Chapter 99: Upper arm disconnection and replantation
Although Officer Zhao is only a police officer in the jurisdiction, he has a strong investigation ability.
The injured have an unusual trust in Dr. Chung, and he sees it all, but things have priorities, and the most important thing now is to save people, and everything else has to be leaned back.
Although Guo Pengfei is also on duty today, it is not enough to operate only him and Zhong Yu.
When Zhong Yu was doing preoperative treatment, someone had already gone to inform Tang Jiaren and Cai Yizhong that they were back.
The nature of a doctor's job is like this, even on holidays, he is on call for 20 hours.
After Zhong Yu's unremitting efforts, Ten's vital signs finally stabilized.
Tang Jiaren and the others also rushed back to the hospital as soon as possible, and they could officially start the upper arm amputation and replantation surgery.
This operation needs to be divided into two groups at the same time, Tang Jiaren and Cai Yi in one group, they will soak the fractured limb with 1‰ Xinjieer extinguishing solution for 3 times, 15 minutes each time, take it out and scrub it with normal saline, disinfect it with iodine, spread sterile towels, make incision and reduction on the dorsal side of the ulna and radius respectively, fix the ulna and radius fracture ends with a diameter of 35mm K-wires, and then find the brachial artery, brachial vein, expensive vein, and cephalic vein from the upper arm end of the amputated limb respectively for pruning for marking for later use.
The median nerve and radial nerve were not trimmed but marked for later use, and the ulnar nerve stump was found along the direction of the ulnar nerve. Then trim the necrotic and devitalized tissue, and the skin is set aside.
Zhong Yu led Guo Pengfei's group to treat the stump of the upper arm under general anesthesia.
After thorough debridement, the brachial artery, brachial vein, expensive vein, and cephalic vein stump were found in the transverse section of the upper arm and repaired, and the markers were made in turn for later use, and then the radial nerve, ulnar nerve, and median nerve were found, and the necrotic inactive muscle and wound skin were trimmed after marking.
After the two groups were ready, the broken ends of the humerus were shortened by 15cm with wire saws, and the right humerus was reduced and the steel plate was fixed.
Zhong Yu continued to trim the right brachial artery, and after the two ends were satisfied, the end of the anastomosis was anastomosed with an 11-0 non-injury suture with the naked eye.
Then the undamaged vascular clip was released, and there was no bleeding from the anastomosis, and for about 2 seconds, the skin of the forearm of the affected limb became ruddy, the blood circulation of the finger was restored, and the right radial artery pulse was palpable.
Director Tang and the others watched intently, all excited.
Zhong Yu saw blood oozing from the distal end of the rupture of the right biceps, right triceps and right brachioradialis muscle, and the arterial anastomosis was successful.
She then performed anastomosis at both ends of the brachial vein to loosen the vascular clip, the anastomosis was not bleeding, the reflux was full, and the important vein and the cephalic vein were anastomosed with the same method, both of which were successful at one time.
The ratio of artery to vein is 1:3, and during the anastomosis process, 12500U is injected with 500ml of heparin saline concentration to drip the broken end of the blood vessel to dilate the blood vessels.
The two distal ends of the radial nerve were sharply aligned, and the epineurium and perineurium were anastomosed with 11-0 non-injury sutures, relaxed, and tension-free, and the median nerve and ulnar nerve were anastomosed in the same way.
She then carefully sutured the trimmed brachioradialis muscle, biceps, triceps, subcutaneous tissue, and skin.
One rubber drainage strip was placed on the dorsal wound of the ulna and radius, and two rubber drainage strips were placed on the replantation wound of the upper arm.
After the operation, Zhong Yu still did not let her guard down, and she personally sent No. 10 to the single ward.
For better recovery of patients, it is necessary to keep the ward ventilated and dry, and keep the room temperature between 23 °C ~ 25 °C with a baking lamp.
After he lay on the bed, Zhong Yu used intravenous infusions of ceftriaxone sodium 2g, ofloxacin 200ml, and methrin 200ml to control the infection.
At the same time, she also had to check her liver and kidney function at any time to prevent poisoning and multi-organ failure.
Zhong Yu arranged for Zhang Yunfei to stay temporarily for postoperative care, and told her to strictly follow the medication standards, and she herself was always in a state of high concentration.
In fact, for patients with amputated limb replantation, the first task is to actively and effectively save lives, and secondly, after the vital signs are stabilized, consider whether to replantate according to the limb injury.
Because the No. 10 upper arm injury was not severed for a long time, she was able to buy time for a complete debridement.
She was careful, accurate and skilled in intraoperative operations, and strictly controlled room temperature, solved vasospasm and thrombosis, and controlled infection, prevention of toxic reactions and multi-organ failure and other key conditions for replantation after surgery.
After her efforts, the chances of replanting the No. 10 upper arm have greatly improved.
She didn't know what No. 10 had experienced during this time, his physical condition was much worse, and the most important thing was that it was difficult to anastomosis the vascular nerve.
