Severe trauma, infection, poisoning, and trauma can all cause an excessive stress response.

The principle is that a large amount of adrenocorticotropic hormones and adrenaline are released, so that a large amount of glycogen is decomposed, a large amount of energy consumption and metabolism are significantly increased, and the arterioles are strongly contracted, resulting in circulatory ischemia, and multiple organs will have dysfunction due to insufficient blood volume.

If the fork is too strong for a long time, the body may enter a state of failure, and physical and psychological functions may be disturbed.

A milder one, such as a gastrointestinal ulcer, will directly give you a hole, or mental problems.

If it is heavier, it will produce diffuse intracapillary coagulation, that is, DIC, kidney failure, etc., and the consequences are very serious.

The stress response is at odds with what is happening today, and if you want to treat burns, debridement is only the first step.

If you can't even complete the first step, the only thing that awaits the mother and daughter is death.

The newly established burn surgery department of the Viet Cong People's Hospital will also become a joke, you must know that although Chen Qi has a good stroke in Viet Cong, how many doctors in the country are waiting to see his jokes.

The debridement work of Ding Xinjuan and Song Yanzi's mother and daughter had to stop, and everyone was thinking of a way.

The little doctor Wu Guonan weakly proposed:

"Dean Chen, Mr. Zhu, can we use general anesthesia, so that patients can not feel pain when changing dressings, and reduce stress reactions."

Zhu Huoyan sighed:

"No, you don't need to look at the vital signs to know that the mother and daughter are already on the verge of shock, if you go to general anesthesia again, this shock will be aggravated, and there is another difficulty, their respiratory tract has been damaged in the fire, and they can't withstand tracheal intubation at all."

This debridement cannot be performed for three or four hours, and without the cooperation of tracheal intubation, general anesthesia cannot be used.

Liu Min, the head nurse, gave a proposal: "Why don't you try sleeping pills?" Let the patient sleep? ”

This proposal was rejected by Zhu Huoyan again: "With such severe pain, any sleeping pills and sedatives are useless, as soon as we do it, they will wake up immediately." ”

Sedative?

Chen Qi's eyes suddenly lit up when he heard these three words:

"Mr. Zhu, I have thought of a way, we can use artificial hibernation therapy."

"What hibernation?"

Many of the doctors in the ward are you look at me, I look at you, obviously I haven't heard this concept.

Seeing everyone's clear and stupid eyes, Chen Qi knew that the concept of "artificial hibernation therapy" had come out early by him, so he quickly explained:

"Artificial hibernation, this is actually very easy to understand, you think why animals can survive the whole winter by hibernation, and they will not die if they don't eat or drink for a few months, that's because animals enter a state of hibernation in winter, and their metabolic rate will be greatly reduced.

This means that their body temperature drops, and their breathing and heartbeat slow, reducing energy expenditure. At the same time, the immune system is regulated, so that the animal's immunity is improved, so as to fight the risk of disease and infection.

In the same way, artificial hibernation is our artificial imitation of animal hibernation, so that the patient is also in a state of hibernation, the advantage of which is to reduce the body's excessive stress response, to reduce metabolism, reduce cell oxygen consumption, improve microcirculation, avoid serious damage to cells, and buy time for doctors to treat. ”

The eyes of the little nurses and the little doctors were still confused.

Zhu Huoyan is a senior director in the end, he understands and understands this principle, but he still has a question in his mind.

"Chen Qi, I understand what you said, so the question is, how can we put the patient into hibernation mode?"

Yang Xiuxiu next to her also laughed out loud: "Dean, we humans are not bears, and we can't hibernate." ”

Zhang Xing interjected at this time: "Others can't help it, Chen Tou must have a way!" ”

Everyone looked at the young deputy director of the department in unison, and they almost gave a thumbs up.

Chen Qi also thought in his heart that this honest boy would also learn to pat himself after entering the officialdom, and finally grew up.

People like to listen to good words, and Chen Qi is no exception, so he was in a happy mood and continued to explain:

"In fact, artificial hibernation therapy has been studied abroad, when I went abroad to visit and study, I had a collusion with foreign doctors, they do not have a complete theoretical system, but who am I, the international double director, I have already secretly learned their skills."

Zhu Huoyan glanced at Chen Qi:

"Don't brag, the patient is still waiting for rescue, hurry up and talk about how to hibernate humanly."

