I can extract side effects.

Chapter 475 Convinced Oral
"Doctor Jane, a stroke patient has just been admitted to the Neurosurgery Intensive Unit from the emergency department. His condition is very critical. Please come over immediately."

A nurse rushed into the office and spoke anxiously.

Jian Lianyun immediately got up and walked towards the door: "I'll go there right away, please tell me about the patient's condition first."

"The patient was sent to the hospital by a friend who called 120. It is said that the two met for fishing in the countryside. In the morning, they began to feel dizzy, but they did not pay attention to it. In the afternoon, the patient's headache worsened, his hands and feet became numb, and he suddenly lost consciousness and fell into a coma. don't wake up."

"After emergency admission, the examination in the emergency department found that the patient's head CT showed massive brainstem hemorrhage, and the bleeding volume had exceeded 11 milliliters. The patient was in a severe coma state, and his spontaneous breathing rhythm was extremely disordered. He was intubated and put on a ventilator for further rescue. into neurosurgery."

The nurse kept talking all the way, and explained the whole situation in detail.

"Brainstem hemorrhage? This is not good." Jian Lianyun's face suddenly became serious, she paused, and said, "You go and invite Dr. Roman over."

"If there is an operation, it will be a major operation. The director is not here now, and he may be required to come on stage together."

"Okay, I understand." The nurse nodded, turned around and trotted away.

Jian Jianyun soon came to the intensive care unit and saw the unconscious patient.

She just arrived on the front foot, and after a while, Dr. Roman also arrived on the back foot.

Jian Lianyun greeted with a smile, turned his gaze to CT, and looked at it intently.

Dr. Roman came over to take a look, and couldn't help frowning.

"Brainstem hemorrhage is the most dangerous type of stroke, and this patient's condition is not optimistic."

"Yes," Jian Lianyun said calmly: "The mortality rate of brainstem hemorrhage is extremely high. The mortality rate is as high as 5% if the bleeding volume is less than 70ml, and the mortality rate is more than 5% if the bleeding volume is more than 90ml. If the bleeding volume exceeds 10ml, you will die The rate is almost 100%.

"And this patient's blood loss was as high as 11 milliliters. We can be said to be racing against death."

Dr. Roman nodded approvingly: "Time is life. His breathing and heartbeat may stop at any time. Conservative treatment is almost impossible, and surgical treatment is necessary."

"However, surgical treatment also faces huge risks. We must inform the family members of this, and let's see their decision."

Dr. Roman showed surprise on his face: "Why should the family members make the decision? The patient has suffered from heavy bleeding and is unconscious. Isn't the right to decide on the operation by the doctor and in the hands of the doctor?"

"Uh, this, the national conditions are different. In China, we need the signature of the family members for the operation." The attending doctor explained with a slightly embarrassed expression.

"Why? Can family members be more professional than doctors? We are the best doctors in the world." Dr. Roman looked incredible.

"It is very dangerous to hand over the decision-making power to the family members. What if the family members make a wrong judgment due to their own limitations and do not agree to the operation?
The attending physician scratched his head and said angrily, "This kind of situation has happened before."

"Huh?" Dr. Roman was even more shocked, and quickly asked, "Then who will be responsible for the loss of the patient's life in this case?"

The attending physician blurted out: "Of course the family members are responsible."

"My God," Dr. Roman's eyes widened. "In Eagle Country, if it's an emergency treatment, the doctor can make a judgment after consulting with the doctor. You only need to tell the family members about the illness and treatment."

The attending physician asked suspiciously: "What if the family members disagree with the operation?"

Dr. Roman said decisively: "The decision is in the hands of the doctor. If the family members do not agree, we will also perform surgery. If we listen to the family members and make a wrong judgment, the hospital will be jointly and severally responsible for the death of the patient caused by not performing the surgery. Besides, it goes against the doctor's conscience to ignore death."

This time it was the attending doctor's turn to be shocked: "Is there such a thing? It seems that our medical system is really very different."

