Hu Xiaotian said: "This warm water is for you to soak your hands, otherwise the blood vessels will shrink after a while, and the blood will not flow out." ” Hu Jinniu saw that there was more and more blood in the copper basin, and said in a trembling voice: "I said how much more I have to ask for my family" He knew that he was scared at this time, and actually took the initiative to get close to Hu Xiaotian.
Hu Xiaotian said: "Don't worry, generally speaking, the weight of human blood accounts for eight percent of your weight, and you weigh 200 catties."
Hu Jinniu shook his head: "One hundred and eighteen" "I'll do the math, that means you have fourteen pounds of blood in your body.
According to my experience, two-thirds of the blood loss will die, which means that you will only die if you shed nearly nine catties of blood, and this will flow out less than half a catty, don't worry, you won't die for a while. ” Although Zhou Wenju knew that Hu Xiaotian was teasing Hu Jinniu, he still admired his profound medical knowledge, and he couldn't imagine that he knew so much at a young age, and he could even count how much blood in the human body, how did he know that Hu Xiaotian studied Western medicine and had an extremely solid foundation in human anatomy and physiology.
Normal people's blood often does not exceed 400 milliliters at a time, but Hu Xiaotian released nearly two catties of Hu Jinniu's blood, which is estimated to be about 1,000 milliliters.
This stopped the bleeding and sutured for him, Hu Jinniu's face was pale at this time, both legs were weak, when Hu Xiaotian stitched up his wounds, Hu Jinniu had a feeling of escaping death, looking at Hu Xiaotian's eyes There was no violence and hatred just now, once a person regarded the other party as a person who could manipulate his own life and death, he would not be majestic no matter what.
Hu Xiaotian looked at the blood in the basin and said, "Although it is not enough, it can only be settled." ” After Hu Jinniu was bandaged, he staggered out with the support of the middle-aged scribe, not even wanting to stay here for a moment.
At this time, the preoperative preparations have almost been carried out, and Zhou Wenju, an anesthesiologist, has also used the golden needle puncture point to pour the numbness into the body of the injured person.
Everything is ready, only the east wind is owed, and the next thing is just waiting for Hu Xiaotian, the chief knife doctor, to show his skills.
Hu Xiaotian looked at the sleeping flower thief. couldn't help but show a sneer, the thief fell into the hands of Lao Tzu, and you have poured mold for eight lifetimes.
Although he thought so in his heart, when he really started the operation to save people, Hu Xiaotian had to show his best medical skills and state.
Habit, medical ethics, when facing a patient.
You can't judge him by good or evil, just as you don't have the right to sentence him to death on the operating table.
The physical condition of the flower thief is not bad, there is no shock caused by anemia, or water and electrolyte balance, and there are no serious symptoms of infection, which is a problem that Hu Xiaotian is puzzled about.
Hu Xiaotian can't help but think of all kinds of infections in modern society.
Perhaps it is directly related to the over-abuse of antibiotics in clinical practice.
Because of the limited conditions, Hu Xiaotian had to omit the steps of gastrointestinal decompression and enema before surgery, and had just asked about the medical history through a middle-aged scribe, this flower thief has not eaten a grain of rice since last night, and he has not drunk a sip of water, so there should not be too much of a problem.
The refractive principle of the copper mirror is used to ensure the illumination of the surgical area.
The patient is placed in the supine position.
According to the routine sterilization of patients and the laying of towels, Hu Xiaotian's surgical equipment is now much more complete.
Zhou Wenju stood beside him.
He temporarily played the role of an anesthesiologist and assistant, and no one else was allowed in.
Once Hu Xiaotian entered the state of surgery, the whole person suddenly became serious, his mouth and nose were covered by masks, and his hair was covered by hats.
Only a pair of eyes were exposed, and his gaze at this time was firm and convinced, and he took a deep breath, and the whole person instantly entered the state of surgery.
Zhou Wenju stood beside Hu Xiaotian, although he couldn't see Hu Xiaotian's face clearly.
But he really felt a completely different temperament from Hu Xiaotian's body, Hu Xiaotian held the narrow lancet, which made Zhou Wenju feel a kind of domineering momentum in charge of life and death, such a feeling he had only felt in a few doctors in his life.
And all of them are heroes in the apricot forest, Zhou Wenju really can't figure out how a sixteen-year-old boy can have this kind of grandmaster-level momentum.
Laparotomy is usually done with a median incision in the abdomen, which allows for an upward and downward extension or lateral expansion to both sides if needed.
The incision is about 8 to 10 centimeters long, with one-third above the umbilicus and two-thirds below the umbilicus.
Although Murong Feiyan had stabbed a sword in the stomach of the flower thief before, the wound was narrow, and Hu Xiaotian chose to make a new incision.
While skillfully cutting the skin and muscles and separating the tissues, Hu Xiaotian introduced to Zhou Wenju: "The principle of routine exploration of abdominal trauma is that if there is a large amount of bleeding in the abdominal cavity, the source of the bleeding should be found first, the bleeding should be controlled, and then other organs should be gradually explored starting from the bleeding organs.
If there is no bleeding in the abdominal cavity and there is an overflow of the contents and gases of the gastrointestinal tract, the gastrointestinal tract is explored first, and then the parenchymal organs are explored.
