Finally got the patient's family, and Li Xiyang and the three hurried back to the operating room.

"How's the patient?"

Li Xiyang asked quickly as soon as he entered the door.

The anesthesiologist stood on the operating table with a solemn expression, "The situation is not good, there have been two ventricular fibrillations before, but fortunately they have been saved!" ”

Li Xiyang walked onto the operating table and quickly swept the ECG monitoring, "We can't delay any longer, start the operation immediately!" ”

"Lao Xu, the patient is under general anesthesia, and the head is focused on anesthesia."

"Good!"

Turning his head, Li Xiyang looked at Wang Tianyi, "Director Wang, please be a helper!" ”

Wang Tian nodded, and said in a solemn tone, "Xiao Li, it's up to you whether people can be rescued or not!" ”

"I'll do my best!"

Li Xiyang's eyes were firm.

Preparation: small surgical kit, brain surgery kit, surgical gown, cloth, large belly monochrome, bipolar electrocoagulation, skull drill,

Disposable materials: suction tube, speculum assist set, 2 10ml syringes, 1 50ml empty needle, scalp clip, brain cotton pad, hemostatic sponge, bone wax, drainage tube, brain surgery film, 21#, 11# blade, sutures.

Surgical incision: select the hematoma closest to the surface to avoid the important bone flap craniotomy.

surgical field skin disinfection,

Iodine, alcohol.

Shop single: 1 folded single is spread under the head and neck.

3 treatment towels, with 4 small stickers.

Hand the 1/3 folded and covered tray in the middle single, 2 medium sheets in the oblique spread, 1 piece of the middle single around the head and tray, and the middle single covers the limbs, and the large single is spread.

Stick to the brain surgery film and make an instrument cloth bag.

Li Xiyang gave instructions in an orderly manner, and Wang Tianyi couldn't help nodding.

Each of the other party's instructions is extremely detailed, like a commander on the battlefield.

Following such a chief surgeon, whether it is an assistant doctor or a little nurse, you can get great improvement and progress.

No wonder this kid in the emergency department is so popular.

Funny boy!

Soon, the preparations were over.

Li Xiyang said, "Hand the skull drilled!" ”

First, the puncture point is located on the surface of the patient's skull, and then the drilling machine is held in both hands to drill the puncture point that has been positioned in advance.

It can be seen with the naked eye that the patient's skull is drilled a hole little by little by a drill.

"Drains!"

Li Xiyang put down the borehole and took the drainage tube handed by the little nurse.

It is inserted into the patient's ventricle through this small drill hole, and the drainage belt is attached to the outside, and then sutured layer by layer.

This step is mainly responsible for intracranial blood pressure lowering and drainage.

But

[Brain: It's over, it's over, it's just scabbed, why is it that my mother's blood has collapsed! ]

】

The voice of the patient's brain rings in the ears, and at the same time the ECG monitoring sounds an alarm.

Wang Tian's face sank, "Blood pressure soars again!" ”

"How so?"

Li Xiyang said, "The patient has parenchymal cerebral hemorrhage, and the amount of bleeding is large, and minimally invasive surgery alone cannot work, and bone flap decompression combined with intracranial hematoma removal must be performed immediately." ”

Wang Tian nodded, "Okay, you let it go, I will fully cooperate with you!" ”

The patient's intracranial hemorrhage increased, and he was in danger, and Director Wang, who had always been prudent, had to decide to go crazy with Li Xiyang at this moment.

Immediate bone flap decompression, combined with intracranial hematoma removal!

Li Xiyang first stroked the patient's entire scalp with his fingertips, and found that every time he passed, the patient's head cortex would have different degrees of slight bulges.

It appears that the patient should have an indefinite number of hematomas of uninterrupted size distributed within the skull.

No. 21 knife,

Cut the scalp and gauntlet!

Scalp clip to stop bleeding, electrocoagulation to stop bleeding...

Flip the flap and pull the scalp retractor to fix it on the tray...

The flap is covered with a block of saline gauze ...

Peel off the periosteum, hand the skull to drill holes...

50ml syringe cooling heat...

Wire guide and wire wire sawing skull...

Bone forceps bite the bone edge, bone wax to stop bleeding...

11# Knife incision, incision due to dura...

meningeal forceps,

meningeal scissors,

If you find a hematoma outside the meninges, remove it immediately!

Bipolar electrocoagulation incision of 2-3cm cerebral cortex...

Hands the cerebral pressure plate and suction device, and separates it deep into the brain directly into the cranial cavity of the hematoma, and removes the hematoma...

Note, using a suction device and bipolar electrocoagulation forceps, to maintain the visualization of the surgical field while removing the hematoma.