"Oh, yes, hibernation therapy is actually very simple, that is, the use of meperidine, chlorpromazine and promethazine three drugs to form artificial hibernation agent, of which promethazine can strengthen the sedative, analgesic, respiratory depression and vasodilation effect of meperidine, after use can cause blood pressure drop, tachycardia and respiratory depression.

A dose of 1 milligram per kilogram of body weight is added to an infusion pot and injected intravenously, and after half an hour, if the patient's breathing and pulse are stable, the same dose is injected intramuscularly once, and the patient can enter a deep sleep.

After the patient falls asleep, put ice packs on the groin and armpits, and use water 2 °C ~ 3 °C lower than the body temperature to make a warm and wet compress on the torso to maintain the body temperature between 34 °C ~ 35 °C, and the low temperature maintenance time is generally 16 to 24 hours. ”

The little doctors listened to it as if they were listening to a book from heaven.

Maintain the human body to a hypothermic state to cure diseases? This is unheard of for them, although it makes sense, but no one dares to play like this.

Zhu Huoyan understood, and his eyes became brighter and brighter:

"Chen Qi, if your system works, it can not only treat burn patients, but also those febrile convulsions caused by severe infections, central hyperthermia heat stroke, toxic or traumatic shock, severe traumatic brain injury, intractable pain, and high mental stress seem to be available."

Chen Qi gave a thumbs up, "Otherwise, how could Teacher Zhu become my teacher, look at Zhang Xing and them, they are still confused." ”

Director Luo Yuyang was also ashamed when he heard it:

"Dean Chen, don't talk about Zhang Xing and them, I'm also confused, if as you said, this set of hibernation therapy is still in the theoretical research stage, but now we have two patients waiting in the clinic, this, what should I do?"

Medical theory research is only the first step, and it needs a lot of laboratory data and clinical data to support it in clinical practice.

A person is not a guinea pig, but a human life is dead.

Others are others, and others are not traversers, but Dean Chen personally applied hibernation therapy in his previous life.

In the domestic hepatobiliary surgery, Professor Wu Mengchao invented "cryotherapy" to do liver surgery, and it was even more ruthless, directly putting people into ice water.

This is actually a kind of "sub-hibernation therapy", so hepatobiliary surgeons are more experienced.

"Head nurse, you immediately contact the pharmacy and get meperidine, chlorpromazine and promethazine, I will demonstrate it today, whether it has any effect and everyone evaluates it, let's try to publish the paper on hibernation therapy before foreign experts."

As soon as I heard that today's surgery could be published, everyone's enthusiasm for work was even higher.

Even an old expert like Zhu Huoyan is not exempt from vulgarity.

You said that you used money to buy him Zhu Huoyan, and it is estimated that he will be kicked out directly.

But if you say that you have a surgical topic in your hand, which is the first in the world and can be published in an international medical journal with the highest SCI impact factor, this is also full of temptation for Director Zhu.

"Okay, then I'll see it today."

The medicine was quickly taken, Chen Qi personally mixed the medicine according to the proportion, the head nurse was also preparing ice packs on the side, and the temperature of the air conditioner in the operating room was also low.

After a while, Ding Xinjuan and Song Yanzi's mother and daughter quickly reacted.

The two of them, who were still crying out in pain just now, were already groggy at this time, Chen Qi tried to prick Ding Xinjuan's wound, although Ding Xinjuan still had a conditioned reflex, but the reaction was already very slow.

Zhu Huoyan paid attention to the whole process and asked curiously, "Is this okay?" ”

Chen Qi nodded with a smile while personally pressing ice packs on the two patients:

"Okay, let's hurry up and debride."

This debridement was directly cleaned up for 4 hours, and if it wasn't for many people taking turns to replace it, otherwise Chen Qi's male dog waist would be scrapped again.

"Hurry up, let's calculate the amount of fluid needed."

Burn patients have a complete set of infusion formulas, which Chen Qi has already introduced in Africa, and Zhang Xing immediately took out a pen and paper to convert it after hearing it.

Zhu Huoyan watched the two patients change from black to pink, and his brows were also furrowed.

"Chen Qi, Mao estimated that the burn area was almost 90%, of which more than 30% were third-degree burns, and the rest were deep second-degree burns; The total burn area of the child is also 83%, and the possibility of saving it is very slim. ”

In the world of burns, there was an unwritten law: if the burn area is more than 60%, there is almost no chance of survival, and if the burn area is more than 80%, death is almost certain.

