Chapter 326 Go All Out

"No." The suction device in Zheng Ren's hand was handed over to Su Yun, who opened the peritoneum for peritoneal protection.

The director of the Chest Department, surnamed Zhang, was a short, fat man wearing a sterile mask, and his eyebrows looked a bit wretched.

This person is in the courtyard, known for being stingy and holding grudges. Generally, there is nothing important, and few people deal with him.

Director Zhang felt a little embarrassed, and stood in front of the operating table, hesitating.

Seeing that there was no movement on the other side, Director Pan, after urging the blood transfusion department, came back just in time to hear this conversation, and gave him a hard look.

I don't blame the chest department for daring to go on stage. Now Yang Lili's blood pressure is still undetectable. She has undergone thoracotomy and laparotomy at the same time, and the possibility of stepping down alive is really not very high.

"Let's have a thoracotomy." Seeing that Director Zhang was still hesitating, Director Pan said directly.

If there were not a lot of hospital leaders standing in the operating room, Director Zhang really wanted to refuse this operation.

He really wanted to say that he was already dead, so why bother.

Up to now, the blood pressure on the ECG monitoring is still undetectable, and the heart rate is extremely fast, and atrial fibrillation has already started.

But seeing the emergency general surgery was performed quickly, I stood here for a few minutes, and found the damaged artery in the mesentery, and began to ligate it.

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

"Su Yun, go help Director Zhang." Zheng Ren stretched out his hand without raising his head, and a piece of warm salt water gauze fell on his hand. While covering the intestinal tract to see which segment of the intestinal tract has symptoms of necrosis, look for knife stab wounds on the intestinal tract.

Um? Director Zhang was taken aback for a moment, and looked sideways at Old Director Pan. Seeing that he did not object to Zheng Ren's words, his heart immediately began to feel haunted.

Director Zhang knows that the emergency department "robbed" the general emergency surgery, this time, is it going to grab the thoracic emergency surgery?

There are not many guns in the emergency department, but this appetite is really big.

Su Yun didn't even look at Director Zhang, turned around and stepped off the stage, began to disinfect the chest incision, then brushed his hands again, and put on the surgical gown.

Director Zhang was very helpless, what the hell was going on.

But in front of so many courtyard leaders, it's not easy to have a fit. The main reason is that Director Pan is a mountain he dare not provoke.

If it happens... Liu Tianxing is still in the hospital, it is said that he is suffering from liver disease.

People, it's time to bow your head. Director Zhang began to communicate with the head nurse of the emergency operating room, and went to the external operating room to pick up the sterile bag of the chest department.

Su Yun ignored Director Zhang. After the disinfection, he began to spread the sheets, brush his hands, and stood beside Zheng Ren. The two operations started at the same time.

The Xie people got busier.

Because it is an unconventional technique, the tacit understanding without speaking has become a luxury.

Zheng Ren and Su Yun kept asking for equipment in low voices, and Xie Yi was barely able to come over.

Director Zhang and the head nurse of the operating room explained the required sterile bags, and then sent their hospital chief to pick them up. Then they turned around and came back, seeing that Su Yun's chest had been opened, they were furious.

"Are you kidding! There is no equipment, are you going to do it blindly?! This is a chest surgery, not your emergency surgery!"

What he said makes sense. There are ribs in the chest, and special instruments are needed to open the chest wall and expose the surgical field. A few retractors can be used for general surgery, but not for chest surgery.

Twenty years earlier, chest surgery would have required amputation of a rib to make the surgical field wider.

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

Su Yun focused on opening his chest. A rising star in cardiothoracic surgery has his own self-confidence and pride. How could he respond to the clamor of a director of Haicheng No. 1 Hospital.

No one paid any attention to him. Zheng Ren and Su Yun were busy. Dean Xiao and Director Pan stood behind Zheng Ren, watching the operation intently, but they didn't seem to hear what Director Zhang said.

Director Zhang was very helpless and didn't dare to complain too much, so he had no choice but to take the stage.

Two surgeries are performed at the same time, and there is simply no room for so many people. Usually, thoracotomy in the thoracic department requires at least three people on stage. But at this moment, Director Zhang and Su Yun are the only ones doing all the planning.

At this time, Yang Lei, who was standing in the first assistant position, became the busiest person.