Taking advantage of the softness of the brain tissue, the cerebral cortex incision is moved within a certain range to expand the field of view.

bipolar electrocoagulation to stop bleeding,

cerebellar cotton pads to stop bleeding,

Hemostatic sponge!

It should be noted that the exposure of a narrow cerebral pressure plate during hemostasis can avoid blind corners of the visual field to the greatest extent, reduce cerebral traction, and completely remove the hematoma.

Rinse the wound with hydrogen peroxide and saline to stop the bleeding completely...

6x17 round needle 1# suture dural edge on temporalis muscle...

Place a 12# or 14# red urinary catheter or a special drainage tube, and fix the angle needle...

Li Xiyang's series of actions were completed in one go, flowing smoothly, and Wang Tian's eyes lit up when he saw it.

He has been a brain surgeon all his life, standing on such an operating table again and again,

I have seen a potential and promising intern doctor, and I have also seen a middle-aged doctor with a skilled memory, it can be said that he has struggled in such a position all his life.

But it was the first time, and the only time I saw a doctor as talented as Li Xiyang.

He had always heard that Renhe had a good young doctor in the emergency department, but he had never really understood Li Xiyang, until today,

He first heard about the other party's bold and avant-garde surgical plan, and then saw the love and support of many patients and their families.

At this moment, I was really shocked by the other party's surgical operation.

This young man seemed to have a holy light with him, as if he was born with a scalpel capable of fighting on the front line.

Soon, the patient's intracranial hematoma was completely cleared.

The patient's intracranial pressure finally returned to normal!

At this point, only the last step of the operation remains, pulling out the tightrope!

"Director Wang, I need you to help me fix the wire!"

Li Xiyang looked at Ichisuke's position.

Wang Tian came back to his senses and nodded, "Okay!" ”

He first moved his knuckles and the muscles of his arms to prepare for a long battle.

Because the wire is submerged in the patient's skull, no one knows how long the wire is and where it has penetrated.

In the next operation, he must fix the wire,

Even the slightest movement can directly cause brain death in patients.

Therefore, whether the operation can be successful in the next step, Wang Tianyi's work is very important.

Re-enacting a pair of sterilized gloves, Wang Tianyi stretched out the index finger and thumb of both hands and pinched the end of the wire tightly.

"Let's get started!"

Li Xiyang took the No. 3 scalpel and gently cut it about 2 centimeters away from the patient's right temple.

There are blood lines flowing down the wound,

"Hemostatic gauze!"

Li Xiyang spoke, and Qian Min, who was standing opposite, hurriedly reached out to wipe it.

When the blood is wiped away, a flat incision is revealed.

But the steel wire did not move, which shows the depth of the penetration.

Later, Li Xiyang took the wire insertion point as the center and opened three more knife edges around it, but the steel wire still did not have the slightest trace of loosening.

Li Xiyang's subsequent actions can only go deeper little by little, looking for the depth of the tightrope,

But slowly, Li Xiyang didn't dare to go any further.

Because if you go further inside, you are likely to injure the cerebral arteries.

In addition, even if you are lucky enough to bypass the artery, you will definitely cut the skull and damage the cranial nerves.

For a while, all Li Xiyang's actions became very cautious.

Minutes and seconds passed, and soon two hours passed.

Looking at Wang Tianyi again, his entire head was oozing with sweat.

Keeping one movement still for two hours is a great test of physical strength and energy.

The most important thing is that Li Xiyang slowed down because he was worried about damaging the cerebral arteries or nerves, but the actual condition of the patient could not be delayed at all.

In the past minute, accidents can happen to patients at any time.

Suddenly, Li Xiyang thought of a good idea.

He starts at the deepest penetration point of the wire and slowly cuts it towards the side of the wire.

It wasn't until he returned to the height of the starting blade that Li Xiyang felt the meaning from the scalpel shaking.

At that moment, his eyes lit up, and he said quickly, "Director Wang, prepare to draw a tightrope out!" ”

Wang Tian nodded, because at the same time he also felt the loosening of the wire.

But after thinking about it, he said, "Xiao Li, let's take a thrombin preparation first!" ”

As soon as Wang Tian spoke, Li Xiyang knew what he was worried about.

So he nodded, picked up the thrombin syringe and pricked a few needles around the wire insertion point.

When the thrombin injection was completed, Wang Tianyi exhaled lightly and prepared to pull out the tightrope.

Li Xiyang reminded in time, "Keep your hands steady and try to be as fast as possible." ”

It is necessary to pull out all the steel wires at one time, and do not hesitate at this time, otherwise the steel wire will deviate from the accident.

It will be easy to cause parenchymal hemorrhage!

Under the mask, Wang Tianyi grinned, he had been pinching the wire for more than two hours, could this hand be stable?

