After 100 Days Of Sign-In, The First Operation Shocked The World

Emergency operating room.

The patient's old lady has been successfully anesthetized and is lying quietly on the operating table.

It took Lin Feng 10 minutes to read various inspection materials of the old lady.

Medical history...

Brain CT...

Because the old lady is too old, she checked her heart, blood routine, etc...

After reading the information, I have a general understanding of the condition.

·C7 scan reveals an intracranial hematoma with obvious brain compression!

·30ml of hematoma on the screen and 10ml of hematoma on the screen!

·And the patient is in a severe coma!

Disinfection, dressing, gloves...a series of master-level process actions...

The nurse has shaved the hair on the back of the patient's head...

And the anesthesiologist has completed the anesthesia...

"Prone position!"

"Craniotomy!"

"General anesthesia, establish venous access, maintain blood supply!"

"Endotracheal intubation!"

Lin Feng was directing and doing his hand.

...

first step,

Cut the brain skin!

Lin Feng took the sterile forceps and disinfected the neck with iodophor gauze, and then the alcohol cotton ball was deiodized.

Use a surgical file to make an incision at the base of the patient's skull and at the chondrified osseointegration site.

"Electric knife!"

Cut under the skin.

"Scalp clamps!"

For each layer cut, you need to use scalp clamps to stop the bleeding of the scalp.

"Mobile bleeding spots!"

"Bipolar coagulation to stop bleeding!"

Lin Feng methodically directed the two assistants Zhang Yuan and Song Ziming.

The scalp was cut open in one piece.

"Scalpel!"

Lin Feng began to sharply separate the loose tissue layer under the galea aponeurosis.

Flip to the base of the flap with forceps.

"Bipolar coagulation to stop bleeding!"

"Saline!"

Place 903 saline pad on the outside of the base, so that the soaked saline pad covers its inner surface.

"Scalpel!"

"Periosteum separator!"

Lin Feng made an incision along the inside of the incision and then peeled off the periosteum.

...

The second step,

Cut open the skull.

"Hand-cranked skull drill!"

"Crunch, crunch..."

A hole was drilled into the skull on the back of the neck.

Lin Feng used a small curette to carefully scrape out the fragments in the skull drill hole.

"Wire saw!"

Lin Feng was cautious, using a jigsaw little by little to cut through the skull.

Then insert the periosteal separator under the bone flap, and forcefully turn the bone flap up.

The skull opened.

"Bone wax stops bleeding!"

"Salt water gauze!"

Receive the saline gauze that was handed over and wrap the bone flap.

...

third step,

Clear the hemocephalus!

"Nerve stripper!"

Lin Feng relied on the nerve stripper to gently free the visible hematoma from the dura mater.

"Attractor!"

Lin Feng gently used the aspirator to remove the free hematoma from the skull.

"Multiple active bleeding spots!"

Song Ziming looked at the data on the microscope probe and reported it.

Lin Feng nodded.

There are two methods for bleeding spots, one is ligation and the other is electrocoagulation.

Although bipolar coagulation hemostasis is easy to use, Lin Feng is still accustomed to using silk thread through the ligation.

After all, bipolar coagulation to stop bleeding will still cause certain damage to the subcutaneous nerve layer in the skull.

"Tie the thread!"

Lin Feng used the smallest thread to ligate the bleeding point little by little.

"Bone wax!"

Fill the middle meningeal artery bleeding in the bone canal with bone wax.

After doing this,

After waiting for a few minutes, there was no bleeding anymore.

And all the blood has been removed.

You can start to close the brain.

...

the fourth step,

Turn off the head!

"Little round needle!"

Using small round needles with both hands, dura and periosteum were suspended and sutured at intervals of 2-3 cm along the bone window.

"4/0 silk thread!"

The round needle guides the silk thread, puncturing and suturing between the periosteum.

disinfect……

Fix the bone flap...

disinfect……

Suture skin flaps, muscles, subcutaneous...

With the last thread being cut...

The operation is over! !

...

The entire operation time, 2 hours and 13 minutes!

Very fast!

Zhang Yuan, Song Ziming and others are already used to it.

Basic fuck!

Don't bully!

All sit down!

With so many operations, it seems that as long as it is in the hands of Lin Feng, no matter how serious the condition is, it can be solved.

The family has just been taken out of the operating room, and the family members continue to thank them.

Lin Feng shouted, "Xiaoli, where is my supper?"

Xiaoli: "It has been delivered, in the lounge..."

Lin Feng laughed. He was hungry. It's nice to have supper.

result……

"Beep Beep Beep Beep~~~~"

Another ambulance stopped at the door of the emergency room.

A flat car pushed an old man and rushed into the operating room.

Lin Feng: "???"

Look bad!

Why do I need to get up and eat supper when I step on a horse?

Doesn't sleep sound?

The nurse quickly understood the condition.

"It's very coincidental and fate. This old man quarreled with the old man with cerebral hemorrhage in front. Because he won the quarrel, he was too proud. After going back, the more he thought about it, the more excited he became and the brain infarcted!"

