The spleen is the most easily injured organ in the abdomen, and the amount of bleeding after the injury is huge, and the principle of rescue for this kind of compound injury is: saving lives first, and preserving organs second. When Zhang Fan made an investigation, he already knew that neither the spleen nor the left kidney could be preserved.
It's hard! It's brutal! Death or kidney or spleen? Such a young body will be dilapidated from now on. Sickness is with him all his life, what Zhang Fan can do now is to minimize the damage of the wounded under the premise of ensuring the life of the soldiers.
The splenic artery must be ligated first to reduce blood loss and allow a large amount of blood in the spleen to flow into the circulating blood, which becomes the best autologous blood transfusion. During the operation, Zhang Fan first incised the gastrocolic ligament and gastrosplenic ligament, ligated the blood vessels in the ligament, entered the lesser omentum cavity, and exposed the body and tail of the pancreas.
Palpate the pulsating splenic artery at the upper edge of the pancreas, and select a raised part of the splenic artery at the junction of the pancreatic body and tail, cut the retroperitoneum, carefully separate the splenic artery with right-angle forceps, and tie it with a thick silk thread. When ligating the splenic artery, two ligatures must be tied. The ligature should not be too tight, so as to close the lumen, so as not to tear the artery wall. In addition, care should be taken to avoid damaging the parallel splenic vein below it as much as possible.
Only Ye Bo can help with this operation, and the remaining two doctors can only pull the hook. On Zhang Fan's side, during the emergency operation, only heard Zhao Quanping's very loud voice from the table next to him: "Quick! Push quietly, push quietly, Xi Dilan! Quickly." You can tell from the tone I could hear Lao Zhao's anxious and helpless tone.
"Director Zhao is dying! The medicine has no obvious effect!" said the anesthesiologist.
"Electric cardioversion!"
"Bang! Bang!" The voice of cardioversion. Zhao Quanping looked at the monitor expectantly, how much he hoped that the soldier's heart would start beating again, but he couldn't be rescued in the end! Zhao Quanping clenched his hands tightly.
"You send him off!" Lao Zhao said softly, the damage was too serious, the soldier's luck was really bad, after the shrapnel entered the abdomen, it caused great damage, but cruelty is cruelty, it didn't kill directly, Instead, the soldier suffered great pain before being sacrificed.
After suturing the remaining wound on his body, the nurse gently wiped the blood on his face, tidied up the dilapidated military uniform, and carried it onto the flat car! Covered with a white sheet, slowly pushed out of the operating room.
Now is not a sad moment, there are still operations waiting, and there are wounded waiting to be rescued. "Doctor Zhang, how are you doing?" Zhao Quanping calmed down a little and asked Zhang Fan while standing under the operating table.
His meaning was clear: Need help! Zhang Fan is not their ordinary young doctor, and Zhang Fan's skills are not inferior to his. This inquiry is a respect for doctors of the same level.
"The bleeding is too severe. I just ligated the artery of my spleen and my kidneys haven't been treated yet. Come on stage and help me." Zhang Fan can lose his temper and scold the assistant, but he can't tell people who haven't participated in the operation that the assistant is not good. , that is humiliation!
The assistant was a little out of rhythm, and Lao Zhao changed his surgical gown and went on stage again. As soon as he came up, he was different, and Zhang Fan didn't need to deliberately explain what to do, pull hooks, suck blood, pinch, and tie knots. The two of them had a very good understanding. The speed is much faster, the spleen is removed, the kidneys are removed, and the abdominal cavity is cleaned.
The power of modern firearms is too great, just rubbing the edge can make a section of intestines rotten, necrotic, and lose its function. "Hey! It's a pity that this wounded man won't even dare to eat a full meal in the future!" The intestinal tract was also severely damaged, and Zhang Fan had a long section of intestinal tract amputated. After the interception, Zhang Fan said in a desolate tone.
"It's okay. The abdomen of the wounded person I rescued was directly smashed into minced meat. It didn't look like a big wound on the outside, and there wasn't much bleeding. But when I opened the abdomen, it was already rotten into a ball. Hey! I'm so young, my children are probably a little older than him Right. They have already gone to the battlefield to defend their home and country, and that bastard in my house spends all day in Internet cafes! They can’t even support themselves!” Lao Wang also expressed his feelings. When a person is old, in this special environment, when he looks at the soldier who has just died, he will think of his own child.
