The spleen is the most easily injured organ in the abdomen, and the amount of bleeding after injury is huge. Moreover, the principle of rescue for this kind of compound injury is: save life first, preserve the organ second. When Zhang Fan did the inspection, he already knew that neither the spleen nor the left kidney could be saved.
It's hard! Very cruel! Life or kidney or spleen? Such a young body will be in disrepair from now on. Illness will accompany him throughout his life. What Zhang Fan can do now is to minimize the injuries of the injured while ensuring the lives of the soldiers.
The splenic artery must be ligated first to reduce blood loss and allow a large amount of blood in the spleen to flow into the circulating blood, making it the best autologous blood transfusion. During the operation, Zhang Fan first incised the gastrocolic ligament and gastrosplenic ligament and ligated the blood vessels in the ligaments one by one, entering the lesser omentum cavity to expose the body and tail of the pancreas.
The pulsating splenic artery is palpated at the upper edge of the pancreas, and a bulging part of the splenic artery is selected at the junction of the body and tail of the pancreas. The retroperitoneum is incised, and the splenic artery is carefully separated with right-angle forceps and tied with a thick silk thread. When ligating the splenic artery, it is necessary to tie it twice. The ligation should not be too tight and should be enough to close the lumen to avoid tearing the artery wall. In addition, care should be taken to avoid damaging the parallel splenic vein below it.
Only Ye Bo could help with this operation, and the remaining two doctors could only pull the hook. On Zhang Fan's side, during the emergency operation, he heard Zhao Quanping's extremely loud voice coming from the table next to him: "Quick! Quiet push, Cidilan push quietly! Quick." From the tone of his voice, he heard He could hear Lao Zhao's anxious and helpless tone.
"Director Zhao is dying! The medicine has no obvious effect!" the anesthesiologist said.
"Shock cardioversion!"
"Bang! Bang!" The voice of electrical cardioversion. Zhao Quanping looked at the monitor expectantly, how much he hoped that the soldier's heart would beat again, but in the end he could not be rescued! Zhao Quanping clenched his hands tightly.
"Send him away!" Old Zhao said softly. The damage was too serious. The soldiers were really unlucky. After the shrapnel entered the abdomen, it caused great damage, but cruelty is cruel. It was not directly fatal. Instead, the soldier suffered tremendous pain before being sacrificed.
After sewing up the remaining wounds on his body, the nurse gently wiped the blood on his face, sorted out the tattered military uniform, and carried him onto a flat car! Covered with a white sheet, he was slowly pushed out of the operating room.
It's not a sad moment yet, there are still surgeries waiting, and there are injured people waiting to be rescued. "Doctor Zhang, how are you?" Zhao Quanping regained his composure and asked Zhang Fan while standing under the operating table.
His meaning is clear: Do you need help? Zhang Fan is not their ordinary young doctor. Zhang Fan's skills are no worse than his. This inquiry is a sign of respect for doctors of the same level.
"The bleeding is too severe. I have just ligated the arteries in the spleen and the kidneys have not been processed yet. Come up to the stage and help me." Zhang Fan can lose his temper and scold the assistant, but he cannot tell people who are not involved in the operation that the assistant is not good. , that would be humiliating!
The assistant was a bit out of rhythm, so Zhao changed into surgical clothes and returned to the stage. As soon as he came up, it was different. Zhang Fan didn't need to deliberately tell him what to do, including hooking, sucking blood, clamping, and tying knots. The two of them had a tacit understanding. Much faster, the spleen was removed, the kidneys were removed, and the abdominal cavity was cleaned.
Modern firearms are so powerful that just a scratch can cause a section of intestine to erode, become necrotic, and lose its function. "Hey! This wounded man won't even dare to eat a full meal in the future. What a pity!" The intestinal damage was also severe. Zhang Fan had to cut off a long section of the intestine. After the interception, Zhang Fan said in a lonely tone.
"It's okay. The abdomen of the wounded person I rescued was turned into minced meat. From the outside, the wound is not big and there is not much bleeding. But when you open the abdominal cavity, it is already a rotten mass. Hey! He is so young, I guess my children are a little older than him. Right. People have already gone to the battlefield to defend their families and the country, and that thing in my house hangs out in an Internet cafe all day long! It can’t even support itself!" Lao Wang also felt this. When a person gets old, in this special environment, when he looks at the soldiers who have just died, he will think of his own children.
Of the six patients, three were successfully rescued in the end, one of whom was Zhang Fan. One patient from the Department of Orthopedics had his thigh injured by an explosion. He had no choice but to have his leg amputated. The other one was shot in the upper chest. Fortunately, the single hole penetrated directly through the tip of the lung and smashed the shoulder blade. Although the injury was serious, it was not fatal.
