Things were inevitable, and as expected, they came to the point of surgery.

The white coats present paused for a moment, and then, their eyes refocused and fell on the chief of urology.

In fact, they have been prepared for a long time.

After all, it is clear that it is a patient admitted to the emergency department, so why is the multidisciplinary consultation prescribed in the urology department?

"Emergency surgery. ”

The chief of urology quickly got into the groove.

"At present, it is considered that emergency surgical exploration, hemostasis, resection of the left kidney that has been diseased without normal anatomy, decompression and other treatments are needed.

However, the patient is currently in critical condition, and the abdominal decompression and bleeding after surgical laparotomy may lead to a sudden drop in blood pressure......"

The chief director of urology paused, and turned his head to look at the chief of hepatobiliary surgery.

Although the two of them usually don't look down on each other, sometimes they even want to play out their dog's brains when they meet talents.

But at the critical moment, it is still a partner.

The chief director of hepatobiliary surgery glanced back with a serious face.

"According to the current CT results of the patient, it is considered that there is no definite lesion in hepatobiliary surgery.

The left kidney and effusion compressed and displaced the pancreas and other surrounding organs, and the spleen was clean without clear bleeding. If treated conservatively, the effusion continues to compress the blood vessels, resulting in a decrease in blood return to the heart and a decrease in peritoneal perfusion.

If surgery is aggressive, hypotensive shock is likely to occur during surgery, followed by DIC. At this stage, the large retroperitoneal mass causes the entire abdominal cavity to be in a state of high pressure, and there is a possibility of fascial space syndrome, which is extremely risky for surgery. ”

Unlike thoracic surgeons, who only described their own problems, the director of hepatobiliary surgery also helped the director of urology to check and fill in the gaps, pointing out the disadvantages of different options.

There was a brief silence in the office again.

Zhang Tianyang stood beside a group of bigwigs, and his mind was in a hurry.

Depending on the patient's current condition, the choice of treatment option is contradictory.

Regardless of whether conservative treatment or emergency surgery is chosen, it may cause a sudden deterioration of the patient's condition, and finally usher in the same result - death.

But...... Do you do nothing because of the possible risks?

Aren't they doctors born to turn the tide at such a time?

Zhang Tianyang's eyes gradually became firm.

Nobody wants to speak, so it's okay for him.

"We can be well prepared, have surgery as soon as possible, and fully inform families of the necessity and risks of surgery. ”

Zhang Tianyang's tone was very calm, without the slightest trembling.

But this sudden silence was broken, and many white coats cast surprised glances at him.

The director of urology was also looking at Zhang Tianyang, looking straight at him, as if he was scrutinizing.

The director of the Department of Hepatobiliary Surgery frowned slightly, also staring at Zhang Tianyang, and then seemed to be a little sudden, slightly bowing his head.

The other white coats also had different looks, but most of them were more restrained.

Only Zhao Tianwang and Pan were anesthetized, and their faces were slightly exaggerated.

Obvious anger appeared on Zhao Tianwang's face again, but it seemed that because the patient's condition was indeed serious, he tried to restrain his desire to scold.

Then make up your mind again.

This stinky boy who likes to make his own decisions, don't be caught by him! Otherwise, he will be scolded a hundred times, a hundred times!

The expression on Pan's face was more complicated.

There was shock and suddenness, excitement and despair, as if there was a palette on the face.

Zhang Tianyang's eyes swept over the faces of a group of bigwigs, still insisting.

"The patient's condition is progressing fast, and we need to hurry. ”

Silent.

Silence is urology tonight.

I don't know how long it took, but the director of the Department of Urology suddenly laughed.

He slammed his thigh, "Fuck!

The corners of the head of the hepatobiliary surgery department also slightly hooked up, and he looked at Zhang Tianyang with gentleness and appreciation, "If problems such as the liver, spleen, and pancreas are found during the operation, our department can assist." ”

When he said this, it means that he also agrees with the decision to operate.

Zhang Tianyang nodded at the two directors, without the slightest intention of relaxing, and as soon as his eyes turned, he looked at Pan Anesthesia.

"Anesthesia teacher, please assess the patient. ”

Pan's anesthesia was shocked, and the excitement of adrenaline rush and the despair of thinking that he hadn't slept flashed, and then he was invigorated.

"The patient is currently in critical condition, but now the peritoneal effusion is encapsulating and compressing the potential bleeding point, and the patient's blood pressure is maintained adequately.

If an emergency laparotomy is performed, the pressure in the blood vessels drops dramatically, which may lead to shock.

It is recommended that the peripheral venous access be enlarged to maintain the patient's blood supply, and extreme conditions such as circulatory instability and cardiac arrest may occur during the operation. Please cooperate with the blood transfusion department!"

The blood transfusion doctor who was named was also shocked, "Our department will fully cooperate with the clinical needs!"

Professor Liu from the Department of Nephrology also spoke at this time, "According to the CT results of the patient, it is considered that there was chronic renal insufficiency before the onset of this disease. The left kidney has no normal renal tissue structure, and there is no urine after admission, which is considered to be acute left kidney injury, and prerenal is mainly considered. CRRT may be used if necessary postoperatively. ”

His eyes were staring at Zhang Tianyang, his eyes were shining, but he turned his head to look at the director of urology next to him, who also had glowing eyes, and rolled his eyes a little depressedly.

The doctor from the intensive care department followed up and said that their department would do their best to cooperate after the patient's operation.

The medical department also hurriedly said that they could coordinate together in the communication with the patient's family.

After confirming that the surgery was to be performed, the doctors in the relevant departments showed great speed and ended the multidisciplinary consultation with great efficiency.

Zhang Tianyang made a final summary quickly.

Then, "Adjournment!"

A group of white coats dispersed with a bang.

Doctors in unrelated departments rushed back to catch up on sleep, or deal with emergencies from patients in their own departments.

The doctors in the relevant departments have begun to perform their duties skillfully.

Zhao Tianwang glared at Zhang Tianyang fiercely, and then pinched the emergency surgery consent template that Zhang Tianyang had prepared a long time ago, and pulled the people from the medical office, walking in a hurry, seeing that he was going to talk to his family.

Pan said hello, and his feet flashed away as if he was smeared with oil, which was the direction of the operating room.

The chief of urology sat down again in front of the computer displaying the imaging results, and began to ponder, as if thinking about the procedure and route of the operation.

The chief inpatient doctor in the Department of Urology began to pull out her cell phone to contact and coordinate with all parties.

She's the general hospitalist, and when everyone is running to the operating room, she still needs to stick to Corey.

Commonly known as keeping home.

Zhang Tianyang also has his own tasks.

He hurriedly said hello to the director of urology, and also chased Pan anesthesia to the operating room.

If the patient has abdominal bleeding and an extremely distended abdomen, he will have to have emergency surgery and may have to prepare more than usual.

......

Three minutes later, Zhang Tianyang found the nurse in the audience with dark circles under her eyes.

"Where are the protective suits in the operating room? We need at least 5 suits!"

The nurses in the audience instantly woke up from the afterglow of sleep.

"What do you want that thing for?"

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Happy double festival of the little cuties~~~

Stealing incense