too tight, it should be just enough to block the outflow of intestinal contents. Use straight hemostats close to both ends to remove the intestine. (To be continued...)