Dr. Roman said with a serious face: "This is not a joke. It is the correct behavior for professional people to make professional decisions."

Jian Lianyun interrupted the conversation between the two, and said, "Let's focus on the patient's condition. I will communicate with the family members and I should be able to persuade them to undergo surgery."

As soon as he came outside the ward, a middle-aged woman rushed over and cried, "Doctor, save my husband. He is still young, only 42 years old. There is an old man and a young child. Both children are studying. We can't do without him."

Jian Lianyun smiled and explained his condition very carefully, explaining everything as clearly as possible.

"The patient is now in a very critical condition and needs surgical treatment. Surgery is also very risky, but it is not without a glimmer of hope."

When the family members heard this, they were immediately anxious: "Then what are you waiting for, do the surgery right away. My old Zhou can't afford the time."

She was holding the consent form and was about to sign it when suddenly a hand reached out and grabbed the document.

A fat middle-aged woman was holding a document in her hand, followed by two anxious old men, and reprimanded him with a hostile expression: "What's the matter? You just want my brother to die that much?"

"My brother's situation is so dangerous, what if the operation fails and he becomes a vegetable? Will you take care of him for the rest of his life?"

The wife said timidly: "The doctor said that the operation is hopeful."

The fat woman sneered, with a look of disdain on her face: "Kun City is a small place. The doctors here are so good. Fortunately, I didn't let you kill my brother when I came home during the Chinese New Year. Parents, what do you think is true?" no?"

The two old people looked at me and I looked at you, but they didn't make a sound for a while.

The fat woman became even more arrogant, and said triumphantly: "I asked my old classmate who works in the third-class hospital in Haishi. He is also a doctor. After knowing the situation, he said that surgical treatment is of little significance, it is too difficult, and it is easy to fail."

"Wouldn't it mean that people and money will be empty by then? You can run away and leave my two poor nephews behind?"

Jian Lianyun couldn't stand it any longer, and interjected: "Actually, I've done this operation many times, and it's not completely hopeless."

The fat woman didn't dare to be too presumptuous towards the doctor, and said coldly: "Doctor, we will decide this matter. I have discussed it with my parents. I am going to ask my classmate to contact the experts in Haishi. Try to invite experts to come over for the operation."

Jian Lianyun looked at his wife and asked, "You are the patient's spouse and the first person to sign the operation. Are you going to have the operation?"

The wife looked at her parents-in-law and sister-in-law, shook her head with a pale face, and said in a low voice, "Let's discuss it again."

Jian Lianyun sighed in her heart. If she followed her usual practice, she should turn around and leave now, and wait for the family members to make a decision.

However, for some unknown reason, a comatose patient suddenly appeared in her mind.

At the same time, what Dr. Roman said flashed through his mind one by one.

"The decision to do surgery should be in the hands of the doctor."

"It is against the conscience of doctors to refuse to save them."

Jian Lianyun made up his mind in an instant, and instead of leaving as usual, he walked up to the fat woman and asked with a smile, "I want to ask, which hospital is your classmate a doctor in Haishi?"

The fat woman said proudly, "How is Ruiji Hospital? This is one of the best hospitals in the country. Later, I will invite an expert from there to perform the operation. It is not much better than you."

Jian Lianyun smiled lightly: "Oh, I forgot to mention, before I came to Kunming City, I worked in Ruiji Hospital. My father is the director of the oncology department. I grew up in Ruiji Hospital since I was a child. I know all the uncles in all departments. .”

"I am familiar with neurosurgery from top to bottom. In the past few years, I haven't heard from my dad that there is any new powerful person. I don't know which expert you want to invite?"

"If you know the name, you might as well tell me, I can invite you here without your classmate's help."

The fat woman was stunned. The old classmate said that he wanted to hire an expert for her, but he didn't tell her who it was.

Her face was blue and white, her lips were trembling, and she couldn't say anything.

At this time, Jian Lianyun said again: "If you don't trust me, if you want to find a neurosurgery expert, you don't need to look far away."