The general sequence is to explore the stomach, duodenum, biliary tract, pancreas, jejunum, ileum, colon, rectum, bladder, etc., then the liver and spleen, and finally the pelvic and retroperitoneal organs. ” Some of these medical terms Zhou Wenju has heard of, some have never heard of them at all, he knows the internal organs, as for the subdivision of the small intestine and colon, it is all a matter of modern medicine, how does he know that as for these organs inside the abdominal cavity of the human body, he has only seen them a few times, and has never dissected them personally, so he can't talk about being familiar with these internal organs.
It is impossible for Hu Xiaotian to instill all the anatomical knowledge into Zhou Wenju in a short period of time, just thinking of what to say, although so, Zhou Wenju's medical concept has been completely changed, allowing him to see a completely new field.
When Hu Xiaotian cut to the peritoneum, he paid attention to the observation that the peritoneum of the injured person showed a dark blue color, which proved that the patient had intraperitoneal hemorrhage, and when the peritoneum was incised, gas escaped, which proved that the injured person should have a hollow organ perforation.
Cut the abdominal muscle layer and let Zhou Wenju help to pull the hook to separate the rectus abdominis muscle, so as to expand the surgical field as much as possible.
Looking at the large piece of blood in his stomach, Zhou Wenju felt that his scalp was numb, Hu Xiaotian was not surprised, and smiled like no one else: "A bad stomach." ” After preliminary observation and judgment, Hu Xiaotian began to clear the blood and exudate in the abdominal cavity, because of the lack of suction device, soon after coming to Qingyun, he specially asked a craftsman to make an iron tool similar to the shape of a needle tube, more like a pumping gun for children to play, this simple suction device can suck the blood, gastrointestinal juice and exudate in the abdomen.
In the process of suctioning, Hu Xiaotian found the bleeding point, he asked Zhou Wenju to press the bleeding point with his hand, then took out the hemostat, used the hemostat to clamp the bleeding point, and quickly ligated and sutured the blood vessels.
After the initial removal of fluid or blood in the abdominal cavity, Hu Xiaotian began to explore the intra-abdominal lesions.
The principle of exploration is based on the exploration of the normal area first, and the exploration of the ward area last.
The probing technique is kept gentle and detailed.
After successively ruling out lesions of the liver, esophageal hiatus, spleen, stomach, and pancreas, the focus is on the small intestine, the transverse colon and its mesangium are pulled upward, and after the duodenal suspensory ligament is confirmed, the duodenal jejunal flexure is proposed and examined sequentially from the beginning of the jejunum.
At the same time as the small intestine is examined, the corresponding mesentery is checked for blood circulation disorders, etc., and the examined intestinal segment is sent back to the abdominal cavity in a timely manner.
The jejunum joins the duodenum, which occupies two-fifths of the entire small intestine and is located in the upper left part of the abdominal cavity, where the patient's problem arises.
While Murong Feiyan's sword pierced his abdomen, it also pierced part of the jejunum.
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After determining the location of the affected area and making a clear diagnosis, Hu Xiaotian decided to perform a partial intestinal resection and perform an intestinal anastomosis.
He first determines the extent of the bowel that needs to be removed and carefully lifts it out of the incision.
The usual surgical principle is to cut 3 to 5 cm from the proximal and distal ends of the lesion.
Hu Xiaotian carefully lifted the injured intestine to the outside of the incision, and separated the intestine from the abdominal wall with a large gauze pad with warm saline; Two pieces of dry-sterilized gauze are placed under the gauze pad to separate them from the incision, which minimizes damage to the small intestine and prevents contamination of the abdominal cavity by intestinal contents.
Watching Hu Xiaotian pull the intestines of the injured person's abdomen back and forth, Zhou Wenju couldn't help but break out in a cold sweat, fortunately he was already mentally prepared for this, and he came over as an ordinary person, but he was afraid that Hu Xiaotian would be regarded as a demon with open intestines, and he would faint with fright.
One of the first critical steps in resection of the bowel is to treat the mesenteric vessels, which are separated by a gap on each side of the major mesenteric vessels supplying the resection segment to fully expose the vessels.
Use two curved hemostats to cut this vessel between the forceps, close to the distal end, and use silk sutures to ligate the distal end first, and then the proximal end.
After the first ligation, do not loosen the proximal hemostat, and add a figure-8 suture to the distal side of the ligature line.
Finally, the mesentery is cut in a fan-shaped manner.
Before the bowel can be cut, the mesentery, which is close to the retained segment of the bowel, must be separated by half a centimeter each.
Check again to preserve the blood vessels of the bowel.
Use a straight hemostat to clamp both ends of the intestinal tube of the segment to be resected, with the tip facing the mesentery, and tilt about 30 degrees to the longitudinal axis of the intestinal tube, the purpose of which is to enlarge the anastomosis and ensure the anastomotic blood circulation.
Then clamp the intestinal tube with intestinal forceps at a distance of 3 to 5 cm from the cutting edge, and should not clamp too tightly, so as to block the outflow of intestinal contents.
Straight hemostats that fit snugly at both ends remove the bowel.
To be continued: