Chapter 94： Posterior peritoneal hematoma
Into the ICU, Zheng Ren immediately felt that countless hostile eyes aimed at himself.
What's wrong? Zheng Ren is very different.
It is said that I have no complaints with the ICU in the long run, and there is no hate in recent days. They...
"Director Pan, you are here." An ICU doctor walked over to Director Pan and Zheng Ren and began to introduce the condition.
"The patient was sent to the five wards of the orthopedic surgery at 9:18, and the diagnosis was a pelvic fracture. The blood pressure was 100/60mmhG, and the blood pressure was 85/45mmhG after one hour. Considering the fracture combined with massive bleeding, emergency pelvic CT , showing a large area of retroperitoneal hematoma. After ICU consultation, transfer to continue treatment."
The report of the medical history is very detailed, and the patient's condition is relatively simple. It is a pelvic fracture with hemorrhage, and there is no problem of differential diagnosis.
Pelvic fractures are generally not heavy, and it can be done for a period of time. There is very little need for surgery.
This is due to the structural characteristics of the pelvis itself. There will usually be bleeding in the fracture section, with a small or medium amount of fluid. This does not require special treatment, and it is sufficient to give hemostasis drugs and antibiotics.
However, once the pelvic fracture causes rupture of the blood vessel, the blood vessels pierced by the fracture end are the internal and external iliac vessels and the pelvic venous plexus.
These blood vessels are located behind the peritoneum and bleeding is entrapped in the posterior peritoneum. In most cases, when the ruptured arterial blood vessels are not large or the venous bleeding occurs, the local pressure will increase, which will stop the bleeding.
But...
This time the patient's condition is quite special, and one hundred patients with pelvic fractures may not be able to pick out such a case.
The vascular injury of the posterior peritoneum is more serious. Considering that the larger arterial vascular rupture, the pressure can not stop the bleeding, the patient's blood pressure continues to decline, and enters the hemorrhagic shock state.
Even more difficult is that because the posterior peritoneal pressure is very large, it is impossible to use surgical methods to stop bleeding.
As long as everything is open after the peritoneum, the blood in the area is under great pressure and immediately slammed into the roof.
When Zheng Ren’s heart moved, he saw Su Yun’s chair, sitting next to the patient, holding a pen and paper in his hand, and calculating what was going on.
After the hangover, he couldn't see a little bit of alcohol, but it was a little decadent.
But when this sense of decadence comes to the face of the handsome face, it doesn't have a taste.
"Look at the patient first." Director Pan Pan did not move, striding to the patient, observing the vital signs and the emergency CT film handed by the doctor next to him.
"The pelvic fracture combined with pelvic artery rupture, posterior peritoneal hematoma." Su Yun heard the voice of the old director Pan, looked up but did not stand up, did not look at the director of the old Pan, but looked directly at Zheng Ren.
Zheng Ren knows what he means.
The patient's condition is not suitable for surgery. He can only stop bleeding by interventional surgery, and then decide the next treatment plan.
Su Yun is very accurate in judging the condition of the disease. How to treat Yemen is clear, this guy is really not simple.
"Xiao Zheng, is it sure?" Director Lao Pan did not know much about the intervention, but after the emergency treatment of the placenta exfoliation, he went home and bought a book related to this intervention.
He doesn't ask himself to do it. At the very least, he has to know if Zheng Ren can do it.
Young people sometimes feel impulsive, or they have to get old comrades to help.
The pelvic fracture combined with retroperitoneal hematoma and hemorrhagic shock is one of the indications for interventional surgery.
However, Director Pan still hesitated. After all, he did not personally do it. This kind of thing still depends on Zheng Ren.
"No problem." Zheng Rendao: "Prepare blood, prepare for surgery, push the patient into the intervention room."
The dark hair of Su Yun’s forehead floated, and the feeling of decadence in his eyes disappeared and he began to get excited.
Zheng Ren is alert, what does this gun want to do?
"I am going to give you a match." Su Yundao: "This is the order of infusion, don't mess up."
Su Yun handed the paper to the nearest nurse and explained it.
"Is the infusion order calculated according to the urine specific gravity?" The little nurse took the paper and glanced at it. Some regretted to say: "Yun Ge, you are really white when you go to the emergency department."
"Oh." Su Yun did not argue, just smiled, the black hair fluttering in front of the forehead, handsome.
Zheng Ren didn't have time to look at Su Yun's intentional and unintentional sisters, but Su Yun still has a set. According to the urine specific gravity, the order of input crystal and colloid can be effectively used to deal with the environmental disorder in hemorrhagic shock.
If it is martial arts, this is a relatively high level of secrets.
Because the network is now developed, this formula is also described on the Internet. But the problem is that if you calculate the urine specific gravity, you need a lot of formula calculations, which is beyond the cognitive scope of medical students.
Moreover, it is also a way of exhausting people to continuously check the urine specific gravity and repeatedly adjust the order of infusion.
