My medical skills add experience

Chapter 220 Dangerous Cerebral Herniation

Not long after, he rushed to the neurosurgery emergency room.

I saw more than a dozen doctors and nurses surrounded a hospital bed in the emergency room.

There was also a blond man suspected of being a family member standing beside the hospital bed and watching worriedly.

"So it's a foreign friend, no wonder the neurosurgery department attaches so much importance to it."

It must be explained that this is not xenophobia.

Let foreign friends feel the beauty of China as much as possible, which can attract more foreign friends to come to invest or work.This is a vision.

In the past, when Zhou Can saw that foreign friends were treated preferentially in China, he always felt that it was too licking.

I despise this very much in my heart.

Later, as his knowledge grew, his thinking gradually became broadened, and he gradually understood the far-reaching intention of preferential treatment of foreign friends.

Treat foreign friends well and gain their friendship and recognition.They will also be more willing to work and invest in such a kind, peaceful and enthusiastic country, which can drive the development of economy, technology and other aspects.

"Doctor Zhou is here!"

This nurse girl should be the one who called Zhou Can just now.

Zhou Can has a little impression of her, her name is Shu Qian.

"Director Wen, Director Wu..."

Zhou Can walked over to say hello to these supernatural bosses.

There were four chief physicians alone, and seven or eight attending doctors and residents. The hospital attached great importance to this patient.

Otherwise, it would be impossible to mobilize so many medical resources.

"Doctor Zhou can take a look at the film and medical records first. The patient has a cerebral hemorrhage. He just arrived. He took a CT scan of the head."

After Wu Baihe said a few words to Zhou Can, he leaned over again to carefully check the patient's condition.

Zhou Can took the CT film to check, and saw that there were many white spots on it, and there was a huge white spot in one place.

White spots on brain CT usually indicate brain calcification, hemorrhage or tumor.

The patient is in a severe coma at the moment, and there is no response to calling or patting his shoulder.

When the eyelids are opened, the eyes are dull and the eyes are blurred.

It means her condition is very serious.

Those small white spots should just be calcification of the pineal gland or choroid plexus.This physiological calcification does not have much impact on the patient and does not require treatment.

The key lesion site should be the huge white spot.

White dots on brain CT usually refer to high-density lesions, and the specific cause of formation should be comprehensively judged based on the size, location, CT value, mass effect, and pressure of surrounding brain tissue.

Zhou Can has been trained in Shenwai for several months, and has already learned to watch brain CT, color Doppler ultrasound, X-ray and other films.

The etiology of this patient is actually well diagnosed.

The intracranial pressure is very high, and the brain tissue is squeezed and displaced, forming a brain herniation with a high mortality and disability rate.

At present, the bleeding site can be roughly locked in the position under the falx cerebri.

When the brain herniation formed at this site exceeds a certain level, it is far more dangerous than ordinary brain hernias.Such as foramen magnum hernia, generally mainly caused by respiratory failure, or respiratory arrest.Before the onset, there will be symptoms such as neck stiffness, sudden dilation of pupils, and brainstem hypoxia.

In general, the onset of foramen magnum hernia is gradual, leaving time for doctors to rescue.

Right now, what this patient suffers from is likely to be a subfalcium hernia with a high rate of death and disability. A large number of nerve tissues will be displaced or cut, and most nerves will be necrotic. The time left for the doctor to rescue is very short. .

Many patients fail even before drilling the skull.

"Xiao Zhou, what do you think of the patient's condition after reading it?"

Master Wen probably wanted to test Zhou Can.

There are several chief physicians at the scene, and it is definitely not a problem to diagnose the cause.

It's not a particularly rare disease in itself.

"It should be a subfalx hernia accompanied by intracranial hemorrhage and intracranial hypertension. The patient's condition is extremely dangerous. When the subfalx hernia is mild, it will only cause paralysis of the lower limbs on the opposite side and difficulty urinating. This patient is already in a deep coma. It shows that the displacement of brain tissue caused by brain herniation has been extremely serious. The best way is to perform an immediate craniotomy. Judging by her current situation, the traditional craniotomy may be too late, and immediate drilling and endoscopic craniotomy may have a chance of survival.”

In such an occasion, Zhou Can naturally wouldn't play any tricks.

Instead, state all your diagnostic opinions truthfully.

As for whether the chief physicians adopt it, it depends on what they mean.

"It seems that it is an extremely correct decision to invite Dr. Zhou to participate in the rescue! Your diagnosis result is basically consistent with our diagnosis result."

Listen carefully, and you will find that what Wu Baihe said was to invite Zhou Can to come over, not to ask Zhou Can to come over to participate in the rescue.

Being able to make the director of neurosurgery so polite is enough to show Zhou Can's status in the minds of the chief physicians at Shenwai.

"Immediately issue a critical illness notice! Then talk to the family members. If they agree, immediately ask the family members to sign the operation notice, and then send it to the operating room for emergency surgery."