But he also knows what this step means.

Such a deep steel wire must not be moved out slowly a little bit, and only a quick one-time removal can limit the amount of bleeding to the greatest extent.

At this moment, everyone looked at Wang Tianyi, and the pressure was great!

Wang Tianyi took a deep breath, then stared at the steel wire in his hand and pulled it out.

Puff~

Blood splattered out instantly from the knife edge and the point where it was drawn.

hemostatic gauze, hemostat tamponade,

Fast!

At the moment when the blood splashed on the clothes of the people around him, Li Xiyang reacted quickly.

He shouted at everyone.

Qian Min, who was prepared in advance, blocked the wound with hemostatic cotton as soon as possible.

Li Xiyang stepped forward and helped Wang Tianyi, who fell backwards continuously.

Nearly, the guy fell off the operating table.

Wang Tianyi shook his somewhat drowsy head, looked at Li Xiyang and smiled bitterly, "I'm old, it's useless, 10 years earlier, let alone two hours, it's five hours, and I'm like no one!" ”

Li Xiyang smiled and took the steel wire from the latter's hand.

The steel wire is about 7 cm long,

Such a long steel wire sticking to the temples and sticking it into the head is terrifying just to think about.

Then put the wire into the tray next to the operating table, and by the way, pull out a roll of hemostatic gauze on the shelf next to it, and walk back to the operating table.

At this time, Qian Min and the little nurse were holding a hemostatic cotton and laboriously filling the place where the blood gushed, but the hemostatic effect was not ideal.

"Let go, I'll fix it!"

The moment Li Min let go, Li Xiyang quickly wrapped a bandage around the wound.

Long strips of gauze, centered on the bleeding point, tightly wound around the circumference of the skull,

When it was wrapped three times, the wound no longer oothed blood, so Li Xiyang cut it with scissors and fixed it.

Because multiple fragments of the patient's skull were removed, the skull had poor pressure-bearing capacity, so it could not be tied too thick or tied too tightly.

Under the operating table, Wang Tianyi gently shook his neck and shoulders, and the soreness and fatigue on his body were also reduced a lot.

He walked up to the operating table and took a look, and the bleeding had almost stopped.

Except for the slightly high blood pressure, the patient's other vital signs were within the normal range, so far, the operation is considered a success.

In the end, only sutures remained.

Li Xiyang regained his position as the chief knife.

Put back the bone flap,

Suture the periosteum.

Hand No. 7 silk thread angle needle suture...

Round needle, 4 wire,

Suture the cap aponeurosis, skin.

Hand iodophor cotton balls to disinfect the skin around the incision, and hand 4# silk threads,

Round needles are sutured to the cap aponeurosis, and horn needles are sutured to the skin...

Seeing Li Xiyang's suturing technique, Wang Tianyi's eyes lit up again.

Does this kid really have no technical shortcomings?

Two minutes later, the operation was officially over!

At this point, everyone exhaled deeply.

Such a dangerous operation is not only a long-term operation, but also the most painful thing is the tense psychological pressure of everyone.

Fortunately, the operation was over, and the person was rescued.

In the operating room, everyone shook the joints of their hands and feet while arranging the surgical instruments.

"Push the ICU!"

Qian Min nodded, and pushed the gurney out of the operating room with the little nurse.

When everyone left, Wang Tianyi patted Li Xiyang on the shoulder, "Boy, the mud marks are good, we will have to rely on young people like you in the future!" ”

Li Xiyang scratched his head, "Director Wang, you are too awarded!" ”

Wang Tianyi's expression was solemn, "I'm not joking with you, I think I've been doing neurology in Renhe all my life, I've done countless surgeries, and I've seen many new treatment plans with ideas, but as I get older, my courage will become smaller, and my thoughts will become conservative.

Being able to go through this surgery with you today, I feel as if I have regained the passion and original intention of being a doctor at the beginning, and I really want to thank you, Xiao Li. ”

Li Xiyang said with a smile, "Actually, I should say thank you to you, if it weren't for you in the operating room today, I may not be sure that this operation will be successful!" ”

Li Xiyang: This is not a kind word, the entire emergency department can not find a doctor as stable as Director Wang, if it is not for Director Wang to fix the wire steadily, and finally pull out the wire without a trace of error, this operation is likely to fail.

Wang Tian smiled and scolded, "You kid, you are young, this fart is quite loud." ”

"But then again, I really don't praise people very often, but you are really a rare talent in terms of surgery, I hope you can guard against arrogance and rashness, always maintain your original intention, and benefit more patients."

Do you keep your original intention?

Li Xiyang nodded, "Okay, Director Wang, I remember!" ”