Chapter 745

In most parts of the world, chest trauma is the business of cardiothoracic surgeons, skull trauma is the business of Neurosurgery, and bone and joints are one-third of an acre of bone surgeons.

Gone are the days when a doctor was able to start from head to toe. This may be the result of the development of medical technology.

Or maybe modern people can't stand loneliness, loneliness, a life without money, and are unwilling to deposit.

In those years, if Zhang Fan didn't stick cloth in his pocket, there was no future. It is estimated that even if he had a system, he walked slower than now, and he didn't have such achievements as now.

People are sometimes a fragile group. A mouthful of steamed bread may choke a person. Even a word from others can make a person lose confidence in life and go to extremes.

But sometimes they are quite resilient. Ups and downs, just don't admit defeat.

I don't believe in this life. It's hard to say whether I succeed or not, but once I seize an opportunity, this kind of person as tough as a small strong can't be underestimated.

Zhang Fan looks very awesome in regional hospitals, even in some provincial hospitals, because there are too few doctors from head to toe. One is one. He has either become the president or retired.

In field hospitals, there are too many doctors. Are they more talented? No, they are forced. Sometimes, they are alone and have no way back.

When there is no team and no rear, if you can't specialize in many skills, you can only watch the wounded die.

In the operating room, old Wu Yizhu, the second assistant of the president of the field hospital and the third assistant of the director of XXX hospital.

There is only one old Wu who really engages in liver and gall. In addition, Zhang Fan is registered in the Department of orthopedics. The head of the field hospital is outside the brain. The director of XXX hospital is Zhenggao of gastrointestinal tract. He can also touch the edge.

Four people, four majors, do a liver operation together, which can only be seen in the field hospital.

"Damage control! Dr. Zhang is too brave! " When the president of the field hospital came to the stage, he saw that the wounded's liver was full of gauze. He was very surprised and said a word to Zhang Fan.

Liver, long ago, a doctor used the filling stop loss method for liver injury.

What do you mean? Simply put, the liver was stabbed and damaged, and the blood was like fireworks.

He did not choose hepatectomy or definitive repair. Instead, fill it with gauze and wait for the liver to repair itself.

His record was not recognized at that time. In four operations, three died and one survived, but the liver that survived was intact.

His technique was considered a cowardly operation at that time. Because the chances of failure are too high.

One hundred years later, the U.S. military once again proposed this operation. However, the risk is still quite huge. There are only a few doctors who can do this kind of operation in the U. S. military.

The president of the field hospital is a person who has seen the world. When he sees this way, it is impossible not to be surprised. To be honest, no one dares to start this operation in their hospital.

"Yes!" Zhang Fan nodded and observed the gauze carefully.

In surgery, there is a standard for measuring bleeding. It is clear how much blood is in the suction device, because the drainage bottle has measurement numbers.

How to calculate other bleeding is to count gauze, blood soaked gauze, 200ml gauze.

"Has Dr. Zhang ever done this kind of operation?" Although the field doctor asked Zhang Fan again, his eyes looked at old Wu.

Zhang Fan was busy observing the gauze carefully. He didn't say for the first time that he wanted to determine whether the patient's bleeding had been stopped or how much it was now.

Wu didn't speak, but shook his head.

"I haven't done this before, but it's the only way he can keep his liver."

"Are you sure?"

"Yes!"

"Brother comrade, this is not a joke. I understand your mood, but we should put survival first, don't we?"

The president of the field hospital said to Zhang Fan with a little regret. He admires Zhang Fan's courage to do stop loss surgery, but he doesn't agree that a doctor without this kind of surgical experience should do stop loss surgery rashly.

Of course, this disapproval is not only verbal disapproval, but also reflected in the following medical records and reports.

This is not a villain's behavior. On the contrary, it is the most basic professional ethics of a doctor. Without shielding, one is one, and two is two. Everything is based on the facts seen by his own eyes.

Mr. Wu is not familiar with this last resort stop loss operation. There are too many variable conditions for this operation, so it is impossible to form a rule with data.

"Now I need ophthalmic surgical instruments, a doctor who can formulate TEG, and a nurse who reminds me every 15 minutes. Be quick. "

Zhang Fan did not explain or argue with the dean. He didn't want to convince others, but to keep his liver.

"Hi! OK, I'll send the doctor from the hospital's hematology department right now. Nurse Chen, your task now is to remind Dr. Zhang every 15 minutes. "

"Yes!" The itinerant head nurse began to count the time while saluting.