"In fact, Dr. Roman, the director of neurosurgery at Cleveland Clinic, the best hospital in Eagle Country, has been studying and communicating in our hospital for the past few days. If he were to operate on patients, would you be willing?"

The fat woman was shocked for a moment, and it took a while before she said in a trembling voice: "Eagle, are you an expert from the Eagle Country? That's fine, so I won't waste time going to Haishi to hire an expert."

The two old men on the side also showed surprise expressions.

Jian Jianyun saw that there seemed to be something going on, so she called Dr. Roman out.

Sure enough, when Dr. Roman appeared in a white coat and looked exotic, he only said a few hello, hello, and the patient's family was shocked.

But he went back quickly, from showing his face to disappearing, the whole process did not exceed 1 minute.

But the patient's family members were completely relieved, almost cheered, and signed the consent form at the speed of light.

Jian Lianyun shook his head secretly, feeling a little uncomfortable.

But saving lives is the most important thing now, she didn't have time to think about it, and immediately started preoperative preparations.

Previously, she had undergone several endoscopic operations for brainstem hemorrhage, all of which had a bleeding volume of less than 10 milliliters.

Although everything went smoothly, there is still a gap in difficulty compared to the operation with 11 ml of blood loss.

For neurosurgeons, ordinary craniotomy is already very complicated and dangerous, and it is even more difficult to operate a knife on the brain stem.

Once the important nuclei of the brainstem are damaged, the patient will die during the operation at any time.

Brain stem surgery is recognized as the most difficult area in the field of neurosurgery, and it is considered difficult to complete in most hospitals in China.

No matter how experienced neurosurgery experts are, they dare not say that they are completely sure.

Not to mention brainstem surgery where the bleeding volume exceeds 10 milliliters and the mortality rate is as high as 100%.

This is also a serious challenge for her.

Jian Lianyun thought of the difficulties he was about to face, not only did he not have any intention of shrinking back, but instead trembled all over his body, his scalp went numb with excitement.

She will lead the team to break into the restricted area of ​​life once, challenge the most difficult operation in the field of neurosurgery, and fight for the only hope of survival for the patient and the family behind him.

Isn't that what it means for her to be a doctor?

The patient was quickly wheeled into the operating room.

Dr. Roman has been eloquently guiding all aspects of the operation, even when he was brushing his hands in the operating room, he didn't stop.

"Young lady, I admire your courage very much. Since you have the confidence to be the chief surgeon, I can only remind you that precise positioning is the most difficult part, followed by the operation during the operation, but the most important thing is to maintain the hand feeling. Stablize."

"Under the extremely high magnification, the basic skills of the surgeon will be fully reflected."

"I have seen many talented young doctors, but due to insufficient accumulation, without exception, they all have varying degrees of hand tremor under high-power lenses, and often have to interrupt operations and stop to adjust."

"In the field of neurosurgery, in order to be as stable as Mount Tai in the operation of equipment, on the one hand, it is a battle-tested, excellent psychological quality, and on the other hand, continuous scientific training."

"This is why only those in their 40s can become a neurosurgery expert. Surgery under a microscope is too delicate and demanding. Only after more than ten years of training can one achieve five or six hours of motionless hands."

Jian Jianyun smiled and said, "Dr. Roman, thank you for your concern. In fact, I am already thirty, and I am not as young as I look."

"You don't have to worry about this. Although I have only been a neurosurgeon for five years, I have many years of experience in skull base tumor surgery, which adds up to more than ten years."

"In addition, when I was 6 years old, I started dissecting frogs and rabbits at home. Since then, I have dissected all the meat our family eats."

"Speaking of which, it's not you who reminded me. I haven't realized that time flies so fast. I've had surgery for more than ten years."

She breathed a sigh of relief, put aside these words, turned and walked into the operating room.

"Brainstem hematoma removal under the craniotomy microscope, start."

Standing at the chief surgeon's position, Jian Lianyun succinctly gave the instruction to start.

