Under the shadowless light, the operation is still ongoing.

Dr. Cao's surgery turned into a combined thoracoabdominal surgery that was unsurprisingly successful. Tong Chunlai, director of cardiac surgery, was in charge of the heart part, and the treatment of the liver was handed over to Deputy Director Chen Hua - Zhao Chongxi, the director of the liver and gallbladder department, was rushing to the hospital from home, and Director Chen's task was to do a good job of peritoneal separation and hemostasis before Director Zhao Chongxi arrived to take over.

"The blood bank already has 6,000 milliliters of stock, and the stock may not be enough...... Just now the blood bank called and said that there is still a reserve of 1,006 in the hospital......" The itinerant nurse in the operating room whispered to Director Chen Hua, "They have already transferred blood from the city blood center, and it will be delivered in about half an hour." ”

Dr. Cao had a lot of bleeding, and there were more than 10 wounds on his body, but half of them were not too deep, and the amount of bleeding was acceptable. Even if the portal vein of the upper limb is broken, the amount of bleeding so far is about 400 ml. The rest of the blood is almost always concentrated in the chest and abdomen.

Pericardial effusion, which means there is bleeding in the heart. Sun Lien's stitch in the emergency room saved Dr. Cao some time, but the situation was still not optimistic. His lateral left ventricular muscle was damaged, and both the left anterior interventricular and left anterior descending artery were broken. These three damages alone resulted in more than 100 milliliters of bleeding in about a minute. And what's even more troublesome is that when inside the pericardium, the amount of bleeding from these wounds is not too great due to the pressure of the pericardium itself. But when Director Tong Chunlai cut Dr. Cao's pericardium with a scalpel, a large amount of blood gushed out inside. Blood quickly obscured the surface of the heart, obscuring all surgical vision.

Although he lost his vision, Director Tong was still unhurried. After cleaning the blood stain from the surface of his heart with a suction device, he dictated to his assistant, "Record, there is a wound about 4.5 millimeters deep and about one centimeter long on the outside of the left ventricle. The left anterior interventricular ramus and left anterior descending artery are broken by about one millimeter. There are no other obvious wounds. ”

The thickness of the left ventricle in the average adult is about 11~16 mm, and although the 4.5 mm wound does not directly penetrate the myocardium, the trauma caused is already very serious - if the heart ruptures caused by direct penetration of the myocardium, then I am afraid that Dr. Cao will not be able to hold up on the operating table at all.

"Ascending aorta and inferior vena cava cannulation, ready for cardiopulmonary bypass. After his assistant said that he had finished recording, Director Tong quickly issued instructions to the physician in charge of perfusion on the side. "Stop beating as soon as possible. ”

Although from a technical point of view, it is possible to suture the myocardium and blood vessels directly on the beating heart. However, because both the coronary arteries and coronary veins are damaged, and the cut heart muscle is also within the blood supply of the anterior descending artery. If a surgical plan that uses a lot of applications to block the upper and lower vena cava and the empty heart, the already damaged myocardium will inevitably accumulate waste and become hypoxic due to the empty beat. The use of a high-K+ depolarization asystole regimen minimizes myocardial damage and creates good conditions for further surgery.

"Let's let it go!" The intubation of the ascending aorta and inferior vena cava was being carried out nervously on the operating table, and Director Zhao Chongxi, who came in a hurry, finally rushed to the operating room. He struggled through the corridors of doctors waiting for news, and rushed into the operating room, "What's the situation?"

"Fourth-degree liver injury, penetrating injury to the left hepatic lobe, rupture of the liver propria artery, hepatic vein. Director Chen Hua, who was responsible for early separation and hemostasis, replied with his head down, his hands were buried in Dr. Cao's abdominal cavity, and the liver was pressed down in the direction of the operating table, and at the same time, the first hepatic portal was blocked with heart-appular forceps, the inferior vena cava cava was blocked by vena cava anastomosis forceps, and the superior and inferior vena cava was compressed with his fingers. At this moment, Director Chen Hua wished that he had three heads and six arms, two fingers pressed on two veins, and a large amount of blood in the abdomen made his gloves slippery, and the compression became very difficult.

