Great Doctor Ling Ran
Chapter 163: 2 times
Ling Ran rushed directly to the operating room.
Pretending to be strong, Lu Wenbin breathed a sigh of relief and quickly reported: "The patient's skin temperature decreased by 5 degrees Celsius, the skin was pale, and the degree of swelling was +, I used it ..."
"He smokes?" Ling Ran was not surprised.
Nicotine is extremely dependent, and the withdrawal difficulty is not less than that of the smoke.
Ordinary people quit smoking and may fail if individuals have a strong subjective will. Smokers who have replanted with broken fingers did not expect their fingers to break, and they were not ready to quit smoking. There will always be people who do not follow the smoking cessation orders demanded by doctors. Because of this, there will be a large number of orthopaedic surgeons in Europe and the United States that refuse to replant broken fingers for smokers.
Lu Wenbin didn't expect Ling Ran's reaction to be so slight, nodded, and then said, "It is said that I took two breaths, only one breath this time."
"It doesn't matter how much." Ling Ran went to see the patient's condition and asked, "Did the patient's family sign the consent for the operation?"
"Signed. I told them that I suspected that the anastomosis had an embolism, so I had to remove the anastomosis and rejoin the arteries, and I also told them that the second time is very risky, and the patient's family insisted on keeping the fingers." Lu Wenbin was somewhat frustrated. Even if the second reconnection is successful, blood circulation may not be established, and the functionality of the finger in the future cannot be compared with the previous one.
For a resident who has just started replanting a limb and has achieved a sense of accomplishment, this kind of thing is worse than 20 hours of continuous work.
Ling Ran has always been indifferent to emotions, and doesn't say much, just saying, "Do it then."
Reconnecting the arteries is much simpler than replanting the broken finger. It is just a matter of cutting two more. For him, from confirming the position of the embolism to rebuilding the blood vessel, it is nothing more than half an hour of work, or he intentionally slows it down. Speed situation.
The last time she replanted the broken finger, Ling Ran considered the possibility of nicotine intake, so when sutured, an extra blood vessel was sewn to improve the blood flow rate.
This time, Ling Ran also protected Mao Haipeng's blood vessels as much as possible, leaving enough space for blood circulation.
After a surgery, several medical staff in the operating room were not in a mood to chat.
Blood circulation crisis does not occur instantly. When such severe vascular embolism occurs, the condition of the blood vessels in the broken finger is not optimistic. It ’s like a road where traffic jams are so severe that it is likely that there are already multiple sections of traffic ...
Repeatedly injured bodies are likely to supply more platelets under the stimulation of nicotine. Judging from the literature, letting rats with tail-replantation smoke increases the adsorption of platelets by 10%, which is corresponding to the low growth rate of endothelial cells-only one fifth of the normal group.
Ling Ran can use surgical methods to remove the anastomotic embolism, and even clean it very clean, but for the inside of the blood vessels with broken fingers, only medication can be used.
The biggest difference between medication and surgical methods is that surgical methods are dominated by doctors, and the efficacy of drugs is often related to the adaptability of people.
This is as if there are often banned drugs in sports. Some people use banned drugs and quickly make huge breakthroughs. Some of them have not changed much, and even their results have deteriorated. In the final analysis, it is different people who use drugs. The response was different.
For example, the anticoagulant heparin has a very good general effect, and some people have very good results or very poor results.
At this moment, to keep Mao Haipeng's fingers, the medicine given to him only achieves universal effects, I am afraid it is not good enough.
Lu Wenbin also saw this. After the operation, he specifically said, "I'd better stay in the hospital and watch Mao Haipeng better."
Ling Ran took off his gloves and surgical gown and considered for a few seconds, and said, "Yes."
"I try to keep my fingers." Lu Wenbin was familiar with Ling Ran's temperament and took the initiative: "I won't participate in surgery tomorrow."
"Yes. Take a day off tomorrow and suspend the operation." Ling Ran does not now require a large number of operations every day. Compared with tang stitching, the replantation of broken fingers is more costly, whether it is mental, energy or time.
Even if Ling Ran is in good health, Lu Wenbin and Ma Yilin will sooner or later be unable to support it.
After all, at the stage of replanting broken fingers, the responsibilities of assistants have become more and more, and they are no longer simply hookers. In addition, the two also had trivial matters such as rounds, writing medical records, and making medical orders. Even if they were replaced by two people, they could not relax.
After today's episode of Tobacco Man, Ling Ran also wanted to rest.
Lu Wenbin gave up the rest completely.
