0094 Large retroperitoneal hematoma
After entering the ICU, Zheng Ren immediately felt countless hostile gazes aimed at him.
What's wrong with this? Zheng Ren was surprised.
It is said that I have no grudges with the ICU in the future and no grudges in the near future, they...
"Director Pan, you are here." A doctor from the ICU walked to Director Pan and Zheng Ren and began to introduce the condition.
"The patient was sent to the fifth ward of orthopedic surgery at 9:18 and was diagnosed with a pelvic fracture. The blood pressure was 100/60mmhG at that time. The blood pressure was 85/45mmhG after one hour. Considering the fracture and large bleeding, the pelvic CT was checked in the emergency room, showing a large area of hematoma behind the peritoneal body. After consultation with the ICU, he was transferred to continue treatment."
The report of the medical history is very detailed, and the patient's condition is relatively simple, which is caused by pelvic fracture and bleeding, so there is no problem of differential diagnosis.
Pelvic fractures are generally not serious, and it is enough to rest for a while, and surgery is rarely required.
This is caused by the structural characteristics of the pelvis itself. Generally, there will be bleeding from the fracture section and a small or medium amount of effusion. This does not require special treatment, and it is enough to give hemostatic drugs and antibiotics to rest.
However, once a pelvic fracture causes blood vessel rupture and bleeding, the blood vessels pierced by the fracture end are the internal and external blood vessels, and the pelvic vena cava plexus.
These blood vessels are located behind the peritoneum, and the bleeding will be wrapped in the posterior peritoneum. In most cases, when the broken artery blood vessels are not large or when the venous bleeding occurs, the bleeding will be stopped due to the increase in local pressure.
But……
The patient's condition this time is quite special. None of the 100 patients with pelvic fractures will be able to pick out such cases.
The blood vessel damage to the posterior peritoneum is relatively serious. Considering that the arterial blood vessels are ruptured, the pressure cannot stop the bleeding, the patient's blood pressure continues to drop, and hemorrhagic shock state.
What's even more difficult is that because the pressure on the posterior peritoneal body is very high, it is impossible to use surgical methods to stop the bleeding.
As long as everything is opened, the blood in the area will immediately jump onto the roof of the room under huge pressure.
Zheng Ren's heart moved and saw Su Yun put on a chair, sitting next to the patient, holding a pen and paper in his hand, calculating something.
After the hangover, he couldn't see any alcohol at all, but he was a little decadent.
But when this sense of decadence appears on the handsome face, it feels a different feeling.
"Look at the patient first." Director Pan calmly walked to the patient, observing his vital signs and the emergency CT video handed over by the doctor next to him.
"The pelvic fracture was accompanied by rupture of the pelvic artery, and the posterior peritoneal hematoma." Su Yun heard the voice of Director Pan, raised his head but did not stand up, nor looked at Director Pan, but looked directly at Zheng Ren.
Zheng Ren knows what he means.
The patient's condition is not suitable for surgical procedures. He can only stop bleeding through interventional surgery, and then decide on the next treatment plan according to the situation.
Su Yun had a very accurate judgment on the condition. How to treat Yemen Qing is indeed not easy.
"Xiao Zheng, are you sure?" Although Director Pan didn't know much about intervention, after the emergency treatment of the placenta exploitation patient that day, he went home and bought a book related to intervention and studied it.
He doesn't ask himself to do it, at least he has to know whether Zheng Ren can do it.
Sometimes young people are impulsive, but old comrades still need to help check it out.
Pelvic fractures combined with retroperitoneal hematoma and hemorrhagic shock are one of the indications for interventional surgery.
But Director Pan still hesitated. After all, he had never done it himself, so it depends on Zheng Ren's such a thing.
"No problem." Zheng Ren said: "Prepare blood, make pre-operative preparations, and push the patient to the interventional operating room."
Su Yun's black hair was floating on his forehead, the decadent feeling in his eyes disappeared, and he began to get excited.
Zheng Ren was alert, what did this sissy want to do?
"I'll go and get a table 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 a nurse closest and explained it to him.
"Is it the infusion sequence calculated according to the specific gravity of urine?" The young nurse took the paper, glanced at it, and said with some regret: "Brother Yun, it's really a waste of your time to go to the emergency room."
"Haha." Su Yun didn't argue, but just smiled, with black hair floating on his forehead, and a handsome pussy.
Zheng Ren didn't have time to watch Su Yun flirt with girls intentionally or unintentionally, but Su Yun still has a set of things. Calculate the input crystals and colloids according to the specific gravity of urine, which can effectively target the environmental disorders of the hemorrhagic shock.
If it is martial arts, this is a relatively high-level secret.
Because the Internet is now developed, this calculation formula is briefly described online. But the problem is that if calculated according to the urine proportional gravity, a large number of formulas are required to calculate, which has exceeded the cognitive scope of medical students.
Moreover, constantly detecting the specific gravity of urine and repeatedly adjusting the infusion sequence is also a exhausting practice.
Therefore, those who can do this are all great people.
This guy is OK. Zheng Ren and Lao Director Pan greeted him, left the ICU, returned to the interventional operating room, and prepared surgical instruments.
After the operation of the placenta exfoliation patient, Director Lao Pan went through the pre-production procedure to get a batch of consumables Zheng Ren needed.
This time, Zheng Ren doesn't have to face the tragic situation of being isolated and helpless again. Not only are consumables, but also assistants, but the assistants are not that satisfied.
...
...
Back in the emergency room, Zheng Ren began to prepare things.
Xie Yiren came to help, and she seized the time to learn all the knowledge about interventional surgery. It seemed that this girl was about to enter the operating room to be an assistant to Zheng Ren.
Zheng Ren will definitely not agree. It is not a circulatory operation. Patients will have cardiac arrest at any time. Why should one more person go in and eat the line?
As for Su Yun, if he wants to help, Zheng Ren will definitely not stop him.
One is an annoying, sarcastic and handsome pussy, and the other is a beautiful and charming girl who cooperates with each other. She tends to be a girl who doesn’t have to think about which one she wants. Zheng Ren is very straightforward.
There are not many equipment needed. After all, it is just an embolization and hemostasis surgery. In interventional surgery, this is just a very simple procedure.
Fifteen minutes later, Zheng Ren heard the sound of a flat car coming.
At this time, the preoperative preparations for the interventional operating room have been completed.
Gently lift the patient onto the operating bed to avoid secondary damage and bleeding, Zheng Ren turned on the machine, changed to the operating room control mode, and started brushing his hands and wearing clothes.
Interventional surgery not only requires radiology, but also requires wearing lead clothes weighing dozens of kilograms. It is more difficult than ordinary surgical operations.
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 lead garment and was about to wear it, but suddenly realized that he seemed to have forgotten something.
After the last isolated and helpless task was completed, the system seemed to reward itself with a set of radiation ray energy conversion lead clothes, and also a silver treasure chest.
Zheng Ren was not interested in opening the silver treasure chest. After all, he had three of them in a row before, and he had three skill books, and it would not make much sense to open them again.
But the conversion of radiation ray energy into lead clothes sounds very high-end. If you understand it literally, it seems that this suit can convert radiation into energy and supply it to yourself.
If that's the case, it will be interesting in the future.
Chapter completed!