The nurse preached helplessly.

Lin Feng: "………………"

Zhang Yuan, Song Ziming, everyone: "..."

This year, there are all kinds of monsters! !

After quarreling and losing anger, cerebral hemorrhage is still in the past, but the mud horse is because of a cerebral infarction. What is it?

Both "cerebral hemorrhage" and "cerebral infarction" are cerebrovascular diseases.

But there is an essential difference in the pathogenesis!

The treatment is the opposite!

Cerebral hemorrhage: Most of the causes are atherosclerosis caused by high blood pressure, aneurysm (aicc) formation, aneurysm rupture, blood overflowing from the blood vessel to the outside of the blood vessel, hematoma compression of the brain tissue and brain tissue necrosis, causing neurological deficits symptom.

Cerebral infarction: It is caused by atherosclerosis, which leads to stenosis of the tube lumen, occlusion of the tube wall, or formation of thrombus in the vascular lumen to block blood flow, causing cerebral tissue ischemia, hypoxia, and necrosis.

...

Zhang Yuan: "Lin Feng, come on..."

Lin Feng: "………………"

I am a person in obstetrics and gynecology!

(Obstetrics and Gynecology: You know too!!!)

Lin Feng checked the physical condition of the old man.

·The heartbeat is so weak that it can be ignored

·Patients have extremely dilated pupils and loss of consciousness.

Lin Feng can basically be judged as "large cerebral infarction"!

In a civilized and harmonious society, if you can't solve anything by hand, you have to use your mouth.

It's fine, the noisy anger caused a cerebral hemorrhage, the winning laughter caused a cerebral infarction.

The price is not big!

So, if you feel unhappy, just do it.

If it hurts a little, just use the last medicine (manually funny)!

Lin Feng said to his family: "The patient judged that he had a large-scale cerebral infarction, so he needed a craniotomy!"

If it is only a small-scale cerebral infarction, and in the window period, it only needs to rely on the degradation of thrombolytic drugs.

However, a large area of ​​cerebral infarction must be counted as a craniotomy.

The patient’s family happened to see the other old lady coming out of the operating room and knew that the operation was successful, so they still trusted Lin Feng.

"Send to the CT, take a quick CT..."

"Xiaoli, let her family sign a medical report..."

...

10 minutes later……

CT results came out,

·There are large patches of low-density foci in the right frontotemporal lobe and basal nucleus area, and irregular patches of high-density are seen inside. The right lateral ventricle is compressed and narrowed. High-density foci were seen in the posterior horns of bilateral lateral ventricles. The midline structure is slightly shifted to the left.

Obviously, a large area of ​​cerebral infarction!

·The subsequent CT results showed that although the cerebral infarction was blocked, the blood pressure continued to increase, and there was a state of penetrating, which would cause arterial vascular rupture and cause cerebral hemorrhage...

·Plus diagnosis: intracranial pressurization!

Emergency operating room...

Lin Feng commanded, and a group of people were busy.

"ECG blood pressure monitoring!"

"Strictly observe the changes in the patient's mind, pupils, and vital signs!"

"anaesthetization!"

"Establish dual venous channels!"

Lin Feng ordered the preparation before surgery as usual.

5 minutes later,

The operation is ready...

The anesthesia is over...

...

Lin Feng stood on the operating table and used a scalpel to cut the scalp on the underside of the patient's left ear.

Brainstorm!

"Hand-cranked skull drill!"

After cutting the dura mater, drill a hole.

The intracranial pressure was immediately relieved, but the value was still above the critical point.

But there is still danger. Lin Feng used a wire saw to cut a bone window on the skull.

"Wire saw!"

Lin Feng manipulated the wire saw to cut off the bone flap in the patient's skull, clamped it out with tweezers, and placed it in the tray.

"Intracranial pressure is still above the critical point!"

Song Ziming said with worry on his face.

It stands to reason that intracranial pressure, after craniotomy and decompression, will definitely fall to the critical point.

Continuously elevated intracranial pressure is a bit difficult.

"Intravenous injection of hypertonic dehydrating agent!"

"Push in 50ml of diuretic!"

Lin Feng commanded.

And the index finger kept tapping on the operating table, thinking of time silently in his heart.

...

Twenty minutes later...

Song Ziming reports data:

"Intracranial pressure is infinitely approaching the high critical point, descending like a cliff!"

Lin Feng gave a sigh of relief. The thrombolytic drugs still have a certain effect on degrading thrombus and reducing intracranial pressure.

Now Lin Feng has to make a choice:

One: Removal of the severely damaged part of the brain tissue.

Two: Choose conservative treatment and resuscitate brain tissues with drugs.

The former is done once and for all, but once it reoccurs, the fatality rate and disability rate are much higher than the probability of the second drug control.

Lin Feng: "Go ask the family members and let them decide and sign..."

Zhang Yuan: "Let me go."

————————

ps: 4600+3300+3100=11100 words

. .

Thank you for reading this story at mtlarchive.com. Your support enables us to keep the site running!