Of the six patients, three were successfully rescued, and Zhang Fan was the chief surgeon. One of the orthopedics department, the orthopedics department's patient was injured in the thigh, and had no choice but to amputate directly. The other was shot in the upper chest. Fortunately, the single hole went straight through the apex of the lung and smashed the shoulder blade. Although the injury was serious, it was not fatal.
Looking at the wounds of these soldiers, Zhang Fan was particularly puzzled. The contact surface was a wound the size of a sesame seed, but when he turned it over, there was a wound the size of a watermelon on his back. This kind of injury is really too difficult to deal with. The bleeding is fierce, and the organ failure is very fast. tragic!
The county hospital has specially vacated two wards, where all the rescue equipment is placed, and all kinds of instruments are gathered in this ward. Soldiers who have just survived the operation cannot leave the hospital yet, so they can only observe and treat here first.
The doctors and nurses of the city hospital have taken over them and accompanied them 24 hours a day. The leader of the municipal party committee specifically explained to Ouyang, "People who dare to sacrifice themselves in peacetime are even more valuable. They have already done what a hero can do. We You can’t let heroes bleed and cry, and I don’t know the specific profession, but I’m here to make a statement, and I want them to recover at all costs. If you have any problems, please contact me directly. The municipal committee will fully cooperate!”
After all, it was an emergency, and the superior leaders of the armed police had not arrived yet, so the leaders of the city are in charge here!
In the lobby of the hospital, there were three flat carts covered with uniform white cloth sheets, and there were very young soldiers lying on the flat carts. He tried his best, but he still didn't take their lives back from the hands of death.
The captain of the armed police, the iron-clad man cried like a child, these are all his soldiers, one by one, they were eating and training together yesterday, alive and well, but today they are lying here in the cold.
"Get up! You all get up! Stand up if you are a man!" There was a sobbing voice and bitter tears.
The iron-blooded warrior bleeds but does not shed tears, but he has not yet reached the point of sadness. The laughter and laughter in the past, the sweat during training, and the scenes of these iron-blooded soldiers, tears flowed. A group of green-faced soldiers defended the chaotic border with blood and sweat. The purpose is to allow people to walk freely and peacefully on the street.
It's over, it's all over! Armed police in police uniforms and doctors in white coats stood on both sides of the flat car to see these heroes off.
"Brother! Let's go!" He took off his hat and bowed. The captain, who was about to collapse from crying, felt guilty in his heart, these fighters were all trained by him! His heartache is really incomprehensible to ordinary people, but there is no medicine for regret in the world! He sent him to battle, he buried him! It's not that soldiers can't understand!
Pensions, disability payments, chronic pain that accompanies a lifetime, and the anguish of not being able to integrate into society are all the pain they have to bear. Are poison (a) products scary? It's quite scary. What this thing brings is not only an addiction problem, but also too many evil consequences, such as AIDS and social instability are all brought about by this thing.
The most beautiful frontier city ever had a huge number of AIDS patients! Why, these chaotic countries brought about a large number of smuggling, prostitution, and the same language as many people. Once infected, it spreads through various channels, and the speed of transmission is quite amazing. Drugs (a) and AIDS have become a dark cloud over this Taoyuan.
Old Zou woke up, and it was over! When the operation was over, the county party committee directly ordered him to be removed from the post of dean. Shi Lei took over, the former surgeon, sitting on the director's executive chair, completely saying goodbye to the technical position.
The director of the ICU of the city hospital, the director of the Department of Respiratory Medicine, the Department of General Surgery, and the Department of Orthopedics each left a doctor to continue treating the surviving soldiers. No one's death can stop the sun from rising the next day.
Zhang Fan and Zhao Quanping were in the same car on the way back. In the car that was silent for a long time, Zhao Quanping said softly, "What should their parents do?"
"Yes!" Zhang Fan looked out the window with blank eyes. This kind of disability was really shocking. Living in a peaceful environment, they were really shocked.
They can only chat in the car now, because Ouyang has already issued a password before getting in the car. This is because he is worried about causing panic among ordinary people. The war is so close. If the people know about it, they will definitely feel fear.
Living a normal life and working peacefully, Zhang Fan began to study English hard. Since he passed CET-4 in his junior year, he has never touched English again. He has almost forgotten English, so let's start from the beginning.
On the weekend, Director Li of General Surgery affiliated to Di University brought his team and patients to Chasu City Hospital. The gate of the hospital, the outpatient building, and the surgery building were covered with banners, all of which used the reputation of the Affiliated Hospital of Di University to raise the slogan of the city hospital.
