On the operating table, Director Leng was already ready for laparotomy. When he saw Dr. Xin's arrival, he immediately gave up his position as the surgeon and quickly introduced the situation:
"28 weeks pregnant, the fetus has died in the abdomen. Two deep vein passages have been established for rapid fluid replenishment and volume expansion, but the blood pressure still has not risen, only 76/58,"
Xin Yue's face became more serious. After rehydration and volume expansion, the blood pressure still cannot rise. There is only one reason: the bleeding in the pregnant woman's body continues.
Fetal death and hemorrhagic shock in pregnant women. This was a third-degree placental abruption, and the dead baby had to be removed by cesarean section immediately.
But before that, although she knew there was little hope, she still wanted to ask one more question: "Where is the blood bank?"
How could Director Leng not understand what she was asking.
She had arranged for someone to control this matter early on: "There is no more type B blood."
This is too much trouble. Open abdominal surgery, no matter how light the incision is, there will still be bleeding. Coupled with abnormal coagulation function, isn't this adding insult to injury?
But wait. Things were different now, and she had other options.
Xin Yue remembered the large bag of needles that she had just carried in without letting go.
"Quick, go to the locker room, get the pack of needles I put there, and disinfect them, quick!"
"By the way, we need to get the coagulation factors right away - I saw they were in stock this morning - and oxytocin, and prepare gauze soaked in hot salt water."
The circulating nurse moved quickly. Xin Yue immediately took four filiform needles and carefully inserted them into several acupuncture points on the mother's chest and lower abdomen. Leng Qi's mind was filled with questions.
"Is this what you went to learn just now?" She finally remembered that there was such a training class in the courtyard tonight, and it was her subordinate Tao Le who gave the lecture.
"Yeah." Xin Yue answered simply and clearly. There was actually a lot of sweat in her palms, and she felt extremely nervous.
What I learned today was just an introductory course. I spent most of my time familiarizing myself with the meridians and acupuncture points. I only learned a superficial knowledge of acupuncture and hemostasis, and I never encountered problems with intrauterine bleeding such as placental abruption.
She dared to perform the acupuncture like this only because Teacher Tao in the space had explained the principles of bleeding in the lower abdomen, which meridians should be sealed, and also pointed out a few commonly used acupuncture points.
The scalpel was very sharp and gently scratched the epidermis - the incision was clean and not a drop of blood seeped out.
This not only greatly improved Xin Yue's confidence, but also amazed Director Leng, the anesthesiologist and nurses in the operating room.
Next, she opened the uterus in layers and took out the dead baby.
At this time, Director Leng glanced at the monitor next to the operating table, and his face suddenly showed joy:
"Dr. Xin, your acupuncture is quite good at controlling pulse and stopping bleeding! The patient's blood pressure has risen!"
Xin Yue turned around and looked, it was really true!
My blood pressure, which had never improved with two-way rehydration before, has now risen to 90/65, and is still rising slowly!
"It actually stopped the bleeding!" Xin Yue looked at the few needles and felt extremely happy in her heart.
Blood pressure is back! From this moment on, the balance of life and death began to tilt towards their side! This is really rare good news!
The most important thing is that she knows very well that she has only learned a superficial knowledge, but it can be of such great use in actual combat, creating possibility out of the impossible.
If you learn the entire course, master it, and become proficient, what will you achieve?
Solving the bleeding problem is like getting a cheating device for the obstetrician and gynecologist. It is so useful!
With great difficulty, Xin Yue came back from her excitement and turned her attention to the mother.
The dead baby was taken out, and the rest of the womb was filled with a mixture of amniotic fluid and blood.
She sighed and looked helplessly at the blood recycling machine pushed over by the nurse: "This kind of blood cannot be recycled and reused."
Both she and Director Leng had often used this kind of equipment in Beijing before, but this was the first time she saw it in Tibet.
The one in front of her looked slightly different from the ones she had used before, but it was still that kind of thing in its bones. She thought there was nothing she could do about this kind of contaminated blood.
Unexpectedly, Leng Qi did not agree with her words.
"This blood recycling machine is different from the ones we used before. Even if the blood is seriously contaminated, after recycling and cleaning, it can be restored to autologous blood and directly transfused."
"How is this possible?" Xin Yue was extremely surprised. If there is such a good thing, then the threshold for blood recovery will be equivalent to a huge drop, which is simply good news for trauma patients.
"I didn't believe it before. But it is the fact. This device from Miao Technology is simply amazing."
As Leng Qi spoke, he operated the negative pressure suction device to suck the fluid in the uterus into the blood storage tank, and then go through a specific centrifugal cleaning process to separate the waste fluid and then infuse the clean blood back into the patient's body.
On the monitor, the patient's blood pressure continued to rise, and soon returned to 100/75, and his heartbeat became more and more stable.
At this time, everyone in the operating room dared to take a long breath of relief.
The life of the mother is now basically guaranteed.
But things aren't quite over yet.
After the amniotic fluid and blood were sucked away, the uterus and placenta, which were covered with blue-purple ecchymosis, were revealed.
This is because the postplacental hematoma increases and the pressure increases, and the blood infiltrates into the uterine muscle, causing muscle fiber separation, rupture and degeneration. When the blood penetrates into the uterine serosa layer, it is commonly known as uteroplacental stroke.
Xin Yue has rich experience in this situation.
The mother was injected with anticoagulant factors, the placenta that had already peeled off was removed, the wound on the peeled surface was sutured, oxytocin was injected, and gauze soaked in hot salt water was taken out and massaged to assist uterine contractions.
After some hard work, the uterus gradually began to contract on its own.
This means that the last resort - hysterectomy will not be used.
Everything is changing for the better.
"That's it." Xin Yue let go of the massaging hand and said happily: "The blood pressure is under stable control. The operation was successful, and now all that's left is sutures."
"Yes." Leng Qi also smiled: "I didn't expect that acupuncture and moxibustion to stop bleeding can be so effective - I will also take the initiative to sign up to learn it in the next issue!"
The instrument nurse handed over the needle holder. Xin Yue was about to reach out to pick it up when her heart suddenly shook. Then her vision went dark and she fell softly to the ground.
"Dr. Xin!" Exclamations rang out in the operating room.
Gan Yi was outside the operating room, accompanied by Duoji, who acted as a translator, and together they comforted the patient's family members.
This was a dark-faced and red-faced Kham man, with his hair covered in small braids and a red hero knot underneath, but he was crying profusely.
