Chapter 465: Double blood supply blocked, incredible operation!
"Hemorrhagic shock, refractory hypotension, such rapid blood loss, there is a high possibility of complex spleen damage..."
Mo Wan's face was very serious. The mortality rate of this kind of patient is over 70%!
Although Xu Qiu quickly infused lactated Ringer's solution through the central vein as soon as the patient was admitted to the hospital, Luo Zhongshi's condition was still not optimistic.
From this perspective, it is reasonable for Xu Qiu to think that the damage of two points is unacceptable.
But, isn't Xu Qiu good at Chen's pancreaticojejunostomy? When did he do liver repair?
…
In the operating room, a drop of sweat oozed from the forehead of the anesthesia team: "Doctor Xu, the blood pressure still can't be raised!"
Low blood pressure means that there is still a lot of active bleeding in the patient's body.
If the blood pressure is not raised, forcing the operation will lead to excessive reduction of heart and brain blood supply, which will cause brain tissue death and cause irreversible devastating consequences.
"Continue, speed up the blood transfusion." Xu Qiu glanced at the life monitor and said immediately.
The nurse heard this and did not dare to delay at all. She immediately pinched the blood bag with both hands and squeezed it hard.
Gurgle——
The speed of the three infusion channels reached the limit that the patient's body could bear, and Luo Zhongshi's blood pressure began to rise slowly.
However, after the three bags of blood were transfused, 600 milliliters of blood entered Luo Zhongshi's blood vessels, and his blood pressure suddenly dropped again.
Seeing this, Xu Qiu immediately said in a steady and calm voice: "Prepare for surgery."
Everyone in the operating room immediately took it seriously.
Clang——
The scalpel was held firmly by Xu Qiu, and he gently cut the skin between the fifth ribs on the left side of the patient.
Since the blood pressure cannot be stabilized, we can only perform rescue surgery while resisting shock!
Mo Wan looked incredulous.
It is difficult enough to repair a ruptured liver, and it must be done while resisting shock. Is this something a human can do?
What responded to her was a neat thoracotomy.
Clang clang clang——
The noise in the operating room was getting louder and louder, and the unique slaughterhouse style of orthopedics made Xu Qiu under the shadowless lamp even more cold.
The patient's chest was opened, and various instruments such as hemostatic forceps and hooks were used. After a while, the aortic blood flow was blocked.
Beep, beep--
After a short wait, the anesthesiologist's surprised voice sounded: "The blood pressure has recovered!"
Xu Qiu immediately changed the knife: "Open the abdomen."
Blocking the aorta above the diaphragm is the most effective but also the most dangerous operation to increase blood pressure and prevent ischemia and hypoxia of the heart and brain during surgery.
Even Xu Qiu dared not be vague. He must immediately find the active bleeding point in the abdomen and quickly restore the aortic blood flow after stopping the bleeding.
Swish--
Xu Qiu made a standard short oblique incision under the right margin. A wound was cut from under the xiphoid process and extended to the right axillary line. A fine S-shaped blood line appeared in the patient's right upper abdomen.
"Suction device."
"Gauze."
After quickly entering the abdomen, Xu Qiu quickly organized his assistants to suck out the accumulated blood and blood clots.
However, just after the blood pool in the abdominal cavity was sucked out, fresh blood soon gushed out again.
Mo Wan's face changed slightly: "The bleeding speed is still very fast!"
Xu Qiu glanced at it lightly: "Blocking band."
Then, he controlled the hepatic artery and portal vein.
The liver is supplied with blood by both the portal vein and the hepatic artery. If these two blood vessels are blocked, even if the liver becomes a sieve, it will not leak a drop of blood.
Of course, this kind of hemostasis is only temporary, also called intermittent blocking method. It must be loosened every fifteen minutes or so, and the blood supply must be restored for about five minutes before the second blockage.
Otherwise, the liver will be gone before the bleeding stops.
Mo Wan was uneasy, and she took a deep breath silently.
Blocking the aorta, and now blocking the hepatic artery and portal vein, is there really a doctor who can handle this operation?
The next moment, Xu Qiu's hand suddenly reached into the abdominal cavity and pressed his hands on the liver.
At this time, a lot of liver tissue fragments can be seen on the diaphragmatic and visceral surfaces of the left lateral lobe of the liver. The injury of the right lobe of the liver is the most obvious. On the reddish-brown soft normal liver tissue, there are a few gray pieces of flesh hanging here and there. That is the broken S7 segment.
In theory, this kind of liver needs to reduce the stimulation of touching as much as possible, but no one could have imagined that Xu Qiu would actually do it directly.
Mo Wan looked flustered. She was about to call a halt, but she found that everyone else in the operating room had a face full of accustomed expressions.
"Is it coming?" Wang Ping was quite excited.
Shi Lian said expectantly: "I can see the method of stopping bleeding with bare hands again. Just this operation of the teacher is enough for me to learn for a lifetime."
Mo Wan: ? ? ?
What, stop bleeding with bare hands?
This is a fragile liver!
If the force is a little stronger, the patient's already scarred liver can even be crushed!
"Success." A surprised voice sounded.
Mo Wan looked at the operation area in astonishment. Under the bright light, the chest cavity was clean in an instant. After wiping with gauze, there were only some shallow blood marks, and the active bleeding had been completely stopped.
Looking at the liver again, Xu Qiu's hands restrained several parts in an exaggerated manner.
"Release."
As soon as Xu Qiu finished speaking, Wang Ping couldn't wait to untie the blocking band.
Boom--
The high-pressure blood lost its obstruction and instantly poured into the liver from the dual blood supply. Xu Qiu's fingers also felt a burst of pulsation.
However, after dozens of seconds, the blood had irrigated the entire liver several times, and there was no new blood spot in the chest cavity.
"Really...successful?" Mo Wan's expression was shocked.
This is more effective than electrocoagulation, right?
"Compression with gauze pad."
In five minutes, the bleeding point was accurately located, and the hemostasis method changed from extreme blocking to compression and interruption.
This step made Mo Wan silent again.
In clinical practice, blocking the double blood supply is not just for stopping bleeding.
More importantly, it is actually for surgeons to reduce the risk of surgery.
After all, if the operation goes wrong, the consequences of a blood vessel with surging blood flow and a shriveled, blocked blood vessel are obvious.
But all this seems to be beyond Xu Qiu's consideration.
And the facts also prove that there is no such thing as operational error or surgical risk.
General clinicians need to repeatedly loosen the blocking band three or four times, for a total of about an hour, before they can complete the liver repair.
But for Xu Qiu, everything seems to be fast-forwarded.
He quickly cleared the blood clots and inactivated liver tissue at the rupture,
and at the same time, he also outlined the specific context of liver repair in his mind.
The still active liver tissues seemed to be reorganized before his eyes, connected and integrated by fine spider web-like sutures, patched up one by one, and returned to the patient.
"Huh."
Mo Wan didn't dare to blink.
At this moment, she finally understood why Xu Qiu dared to block without hesitation and release easily... because the speed was too fast!
It was so fast that there was no need to consider the damage caused by the blockage, and the operation could be ended early!
"What's next, how to solve the liver cutting?" Mo Wan suddenly looked forward to it.
