To put it bluntly, in the whole of Polythanvia, even in several nearby countries, and even in the entire southeast of Africa, there will be no one who is more capable of surgery than Chen Tianyang. If the area that needs surgery is concentrated in the hepatobiliary area, then Chen Tianyang said that he is the strongest in the entire African region, and absolutely no one will jump out to express objections - Professor Smith, director of general surgery at Sland University Hospital in South Africa, has communicated with Chen Tianyang, and he admires Chen Tianyang's ability.

Splenectomy is also one of the treatments in traditional hepatobiliary and pancreatic surgery. After a year of surgery in Polythanvia, Chen Tianyang, who had not encountered a splenectomy so far, suddenly came to his senses, leaned over and glanced at the images on the B-ultrasound, and then immediately made a judgment based on his experience of cutting thousands of spleens, "The bleeding is at least 800cc, and the damage above the third grade has to be partially resected or even completely resected." ”

The medical team did not carry the collection and purification equipment required for autologous blood retransfusion. Although the bleeding contamination caused by splenic rupture is less, it is an ideal source of autologous blood retransfusion. But it was difficult for a clever woman to cook without rice, and Chen Tianyang could only look at the blood drawn from the old man's stomach and sigh, "It's much more convenient to be able to lose back." ”

The operating room is preparing for the operation as quickly as possible, and due to equipment limitations, anesthesiologists can only perform unilateral endotracheal intubation first—the unilateral ventilation function of bilateral intubation, which is commonly used in China, has now become a luxury. Sun Lien himself was pulled by Hu Jia to start preoperative disinfection and instrument checking. The atmosphere in the operating room was tense,

"The family and the entourage have completed blood tests, and 20 people can donate blood – rapid tests for malaria, hepatitis B and HIV. "Almost all departments with more than one person in the medical team, except for ophthalmology, have supported doctors in the operating room, and even the gynaecology department has someone to help prepare for the operation—she came to the stage as a second assistant. When the second assistant arrived at the operating room, he also brought good news, "The work at the outpatient clinic is basically stopped now, and the doctors who are available are preparing to collect blood." ”

Direct transfusion has a number of disadvantages, the most obvious of which is its limited infusion rate. The standard practice for direct transfusion is to draw 45 ml of blood from a donor at a time through a syringe prefilled with 5 ml of 3.8% sodium citrate solution and inject it into the vein of the patient who needs the transfusion. In this way, the speed of blood drawing is limited, and the speed of blood transfusion is also limited. A 400ml blood transfusion takes at least 20 minutes.

400ml of blood transfusion in 20 minutes is not slow in normal times, and it is even faster than the 5~10ml/min of general blood transfusion treatment. However, when rescue blood transfusion is required, this speed is absolutely not enough - the maximum speed of pressurized blood transfusion can reach about 100ml per minute, and no matter how skilled the medical staff are in direct blood transfusion, the upper limit of physical speed of 20ml/min cannot be broken.

In a hospital assisted by a blood transfusion medicine department, Chen Tianyang may dare to ask doctors to open two or more intravenous lines at the same time to administer multi-channel pressurized rapid blood transfusions to patients. But in Polythanvia, in the poor conditions of the Seventh Bureau camp, if Chen Tian was given three more dares, he would never dare to do so. There is no professional blood transfusion doctor in charge, and if there is a transfusion reaction in the process of direct blood supply to many people, then there is no need to do surgery - this person is dead.

The Grand Wizard needed two surgeries to survive, the first of which was a hemothorax and rib fracture surgery to solve the main problem. The second is an abdominal splenic rupture surgery that can start at any time - if there is active bleeding in the middle of the hemothorax, the chest surgery must be stopped at any time and an emergency abdominal opening and part or even most of the spleen will be removed and the bleeding will be stopped.

Both surgeries were the most urgent emergency surgeries, and both were serious injuries that could have killed people. Liu Tangchun was the first to admit it, and Chen Tianyang also realized that he was alone, and it was impossible to take care of two surgeries at the same time no matter what. Originally, the doctor of the medical team who was expected to be in charge of Ichisuke was moved to the position of mobile surgery, and if an emergency laparotomy was required during the operation, then the doctor Huang from the Second Hospital of Song An Province would be the main hemothorax.

