The operating table in the operating room is like entering the telecommunications department, with patients covered with monitoring equipment.
ECG monitoring, blood oxygen monitoring, oxygen intubation, gastric tube intubation, urethral drainage, suction tubes, venous suspension of plasma and liquids on the limbs.
Although the lines can't be called densely packed, it still makes people's scalp tingling just looking at them.
In particular, the transparent liquid and red blood vessels are divided into two ends like wires.
The invention of intravenous infusion can be said to be an invention that can bring patients back from the brink of death at a critical moment.
Many people are often curious as to why the infusion is not in the arteries but in the veins.
First of all, arteries are afraid of death. Larger arteries are generally hidden deeper, and it is usually very difficult to find them in an emergency, while veins are relatively superficial.
Secondly, the arterial pressure is relatively high, and it cannot be transfused without external pressure. If pressure is applied, it may cause the red blood cells in the blood vessels to rupture.
Therefore, for general emergency infusion, intravenous infusion is used. As long as the liquid bottle is raised above the head, it will be fine.
Under what circumstances should arterial infusion be selected? For example, when the patient's veins cannot be selected, arterial infusion, to be honest, is only implemented as a last resort.
But now many drug addicts, in order to obtain satisfaction more quickly, will insert arterial injections into the groin. Really, if this method is not careful, it will cause arterial bleeding, and the consequences...
When intravenous infusion, this life-saving treatment method, is fully used to treat common colds, people are speechless.
Can colds be treated with medicine?
no!
This thing is a self-healing disease. A common cold will recover if you don't care about it. The treatment is just to relieve the symptoms, such as nasal congestion and cough.
In other words, there is no difference between taking medicine and not taking medicine when it comes to colds.
"Knife!" The preparation for the operation was very fast, with almost no pause in the steps.
The patient's blood loss was so severe that the transfused fluid could not withstand the patient's outflow.
Zhang Fan took the scalpel and started to spread the wound along the patient's back.
If there is a fixed format for some abdominal surgeries such as appendix and gallbladder.
So this kind of traumatic rescue surgery is a surgery that doctors can use freely.
It seems that free play is easier, but in fact, free play is more difficult.
Over the years, generations of doctors have discovered, actively or passively, almost all the unexpected conditions that can occur near organs due to the fixed format of surgery.
Therefore, as long as you are serious and have a solid foundation, things like cutting blood vessels and damaging nerves will generally not happen.
But this kind of free play is no longer possible. Once you are not careful, it will make things worse for the patient.
The male owner of the optical shop had a wound on his back, and the white fascia and red muscles had turned out.
Like a little kid, she pouts and puffs out her lips, exposing the red lining of her lips.
It was like spitting and spitting, and the patient's wound was now spitting out blood.
The abdominal cavity of the human body is slightly larger than the atmosphere, and most people have probably never seen it.
When a sharp instrument enters the abdomen, the wound will feel like farting, and a gas will emit a smell that may or may not be smelly, but it is definitely not pleasant.
This smell can be called coquettish! Like the smell of rat urine after it evaporates on your hands.
"The blood doesn't coagulate, and the organs are injured. How are your vital signs?"
Zhang Fan traced the incision along the wound and looked at the non-coagulated blood, feeling anxious.
"The blood pressure cannot be measured, and cardiotonic drugs have been used!" Na Duo stared at them and reported to Zhang Fan.
Naduo was assigned to Zhang Fan's side to participate in the patient's shock correction, while Ren Li went to another operating room.
Now everyone knows that the patient's life is on the line of life and death, and any accident will lead to the patient's death.
The patient lay prone on the operating table. When the abdominal cavity was incised along the wound, the blood flowed out like boiled meat.
"Quick, big curved forceps!" Sure enough, the patient's spleen was inserted into a large hole in the wound, just like a smashed apple, and the wound took on the shape of a petal.
Taking the curved pliers, Zhang Fan directly stuffed his left hand under his spleen, with the palm of his hand facing up and the back of his hand facing down.
Then he used a little force to free the nearby tissue and the damaged spleen hilum. In an instant, Zhang Fan's palm was filled with bright red blood.
Without any hesitation, Zhang Fan clamped the entrance vessel of the spleen with a click and a huge curved forceps.
The curved forceps bit the veins of the splenic hilum like a crocodile. "Old Li, attractor!"
"Gauze!" Clamping the spleen hilum is not enough at this time, the spleen wound must be packed with gauze.
Lao Li, who was acting as the first assistant, took the suction device and put it into Zhang Fan's left hand. The suction device was like sucking watermelon juice.
He sucked the blood quickly, and the semi-coagulated blood clots in the blood were quickly sucked in through the transparent plastic pipe like the black seeds of watermelon juice.