Therefore, all who can do this are cows.
This guy can, Zheng Ren and Lao Pan, greeted him, then left the ICU, went back to the operating room, and prepared surgical instruments.
After the operation of patients with placental exfoliation, Director Pan Pan went into the process of entering a group of consumables that Zheng Ren needed.
This time, Zheng Ren does not have to face the horror of isolation and helplessness again. Not only consumables, but even assistants, but the assistants are not so satisfied.
......
......
Back in the emergency operating room, Zheng Ren began to prepare things.
Shea people came to help, she took the time to learn all the knowledge about interventional surgery, it seems that this girl is ready to enter the operating room to give Zheng Ren an assistant.
Zheng Ren will definitely not agree, and it is not a circulatory operation. The patient will have a cardiac arrest at any time. Why should one more person go in and eat the line?
As for Su Yun ~ www.novelhall.com ~ he wants to help, Zheng Ren will certainly not stop.
One is an annoying and savvy, and the other is a sister who is intimate and handsome. I tend to think that I don’t have to think about it. Zheng Ren is very straight.
There aren't a lot of instruments needed. After all, it's just a plug embolization surgery. In interventional surgery, this is just a simple procedure.
After fifteen minutes, Zheng Ren heard the sound of the flat car coming.
At this point, the preoperative preparation of the interventional operating room has been completed.
The patient was gently lifted onto the operating bed to avoid secondary bleeding. Zheng Ren turned on the machine, changed to the operating room control mode, and began to brush his hands.
Interventional surgery not only requires radiation, but also wears a few tens of kilograms of lead clothing for surgery, which is harder than ordinary surgery.
However, in special cases, interventional surgery is the only way to solve the problem. If you don't do it, you can only watch the patient die because of excessive blood loss.
Zheng Ren went to the storage room and picked up a lead coat just ready to wear. He suddenly realized that he seemed to have forgotten something.
After the last isolated helpless task was completed, the system seemed to reward yourself with a set of radiant ray energy conversion lead clothing, and there is also a silver treasure chest.
Silver treasure chest, Zheng Ren is not interested to open. After all, three more open before, three out of the skills book out, and then open the words are not significant.
But the conversion of radiation energy into lead clothing sounds very high. If you understand it literally, it seems that this clothes can convert radiation into energy and supply it to yourself.
If that's the case, it will be interesting in the future.
Zheng Ren put down the lead coat and glanced at it. Su Yun was still in the position and prepared for the preoperative, then he came to the locker room and entered the system space to take out the radiation energy to transform the lead clothes.
What's wrong? Zheng Ren is very different.
It is said that I have no complaints with the ICU in the long run, and there is no hate in recent days. They...
"Director Pan, you are here." An ICU doctor walked over to Director Pan and Zheng Ren and began to introduce the condition.
"The patient was sent to the five wards of the orthopedic surgery at 9:18, and the diagnosis was a pelvic fracture. The blood pressure was 100/60mmhG, and the blood pressure was 85/45mmhG after one hour. Considering the fracture combined with massive bleeding, emergency pelvic CT , showing a large area of retroperitoneal hematoma. After ICU consultation, transfer to continue treatment."
The report of the medical history is very detailed, and the patient's condition is relatively simple. It is a pelvic fracture with hemorrhage, and there is no problem of differential diagnosis.
Pelvic fractures are generally not heavy, and it can be done for a period of time. There is very little need for surgery.
This is due to the structural characteristics of the pelvis itself. There will usually be bleeding in the fracture section, with a small or medium amount of fluid. This does not require special treatment, and it is sufficient to give hemostasis drugs and antibiotics.
However, once the pelvic fracture causes rupture of the blood vessel, the blood vessels pierced by the fracture end are the internal and external iliac vessels and the pelvic venous plexus.
These blood vessels are located behind the peritoneum and bleeding is entrapped in the posterior peritoneum. In most cases, when the ruptured arterial blood vessels are not large or the venous bleeding occurs, the local pressure will increase, which will stop the bleeding.
But...
This time the patient's condition is quite special, and one hundred patients with pelvic fractures may not be able to pick out such a case.
The vascular injury of the posterior peritoneum is more serious. Considering that the larger arterial vascular rupture, the pressure can not stop the bleeding, the patient's blood pressure continues to decline, and enters the hemorrhagic shock state.
Even more difficult is that because the posterior peritoneal pressure is very large, it is impossible to use surgical methods to stop bleeding.
As long as everything is open after the peritoneum, the blood in the area is under great pressure and immediately slammed into the roof.
When Zheng Ren’s heart moved, he saw Su Yun’s chair, sitting next to the patient, holding a pen and paper in his hand, and calculating what was going on.
After the hangover, he couldn't see a little bit of alcohol, but it was a little decadent.
But when this sense of decadence comes to the face of the handsome face, it doesn't have a taste.
"Look at the patient first." Director Pan Pan did not move, striding to the patient, observing the vital signs and the emergency CT film handed by the doctor next to him.
