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The Surgeon’s Studio

Chapter 94: Retroperitoneal macrohematoma

When he entered the ICU, Zheng Ren immediately felt countless gazes with strong hostility aimed at him.

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

It is said that he and ICU far day no grudge, recently no enemy, they ......

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

"The patient was brought into the orthopedic surgery five ward at 9:18 citing traffic accident injuries, diagnosed as pelvic fracture, blood pressure was 10060mmhG at that time, blood pressure measured an hour later was 8545mmhG, considering the fracture combined with massive bleeding, emergency check pelvic CT, showing a large retroperitoneal hematoma. After ICU consultation, he was transferred to continue treatment."

The reported history was very detailed, and the patient's condition itself was relatively simple, a pelvic fracture combined with hemorrhage, and there was no problem of differential diagnosis.

Pelvic fractures are generally not serious, and a period of recuperation is all that is needed, rarely requiring open surgery.

This is due to the structural characteristics of the pelvis itself. There will usually be bleeding from the fracture section and a small or moderate amount of fluid accumulation. This does not require any special treatment, and the administration of hemostatic drugs and antibiotics is sufficient.

However, once a pelvic fracture triggers bleeding from a ruptured vessel, the vessels that are pierced by the fracture section are the internal and external iliac vessels and the pelvic venous plexus.

These vessels are located posterior to the peritoneum and the bleeding will be encapsulated by the posterior peritoneum. In most cases the ruptured arterial vessels are not large or the venous bleeding will be stopped because of the increased local pressure.

But ......

This patient's case is unique, and it may not be possible to pick such a case out of a hundred pelvic fracture patients.

The vascular damage to the posterior peritoneum was more severe, and a relatively large arterial vascular rupture was considered. The pressure was unable to stop the bleeding, and the patient's blood pressure continued to drop and he went into hemorrhagic shock.

To add to the problem, because the pressure in the posterior peritoneum is very high, it is simply impossible to use surgical procedures to stop the bleeding.

As soon as the posterior peritoneum was opened, the blood accumulated inside immediately leapt up to the roof under the huge pressure.

Zheng Ren's heart moved and glanced at Su Yun running a chair, sitting next to the patient, pen and paper in hand, calculating something.

After the hangover, he could not see any semblance of alcohol, only slightly disheveled.

But this sense of decadence surfaced on that handsome and stunning face, but something else.

"Let's see the patient first." The old Pan director did not move, and walked to the patient with big steps, observing the vital signs as well as the emergency CT films handed up by the doctor next to him.

"Pelvic bone fracture combined with pelvic artery rupture and retroperitoneal hematoma." Su Yun heard Old Director Pan's voice, raised his head but did not stand up or look at Old Director Pan, but looked straight at Zheng Ren.

Zheng Ren knew what he meant.

The patient's condition was not suitable for surgery, so he could only stop the bleeding through interventional surgery first, and then see the situation to decide the next treatment plan.

Su Yun's judgment of the condition was accurate, how to save Yemen Qing, this guy was indeed not simple.

"Xiao Zheng, are you sure?" Although the old director Pan did not know much about interventions, after the emergency treatment of the placental abruption patient that day, he also went home and bought a book related to interventions and studied it.

He did not ask himself to do it, but at least to know if Zheng Ren could do it.

Young people are sometimes impulsive, or older comrades to help keep the gate.

The pelvic fracture combined with retroperitoneal hematoma, hemorrhagic shock, is precisely one of the indications for interventional surgery.

But the old director Pan still hesitates, after all, he has not done it personally, this kind of thing still has to look at Zheng Ren.

"No problem." Zheng Ren said, "Prepare the blood, do the preoperative preparation, and push the patient to the interventional operating room."

The black hair on Su Yun's forehead fluttered, and the disheveled feeling in his eyes disappeared and he became excited.

Zheng Ren alert, what does this pussy want?

"I'll go and match the table for you." Su Yun said, "This, is the order of infusion, don't mess it up."

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

"Another order of infusion according to urine specific gravity?" The young nurse took the paper, glanced at it, and said with some regret, "Brother Yun, you really went to the emergency room for nothing."

"Huh." Su Yun did not argue, just smiled, black hair fluttering in front of his forehead, handsome.

Zheng Ren did not have time to watch Su Yun intentionally or unintentionally tease the girl, but Su Yun still has a set. Calculate the order of inputting crystals and colloids according to the specific gravity of urine, which can effectively target the disorder of the internal environment of hemorrhagic shock.

If it is a martial art, this is considered a higher level of secrets.

Because the network is now developed, this calculation formula is also described in the Internet. But the problem is that according to the urine specific gravity calculation, it requires a large number of formulas to calculate, which is beyond the cognitive scope of medical students.

And constantly testing the urine specific gravity and repeatedly adjusting the order of infusion is also an exhausting practice.

So, those who can do this are cattlemen.

This guy can be, Zheng Ren and the old Pan director greeted, then left the ICU, went back to the interventional operating room, and prepared the surgical instruments.

After the placental abruption patient's surgery, Director Pan Sr. went through the procecuting procedure to get in a batch of consumables that Zheng Ren needed.

This time, Zheng Ren did not have to face the miserable situation of isolation again. Not only consumables, but even assistants are available, only the assistants are not so competent.

......

......

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

The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things.

Zheng Ren certainly will not agree, and not a circulatory surgery, the patient will be cardiac arrest at any time, why should one more person go in and eat the line?

As for Su Yun, he wants to help, Zheng Ren will certainly not stop.

One is a nasty sarcastic handsome pussy, one is with the interminable, beautiful girl, tend to which simply do not have to think about it, Zheng Ren can be very straight.

The equipment needed is not a lot, after all, "just" an embolization to stop bleeding, in the interventional surgery, this is only a very simple procedure.

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

At this time, the preoperative preparation in the interventional operating room had been completed.

Lifting the patient gently onto the surgical bed to avoid secondary damage and bleeding, Zheng Ren opened the machine, changed to the operating room control mode, and began to brush his hands and put on clothes.

Interventional surgery is not only to eat radiation, but also to wear dozens of pounds of lead clothing to do surgery, than ordinary surgical procedures are more difficult.

But when it comes to special situations, interventional surgery is the only way to solve the problem, and if you don't do it, you can only watch the patient die because of excessive blood loss.

Zheng Ren walked to the storage room, picked up a lead suit just ready to wear, suddenly realized that he seemed to have forgotten something.

After the last isolated mission was completed, the system seemed to reward himself with a set of radiation energy conversion lead suit, and a silver treasure chest.

Silver treasure chest, Zheng Ren is not interested in opening. After all, the previous three in a row, open out three skill books out, and then open it again is not very meaningful.

But the radiation ray energy conversion lead clothes, sounds very high, if according to the literal understanding, as if this body can transform radiation into energy, supply yourself.

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

Zheng Ren put down the lead suit, took a look, Su Yun was still in position, doing preoperative preparations, so he came to the dressing room and entered the system space to take out the radiation ray energy conversion lead suit.

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