Zhang Fan was particularly puzzled when he looked at the wounds of these soldiers. The contact surface was a wound as big as a sesame seed, but when he turned it over, he saw a wound on the back as big as a watermelon. This kind of injury is really difficult to deal with. The bleeding is fierce, and the organs fail very quickly. Some even beat the organs to pieces. This means that all the experts from the city hospital are dispatched. Otherwise, today's results will be even worse. The tragedy!
The county hospital has specially set aside two wards to house all rescue equipment. All kinds of instruments are gathered in this ward. Soldiers who have just undergone surgery and survived cannot leave the hospital and can only be observed and treated here.
Doctors and nurses from the city hospital have taken over their care and are accompanying them 24 hours a day. The leader of the municipal party committee specially told Ouyang, "Those who dare to sacrifice themselves in peacetime are even more valuable. They have done what a hero can do. We Heroes cannot be allowed to bleed and shed tears. I don’t know the specific profession, but I am here to express my position and let them recover at all costs. If you have any problems, please contact me directly. The municipal party committee will fully cooperate!"
After all, this is an emergency, and the superior leaders of the armed police have not arrived yet. It is the city leaders who make the decision here!
In the hall of the hospital, there were three flat cars covered with white sheets. Very young soldiers were lying on the flat cars. Although they tried their best, they still could not take back their lives from the hands of death.
The captain of the armed police, the tough man cried like a child. These are all his soldiers, one by one. Yesterday they all had meals and trained together, very lively, but today they are lying here cold and cold.
"Get up! Get up, all of you! If you're a man, just stand up!" There were sobs and bitter tears.
The iron-blooded warrior bleeds without shedding tears, but he has not yet reached the point of sadness. The laughter and laughter in the past, the sweat during training, and the scenes passed through these iron-blooded warriors, and tears flowed freely. A group of young-faced soldiers defended the chaotic border with blood and sweat. The purpose is to allow people to walk on the street freely and peacefully.
It's over, it's all over! Armed police in police uniforms and doctors in white coats stood on both sides of the flat car to see these heroes off.
"Brother! Way to go!" He took off his hat, saluted and bowed. The captain, who was almost exhausted from crying, felt extremely guilty in his heart. These soldiers were all trained by him! His kind of heartache is really incomprehensible to ordinary people, but there is no regret medicine in the world! He sent him to the battlefield, and he buried him! It’s not that soldiers can’t understand!
Pensions, disability payments, chronic pain that will accompany them throughout their lives, and the anguish of being unable to integrate into society are all the pain they have to bear. Are drugs scary? It's quite scary. This thing not only brings about an addiction problem, but also has too many negative consequences. AIDS and social instability are all caused by this thing.
The most beautiful frontier city ever had a huge number of AIDS patients! Why? It's because these chaotic countries bring a lot of smuggling and prostitution, and they speak the same language as many people. Once infected, it spreads through various channels, and the speed of spread is quite alarming. Drugs and AIDS have become a dark cloud over this peach garden.
Lao Zou woke up and it was over! When the operation was over, the county party committee directly ordered that he be removed from the post of director. Shi Lei came to the position. This former surgeon sat in the dean's executive chair, saying goodbye to the technical position once and for all.
The director of the ICU, the director of the respiratory department, and a doctor from the general surgery and orthopedics departments of the city hospital each stayed behind to continue treating the surviving soldiers. The others rushed back to the city overnight because they had to go to work and go to the clinic as usual the next day. No one's death can stop the sun from rising the next day.
On the way back, Zhang Fan and Zhao Quanping were in the same car. In the car that was silent for a long time, Zhao Quanping said softly: "What should their parents do?"
"Yes!" Zhang Fan looked out the window with blank eyes. This kind of disability was really shocking. They were really shocked when they lived in a peaceful environment.
They can only chat in the car now, because Ouyang has issued a gag order before getting in the car. This is because he is worried about causing panic among ordinary people. The war is so close, and if the people know about it, they will definitely feel fear.
With a normal life and a quiet job, Zhang Fan began to study English hard. After passing CET-4 in his junior year of college, he never touched English again. He had almost forgotten English and started from scratch.
Over the weekend, Director Li from the Department of General Surgery affiliated to Didi University brought his team and patients to Chasu Municipal Hospital. The hospital gate, outpatient building, and surgical building are covered with banners, all of which use the reputation of the University Affiliated Hospital to raise the slogan of the city hospital.