"The pelvic fracture combined with pelvic artery rupture, posterior peritoneal hematoma." Su Yun heard the voice of the old director Pan, looked up but did not stand up, did not look at the director of the old Pan, but looked directly at Zheng Ren.
Zheng Ren knows what he means.
The patient's condition is not suitable for surgery. He can only stop bleeding by interventional surgery, and then decide the next treatment plan.
Su Yun is very accurate in judging the condition of the disease. How to treat Yemen is clear, this guy is really not simple.
"Xiao Zheng, is it sure?" Director Lao Pan did not know much about the intervention, but after the emergency treatment of the placenta exfoliation, he went home and bought a book related to this intervention.
He doesn't ask himself to do it. At the very least, he has to know if Zheng Ren can do it.
Young people sometimes feel impulsive, or they have to get old comrades to help.
The pelvic fracture combined with retroperitoneal hematoma and hemorrhagic shock is one of the indications for interventional surgery.
However, Director Pan still hesitated. After all, he did not personally do it. This kind of thing still depends on Zheng Ren.
"No problem." Zheng Rendao: "Prepare blood, prepare for surgery, push the patient into the intervention room."
The dark hair of Su Yun’s forehead floated, and the feeling of decadence in his eyes disappeared and he began to get excited.
Zheng Ren is alert, what does this gun want to do?
"I am going to give you a match." Su Yundao: "This is the order of infusion, don't mess up."
Su Yun handed the paper to the nearest nurse and explained it.
"Is the infusion order calculated according to the urine specific gravity?" The little nurse took the paper and glanced at it. Some regretted to say: "Yun Ge, you are really white when you go to the emergency department."
"Oh." Su Yun did not argue, just smiled, the black hair fluttering in front of the forehead, handsome.
Zheng Ren didn't have time to look at Su Yun's intentional and unintentional sisters, but Su Yun still has a set. According to the urine specific gravity, the order of input crystal and colloid can be effectively used to deal with the environmental disorder in hemorrhagic shock.
If it is martial arts, this is a relatively high level of secrets.
Because the network is now developed, this formula is also described on the Internet. But the problem is that if you calculate the urine specific gravity, you need a lot of formula calculations, which is beyond the cognitive scope of medical students.
Moreover, it is also a way of exhausting people to continuously check the urine specific gravity and repeatedly adjust the order of infusion.
Therefore, all who can do this are cows.
This guy can, Zheng Ren and Lao Pan, greeted him, then left the ICU, went back to the operating room, and prepared surgical instruments.
After the operation of patients with placental exfoliation, Director Pan Pan went into the process of entering a group of consumables that Zheng Ren needed.
This time, Zheng Ren does not have to face the horror of isolation and helplessness again. Not only consumables, but even assistants, but the assistants are not so satisfied.
......
......
Back in the emergency operating room, Zheng Ren began to prepare things.
Shea people came to help, she took the time to learn all the knowledge about interventional surgery, it seems that this girl is ready to enter the operating room to give Zheng Ren an assistant.
Zheng Ren will definitely not agree, and it is not a circulatory operation. The patient will have a cardiac arrest at any time. Why should one more person go in and eat the line?
As for Su Yun ~ www.novelhall.com ~ he wants to help, Zheng Ren will certainly not stop.
One is an annoying and savvy, and the other is a sister who is intimate and handsome. I tend to think that I don’t have to think about it. Zheng Ren is very straight.
There aren't a lot of instruments needed. After all, it's just a plug embolization surgery. In interventional surgery, this is just a simple procedure.
After fifteen minutes, Zheng Ren heard the sound of the flat car coming.
At this point, the preoperative preparation of the interventional operating room has been completed.
The patient was gently lifted onto the operating bed to avoid secondary bleeding. Zheng Ren turned on the machine, changed to the operating room control mode, and began to brush his hands.
Interventional surgery not only requires radiation, but also wears a few tens of kilograms of lead clothing for surgery, which is harder than ordinary surgery.
However, in special cases, interventional surgery is the only way to solve the problem. If you don't do it, you can only watch the patient die because of excessive blood loss.
Zheng Ren went to the storage room and picked up a lead coat just ready to wear. He suddenly realized that he seemed to have forgotten something.
After the last isolated helpless task was completed, the system seemed to reward yourself with a set of radiant ray energy conversion lead clothing, and there is also a silver treasure chest.
Silver treasure chest, Zheng Ren is not interested to open. After all, three more open before, three out of the skills book out, and then open the words are not significant.
But the conversion of radiation energy into lead clothing sounds very high. If you understand it literally, it seems that this clothes can convert radiation into energy and supply it to yourself.
If that's the case, it will be interesting in the future.
Zheng Ren put down the lead coat and glanced at it. Su Yun was still in the position and prepared for the preoperative, then he came to the locker room and entered the system space to take out the radiation energy to transform the lead clothes.
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