Chapter 789 Humanoid Medical Codex
It is almost impossible to find out the indications of a new theory without a huge amount of data and blood.
Could Xu Qiu also list the indications?
…
"The next part is about the indications, timing, and treatment characteristics of various injuries of damage control surgery!"
Xu Qiu's words excited the whole audience.
It really exists!
Xu Qiu actually studied the damage control theory thoroughly?
Everyone's faces were full of unconcealed joy at this moment, and they all pricked up their ears and listened attentively.
Xu Qiu continued:
"There are two basic conditions for applying damage control surgery.
"One is that the injury severity score is greater than 16 points. The second is that the estimated operation time is more than two hours. ”
If the score is greater than 16 and the operation time exceeds two hours, damage control can be considered...
You can imagine the difficulty of Dai Kai's operation.
With a maximum score of 75 and an estimated operation time of seven or eight hours...only Xu Qiu dared to pick up the scalpel.
Everyone was in a state of panic.
Xu Qiu continued: "In addition to the two basic conditions, there are a series of physiological risk parameters.
"The first is the indicators related to the special triad, which are acidosis, serum pH less than 7.3; body temperature less than 35 degrees; and prothrombin time greater than 16 seconds and coagulation activator time greater than 50 seconds in coagulation disorders...
"The fourth is massive blood loss. As long as the required blood transfusion volume is greater than 10U, it can be considered a massive blood loss transfusion.
"Fifth, during rescue or surgery, the patient's circulation is seriously unstable and the hemodynamics is poor.
"Finally, severe liver damage, severe pancreaticoduodenal damage, abdominal large blood vessel damage, and severe swelling of abdominal viscera make it impossible to close the abdomen...
"As long as any of the above six dangerous parameters appears and two basic conditions are met at the same time, damage control surgery can be considered."
...
"Then, it is the timing of application of damage control surgery.
"This is difficult to solve by teaching. If you want to accurately control the timing, there are not many tricks. You can only rely on the amount of surgery and experience.
"But I can still provide three suggestions.
"First, avoid excessive resuscitation before effective hemostasis. If resuscitation is forced, the process will delay a lot of time, and it is very likely to miss the best conditions for damage control surgery.
"The second is to predict the development of the disease. When it is predicted that the patient will have dangerous parameters, damage control surgery can be performed in advance. In this case, sequelae and risks can be further reduced, ensuring a higher success rate of surgery and a better prognosis.
"The last point is to make a comprehensive analysis of different trauma types, locations of multiple injuries, and severity, and promptly decide on the implementation plan of damage control surgery. ”
The third point is the most difficult for ordinary doctors to understand.
But all the people present are experts, and at least they are old doctors at the deputy director level, so they immediately understood what Xu Qiu meant with just one word.
In clinical practice, patients with various abdominal organ injuries often appear. For such patients, the conventional damage control judgment method is not applicable. At this time, the third point should be followed, that is, open surgery first, and then decide whether to perform damage control surgery or conventional surgery based on the damage to the abdominal organs seen by the naked eye...
"What a perfect theory..." In the auditorium, the directors of the Temple of Heaven were stunned.
They thought it was just a routine surgical tutorial, but they didn't expect to give them a big surprise at the beginning!
The two theories of golden time and damage control alone are enough to bring huge improvements to each department.
"It's worth it!"
"Dr. Xu is simply a human medical bible..."
"Although Linyi has cooperated with our neurosurgery center, we seem to have also relied on Academician Xu! ”
Everyone was so excited that they could not help but discuss in a low voice.
However, when Xu Qiu spoke again, everyone immediately fell silent, their eyes fixed on him.
“Damage control surgery has four key nodes.
“Hemostasis, abdominal organ treatment, resuscitation, and the timing of another operation.
“I only talk about one principle for hemostasis, palliative hemostasis. The hemostasis of multiple injuries does not require thoroughness, as long as the bleeding can be controlled in the fastest time.
“The focus is on the treatment of abdominal organs.
“I will talk about this in more detail, and I will also hand over the relevant treatment guidelines to various departments of Tiantan in the form of paper versions.
“For severe liver damage, the Pringle technique is required to block the blood flow to the liver. Twenty minutes at room temperature is the safe time limit for liver blood flow blockage. In addition, it is necessary to ligate the active bleeding in the wound, clean up the free damaged liver tissue, and fill the liver wound and the upper and lower parts of the liver with large gauze pads.
“Pay special attention to the hemostasis pressure here. The treatment of liver injury does not require hemostasis, as long as the bleeding can be controlled. If the pressure is too high, the liver, bile duct and hepatic blood vessels are very likely to be torn.
"The second is pancreatic injury. The treatment method mainly depends on the difficulty of planning the injury of the main pancreatic duct. The principle is to control bleeding, thoroughly clean the wound, preserve pancreatic function and fully drain. If the pancreatic head and duodenum are severely and extensively damaged, pancreaticoduodenectomy is performed immediately, but the digestive tract cannot be reconstructed!
"There are also spleen rupture, kidney rupture, large blood vessel injury..."
Xu Qiu carefully described the various situations that may be encountered in clinical practice.
No one in the auditorium spoke, and everyone held their breath. They all knew that this was an opportunity for Tiantan to develop from a comprehensive top three hospital with brain surgery.
This academic lecture lasted for four hours.
It was dusk when it ended.
It was not until Xu Qiu was about to leave that the senior executives of Tiantan, who were still in a daze, woke up as if from a dream and stood up to see him off.
Papa--
Thunderous applause rang out, and Xu Qiu still had a peaceful smile on his face and nodded slightly to everyone.
Academicians Su and Cui stepped forward to personally see Xu Qiu off.
Xu Qiu talked about too many things in this cooperation.
Tiantan gained not only the total pelvic dissection, but also the experience and ability to deal with severe multiple injuries.
And this made Tiantan take a crucial step on the road to becoming a comprehensive top three hospital.
…
On the third day, Xu Qiu returned to Linyi.
With him, there was also an agreement for Tiantan and Linyi to formally establish a strategic cooperation.
On the same day, Tiantan and Linyi issued an announcement at the same time.
"Tiandu Tiantan Hospital has officially established a strategic partnership with Linyi and Linhai University Medical School!"
"Linyi and Linhai University Medical School have officially established a strategic partnership with Tiandu Tiantan Hospital!"
The industry was shocked by the news.
"Damn, Linyi, which is in its heyday, is cooperating with Tiantan, a well-established and powerful hospital?"
"What the hell, do these two hospitals have the motivation to cooperate? The two hospitals are not in the same field, right?"
