Chapter 94 Large Retroperitoneal Hematoma

After entering the ICU, Zheng Ren immediately felt countless hostile eyes aimed at him.

What's going on here? Zheng Ren was surprised.

It is said that they have no grudges with the ICU in the past, and no grudges recently. They...

"Director Pan, you are here." An ICU doctor walked up to Director Pan and Zheng Ren and began to introduce the condition.

"The patient was sent to the fifth ward of the Orthopaedic Surgery Department at 9:18 due to a traffic accident injury and was diagnosed with a pelvic fracture. The blood pressure at that time was 100/60mmhG, and the blood pressure was measured 85/45mmhG an hour later. Considering the fracture complicated by massive bleeding, an emergency pelvic CT was performed. , showed a large retroperitoneal hematoma. After consultation in the ICU, he was transferred to continue treatment."

The reported medical history is very detailed, and the patient's condition is relatively simple. It is a pelvic fracture combined with bleeding, and there is no problem of differential diagnosis.

Pelvic fractures are generally not serious, and it is enough to rest for a period of time, and surgery is rarely required.

This is due to the structural properties of the pelvis itself. Generally, there will be bleeding from the fracture surface, and a small or moderate amount of effusion will appear. This also does not require special treatment, and it is enough to give hemostatic drugs and antibiotics intravenously.

However, once the pelvic fracture causes blood vessel rupture and bleeding, the blood vessels punctured by the fracture end are the internal and external iliac blood vessels, and the pelvic venous plexus.

These blood vessels are located behind the peritoneum, and the bleeding will be enveloped by the retroperitoneum. In most cases, when the ruptured arteries are small or venous bleeding, the bleeding will be stopped because of the increased local pressure.

But……

The patient's situation this time is rather special, and such a case may not be picked out of 100 patients with pelvic fractures.

Vascular damage in the retroperitoneum is relatively serious, and it is considered that a relatively large arterial vessel ruptures, and the pressure cannot stop the bleeding. The patient's blood pressure continues to drop and enters a state of hemorrhagic shock.

What's more tricky is that because the retroperitoneal pressure is very high, it is impossible to use surgical methods to stop the bleeding.

As long as the retroperitoneum is opened, the blood stored in it will immediately jump to the roof under huge pressure.

Zheng Ren's heart moved, and he caught a glimpse of Su Yun making a chair and sitting next to the patient, holding a pen and paper in his hand, calculating something.

After the hangover, he couldn't see the slightest bit of alcoholism, just a little decadent.

But when this sense of decadence surfaced on that beautiful face, it was different.

"Look at the patient first." Director Pan calmly walked over to the patient and observed the vital signs and the emergency CT images handed over by the doctor next to him.

"Pelvic fracture combined with pelvic artery rupture, retroperitoneal hematoma." Su Yun heard Director Pan's voice, but did not stand up, nor looked at Director Pan, but looked directly at Zheng Ren.

Zheng Ren knew what he meant.

The patient's condition is not suitable for surgery, and hemostasis can only be treated by interventional surgery first, and then the next treatment plan can be determined according to the situation.

Su Yun's judgment of the condition is very accurate. How to treat Yemen Qing is indeed not easy for this guy.

"Xiao Zheng, are you sure?" Although Director Pan didn't know much about intervention, after the emergency treatment of the placental abruption patient that day, he went home and bought a book on intervention to study it.

He didn't ask himself to be able to do it, at least he had to know if Zheng Ren could do it.

Young people are sometimes impulsive, and old comrades still need to help check.

Pelvic fractures combined with retroperitoneal hematoma and hemorrhagic shock are one of the indications for interventional surgery.

But Director Pan was still hesitant. After all, he didn't do it himself, so it's up to Zheng Ren.

"No problem." Zheng Ren said, "Prepare blood, prepare for surgery, and push the patient to the interventional operating room."

The black hair on Su Yun's forehead fluttered, the decadent feeling in his eyes disappeared, and he began to get excited.

Zheng Ren is alert, what is this bitch trying to do?

"I'll give you a set." Su Yun said: "This is the infusion sequence, don't mess it up."

Su Yun handed the paper in his hand to the nearest nurse and explained it.

"Is the infusion sequence calculated according to the specific gravity of urine again?" The little nurse took the paper, glanced at it, and said regretfully, "Brother Yun, you went to the emergency room for nothing."

"Haha." Su Yun didn't argue, just smiled, black hair fluttering on his forehead, looking handsome.

Zheng Ren didn't have time to watch Su Yun flirting with her sister intentionally or unintentionally, but Su Yun still had a set. The order of crystalloid and colloid input according to the calculation of urine specific gravity can effectively target the disturbance of the internal environment of hemorrhagic shock.

If it is martial arts, this is a relatively high-level secret.

Because the Internet is now developed, this calculation formula is also roughly described on the Internet. But the problem is that calculating the specific gravity of urine requires a lot of formulas, which is beyond the cognition of medical students.

Moreover, it is also a tiring practice to continuously detect the specific gravity of urine and repeatedly adjust the infusion sequence.

Therefore, those who can do this are all geniuses.

This guy can do it, Zheng Ren and Director Lao Pan greeted him, then left the ICU, returned to the interventional operating room, and prepared surgical instruments.

After the surgery on the placental abruption patient, Director Pan went to the collection procedure to buy a batch of consumables that Zheng Ren needed.

This time, Zheng Ren doesn't have to face the tragic situation of being isolated and helpless again. Not only consumables, but even assistants, but the assistants are not so satisfactory.

...

...

Back in the emergency operating room, Zheng Ren began to prepare things.

Xie Yi came to help. She took the time to learn everything about interventional surgery. It seemed that this girl was going to enter the operating room to be Zheng Ren's assistant.

Zheng Ren will definitely not agree, and it is not a circulatory operation, and the patient will suffer cardiac arrest at any time, why should one more person go in to eat the thread?

As for Su Yun, if he wants to help, Zheng Ren will definitely not stop him.

One is a nasty and sarcastic handsome guy, and the other is a beautiful and beautiful girl who cooperates with each other. I don't need to think about which one I prefer. Zheng Ren is very straight.

There are not many instruments needed. After all, it is "just" an embolization hemostasis operation. In interventional surgery, this is just a very simple operation.

Fifteen minutes later, Zheng Ren heard the sound of a flat car.

At this point, the preoperative preparation of the interventional operating room has been completed.

Gently lift the patient onto the operating table to avoid secondary injury and bleeding. Zheng Ren turned on the machine, changed it to the operating room control mode, and began to brush his hands and put on clothes.

Interventional surgery not only requires radiation, but also wears dozens of pounds of lead clothing for the operation, which is more difficult 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 from excessive blood loss.

Zheng Ren walked to the storage room, picked up a lead coat and was about to wear it, when he suddenly realized that he seemed to have forgotten something.

After the last mission of isolation and helplessness was completed, the system seemed to reward him with a set of radiation ray energy conversion lead clothes, and there was also a silver treasure chest.

Zheng Ren was not interested in opening the silver treasure chest. After all, three books were opened in a row before, and three skill books were opened, and it would not make much sense to open them again.

But radiation ray energy transforms lead clothing, which sounds very high. If it is understood literally, it seems that this clothing can convert radiation into energy and supply itself.

If that's the case, it will be interesting later.

Zheng Ren put down the lead coat and glanced at it. Su Yun was still posing, making preparations before surgery, and then came to the dressing room and entered the system space to take out the radiation ray energy into the lead coat.

Thanks to the Yangtze River and Xi Baoer for their reading time, indifferent love, cats reading books, smart De Yi, and cats reading books.