Chapter 326： Go all out

"No." Zheng Ren's hand is handed over to Su Yun, open the peritoneum and do peritoneal protection.

The director of the thoracic department, surnamed Zhang, is a short fat man with a sterile mask and looks a bit cumbersome between the eyebrows.

This person is in the courtyard, famous for his stinginess and vengeance. There is usually nothing important, and few people deal with him.

Director Zhang felt a little embarrassed and hesitated before standing at the operating table.

Seeing that there was no movement, after the old Pan director rushed through the blood transfusion department, he came back to hear the conversation, and he gave him a look.

I don’t dare to go to the chest without complaining. Now, Yang Lili’s blood pressure is still undetectable. At the same time, the possibility of undergoing thoracotomy, open surgery, and being able to step down alive is not really great.

"Exploration of the thoracotomy." Director Pan said that Zhang was still squatting, and he said directly.

If there is not a large number of hospital leaders standing in the surgery, Director Zhang really wants to refuse this operation.

He really wants to say that he is already dead, and he still has a hard time.

Until now, the blood pressure on ECG monitoring has not been measured, and the heart rate is extremely fast. Atrial fibrillation has already begun.

However, looking at the emergency surgery, the one called a quick, standing here for a few minutes, has found the mesenteric artery, and began to ligature.

Director Zhang sighed and said: "Do your best."

"Su Yun, go to help Director Zhang." Zheng Rentou did not lift, reach out, a piece of warm salt water gauze fell on the hand. Cover the intestines to see which part of the intestine has necrotic symptoms, while looking for a knife wound on the intestine.

Ok? Director Zhang stunned and squinted at Director Pan. Seeing that he did not object to Zheng Ren’s words, he immediately began to draw the soul.

The emergency department "grabbed" the emergency surgery. Director Zhang knows that this time, is it necessary to take emergency surgery outside the chest?

There are not a few guns in the emergency department, but the appetite is really big.

Su Yun did not look at Director Zhang, turned directly to step down, began to disinfect the chest incision, and then brushed his hands and put on the surgical gown.

Director Zhang is very helpless. What is special about this.

But in front of so many hospital leaders, it is not good. Mainly because the director of the old Pan is a mountain that he dare not provoke.

If it happens... Liu Tianxing can still be hospitalized, and it is said that he is suffering from liver disease.

People are embarrassed, the bow must be bowed, Director Zhang began to communicate with the head nurse in the emergency operating room, to go to the external surgery room to take the sterile package of the chest.

Su Yun ignored the director Zhang. After eliminating the poison, he began to lay the list, brush his hands, and stood next to Zheng Ren. Both operations began at the same time.

The Sheikh is busier.

Because it is unconventional, the tacit understanding without talking becomes a luxury.

Zheng Ren and Su Yun kept whispering to the equipment, and the Xie Yi people could barely come over.

Director Zhang and the head nurse of the Dawai operating room handed over the necessary sterile bags, and sent their own hospitals to take them. After turning around, they saw that Su Yun had opened his chest and suddenly became angry.

"What a joke! No equipment, you are going to blindly!! This is a thoracic surgery, not your emergency!"

He said it makes sense, the chest has ribs, special equipment is needed to open the chest wall and expose the field. A few hooks can be used, but not on the chest.

If you do chest surgery two decades earlier, you need to cut off a rib to make the field wider.

It makes sense to make sense, but emergency rescue, every minute, every second is more precious than gold.

Su Yun's dedication to open the chest, the heart of the chest surgery tomorrow has its own self-confidence and pride, how can we take care of a director of the Haicheng First Hospital.

No one took care of him, Zheng Ren and Su Yun were busy, Xiao Dean and Director Pan Pan stood behind Zheng Ren, watching the surgery intently, and did not seem to hear Director Zhang’s words.

Director Zhang was very helpless. He didn't dare to complain too much. He had to brush his hands.

The two operations were opened at the same time, and there were no more people standing at all. Usually chest surgery for thoracic surgery, at least three people need to go on stage. At this moment, only Zhang and Su Yun do it.

At this time, Yang Lei, who stood in a helping position, became the busiest person.

While pulling the hook, you must hand the device.

Zheng Ren used both minds and his eyes aimed at Su Yun.