When the patient's brain appeared in front of her eyes, the whole world seemed to disappear.

The neuroendoscope seemed to have life in her hands, moving forward briskly and smoothly.

The brainstem was quickly found through the base of the skull. There are dense nerve tissues everywhere, and a little carelessness will bring the patient's life into danger.

Jian Lianyun stared at the microscope without blinking, and gently avoided the dense nerves.

At a place where a superficial hematoma was about to burst out of the ground, she found a breakthrough point for the surgical approach.

Her movements became lighter and more gentle, tossing and turning between square inches.

The brainstem was gently scratched, and a cut was made.

Jian Jianyun picked up the suction device, ready to drain the hematoma inside.

However, the aspirator sucked, but it didn't work at all.

Upon closer inspection, it turned out that the hematoma inside had clotted into a block and could not be sucked out at all.

Countless thoughts flashed through Jian Jianyun's mind in an instant.

How to do?
How can I suck out the lump inside?
Damn it, why is my mind so messed up, but I can't think of anything.

Jian Lianyun was burning with anxiety, and fine beads of sweat appeared on his forehead.

At this critical moment, a serious voice suddenly came from the side.

"Use forceps to remove the blood clot bit by bit."

Hearing this voice, Jian Lianyun immediately calmed down.

"That's right, using forceps instead is just like removing tumors."

She replaced the aspirator in her hand with pliers, and took out the blood clot bit by bit.

There was a cheer from the entire operating room when the last clot was also removed.

There was a joyful smile on everyone's face.

Jian Lianyun glanced at the clock, five and a half hours had passed, and a stone fell from his heart.

With the tacit cooperation of the entire surgical team, after more than five hours of painstaking efforts, the patient was finally brought back from the death line.

She put down the endoscope in her hand, only to feel that her back was soaked and her legs were a little numb.

Dr. Roman's hearty laughter sounded: "Dr. Jane, the operation was successful, congratulations."

Jian Lianyun nodded slightly, she didn't have the strength to force another smile.

Soon, the attending doctor took over the follow-up work.

Jianlian Yunshen walked out of the operating room with one foot and one foot, and Dr. Roman followed closely behind her.

The fat woman who had been waiting outside the door let out a scream, jumped over Jian Lianyun, and rushed straight to Dr. Roman, shouting in surprise, "Doctor, is the operation over? How is my brother?"

Dr. Roman nodded with a smile, and the family members cheered instantly.

They surrounded Dr. Roman and asked questions in a hurry.

Dr. Roman looked at the family members clustered around him, and the smile on his face gradually disappeared, replaced by faint anger.

"Let's go." He said with a straight face, and the family members looked at each other in blank dismay, and quickly moved out of the way.

Dr. Roman walked quickly to Jian Lianyun, pointed at her, and said loudly to the family members.

"The operation was very successful, but I didn't operate on the patient. She was the one who performed the entire operation."

"She is the one you should thank."

"It's her who brought your relatives back from death."

"She is the best and hardworking doctor I have ever seen, much better than me."

"You should trust Huaxia's doctors. They are no worse than us. In fact, I came to Kunming this time to study."

The family members were dumbfounded when they heard the translation.

Only then did they realize that it was the female doctor in Kunming who performed the operation, not the foreign expert.

The fact that foreign experts actually came to Kunming for further study also completely broke their inherent impression.

"It turns out that the doctors in Kunming are better than foreign experts."

"I really can't see that foreigners are so convinced by her at such a young age."

"Great, I don't have to go to Haishi for surgery in the future."

The family members exclaimed again, but this time they surrounded Jian Jianyun and expressed their gratitude one after another.

The fat woman came forward with a face of shame, lowered her head and apologized: "I'm sorry, I said something wrong before."

"Doctor, thank you for saving my brother's life."

Jian Lianyun looked at the scene in front of him, his eyes were bright, and the corners of his mouth were raised.

I just felt that all the fatigue disappeared.

(End of this chapter)