"Increase the input volume and see if urine is produced? The wound has been clamped. Replenish the blood volume quickly and raise the blood pressure as soon as possible."
Zhang Fan frowned and gave orders to the anesthesiologist and internist while performing the operation.
"No urine seen, use diuretics!" The internal medicine correction shock team felt much more relaxed when they heard that Zhang Fan had stopped the bleeding.
If there is no rescue to stop the bleeding, filling in a large amount of liquid is like boiling the soup to stop it from boiling.
It can only be used to maintain the patient's fragile blood pressure and electrolytic balance that is facing collapse. There is no way to solve the fundamental problem.
Now that the bleeding from the wound has been stopped, they can show off their skills. But Zhang Fan didn't feel relaxed at all, because the patient's spleen was severely damaged.
In Western medicine, if you choose to represent the organs of the human body, you can use the heart, lungs, liver, kidneys, and brain plus the gastrointestinal tract to represent them.
The heart and lungs are not separated, representing the respiratory and vasculature systems, the liver represents secretory immunity, and the kidneys can represent the urinary system.
The brain can represent the central nervous system, and the gastrointestinal tract represents the digestive system.
So, which system does the spleen belong to?
According to traditional Chinese medicine, the spleen transforms water and grain into essence, which is then distributed throughout the body.
Huangdi Neijing Neijing Suwen says: All dampness, swelling and fullness belong to the spleen.
Generally speaking, when a person becomes swollen, the problem lies in the spleen.
The ancestors of China at that time didn't know if a plug-in was used. How did they come up with it? Although it was very general, the explanation was also very general.
However, in recent years, Western medicine has slowly studied and clarified what the spleen does.
Earlier, Western scholars believed that the spleen function was very important during the fetal period as it was the hematopoietic system.
After adulthood, its function is replaced by bone marrow, so it is a useless organ in adults.
In the past few years, I have gradually discovered the function of the spleen. First of all, the spleen can not only continue to produce blood in critical situations, but also when the bone marrow of the younger brother cannot produce blood.
It can also filter blood. When the body's red blood cells age, the spleen will eat these old red blood cells.
When this function becomes hyperactive, it not only eats aging red blood cells, but also healthy red blood cells, causing refractory anemia.
While it eats red blood cells, it also stores blood. When the human body is excited or ischemic, it releases the stored blood.
Therefore, when there is hot blood in the head, this blood comes from the spleen.
There is a more important function: immune response.
After the human body is infected by bacteria or parasites, various combat factors in the spleen will be released, and it not only releases combat factors.
For example, the spleen can eat malaria parasites like jelly beans. It is a very overbearing organ.
Therefore, this thing is actually an armed part of the body.
However, its texture is not that good. It is very fragile, just like the freshest radish. If you drop it and snap it, it will definitely break into eight petals.
Although it is hidden under the ribs, of all the organs, it is the most susceptible to damage and rupture.
And this thing is not only easy to break, but if it is slightly damaged, it can easily lead to splenectomy.
There is a saying in surgery that spleen-preserving surgery is thrilling. It belongs only in noble surgical textbooks and should not appear in the operating room.
The spleen is such an organ that is flammable, cracking, and explosive.
In the surgical operating room, physiological function is the emperor, anatomical form is the queen, and the doctor, a mature surgeon, can only be a prince.
Everything must be done with the consent of the emperor and empress before doing something secretive, such as unofficial rules for a palace maid.
The shape of the spleen is like the subway in the land of meatballs during rush hour. It has layers of thin coats on the outside.
Just like the body fooling the body, of all the organs, its coat is the thinnest.
Inside this thin coat, the spleen tissue is fully stuffed, just like a plump woman who insists on wearing a smaller size of underwear.
I don’t know what the body was thinking at the beginning.
Under this kind of structure, sometimes, let alone a deliberate blow, an accident will cause it to break.
In the middle of winter, a man pulled his slender girlfriend, but she accidentally fell due to her high heels. He thought it was nothing, and the woman didn't feel any pain at all.
After walking for half an hour, the man patted the woman on the back and affectionately called her a little fool.
He slapped her affectionately, but no effort was used. In the end, he slapped his girlfriend and sent her into shock!
It can scare people to death. This is because the spleen was shattered when he fell, but the clothes outside the spleen were not torn.
When the bleeding became more and more, the clothes couldn't hold on any longer. With a pop, the clothes burst. It was like a massive hemorrhage, and the blood pressure dropped instantly.
Therefore, sometimes, for example, I am rubbed by a car or bumped from the back by a motorcycle.
Many people are careless and pat their butts and say it’s okay!
Don't be careless at this moment. It's not about getting into trouble. It's best to go to the hospital for an abdominal CT at this moment.
Because once the spleen is damaged, it is really difficult to save the spleen in the operating room.
