Chapter 128

Zhang Fan's plan to accompany his sister to bayinbrook failed. Shao Hua and Jing Shu signed up for a two-day tour group and went to Bayinbuluk happily.

Bayinbuluk is an alpine basin in the middle of Tianshan Mountains, surrounded by snow mountains, with an altitude of about 2500 meters and an area of 23835 square kilometers, second only to NMG Ordos grassland. Bayinbrook   In Mongolian, it means abundant spring - "abundant spring". The grassland is flat and rich in water and grass. It is a typical grass meadow grassland and one of the most important animal husbandry bases in the frontier. There is not only a paradise surrounded by snow mountains, the Kaidu River with "nine bends and eighteen bends", but also the elegant and charming Swan Lake.

In the Ming Dynasty and the early Qing Dynasty, the yuledus River Basin was mainly the nomadic belt of lihuite in Western Mongolia. In the 39th year of the reign of Emperor Qianlong of the Qing Dynasty (1774), the turkut Mongols who returned to the East under the leadership of wobashi were settled.

Saturday, surgery. The patient's grade is not big and his vital signs are good. Haila bought breakfast for Zhang Fan in the morning. The patient is his. On the weekend, Zhang Fan came for surgery. Although it was the order of the director, he can be the competent doctor. He specially bought breakfast to thank Zhang Fan. Also specifically told Zhang Fan not to eat breakfast. After three people ate steamed stuffed buns in a few bites, they were ready to enter the operating room. The patient's family had some local contacts. Li Jianguo specially comforted his family in the morning. Generally, this kind of thing is done by the doctor in charge, and the director doesn't come forward.

In the operating room, put your body in a good position and start anesthesia and disinfection. The incision and exposure steps vary according to different kidney parts and lesions. Li Jianguo chooses a conventional surgical incision to cut the fascia around the kidney. After reaching the fascia around the kidney with various lumbar incisions, separate the back and make a small incision to expand up and down. At this time, we should pay attention to avoid damaging the peritoneum.

Haila's assistant and Zhang Fan's assistant. This kind of operation is not difficult for Li Jianguo, Zhang Fan is no problem, and it is a little difficult for Haila. However, the nephrectomy operation is a major operation in the urology department, and it is impossible for Zhang Fan to take the lead.

Slowly separate the kidney. Use your fingers to separate the fascia around the kidney, starting from the convex surface and back of the kidney, then to the upper, lower poles and front, and finally along the upper segment of the ureter to the renal hilum to separate it from the renal pedicle.

Li Jianguo's level is good. Years of experience and cautious character make his operation look very clean. He is not in a hurry. He is very solid step by step. He needs to be ligated to stop bleeding regardless of the size of bleeding. He is very careful.

Zhang Fan also learned a lot from Li Jianguo's operation. Li Jianguo is the most careful surgeon he has ever seen, and the operation is also very meticulous.

Start to treat the ureter, separate the lumbar segment of the ureter, surround and lift it with gauze strips, and separate it downward as far as possible. At the lowest part of the separation section, clamp the ureter with two hemostatic forceps, cut it between the two forceps, and disinfect the two broken ends with small cotton balls dipped in pure carbolic acid, 75% alcohol and normal saline. Then the distal ureter was ligated and sutured.

The second half of the operation begins. The early work is to free the kidney. The rest is to deal with the renal vessels, carefully separate the adipose tissue at the renal hilum, and expose the renal arteries and veins. Clamp the renal vessels with renal pedicle forceps or large curved hemostatic forceps. Cut off the blood vessel between the two distal forceps and take out the diseased kidney.

It was at this time that something happened!

Because the family members were very anxious, they also asked the superior leader in charge to say hello. Lao Li couldn't help it. He was also anxious to pull the patient into the operating room. Many examinations were not done.

Originally, during the operation, Lao Li was very careful and was deeply afraid of a problem. As a result, be careful. Something happened.

The patient's kidney mutated an extra renal vessel, and it was also an artery, although not thick, but not thin. Because it was a variant blood vessel and was on the side of the renal fossa, Lao Li didn't notice. He cut off the ligated renal pedicle with a pair of scissors and was ready to remove the affected kidney.

As a result, after a stab, the blood gushed out, and the blood vessel mouth was just facing Haila. The pressure of renal vessels was not small, so he directly sprayed Haila's face. Haila was stunned at that time. Her blood vessels were ligated. Where did the arterial blood come from? And with this ejection, Haila subconsciously closed her eyes and forgot to help Lao Li.

Lao Li was still holding hemostatic forceps to clamp the blood vessels, and he had no spare hands to stop the bleeding. His cold sweat came out at once, and he was surprised with a voice: "it's over! It's big today! "

This moment is the most embodiment of the assistant moment, but Haila has been solved by blood! As soon as the blood cooled, the viscosity increased, and it took Haila a lot of trouble to open her eyes. Lao Li couldn't do it in a hurry, but he didn't have a good way. He didn't dare to relax the hemostatic forceps in his hand. He shouted in his mouth, "Zhang fan, Zhang Fan. Look, where's the blood vessel. "

At this time of bleeding, the aspirator can't attract it at all. The bleeding pressure of renal arterioles is large and the amount is large. In a few seconds, the bleeding has flooded the renal fossa.

Just when Lao Li shouted Zhang Fan's name, Zhang Fan didn't delay at all. He stuck his fist in the kidney nest“ Wipe Hella's face. " Zhang Fan pressed the kidney nest and said to the tour. His position is not good. He can only do this step. The rest depends on one help.

Then he said to the anesthesiologist, "step down quickly." Zhang Fan held the bleeding. Lao Li's nerves were stretched to the tightest at this time. He said to the anesthesiologist, "yes! yes! yes! Step down. "

When Hera was fascinated by blood, he was really desperate. Xin Kui's second assistant today is Zhang Fan. If other doctors are transferred, it's estimated that they will be in trouble. Zhang Fan reacted too quickly. Without his command, he had already handled it accordingly.

Fast, stable and accurate. Zhang Fan immediately sealed the bleeding with his fist. After wiping the blood, Haila was still confused. As a result, she said without thinking, "didn't you clamp the kidney pedicle?"

Lao Li is crazy. At this moment, I didn't hurry to find the blood vessel, but I was still stunned, "less nonsense, are you blind? Where did the hemostatic forceps not hold well? This is a variant blood vessel. Come on! "

Lao Li's tone was very serious. Haila, who was not frightened by the bleeding, made Lao Li afraid. As soon as he was stunned, he knew he had said something wrong. This means Lao Li's operation is not done well! Not careful. Patients with imperfect examination are afraid of this kind of thing. Doctors can't say that if the examination is not perfect, they will have an operation. The mistake must be the doctor's. at this time, there is nothing that leaders don't call.

"Transfuse blood, correct shock and increase fluid speed." Zhang Fan ignored their emotions and began giving oral medical advice to the itinerant nurse. Blood was sprayed not only on Haila's face, but also on the wall of the operating room.

The itinerant nurse was in a hurry. As soon as Zhang Fan's oral medical advice was said, she knew what to do. If you know what to do, you won't be in a hurry.

Blood pressure dropped and there was less bleeding. Haila quickly began to tie knots. The atmosphere in the operating room was tense. Lao Li Tieqing's face was blue and his voice was cold. Hella wanted to slap herself regretfully.