On the one hand, the hook needs to be drawn, and on the other hand, the equipment must be handed over.

Zheng Ren focused on two things, and his eyes were on Su Yun's side.

Seeing that Su Yun's techniques are proficient, he is indeed a doctor with a background in chest medicine, and he is more than a little bit better than the general foreigner who has become a monk halfway through.

In fact, Zheng Ren asked Su Yun to support Director Zhang because Su Yun had already undergone a heart transplant in the imperial capital.

Can perform top-notch extra-thoracic surgery, but an emergency room can't handle it?

joke!

In order to better cooperate with Su Yun, Zheng Ren did not hesitate, and ordered a master-level skill book, which was added to the skill tree of cardiothoracic surgery.

Yang Lili was stabbed twice in the chest, and then tried her best to hug the gangster's arm, and was stabbed several times in the abdomen after breaking free.

The liver and spleen were not injured, but there were seven or eight breaks in the intestinal tract, and some intestinal tracts were penetrated.

Severe contamination in the abdominal cavity.

After repeated washing and suction with warm saline, and ligation of part of the injured mesenteric artery, the operative field became much clearer.

The repair of damaged intestines is a small problem, Zheng Renfei quickly repaired every place with needles.

The big problem is that the patient's mesenteric artery is punctured, resulting in ischemia and necrosis of the mesentery. After ligation of part of the mesenteric artery, necrosis will inevitably occur in the intestinal tract supplied by the ligated artery.

The main task of abdominal surgery lies in the resection and anastomosis of the intestine.

But for Zheng Ren, it is best to have an assistant. If not, doing it alone is enough.

Gradually, Yang Lei helped Su Yun to do more work, and Zheng Ren just pulled a hook to help expose the surgical field.

Even Zheng Ren did all the knotting and thread cutting by himself. The scissors are contained in the palm of the hand, appearing and disappearing like magic, without delaying the movements of the hands at all.

Yang Lili's intestinal necrosis is about 60cm long, which is acceptable. If it is longer, you must be careful of complications such as jejunum syndrome after surgery.

Fifteen minutes after the laparotomy, Zheng Ren had already removed the necrotic intestine and anastomosed the normal intestine.

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

"One bag per person." Mr. Pan, the chief marshal, first picked up a bag of red blood cells and simmered it with both hands.

Dean Xiao frowned, watching the operation.

But he also saw that the blood was delivered, and asked Director Ding to bring him a bag of red blood cells as well.

With the dean as an example, who can say "no" among the leaders who came?

"There's no more blood on the side of the blood transfusion department." The phone rang, and the head nurse in the emergency operating room answered it, and then said.

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

"Platelets and fibrinogen are also needed." Su Yun, the author of the operation, also paid attention to the situation behind.

Dean Xiao is from a clinical background. He knows that even if the patient is able to step down, he will inevitably face the complications of ischemia-reperfusion injury of many organs and DIC after massive blood transfusion.

He nodded.

Director Ding immediately ran out to make a phone call and contacted the central blood bank.

Soon, he ran back, approached Dean Xiao and whispered, "Dean, type B RH positive blood, the central blood bank doesn't have so many."

The city's blood supply comes from the blood bank in the city center. There may be insufficient blood preparation for some rare types, or the blood types that have been used more recently.

"You contact the blood bank and the hospital to find someone with the corresponding blood type to donate blood. Hurry up!" Dean Xiao looked at the operation with a livid face.

"Okay." Director Ding immediately left the operating room and went out to discuss these matters.

In general, even if someone donates blood, the central blood bank has its own set of cumbersome procedures, and blood cannot be transfused every day.

At this time, the words of the chief director of the city's largest hospital still carry a certain amount of weight.

Zheng Ren felt a lot more at ease when he heard the following conversation.

The hospital came forward to brush his face, which means that there will be no shortage of platelets and fibrinogen.

These two things are necessary for patients to survive and step down, but now they are rarely available, especially fibrinogen.

Many portal azygos devascularization procedures cannot be performed due to lack of fibrinogen.

After the intestinal anastomosis is completed, the warm saline gauze is covered for five minutes. Zheng Ren searched the abdominal cavity and saw that there were no other injuries that had not been treated. He opened the warm saline gauze and saw a slight blood color at both ends of the intestinal anastomosis.

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

The peritoneal cavity was flushed again and the abdomen was closed.