Zhong Yu must ensure the quality of the match, and it can only be done right the first time.
Fortunately, she is highly skilled and has the add-on assistance of the resurrection vine, and the number ten is enough to trust her to cooperate actively.
In short, the success of this upper arm dissection and replantation surgery was not easy to come by.
Zhong Yu waited for the patient's condition to stabilize before he was free to deal with follow-up matters.
At this time, it was already eight o'clock in the evening, and Officer Zhao never left.
As soon as Zhong Yu came out of the ward, he met him head-on, and he looked at Zhong Yu with scrutiny in his eyes.
As a people's policeman, it is correct to remain suspicious of everyone in the event of an emergency, and Zhong Yu does not mind.
In addition to Officer Zhao, another police officer was also stationed outside the ward.
Zhong Yu motioned Officer Zhao to go to the office to talk to her in detail, but Officer Zhao did not hesitate, and repeatedly instructed his colleagues to protect the victim before leaving.
Guo Pengfei was discussing the details of the operation with Cai Yizhong fiercely, and when he looked up and saw Zhong Yu coming in with Officer Zhao, he immediately closed his mouth.
The two knew they had something to talk about, so they took the initiative to avoid going out.
Zhong Yu's face remained unchanged, she politely invited Officer Zhao to sit, and then poured him a glass of water.
The two didn't just meet, and they also had the love of helping Xiao Budian find his mother before, and Officer Zhao didn't have a cold face all the time.
Zhong Yu didn't mean to grit her teeth and not let go, she said bluntly:
"Officer Zhao, I know that you are responsible, so I want to find out the relevant information of the patient with the broken arm, in fact, I don't know what his name is, what happened to him, what I can tell you is that I will be transferred to the General Hospital of the Military Region soon."
Officer Zhao didn't understand why she suddenly said this topic, Zhong Yu didn't wait for him to ask, and then said:
"The patient with the broken arm was my patient at the General Hospital of the Military Region, and because I was his attending physician, he trusted me a lot."
Officer Zhao's head immediately turned around, and he was surprised: "Could it be that he is ...... because he is on a mission?"
Zhong Yu's eyes sharpened and motioned him to shut up, and said in a low voice:
"I don't know what his mission is, but I hope you can make sure that he is safe, and it is best that this incident can be as if it never happened, and I will also report this matter to the relevant leaders, and I am sure that someone will deal with this matter soon."
Officer Zhao never doubted Zhong Yu's words, he knew a lot about her, and he also believed in her as a person, as a public official, he still had the ideological consciousness he should have, he stood up and put on his hat again, and said with a serious face:
"To tell you the truth, we rescued him in the mixer at the construction site, and there was no one else at the time except for the escaped assailant, and there was no fanfare when he was brought to the hospital, and not many people knew that he was here."
Zhong Yu nodded, and she said solemnly:
"I thank you for the rescue on his behalf, I will call and report it immediately, and I will listen to the instructions on what to do next."
Officer Zhao said calmly: "Then I'll go over and guard him first."
Zhong Yu watched him leave, and she guessed that No. 10 should have been forced into the blender.
The assailant saw his right upper limb torn off from his upper arm by a mixer, and he must have wanted to kill him, if it wasn't for Officer Zhao's timely appearance, he was afraid that his whole person would be ruined.
Zhong Yu didn't dare to think deeply, she picked up the phone and wanted to contact Dean Luo, and then thought that Ji Xueli seemed to have said that he would go to the relevant tasks of the 10th, and instead of relaying it through Dean Luo, it was better to contact Ji Xueli directly.
Ji Xueli was still discussing the patient's surgical plan at the moment, and when the nurse came to call him, he was a little unhappy.
But when the nurse said that Dr. Zhong was looking for him, he stood up without hesitation and walked out with his long legs.
Zhong Yu's character he understands, and he must be in a hurry to ask him to answer the phone even though he knows that he is holding a meeting.
Although his pace was fast, when he arrived at the office, his face was not red or panting, he steadied his mind and took the phone and said softly:
"Ah Yu, it's me, what's going on?"
Zhong Yu listened to his voice and felt a little relieved, and said unhurriedly:
"I met No. 10, he was pushed into the mixer and his right upper arm was torn, and he was rescued by the patrol area police and sent to our hospital, I just did the upper arm dissection and replantation surgery for him, and he has not yet passed the dangerous period, I don't know what to do next."
Ji Xueli's hand holding the phone tightened, and he said with an ugly face:
"Ah Yu is obedient, don't go to his hospital room unless necessary, are the local police protecting him?"
Zhong Yu's chest tightened because of his words, and he said calmly:
"There was someone in the ward to protect him, his condition was unstable, and I couldn't leave him on the sidelines."
Ji Xueli exhaled deeply, and said calmly: "You stay in the office first and don't go anywhere, he just finished the operation and there will be no problems for the time being, you wait for my call."
Although he didn't say much, Zhong Yu could feel his anxiety.