Director Burn Corot also chimed in:

"Director Zhu is right, at present, in the international literature and related papers, there is no record of patients with large-scale burns surviving."

Chen Qi was just about to speak, but Zhang Xing was unconvinced:

"Teacher Zhu, Director Luo, this statement is not right, when we rescued a burn patient in Africa, the total burn area reached 90%, and it was a 3rd degree or deep 2nd degree burn, but we saved it."

Zhu Huoyan was a little surprised: "I thought you were bragging, and you really saved a patient with extensive burns, why didn't you publish a paper?" ”

Chen Qi was a little embarrassed:

"I submitted the paper, but it was rejected because I only had such a patient at hand at the time, and the orphan certificate was not counted, so the paper was not accepted, and my stinky tofu skin grafting was not promoted."

The medical conditions in Africa are so poor that even bacterial culture cannot be completed, and the quality of papers cannot be improved.

In addition, Chen Qi didn't think about developing into burn surgery at that time, so a few months after sending it out, after learning that the paper had been shot, the matter was put down and he did not continue to revise it before submitting it.

Hearing Chen Qi's words, there was a chuckle in the ward, it turned out that the omnipotent Dean Chen also had a time when his manuscript was rejected.

Zhu Huoyan also smiled when he heard this, and asked:

"Then how exactly do you do this stinky tofu skin graft?"

Chen Qi pointed to Ding Xinjuan on the hospital bed and said:

"Look, like this patient, a patient with extensive burns all over the body, the entire back, limbs, and part of the skin of the head and face have been burned, and while we are fighting infection and shock, the important thing is how to protect the wound, which requires skin grafting.

But with such a large area of burns, the whole piece of skin can no longer be found, what should I do? Look here, and here, these are all fragmented normal skin, especially the abdomen has a lot of residue, so we can make use of this island-like skin.

In the past, we used stamp-shaped skin grafting, which is to scrape off normal skin, cut it into small pieces of stamp shape, and then paste it on the burn wound, but this skin implant has a disadvantage: that is, if the burn area is too large, and the normal skin is too little and not enough, then there is no way to graft skin.

Even if the skin graft is forced, after the scar tissue is proliferated, the skin of the skin graft will be dark red pigmentation, and the appearance will be fish scales or bark-like, which is very ugly, and it is very difficult for lesbians to accept.

In addition, there is another stamp-like skin graft that is attached to the skin alone, there is no support around it, and there is no way to fix it well, sometimes a pack of gauze, the normal skin is displaced, and it is not left in the predetermined place, so the prognosis is poor.

What about my stinky tofu skin grafting, that's amazing, but I've tried it on the African Roast Duck Commander, and it's completely successful. The specific method is to scrape off the normal skin, cut it horizontally and vertically, cut it into small pieces, and put it on a special piece of gauze.

When skin grafting is needed, I pull the gauze evenly on all sides, and as the gauze area increases, the original tight small pieces of skin are also evenly dispersed, but they are all fixed on the gauze, pasted to the burn wound, and finally connected into a piece.

One of the biggest advantages of this skin implant is that a small piece of normal skin can be expanded to 3 times, 5 times the area, and up to 9 times, in layman's terms, that is, to spend the least amount of skin and cover the largest wound. ”

Everyone was listening in fascination, and then Chen Qi stopped.

Zhu Huoyan asked in surprise, "That's good?" It's that simple? ”

Chen Qi shrugged:

"It's very simple to say that the stinky tofu skin grafting is very simple, the key is creativity, you didn't expect it, I thought of it, this is my patent, the advantage of our Vietnamese Traditional Chinese Hospital.

Everyone should pay attention to the fact that there are many hospitals that carry out burn surgery in China, such as Dongshan Hospital in Huhai City, which is very strong.

In fact, to put it bluntly, it is very simple, to innovate, they will do the surgery, we will also do it; They won't do surgery, we will. Boldly break through the shackles of the current medical literature, break superstition, dare to think and do, this is our advantage.

Teacher Zhu just said that more than 60% of the patients with super-large burns have few successful cases, and more than 80% of the burns will definitely die, so we have to break this rule, others can't treat it, and our Vietnamese Hospital can treat critically ill burn patients.

Think about it, when the burn department of our Vietnamese Hospital is so good, won't it become one of the best departments in the country or even in the world? Are all of you burn surgeons here still afraid that they won't be famous? ”

"Well said!!"

To be a good leader, you must be able to draw a big pie and fool, so that your subordinates will follow you. (End of chapter)