Along the way, Li Jingjin's face turned dark. This Ouyang was doing everything, and he was really a bit careless. But there was nothing he could do, because his skills were inferior to others.
The hospital conference room is a little better. The decoration here belongs to the equipment manufacturer. The venue is of high standard. The mineral water is imported. The gift prepared for the local and county doctors is a shopping card worth 200 yuan each. This equipment dealer is a rising star because its leader is young! There is no explanation for this.
So now we are spending a lot of money in order to open up sales. There were many doctors, hundreds of them, sitting in the large conference room of the hospital in darkness.
After debugging the lens and microphone, Ouyang personally presided over the meeting. "Dear experts and colleagues, first of all, welcome to Chasu City Hospital. On behalf of all the medical staff of the hospital, I would like to extend a warm welcome to you. Today, our hospital's doctors have the honor to operate on the same stage as Professor Di Da. Please Experts and scholars provide corrections and criticisms." Ouyang was in high spirits, how could she be unhappy! Huang has been engaged in surgery all his life, but has never been so prosperous. She has only been in office for a few days!
In the operating room, preoperative preparations were still being made. Professor Li's doctoral students were responsible for these things. He joked to Zhang Fan: "I will probably be criticized when I go back to Bird Market this time. You, Dean Ouyang, are really too good." incredible."
What can Zhang Fan say? It's not easy to talk to him. However, the director of the anesthesiology department answered: "Is the dean of Di University willing to criticize you? I heard that you were invited to the capital for surgery a few days ago. You are the general surgeon at the border area." He raised his thumb as he spoke. stood up.
"Hi! I'm ashamed. Do you know what kind of surgery I went to the capital for?" Lao Li looked embarrassed.
"What's wrong!" Zhang Fan was also curious. Zhang Fan wanted to help and make some pre-operative preparations, but Lao Li held him back.
"A leader with a special status in the border area contracted liver hydatid for some unknown reason. I was the one who diagnosed him at the time. I suggested that he have surgery at that time, and he said he would go back and think about it. The results came a week later. , Mr. Chen from Zhongyong in the capital called me and said that he had a liver hydatid surgery and wanted me to fly there to do it. Although we are a border hospital, liver hydatid surgery, to be honest, is estimated to be performed all over the world, let alone China. It’s considered top-notch.”
The anesthesiologist asked with admiration: "What next?"
"Then I got embarrassed! I flew over in a hurry and took a look, hey! Isn't this an acquaintance? It was that person, he was also embarrassed, he was thousands of miles away, hey!"
A few people were chatting and waiting for pre-operative preparations, but the two doctors brought by Lao Li were a little unhappy. They almost didn't have to do these things in the hospital affiliated to Di University, but when they came to a small city hospital, they actually started working as a resident doctor. And the most annoying thing was that the surgeon was younger than them. doctor.
They have been working hard in the high-end medical field of a province for more than seven or eight years. If they say that a small doctor in a small frontier city can perform this kind of surgery today, I really would not believe it. This completely overturns their work. It took more than ten years of hard work to obtain the academic qualifications.
Five years as an undergraduate, three years as a graduate student, and two years as a Ph.D., but the result is probably just a brat who has graduated from an undergraduate degree, sitting there chatting and kicking their tutor, and it seems that their tutor is a bit of a pleaser! Have we read our books in vain?
Those who can be brought out by the instructor to perform surgery, and it is such an important surgery, are all academic masters and top technicians. Although many of them are Ph.D.s, there are many who cannot even recognize the instruments.
Although I am dissatisfied, the instructor is sitting here, so even if I am extremely dissatisfied, I will not show it. Let's go on stage and watch. For those who are still studying for a Ph.D., the Great Master of Heaven and Earth is the greatest.
The operation began, and after the anesthesia was completed, Zhang Fan stepped onto the stage. Now Zhang Fan is really awesome. In a regional municipal hospital, wearing surgical clothes can make the head nurse of the surgery rush to put it on for him. He is really awesome. Ordinary department heads do not receive this kind of treatment.
"Doctor Zhang, what approach are you planning today?" Professor Li asked. Zhang Fan is too stable. If you don't ask him, he won't take the initiative to say anything to you. This made Professor Li a little depressed. A professor with many years of experience took the initiative to ask a junior doctor, and he was really blushing!
This was actually an injustice to Zhang Fan. He also felt that it was a bit embarrassing for a junior doctor to take the initiative to discuss surgery with a professor-level doctor. He was really a technical geek and was hopeless!
"Let's use the conventional approach. Professor Li, shall we start the operation?" Zhang Fan asked.
"Start, start!" It was an awkward conversation, and both of them were very embarrassed.