Ji Xueli hung up the phone and immediately called his superiors.
The phone was connected, and he explained the incident succinctly and clearly without personal emotion, and the person on the other end of the phone immediately gave instructions that they would send additional personnel to the rescue as soon as possible, and that the tenth should be quickly transferred.
The military has already received the news that Mission 10 has been completed, and he has important evidence in his hand, and the things he brought out have not yet been handed in, and his safety must be ensured.
Ji Xueli had to inform his superiors that No. 10's current physical condition was not suitable for transfer, and if he had to be transferred, he must be accompanied by a doctor with excellent professional skills, otherwise he might lose his life at any time due to postoperative infection.
The person on the other end of the phone didn't seem to find this difficult to do, and he said calmly:
"Since it was treated by Doctor Zhong again, then she should be escorted by the accompanying doctor, and it will only take a day at most, as long as they rush back to the military region as quickly as possible, they should be able to get out of danger."
Ji Xueli's face was hard to see, and he objected without hesitation:
"Doctor Zhong is a young woman, and she has never been on a mission, although her professional skills are excellent, but she has no ability to protect herself, the life safety of the tenth cannot tolerate half a difference, I apply for a personal escort."
The leader on the other end was silent for a moment, "Wait for you to rush over, is it too late?" ”
Ji Xueli said calmly: "I just had surgery on the 10th, and it is not appropriate to move within forty-eight hours, which is enough time for me to arrive in Haishi."
In the minds of the leaders, Ji Xueli is naturally more down-to-earth and reliable, but this mission is too risky, and he will inevitably hesitate.
"Chief Ji, do you want to ask for instructions first, after all, this mission is not simple."
Ji Xueli smiled indifferently, and said in a relaxed tone:
"Rest assured, Chief Ji will not object, he would rather his son go on a mission than see his daughter-in-law take risks."
The superior leader who was through the earpiece was stunned when he heard this, and then laughed again.
"Good boy! No wonder you are so anxious, okay, as you wish, be careful in everything, do not be greedy for merit, and take life safety as the first principle. ”
Ji Xueli solemnly agreed, after the phone hung up, he called Zhong Yu again, Zhong Yu had not left the office, Ji Xueli made a long story and said: "Someone will soon go to protect the personal safety of No. 10, you don't have to worry too much about working as usual, try to go to his ward as little as possible, I will arrive soon."
Zhong Yu was surprised: "Why did you come here?" Didn't someone take over? ”
Ji Xueli explained softly: "The leader asked No. 10 to be transferred back to the military region, and he needs the accompanying doctor to ensure the safety of his life."
Zhong Yu subconsciously said: "I am the most suitable for this accompanying doctor!"
She did not shirk her responsibility, the danger of this accompanying mission is obvious, since she chose to join the General Hospital of the Military Region, she should take the initiative to assume the responsibilities she should undertake.
Ji Xueli refused without hesitation: "You are not the most suitable candidate, you have no experience in tasks, and you do not have excellent physical fitness, if you really encounter an unexpected situation, it will drag everyone back, there are many things you can do, but this one is not good."
His tone was resolute, Zhong Yu seemed to have been poured a basin of cold water, there would definitely be an emergency on the road, she didn't even have the ability to protect herself, how could she take care of No. 10.
She was not disappointed, and said calmly:
"Then pay attention to safety on the road, I will prepare the relevant medicines that may be used on the tenth road in advance."
Ji Xueli admired her coolness very much, and the two hung up the phone and were busy separately.
The people from the military region came quickly, probably from the nearest place, and Officer Zhao was also relieved after handing over to them.
After all, he is just a police officer in the area who deals with trivial matters, and suddenly let him deal with such a tricky matter, the psychological pressure is not insignificant.
Ward 10 was quickly tightly controlled, and no other medical staff were allowed to enter except Zhong Yu.
Zhong Yu simply didn't go home, she was the main force to take care of No. 10, and at two o'clock in the morning, she took the medicine to the ward to make an intravenous drip for No. 10, and No. 10 fell asleep without realizing anything.
After carefully checking the wound for infection, she told the staff on duty to pay attention to the patient's reaction at all times before turning to leave.
Coming out of the ward, Zhong Yu's face showed a tired look.
Ever since she saw the Tenth, she had been in a state of nervousness, and she hadn't let her guard down even now.
As soon as she reached the corner, she ran into a strange female nurse.
As soon as Zhong Yu got closer, he smelled the strong smell of perfume on her body, and she was wearing leather boots with heels on her feet, walking in the empty corridor, and her voice was particularly abrupt.
Zhong Yu's unresponsive brain immediately sobered up.
Their hospital has a clear rule that medical staff are not allowed to wear perfume and high heels during work, and this woman looks wrong.
Zhong Yu paused suddenly, her heart beat to her throat, and seeing that the woman was getting closer and closer to the ward, she shouted loudly:
"She's not a nurse! Be careful, everybody......"