If you want to cut the spleen, you must let Chen Tianyang do it.

Liu Tangchun was retained by Chen Tianyang, who was responsible for monitoring the patient's vital signs with the anesthesiologist and organizing blood transfusions when necessary. Sun Lien didn't run away either—he was the second assistant, and he was responsible for exposing the surgical field by pulling the hook during the operation.

Sun Lien, who got the task, was excited, and he, a doctor in the emergency internal medicine department, could still have the time to pull the hook. However, Hu Jia next to him asked a little worriedly, "You don't faint blood, do you?"

"Don't get dizzy, don't worry. Sun Lien hurriedly shook his head, what are you kidding, if the emergency doctor faints blood, it is better to change careers and engage in administration as soon as possible.

All the noise was silent in five minutes. Chen Tianyang was very rare to close his eyes and be silent for more than ten seconds before the operation began, and anyone with a discerning eye could see that Chen Tianyang was very unwilling. If it is in Tongxie or Ningyuan Fourth Hospital, with sufficiently advanced equipment and a relatively complete blood bank preservation system, and a group of experienced medical staff, the risk of this operation can be reduced to a very low level.

But this is in Polythanvia. Chen Tianyang has no choice, he can only accept direct person-to-person blood transfusion, he can only interrupt his scheduled splenectomy operation, and mobilize all the forces that can be mobilized to the operating room, so that it is possible to send the old man in front of him safely off the operating table - as for whether the surgical plan with the least damage to the patient can be adopted, and whether the patient's recovery time can be shortened as much as possible, Chen Tianyang has no choice at all.

He opened his eyes and whispered to Hu Jia beside him, "Let the operating room next door send the patient back to the ward, and then call Willis over as well—let him observe the operation." ”

After speaking, Chen Tianyang stretched out his hand and said in a deep voice, "Record, the operation begins!"

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Four hours had passed, and although it was learned that the doctors of the medical team were working hard to carry out a rescue operation, there was no way to allocate personnel to receive the treatment, but the local residents who had come with their families to ask for help were still standing at the gate of the camp. They have been suffering from illness for a long time, and as long as they can get the opportunity to be treated, then they are willing to continue to wait.

As for the knights of the Clan Horse Team - all of them have already donated blood according to the 400ml limit. There are also eleven knights with blood type AB who also happily decided to donate blood after hearing that their blood can save lives—this batch of whole blood will also be kept in the temporary blood bank of the Seventh Bureau camp. The rarest blood type in Africa is type AB, and the medical team tried to find a way to get 20 units of whole blood for the patients who were scheduled for liver transplants today. In the end, enough blood was collected from the Chinese workers of the Seventh Bureau. Now that they can get 11 units of AB whole blood in one go, the doctors of the medical team are also very happy.

"Usama, the first group to go in has returned. "The young wizard sits in the wilderness, the fire in front of him crackling, which is the trick of the people who are shown to repel mosquitoes while resting. "They saw the Great Wizard. A young man who looked a little tired said excitedly to the young wizard, "The great wizard has been cut open in the chest by an outsider, and we have been deceived!"

"That's an outsider's medical skills. Like our prayers, it is for the technique of healing. The young wizard shook his head, "You're in too much of a hurry, Un. ”

"I've got people to go back and inform the tribe. Unn was still excited, "They cut open the chest of the Great Wizard, and they also drew blood from the body of the warrior to perform evil sorcery! Usama, blood can only be used for curse practices, you know!" he said angrily, "I will gather all the warriors of the clan, and if the Great Wizard dies at the hands of outsiders, then let them pay with their lives!"

The young wizard stood up in silence, then slapped Unn in the face.

"Your father once came to see the Great Wizard for cold fever, and the Great Wizard prayed for him for three days and three nights. The young wizard's face was gloomy, and he asked in a loud voice, "But then your father died. Do you still want to gather all the warriors in the tribe and kill the Great Wizard to compensate him?!"

"No sorcerer can cure all diseases, and no outsider's doctor can cure all diseases. Usama drew his saber from the saddle and put it directly on Un's neck, "The archwizard is badly wounded, and no wizard can bring him back. Outsiders are our only hope - find out who we are, we're here for help!"