Along the way, Li Jingjin's face turned dark. This Ouyang is omnipotent, and he is really a bit careless. But he can't help it, who made him inferior to others.
The conference room of the hospital is a little better. The layout here belongs to the equipment manufacturer. The venue layout is of high standard. The mineral water is all imported. The gift for the prefectural and county doctors is a shopping card of 200 yuan per person. This equipment manufacturer is a rising star because the leader is young! This is not explained.
So now in order to open up the market, it is also spending a lot of money. There were many doctors who came, hundreds of them, sitting in the large meeting room of the hospital in a dark crowd.
Adjusting the lens and microphone, Ouyang presided over the meeting himself. "Experts and colleagues, first of all, welcome to Chasu City Hospital. On behalf of all the medical staff in the hospital, I would like to extend a warm welcome to you. Today, the doctors in our hospital are honored to operate on the same stage with Professor Di Da. Please Experts and scholars give corrections and criticisms." Ouyang is very high-spirited, how can she be unhappy! Lao Huang has been in surgery all her life, but she has never been so successful. She has only been in office for a few days!
In the operating room, preoperative preparations are still being done. Professor Li's doctoral students are doing these things. He joked to Zhang Fan: "This time I go back to Bird City, and I will probably be criticized. Your Dean Ouyang is really too serious. incredible."
What can Zhang Fan say, it is not very easy to talk to. However, the director of the anesthesiology department answered, "Is the dean of Di University willing to criticize you? I heard that you were invited to the capital for surgery a few days ago. This is you from the frontier general surgery department." Stand up.
"Hi! Ashamed, do you know what kind of surgery I went to the capital?" Lao Li looked embarrassed.
"What's wrong!" Zhang Fan was also curious. Zhang Fan was going to help and do some preoperative preparations, but Lao Li refused to let him do it.
"A leader with a special identity in the frontier, for some reason, suffered from hepatic echinococcosis. I was the one who diagnosed it at the time. I suggested him to have an operation at that time, and he said to go back and think about it. The result came out a week later. , Mr. Chen from Zhongyong in the capital called me and said that there is a liver hydatid surgery that I want to fly over to do. Although we are a frontier hospital, the liver hydatid surgery, to be honest, let alone Huaguo, it is estimated that the whole world It’s top notch.”
The anesthesiologist asked like a joke: "And then."
"Then it was embarrassing! I flew over in a hurry to have a look, hey! Isn't this an acquaintance, even that one, he was also embarrassed, from a thousand miles away, hey!"
Several people were chatting and waiting for preoperative preparations, and the two doctors brought by Lao Li were a little unhappy. They almost didn't have to do these things in the affiliated hospital of Didi University, but when they came to a small city hospital, they actually started to work as a resident doctor, and the most annoying thing was that the chief surgeon was a little girl who was younger than them. doctor.
They have been working in the high-end medical field in a province for more than seven or eight years. Today, it is said that a small doctor in a small border city can perform this kind of surgery. I really would not believe it. He has worked hard for more than ten years of academic qualifications.
Five years of undergraduate, three years of postgraduate, and two years of Ph.D., but in the end, I guess it's just a bastard who graduated from undergraduate, sitting there chatting and spanking with their tutor, and it seems that their tutor is a bit flattering! Have we read our books in vain
Those who can be brought out by their instructors for surgery, and it is such an important surgery, are all academics and top-notch technicians. Although many of them are doctors, many of them can't even recognize the equipment.
Although dissatisfied, but the instructor is sitting, even if there is a big dissatisfaction, he will not show it, let's go to the stage and watch. For those who are still studying for a Ph.D., the mentor is the biggest.
The operation started, and after the anesthesia was finished, Zhang Fan went up to the stage. Now Zhang Fan is really amazing. In a city-level hospital in a certain area, wearing surgical clothes can make the head nurse rush over to wear it for him. It's really amazing. General department directors do not have this treatment.
"Doctor Zhang, what approach are you planning for today?" Professor Li asked, Zhang Fan is too steady, if you don't ask him, he won't take the initiative to say anything to you. This made Professor Li a little depressed. A professor with many years took the initiative to ask a doctor with a low seniority, and he really blushed!
This is actually wronging Zhang Fan. He also felt that it was a bit embarrassing for him to take the initiative to discuss surgery with a professor-level doctor. He is really a technical nerd, and there is no hope!
"The conventional approach. Professor Li, shall we start the operation?" Zhang Fan asked.