"Connect the camera, connect the headset! Connect to the conference room!" The staff of the technical department, after watching the surgeons start the operation, turned on the power and informed them to go out.
"Okay, the operation has begun. Please give me your advice!" Ouyang put down the phone and sat down where she was.
When the picture appeared, some of the doctors present couldn't help but say "Hey!" They originally thought it was the director of general surgery at the city hospital, but when they saw it, they saw that it was an unknown doctor, and a particularly young doctor. They were surprised. They couldn't even close their mouths. These doctors who were particularly surprised were actually doctors from other hospitals in the city.
The doctors in the county were also surprised. They didn't expect that Dr. Zhang, whom they hired for profit, could perform such a level of surgery. Some people couldn't help but say: "Zhang Fan! Dr. Zhang!" And those who said this also said Quite a bit, within one year, Zhang Fan had already become very famous in the county.
In just one year, Zhang Fan has carved out a niche for himself in the surrounding county hospitals. Although there is systematic help, without a strong liver and the ability to give up some of his interests, Zhang Fan would never be where he is today. fame.
When these voices gathered together, everyone in the venue knew that the surgeon was Zhang Fan!
When the operation started, Zhang Fan performed it quickly. He is already very proficient in this operation, and Professor Li has seen Zhang Fan's operation to remove a huge liver tumor. He did not know how many times he simulated it while lying in bed at night. This is talent, talented people who are constantly improving. Why can they stand at the top of a province's medical field? They don't have the spirit of hard work and rely on qualifications. You are overthinking it~!
Zhang Fan did it quickly, Professor Li was not bad at it, and the other two Ph.D.s were not given in vain. Various retractors and various surgical fields are done very well, almost comparable to the assistants in the system.
Because it was an observation operation, there was almost no communication between the surgeons and the whole process was silent. Moreover, doctors of their level did not need to communicate. There was no need for Zhang Fan to give any advice on what to do next.
Entering the abdominal cavity, Zhang Fan slowed down. When entering the abdominal cavity, he couldn't go fast. Slow is fast, a classic mantra of the general surgery boss. Start ligating bit by bit to stop the bleeding.
The head nurse of the operating room personally made rounds for Zhang Fan! In the observation hall, when the operation progressed to the abdomen and everyone saw the huge tumor, they couldn't help but exhale softly. It was too big and the position was so central. This kind of surgery, let alone being performed, was even mentioned in the surgical textbooks. Clearly written: "Unfit for surgery!"
But now, the operation that subverts their worldview has come. This is a small place on the frontier. The doctor's sorrow is that the sayings or practices that are regarded as classics may be outdated! But they don't know!
"After the operation is completed, it's up to the patient whether he can get off the operating table or not. Really! This Professor Li is also a bit crazy." The director of general surgery at another hospital in the city said to another director.
"I don't think so. I'm not very sure. Do you think Ouyang will make such a big show of it? I don't know if the operation will be successful, but what I know is that this woman is very powerful. She will definitely be fine."
A little bit of peeling, a little bit of hemostasis. The scary thing about tumors is that the tissue boundaries are unclear. To remove a one-cm tumor, you need to remove at least five centimeters or more of surrounding normal tissue.
Zhang Fan, who has average talent and average IQ, has finally reached the top of the regional and municipal hospitals. This surgery is his path to enlightenment.
He felt helpless after graduation, envied others for having a good father, and rode his bicycle around the world to find a job. Finally, his two years were not wasted. At this time, on this operating table, he was highly focused. He is already at the forefront of his peers.
Hard work pays off, as long as you fight and fight, even if you are in a mud pit or in the rain, sooner or later you will crawl out, and sooner or later you will see a rainbow, don't wait! Don't rely on it! You can rely on mountains to fall, and you can rely on everyone to fall. Only your own strength is truly powerful.
Two doctors from the Affiliated Hospital of Dezhou University couldn't breathe smoothly. They knew who invented this surgery, they knew the brilliance of this surgery, and they knew even more how difficult it was.
Today, just today, in Chasu City Hospital, a small undergraduate resident doctor taught them an unforgettable lesson about what is precise surgery and what is precise liver cancer surgery. Lao Li has the deepest experience. Last time he was a bystander, this time he is a participant. Is the operation difficult? It was really difficult. Without dozens of surgeries like this, he probably wouldn't be able to do it alone.
Because the tumor is too big and the location is too central, a little inadvertence could lead to either liver failure or incomplete removal of the tumor. The failure of this kind of surgery will not give you a chance to do it again. Once it fails, you will either die or the cancer cells will die. diffusion!
Slowly, when the last cut was made, Zhang Fan spoke.