"Why, didn't the bleeding stop?" As soon as Wu heard this, he knew that the bleeding and hemostasis of the wounded were not optimistic.

"There are still some bleeding, martial uncle. We still need to wait two hours."

After checking the gauze, Zhang Fan looked up at old Wu.

Old Wu's heart was also tangled. On one side, he completely preserved the wounded's liver, while on the other side, he sacrificed.

Really, at this time, doctors are like standing in front of the God of death, patting their thighs and provoking the God of death. Come on, come on, come on.

The God of death, like a Tibetan mastiff, bared his teeth and roared.

Sometimes even when the patient has a cough, the iron chain tied to death will break, and then there will be devastating consequences.

Difficult, often in medical treatment, many, many times, will face this dilemma.

"I disagree. He is still very young, Mr. Wu. We are gambling with his life. Now, even if the liver is cut in half, his life can continue. "

The president of the field hospital was also anxious. He didn't meet Zhang fansu. He was definitely not against Zhang Fan. He was also for the wounded.

This is the difference in concept, the difference in age. Older people tend to be conservative, while younger people are radical.

Who is right and who is wrong? It's hard to say.

Old Wu looked at Zhang Fan. Zhang Fan straightened his body and looked at old Wu. He didn't have to talk with his firm eyes. The tacit understanding cultivated by the two masters knew that Zhang Fan was sure.

"There's still time. First ask someone to make a map. We are all doctors and doctors responsible for the wounded. I support Zhang Fan and director Li. What about you?"

Mr. Wu chose Zhang Fan at this time because he really recognized Zhang Fan's technology and personality. He didn't think Zhang Fan would be willful in this matter.

"I object!" The president of the field hospital insisted on his own view.

Three people and six pairs of eyes looked at the director of XXX naval hospital. The director closed his eyes at this time.

He is not running away. At this time, his mind is full of clips of Zhang Fan's operation at sea, just like a movie.

Section by section, accurate, rapid and decisive! At the age of 40, he kept remembering Zhang Fan's operation.

Slowly opened his eyes, but his eyes were like a flash, "I support Dr. Zhang!"

Saying this is not something that can be completed when the upper lip touches the lower lip. At this time, every word and punctuation are recorded by the nurse. Then archive it. It's not allowed to be destroyed within 20 years!

You should be responsible for speaking at this time!

He did not choose a more robust hemihepatectomy. He did not consider whether he would be responsible for today's sentence in the future.

However, he chose to support Zhang Fan today just to make the quality of life of the wounded more comfortable in the future. I just want to make him live in this world like a normal person, without other people's pity or other people's

"Hi! They are young, old Wu. You, hi, I'll contact the backup staff now. " Although no one supported him, the president of the field hospital also began to make active preparations.

This is the disciplinary force.

This is the medical force that is the last guarantee of our Chinese medical care.

As time went by, the TEG diagram began to describe. In the sound of reminders again and again, two hours passed.

"Start!" After reading TEG, Zhang Fan spoke.

In the operating room, only the sound of waves came.

So clear!

Gauze, gauze stuffed in the liver, Zhang Fan gently pressed his hands. Zhang fan can clearly understand the feeling from the gauze. Now how much gauze is dry and how much gauze is wet.

This is his ability. This is the super sensitive perception he practiced in the system.

Dare to go to Daliangshan without three-thirds?

make fun of!

Like shaking dice to open treasure, gently, a piece of gauze was taken out without bleeding.

Although Zhang fan can sense how much bleeding there is, he doesn't know where it is. Just like buying a lottery ticket, he knows that one of them will win the prize, but he doesn't know which one will win.

So every piece of gauze, he faced it slowly and gently in the presence of bleeding gauze, all with tight muscles.

"Salt water, ice salt water!" When the gauze covering the most surface was taken off, I finally saw the gauze with blood stains.

Almost all injured people have had the experience of dressing change. The bigger the wound, the more painful the dressing change.

If you meet an anxious doctor, changing dressing can become killing a pig.

The gauze covering the wound surface is soaked with blood, dried over time, and pasted on the newly grown tender granulation.

When the dressing was changed, the anxious doctor tore and pulled the gauze away. Really, there was no way to describe which hurt.

Just like the meat that has been wrapped in the skin, one day it was suddenly pulled out by a fierce scratch, and then it was scratched up and down in denim. It hurts. It hurts hard and unforgettable. After the pain is over, there is a continuous stabbing pain. Really, people who can hurt want to contain this meat in their mouth.