Broken finger replantation is similar to other types of surgical procedures. It has the most advanced conditions. If you can break through, replanted fingers have a great chance to survive.
Lu Wenbin stayed up all night and made medical orders to cooperate with the medicine at any time, hoping to improve some success rates.
During the second day, Lu Wenbin remained inseparable from Mao Haipeng.
Then it was all night.
During this period, Lu Wenbin only slept intermittently. Whenever the wind blows grass or the phone shakes regularly, he will wake up.
This kind of life, Lu Wenbin is not unfamiliar, he did so when he cooked pork trotters. Calculate the time, put the raw materials on what you should put, and hurry to rest and sleep ...
It is just too difficult to wait until the color of the broken finger changes compared to the trotters.
The third day.
Ling Ran inspected the room as usual.
Lu Wenbin stood up in a disheveled hair, and with his family, stood on the other side of the bed.
Mao Haipeng stared blankly at the front, his fingers were still pale, even with a slight dark gray.
"Show me the medication record." Ling Ran asked for the case and read it from top to bottom.
Unlike physicians, surgeons usually use simple and rude medications with the purpose of resolving symptoms and do not pursue deep causality. Nevertheless, Ling Ran could still see his attempts and efforts from Lu Wenbin's medical order.
Dilation of blood vessels, reduction of blood viscosity, improvement of recovery ability, enhancement of cardiopulmonary function ... Lu Wenbin has done everything possible.
Ling Ran put down the case and looked at Lu Wenbin.
Lu Wenbin's eyes fluttered and he was unwilling to meet Ling Ran.
Ling Ran waited quietly.
After a long time, Lu Wenbin finally hoarsely said, "Can't keep it ... amputation."
Mao Haipeng's wife was psychologically prepared to hear him speak, but at the end, she couldn't help but shed tears: "Why ... why am I still amputated? I used so many medicines and suffered two pains ... "
The woman dwelled in tears, Ling Ran could only watch silently. Ask yourself, if he can predict the future, he may make different decisions, such as direct amputation, stricter means of quitting smoking, at least, can give up the second reconnection, or even refuse Lu Wenbin's care requirements, which can save a lot of resources , Save the patient and family members to pay, whether it is money, energy, time, or mental trauma and physical torture.
But what if the future cannot be predicted?
Ling Ran thought that most of him would replant the broken finger for Mao Haipeng.
Nicotine does not necessarily lead to amputation, nor does Mao Haipeng necessarily smoke ...
"Amputation is currently the only option." Ling Ran could finally give an inevitable answer.
The woman shed tears and said, "Can't I stop it? What can I do without a finger ..."
"The broken finger that has been necrotic is a great risk to other fingers. It is best to send it to the operating room now ~ www.wuxiaspot.com ~ Ling Ran looks at his watch and says:" We will finish as soon as possible. "
The patient's family members hesitated again and again, but in the end they looked at Lu Wenbin.
"It can only be cut off." Lu Wenbin was helpless.
After a few more persuasion, the family members finally signed a new informed consent form, and Mao Haipeng was pushed into the operating room as soon as possible.
After six hours.
Ling Ran again stood in front of Mao Haipeng.
Mao Haipeng's hand was wrapped up, his finger was missing, and the whole person was slightly more energetic.
Seeing Ling Ran, Mao Haipeng was slightly agitated, and said "Thank you" inarticulately, then coughed violently, and made it clearer: "Dr. Ling, trouble you."
"How do you feel?" Ling Ran asked.
"It's okay, I don't want to recover, and the pressure is a little bit less." Mao Haipeng showed an ugly smile, barely saying that he wanted to drive.
"Rehabilitation is still to be done ... hmm ..." Ling Ran paused because a new junior treasure chest had just appeared in front of him.
Achievement: Heartfelt thanks from the patient
Achievement description: The patient's sincere gratitude is the greatest compliment to the doctor.
Reward: Junior Treasure Chest
Looking at Mao Haipeng, Ling Ran was quite surprised. He was able to give the patient "heartfelt thanks" twice. It was his first time to see him.
He shook his hand and opened the treasure box by the way.
I saw a flash of silver, and another silver-gray book appeared. The title page read:
Intermittent horizontal mattress inversion suture method (specialization), also known as Hurst suture method, is mostly used for gastrointestinal plasma muscular suture.
Ling Ran was taken aback again. In the second straight out of the box, it was also the first time he had met.
"It's okay to amputate, so as not to be scared afterwards." Mao Haipeng explained almost to himself, the other hand was on the bed sheet, and kept fumbling.
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