It's not a top tertiary hospital, I can't even think about it.
"The blood pressure is up! Zhang Yuan, the blood pressure is up!" The anesthesiologist immediately reported the patient's vital status to Zhang Fan.
"Okay! Well, if there is still bleeding now, can you ensure that the patient's current condition is maintained?"
Zhang Fan turned his head slightly and asked Na Duo.
Upon hearing this, Naduo pondered for a moment, and then held an emergency meeting with several other physicians.
"If the bleeding is not very severe, it should be OK. However, if major bleeding occurs again, the patient's medication threshold has almost reached its peak, and it is estimated that he will not be able to survive."
Naduo told Zhang Fan the results of their discussion.
Surgery pays special attention to pre-operative discussions. For example, simple appendix and gallbladder surgeries are just mentioned in the morning meeting and are routine surgeries.
For other slightly larger surgeries, regardless of whether you are part of a team of doctors or not, as long as you are a doctor in the department, you must express your opinions at the morning meeting.
However, emergency surgery is not possible. For example, right now, spleen preservation or spleen removal is just a thought on Zhang Fan's mind.
Is splenectomy difficult? It's so simple that it was pretty much taken down by surgeons over a hundred years ago.
But what about preserving the spleen?
With the current technology and the current medical level, even the weaker top tertiary hospitals dare not mention it.
Don't ask, just ask and it will be settled.
This is not because doctors are irresponsible. When the spleen is destructively damaged, spleen removal can save lives.
But if spleen-preserving surgery is successful, the cost of surgery is higher than that of spleen-removing surgery, and the risk is quite high. If it is not done well, the spleen cannot be saved, and not even the person can be saved.
Therefore, the spleen is an organ that is really an anomaly in the human body.
Zhang Fan pondered, this was the first time this happened during the operation.
"Zhang Yuan, if it doesn't work, just have it cut off. I've already lost thousands of ml of blood through the blood transfusion. It's too dangerous!"
As an old doctor, Lao Li understands Zhang Fan and understands what Zhang Fan is hesitating about now.
"How was Director Zhao's surgery?"
Zhang Fan nodded slightly, but still asked one more question unwillingly.
"Their operation went very smoothly. The patient's shock was corrected and the blood vessels were repaired. It's almost over now."
The head nurse in the operating room responded immediately.
"Okay, let Director Zhao come over!" Zhang Fan made up his mind. Since he has the ability, he must perform the operation perfectly.
The organs of the human body are not leeks. Once you cut them, they will never grow again.
Now that he had the conditions and a certain degree of confidence, Zhang Fan decided to undergo spleen-preserving surgery.
Outside the operating room, the patient's family members burst into tears. The parents of the eye shop owner were out of breath while holding their little girl in their arms.
In the alley where the incident occurred, the owner who bought dried fruits could not suppress his heartbeat.
Normally, he could be considered a tyrant due to his physical strength, but now he couldn't even hear the sound of metal clanking.
As long as there is a crisp sound of metal hitting, the urge to pee surges into his heart and he can't hold it in!
In the operating room, Lao Zhao also went to Zhang Fan's operating table. The director of general surgery is not given for free. Although the surgery is not as good as Zhang Fan, there is still life in his eyes.
Zhang Fan asked Lao Zhao to take a look as well.
"How about it?"
Zhang Fan asked.
"Zhang Yuan, you can give it a try and I'll help you."
"Okay! Who will be the second assistant?"
"Zhang Yuan, I'll do it!" Although Lao Li supports spleen removal, now that the surgeon and director have decided to preserve the spleen, he must go all out.
This is the hospital, this is the operating table, and the assistant can have opinions or even reservations.
However, when the surgeon makes a decision, no matter whether you object or not, you must go all out to complete the order of the surgeon.
Therefore, a qualified surgical surgeon is very valuable in the department and even in the hospital.
Internal medicine can discuss around the patient and slowly study medication together, but surgery cannot. In a short period of time, someone must stand up and take responsibility for what needs to be done.
Therefore, surgeons pay attention to one inheritance and one level, because their experience can be said to be acquired through one life after another.
"Okay, let's start! Start preserving the spleen."
"Start!" Lao Zhao also gritted his teeth and roared softly.
Just like the shout before a charge, the low shout made everyone concentrate.
The wound on the spleen was displayed in front of them like the petals and stamens of a flower. They began spleen-preserving surgery.
The female owner of the eye shop also woke up slowly under the urging of the anesthetist.
Looking at the white wall above, her heart was full of regrets, all kinds of regrets mixed together.
Tears filled her eyes. Looking at the nurse beside her, she didn't even have the courage to ask her husband.
She didn't dare to ask, for fear of hearing bad news.
Really, the thing that money can’t buy in this world is the medicine of regret.