Seeing Su Yun's skillful approach, it is indeed a doctor born in the chest, which is more than a little bit stronger than the half-way.

In fact, Zheng Ren asked Su Yun to go to Taiwan with Director Zhang. It is also a fancy that Su Yun had already had a heart transplant surgery in the Imperial Capital.

Can do the best surgery on the chest, an emergency can not handle?

joke!

In order to better cooperate with Su Yun, Zheng Ren did not hesitate to order a master skill book, added to the skills tree of cardiothoracic surgery.

Yang Lili began to be stabbed two times by the chest, and tried her best to hug the gangster's arm. After she broke free, she was stabbed several times.

Did not hurt the liver, spleen, but there are seven or eight breaks in the intestines, and some intestines are also penetrated.

The abdominal cavity is seriously polluted.

After the warm saline was repeatedly washed, sucked, and some of the injured mesenteric arteries were ligated, the surgical field was much clearer.

The repair of the damaged intestinal tract is a minor problem. Every place of Zheng Renfei needles is quickly repaired.

The big problem is that the patient's mesenteric artery is punctured, mesenteric ischemia and necrosis, and after the mesenteric artery is ligated, the part of the intestine that is ligated by the ligated artery will inevitably become necrotic.

The great work of abdominal surgery lies in the removal and anastomosis of the intestines.

However, for Zheng Ren, it is best to have an assistant. If not, it is enough for one person to do it.

Gradually, Yang Lei helped Su Yun to do more work. Zheng Ren’s face is just a hook to help expose the surgical field.

Even Zheng Jie, who is tying and cutting the line, has taken it all. Scissors are contained in the palm of your hand, and the magic usually appears and disappears, without any delay in the movement of the hand.

Yang Lili's intestinal necrosis is about 60cm, which is acceptable. If you grow a little longer, you should be careful about complications such as jejunal syndrome after surgery.

After fifteen minutes of laparotomy, Zheng Ren had already removed the necrotic intestine and completed the normal bowel.

At this point, fresh frozen red blood cells and fresh frozen plasma have just been retrieved.

"One person and one bag." Director Pan Pan first picked up a bag of red blood cells and used both hands to heat up.

Dean Xiao tightened his eyebrows and looked at the surgery.

But he also saw the blood sent, and let Director Ding give him a bag of red blood cells.

The dean has a good example, who can come to the hospital leaders who can say "no"?

"There is no blood on the side of the blood transfusion department." The phone rang and the head nurse of the emergency operation room picked up and said later.

"Director Ding, contact the blood bank in the city center." Xiao Yuan said: "At least 20u red blood cells."

"Platelets and fibrinogens are also needed." Su Yun authors surgery, but also pay attention to the latter situation.

Dean Xiao is a clinical origin. Knowing that the patient's current situation can be stepped down, it is also necessary to face the complications of many organ ischemia-reperfusion injury and DIC after a large number of blood transfusions.

He nodded.

Director Ding immediately ran out to call and contacted the center blood bank.

Soon, he ran back and screamed to the side of Xiao Dean: "The dean, type B RH-positive blood, the central blood bank is not that much."

The city's blood supply is from the blood bank in the city center. Some rare types, or more recently used blood type blood preparation may not be enough.

"You contact the blood bank and the hospital, and find the person with the appropriate blood type to donate blood. Be fast!" Dean Xiao looked at the operation and his face was a little bit blue.

"Okay." Director Ding left the operating room and went out to do these things.

The general situation Even if someone donates blood, the center blood bank has its own set of cumbersome procedures, and no one can lose blood.

At this time, the chief of the city's largest hospital, speaking, still has a certain weight.

Zheng Ren heard a lot of conversations in the back.

Brushing your face in the yard means that the platelets are not missing, and fibrinogen is not missing.

These two are necessary for the patient to step down alive, but now it is rarely available, especially fibrinogen.

Because of the lack of fibrinogen, many portal venous devascularizations cannot be performed.

The intestines were anastomosed and covered with warm saline gauze for five minutes. Zheng Ren looked for the abdominal cavity, see no other untreated injuries, open the warm saline gauze, see a slight blood color at both ends of the intestinal anastomosis.

This proves that no ischemic necrotic tissue remains, and postoperative intestinal anastomosis should not be a problem.

Rinse the abdominal cavity and start to close the abdomen.