Director Zhao Chongxi came over, looked at the damage on the liver carefully, and immediately asked the instrument nurse for the suture needle and needle holder, and said to Chen Hua at the same time, "You press and don't move first, I'll stitch it." ”

The blood in the abdominal cavity was sucked into the blood recovery purifier by the straw held by the assistant, and then re-injected into Dr. Cao's vein. But his blood pressure kept dropping. Of the six thousand milliliters of blood sent by the blood bank, only 800 milliliters remained.

No one spoke in the operating room, and the air was oppressive as if it were a physical entity. No one still has the heart to tell jokes and chat, even with the ability of the Fourth Central Hospital, this kind of trauma is still extremely dangerous - thanks to Dr. Cao was in the hospital when he was stabbed, you know, most patients with hepatic vein rupture and hepatic artery hemorrhage will not be able to survive the laparotomy, even if they can go on stage to open the abdomen, before the doctors complete the blood vessel sutures, they are likely to die due to massive bleeding.

A normal adult generally has about 4,000 milliliters of blood in their body. Now, doctors have infused about 5,200 milliliters of blood into Dr. Cao's body. The blood in his body had been almost completely replaced.

Surgery on the liver is not only about speed, but also about the quality of the completion. Looking at Tong Chunlai's open chest, Director Zhao, who was in charge of the operation, knew that Dr. Cao had no second chance for surgery. Either solve the problem one at a time, or watch him die because of a problem that was not solved in the first operation. There is no third option.

What are the chances of a patient with more than 4,000 milliliters of blood transfusion surviving after surgery? Zhao Chongxi shook his head and drove all these irrelevant thoughts out of his mind. Lying on the bed was just a patient, a patient with severe liver trauma. Just keep your mind calm and complete the surgery as before.

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Sun Lien accompanied Shen Yue to stand outside the operating room without saying a word.

Xu Yourong and the others stood a little farther away, and they were also silent. Dr. Pascal looked at Sun Lien with some concern, and whispered to his colleagues, "He's so abnormal. ”

Zhou Ce nodded and didn't speak, but Yuan Ping'an responded, "When this kind of thing happens, if it's still the same as usual, we should be worried, right?"

Xu Yourong said in a low voice, "Dr. Cao is his roommate, and the relationship is originally closer than that of ordinary colleagues. ”

Zhou Ce rolled his eyes, "It's boring what you're saying, if any of us are stabbed, he will be better?"

"If you have kung fu bickering, it's better to think about what you should do when you wait. Dr. Pascal glared at the two of them. He is the oldest and the first in the treatment group, so it is only fitting to play the role of a stabilizer at such a time, "I remember that there was a special psychotherapy counseling department in the hospital, right?"

Yuan Ping'an nodded, "I've heard that there is this department, but I've never seen anyone." ”

"Then they're going to be very busy during this time. Dr. Pascal sighed, "I hope the surgery goes well." If the door is opened with bad news, it's a big problem. ”

Outside the operating room, Shen Yue lowered his head and trembled twice from time to time, then quickly and covertly wiped away his tears, and raised his head again to look at the monitor screen on the wall. It simply shows the situation in the operating room with a few lines of words, "during surgery".

"It's been almost an hour. Shen Yue finally couldn't help it, she asked Sun Lien in a low voice, for fear that her voice would affect the doctors who were operating inside, "Is this normal?"

Sun Lien was silent for a while and nodded, "Brother Cao's injured organs are more complicated to deal with, and the longer the operation, the better the effect of the operation." "If this kind of large-scale joint surgery involving the heart and liver is over in an hour, I am afraid that it will be accompanied by only bad news. The longer the doctors operated on it, the more likely it was that Dr. Cao would survive.

Although he looked quite calm on the surface, Sun Lien's heart had already become a mess. About ten minutes ago, nurses from two central nurse stations pushed two cryogenic boxes with the logo of the central blood station into the operating room. Sun Lien knew at a glance that it contained blood that was urgently called from the blood bank.

Even the blood station of the Fourth Hospital is not enough to prepare blood. Sun Lien only felt his heart pound when he realized this.

He stared at the door of the operating room, and there was no thought in his mind.