The Surgeon’s Studio

Chapter 96: 0094 Massive retroperitoneal hematoma

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

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

Ordinarily, I have no grudges with the ICU in the past, and no grudges in the recent past. 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 injured in a traffic accident and was sent to the fifth ward of the Orthopedic Surgery Department at 9:18. He was diagnosed with a pelvic fracture. The blood pressure at that time was 100/60mmhg. The blood pressure measured an hour later was 85/45mmhg. Considering that the fracture was combined with massive bleeding, a pelvic CT scan was performed in the emergency department. , showing a large area of retroperitoneal hematoma. After consultation in the ICU, the patient was transferred to continue treatment."

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

Pelvic fractures are generally not serious and can be treated with a period of rest. Surgery is rarely required.

This is due to the structural characteristics of the pelvis itself. There is usually bleeding from the fracture section and a small or medium amount of effusion. This does not require special treatment, and intravenous administration of hemostatic drugs and antibiotics is enough.

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

These blood vessels are located behind the peritoneum, and bleeding will be wrapped by the retroperitoneum. In most cases, when the broken artery is small or the vein bleeds, the increased local pressure will stop the bleeding.

But…

The patient's situation this time is quite special. Among a hundred patients with pelvic fractures, such a case may not be picked out.

The vascular damage to the retroperitoneum is relatively serious. It is considered that a relatively large arterial blood vessel has ruptured, and the pressure cannot stop the bleeding. The patient's blood pressure continues to drop, and he enters a state of hemorrhagic shock.

What is even more difficult 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 accumulated inside will immediately jump to the roof under the huge pressure.

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

After a hangover, he didn't appear to be drunk at all, but looked slightly decadent.

But when this sense of decadence appeared on that extremely handsome face, it had a different flavor.

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

"Pelvic fracture combined with pelvic artery rupture and retroperitoneal hematoma." When Su Yun heard Director Pan's voice, he raised his head but did not stand up or look 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 the only way to stop the bleeding is through interventional surgery, and then the next step of treatment will be decided based on the situation.

Su Yun's judgment of the condition was very accurate. How to treat Yemen Qing was indeed not easy.

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

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

Young people can sometimes be impulsive, but they still need the help of older comrades to keep them in check.

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

But Old Director Pan still hesitated. After all, he had never done it himself. This kind of thing still had to be decided by Zheng Ren.

"No problem." Zheng Ren said: "Prepare blood, make preoperative preparations, and push the patient to the interventional operating room."

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

Zheng Ren was alert, what did this sissy want to do

"I'll go and set up the infusion 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.

"Another order of infusion based on urine specific gravity?" The nurse took the paper, glanced at it, and said with some regret, "Brother Yun, your trip to the emergency room was really in vain."

"Haha." Su Yun didn't argue, just smiled, his black hair flying in front of his forehead, looking handsome.

Zheng Ren didn't have time to watch Su Yun flirt with girls intentionally or unintentionally, but Su Yun still had a way. Inputting crystalloids and colloids in the order calculated according to urine specific gravity can effectively target the internal environment disorder in hemorrhagic shock.

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

Because the Internet is now developed, this calculation formula is also roughly explained online. But the problem is that calculation based on urine specific gravity requires a lot of formula calculations, which is beyond the cognitive scope of medical students.

Moreover, constantly testing urine specific gravity and repeatedly adjusting the order of infusion is also a tiring practice.

Therefore, those who can do this are all great people.

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

After the placenta ablation patient's surgery, Director Pan went to the pre-surgery procedure and bought a batch of consumables that Zheng Ren needed.

This time, Zheng Ren does not have to face the tragic situation of being isolated and helpless again. Not only are there consumables, but there are also assistants, but the assistants are not that satisfying.

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

Xie Yiren 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 would definitely not agree. It is not a circulatory surgery and the patient could have a cardiac arrest at any time. Why bother with an extra person going in to take the thread

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

One is a handsome guy who is annoying and sarcastic, and the other is a cooperative, pretty and lovely girl. You don’t have to think about which one you prefer. Zheng Ren is very straightforward.

There are not many instruments required. After all, it is "just" an embolization and hemostasis surgery. Among interventional surgeries, this is just a very simple procedure.

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

At this point, the preoperative preparations for the interventional operating room have been completed.

Gently lifting the patient onto the operating bed to avoid secondary injury and bleeding, Zheng Ren turned on the machine, switched to operating room control mode, and began to brush his hands and put on clothes.

Interventional surgery not only requires radiation, but also requires wearing a lead garment weighing dozens of kilograms, which is more difficult than ordinary surgery.

However, in special circumstances, interventional surgery is the only way to solve the problem. If you don't do it, you can only watch the patient die due to excessive blood loss.

Zheng Ren walked to the storage room, picked up a piece of lead clothing and was about to put it on when he suddenly realized that he seemed to have forgotten something.

After completing the last isolation mission, the system seemed to reward him with a set of lead clothing that converted radiation ray energy, and there was also a silver treasure chest.

Zheng Ren had no interest in opening the silver treasure chest. After all, three skill books were opened in a row before, so it would not make much sense to open them again.

But the conversion of radiation ray energy into lead clothing sounds very high-end. If we take it literally, it seems that this clothing can convert radiation into energy and supply it to itself.

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

Zheng Ren put down the lead clothing and took a look. Su Yun was still posing and making preparations for the operation. Then he went to the dressing room and entered the system space to take out the radiation energy-converting lead clothing.