The liver is the same. Whether it hurts or not has anesthesia. The most difficult thing is secondary bleeding.

After coagulation, the protein in the blood sticks to the blood vessels, but it also sticks to the gauze.

The gauze at this time is not the small area of your dressing change, but the adhesion of the whole piece.

Once one is not careful, all previous efforts will be wasted.

Salt water ticking, ticking low, gauze with blood coagulation, but not much water absorption.

This is also one of the difficulties that this kind of operation is difficult to solve. Not only to prevent unclosed bleeding, but also to prevent secondary bleeding after adhesion. It's too difficult.

"Doctor Zhang, fifteen minutes have passed!"

"Yes!" Zhang Fan nodded. The exposure time of the wound was longer and longer, and the probability of infection was greater and greater.

"Tweezers!" Zhang Fan took the tweezers and everyone in the operating room held their breath.

Tick, tick.

Gently, at this time, others can't help Zhang Fan a little. Even if they can help, they can only pray in their heart.

it's too hard.

The hand can't tremble. Once the gauze is clamped with tweezers, no one can guarantee that it may be an artery at the invisible adhesion.

Slowly, the heart is hanging up. Open your mouth and the beating heart is in your throat.

People with poor psychological quality can be scared to death here.

Once, once, a piece of gauze was completely taken out by Zhang Fan.

Like a crumpled pink letterhead, Zhang Fan made a clang sound when he threw it in the bend.

It can be thought that Zhang fan can take out the gauze completely without bleeding the liver in all directions. How high is this level and technology.

After the gauze was taken out by Zhang Fan, the president of the field hospital became more and more confident in Zhang Fan.

Just when everyone can breathe a little and breathe smoothly, show! Bleeding, Zhang Fan, who was almost leaning on his liver, was sprayed with blood on his face.

"Come on, I can't see!" The blood came into Zhang Fan's eyes. It's really worse.

The warm blood, like the tongue of a beauty, has temperature and viscosity. Zhang Fan tried his best to open his eyes, but his eyelids could not be opened.

This wound can only be seen by the main knife, because the area is too small, and others can't see the specific wound inside.

And Zhang Fan's eyes were covered with blood. The itinerant head nurse, like a leopard, misfired at a distance of two or three meters and arrived in the blink of an eye.

One held the back of Zhang Fan's head, jerked up his chest, and fixed Zhang Fan's head on her chest.

Then the other hand took the gauze of xinjieermen and directly stained it on Zhang Fan's eyes.

And Zhang Fan, after shouting, was like a big cock with his head cut off.

His head was leaning against his chest, he didn't feel it, and he didn't feel it when his eyes were stained with Jermaine. The head is direct as if it is not your own, without a little resistance.

But the body and hands did not stop. At the moment when the blood came out, Zhang Fan's eyes had not come and reacted, but his hands had already shot.

Like the most accurate missile, the pliers shot at the blood vessels that sprayed blood.

Just a few breaths, Zhang Fan immediately asked, "martial uncle, look, look, is there bleeding?"

His heart hung up. He couldn't see it. He didn't know if he had clamped the bleeding for the first time. Flustered, flustered like thousands of wild dogs chasing him who threw an elephant with his bare ass.

"Stop, stop, don't move, don't move!" Martial uncle's voice began to tremble.

Blood vessels, blood vessels that can expose blood, can't run away. It's definitely an artery, and the artery is like an earthworm spitting out in a cave. If it looses a little, he can definitely take it back.

Once you take it back, you can only cut the liver.

Hand, holding the vascular forceps, resting on the wound of the liver.

The eyes finally saw, "how's it going, see?"

"Yes!"

Then, Zhang Fan didn't dare to move. He didn't know what his position was now.

Gently, the head nurse gently pushed Zhang Fan's head away with her hand and pushed it to the normal position.

Zhang Fan blinked, "hemostatic forceps!"

One piece, one piece, no danger, really no danger. Slowly, all the gauze was taken out.

The wound of the liver was as clean as the bowl licked by erha.

"Shh!" Old Wu took a long breath.

"Awesome!"

"Place the drainage tube and close the abdomen!"

……

Cool! It was great. Zhang Fan looked at the young wounded, breathed smoothly and slowly recovered his bloody face.

Although it was dangerous all the way, he felt so happy. In particular, this sense of relief is like the pores of the whole body are opened and the muscles of the whole body are trembling slightly.

Cool enough to make Zhang Fan shout, cool enough to make Zhang Fan reluctant to leave this feeling.