"Start, start!" It was an awkward chat, and both of them were very embarrassed.
"Connect the camera, connect the headset! Connect the meeting room!" The staff of the technical department, after watching the surgeons start the operation, turned on the power and informed them to go out.
"Okay, the operation is starting, please give me your advice!" Ouyang put down the microphone and sat in her seat.
When the picture appeared, some of the doctors present couldn't help but let out "Hey!" At first they thought it was the general surgery director of the city hospital, but when they saw it was an unknown doctor, and a very young doctor, they were surprised They couldn't even close their mouths. These surprised doctors were actually doctors from other hospitals in the city.
The doctors in the county were also very surprised. They did not expect that Dr. Zhang, who was hired by them for profit, would be able to perform this level of surgery. Some people couldn't help saying: "Zhang Fan! Dr. Zhang!" Quite a few, Zhang Fan has become very famous in the county within a year.
In just one year, in the surrounding county hospitals, Zhang Fan has created his own sky. Although there is systematic help, but without a strong liver and the practice of giving up part of his interests, Zhang Fan will never be where he is today. fame.
When this kind of voice gathered, everyone in the venue knew that Zhang Fan was the chief surgeon!
The operation started, and Zhang Fan did it quickly. This operation is already very proficient, and after seeing Zhang Fan's huge liver tumor resection, Professor Li did not know how many times he simulated it while lying in bed at night. This is talent, talents who are constantly improving, why they can stand at the top of the medical field in a province, without the spirit of hardship, relying on qualifications, how can you think too much~!
Zhang Fan is fast, Professor Li is not bad, and the other two doctors are not free. All kinds of retractors, all kinds of good surgical vision, are quite impressive, almost comparable to the assistants in the system.
Because it was an observation operation, the surgeons hardly communicated with each other, the whole process was silent, and doctors of their level did not need to communicate, and there was no need for Zhang Fan to mention what to do next.
Entering the abdominal cavity, Zhang Fan's speed slowed down, and he couldn't try to go fast when entering the abdominal cavity, slow is fast, the classic mantra of the general foreigner. Start a little ligation and stop bleeding.
The head nurse in the operating room personally patrols for Zhang Fan! In the observation hall, when the operation progressed to the abdomen and everyone saw the huge tumor, they couldn't help exhaling softly. Clearly wrote: "Not suitable for surgery!"
But now, the operation that subverts their worldview is coming. This is a small place in the frontier. The doctor's sorrow, the saying or practice that is regarded as a classic, may be outdated! But they don't know!
"After the operation, whether the patient can get off the operating table is a matter of discussion, really! This Professor Li is also a bit messy." The general surgery director of another hospital in the city said to another director.
"Probably not, I'm not very sure. Do you think Ouyang will make such a big fuss? I don't know if the operation will be successful, but what I know is that this woman is very powerful. It will definitely be fine."
A little bit of peeling, a little bit of hemostasis, the scary thing about tumors is that the tissue boundaries are not clear. To remove a 1 cm tumor, you have to remove at least 5 cm or more of the surrounding normal tissue.
Zhang Fan, with average talent and average IQ, has finally reached the pinnacle of the regional city hospital level, and this operation is his road to enlightenment.
When he graduated from college and felt helpless, he envied others for having a good father, and he rode a bicycle all over the world to find a job. Finally, he did not spend two years in vain. At this time, on this operating table, the highly concentrated He is already ahead of his peers.
Hard work pays off, as long as you fight hard, even if you are in the mud and rain, you will climb out sooner or later, and you will see the rainbow sooner or later, don't wait! Don't rely on it! Relying on the mountain to fall, relying on everyone to fall, only one's own strength is truly powerful.
The two doctors from the Affiliated Hospital of Didi University couldn't breathe freely. They knew who invented this operation, they knew the brilliance of this operation, and they knew the difficulty of this operation even more.
Today, just today, in the Chasu City Hospital, a small undergraduate resident gave them a lesson, a lesson they will never forget, what is precise surgery and what is precise liver cancer surgery. Lao Li has the deepest experience. Last time he was a bystander, but this time he is a participant. Is the operation difficult! It's really difficult. It is estimated that there are not dozens of such operations, and he may not be able to do it alone.
Because the tumor is too big, the location is too central, a small inadvertent, either liver failure or tumor removal is not clean, the failure of this kind of operation does not give you a chance to do it again, once the failure is either death or cancer cells diffusion!
Slowly, when the last cut was made, Zhang Fan spoke.