Wu Baihe made a decisive decision and made a series of arrangements.

Any kind of herniation is extremely dangerous.Most of this patient's body has already entered the gate of hell, and emergency surgery is the only hope.

"However, the site of the intracranial hemorrhage has not yet been identified, and the operation hastily is full of too many uncertainties. This operation is inherently extremely risky, and I am worried..."

A chief physician raised a question with a worried face.

"The patient's current condition can't wait for an angiography. I have done intracranial surgery for so many years, and I know the structure of the brain well. I can only fight with experience. Let's act!"

Peak scalpel is not called for nothing. Wu Baihe's understanding of the structure of the brain probably surpasses everyone else.

Even without filming, he is certain to successfully complete this high-risk operation with the help of his rich surgical experience.

After Wu Baihe gave the order, he personally talked to the foreign friend.

I really didn't see that Wu Baihe not only has the reputation of the peak scalpel, but also speaks English very fluently.

Communication with the family went very smoothly.

Surgery was quickly agreed.

The nurse immediately used clippers to shave the patient's hair and prepare the skin before surgery.

The patient was quickly rushed to the operating room.

Dr. Feng, the most powerful anesthesiologist in Tuya Hospital, was also temporarily called to work overtime.

Zhou Can helped to administer anesthesia to the patient.

Different from the anesthesia of ordinary patients, this patient's anesthesia operation has many skills and key points, and it is required to complete the general anesthesia operation in the shortest time.

Dr. Feng and him drove at full speed, and the two cooperated with each other with a high degree of tacit understanding. After a lot of hard work, they finally managed to give the patient general anesthesia.

[Anesthesia experience +1.]

[It is the first time you have completed general anesthesia for a patient with cerebral hernia, and you will be rewarded with anesthesia experience +100.]

This is the first time that Zhou Can has received an experience point reward for anesthesia, and it is as high as 100 points.

This surprised him very much.

However, the implementation of this anesthesia operation is indeed full of many challenges, and it also taught him many more advanced skills.

In particular, the protection and stabilization of the vital signs of patients in emergency situations, including preoperative medication, many of them are learning for the first time.

"Dr. Zhou's operation is fast, and you will cut the scalp."

Wu Baihe didn't invite Zhou Can over to watch the excitement.

In addition to taking a fancy to Zhou Can's ability in endoscopic surgery, he can act as a backup surgeon when necessary.In addition, Zhou Can's rapid operation ability is not comparable to that of other doctors.

There are only two quick-surgery doctors in the entire Tuya Hospital.

That is Dr. Xu and Zhou Can.

Unless it is absolutely necessary, Dr. Xu would not be easily asked to participate in this kind of rescue operation.

Although it has been a long time since that incident, Dr. Xu's identity is still highly sensitive.

This operation also involves foreign friends, so the hospital is very cautious.

In case the patient is not rescued, the list of surgeons is reported, and Dr. Xu is seen on the list by interested people, the trouble will be big.

Zhou Can's sharp knife has been taught by Dr. Xu. Although it is still far behind, it can be used.

Standing on the main knife position, Zhou Can also lived up to his high expectations, and cut the scalp according to the drawn knife position as quickly as possible.

Zhou Can did not dare to do the next skull drilling.

Because of poor drilling, it is easy to cause serious damage to the patient.

Drilling holes in the removed bone flap is something even a surgeon dares to do.However, directly drilling holes in the patient's skull is extremely technical, and it is difficult for ordinary deputy chief physicians to complete this operation.

Under the skull is the dura mater, and below that is the important brain tissue, brainstem, blood vessels, and nerves.

Wherever it hurts, it will cause unpredictable damage.

It is perfectly normal to directly cause the patient's respiratory arrest and cardiac arrest.

Therefore, the drilling of the skull must be done by a chief neurosurgeon with extremely rich surgical experience.

Wu Baihe personally drilled holes in the patient's skull and opened windows.

Assistant Yi used the mastoid retractor to stretch the scalp so that Wu Baihe could open the bone window smoothly.

Wu Baihe carefully drilled holes in the patient's skull, while Zhou Can stood by and watched and studied.

Skull openings, whether by drilling or cutting a bone flap with a chainsaw, are extremely dangerous.

The main reason is that it is difficult to grasp the degree.

After Wu Baihe finished opening the window, he cut open the brain's dura mater, and used an endoscope to perform cerebral hematoma removal surgery for the victim.

He removed the patient's intracranial hematoma bit by bit, as if he was caring for a baby.

Fear of excessive movement and hurt the baby.

The brain tissue in the cranium is actually more immature and fragile than that of a baby, and a little carelessness will cause irreparable and serious consequences.

Zhou Can stood under the stage and stared at the endoscope screen from time to time, and looked at how Director Wu's hands operated the endoscope from time to time.

"Oops!"

After Wu Baihe removed part of the hematoma in the patient's skull, his complexion changed drastically, and there was a trace of solemnity and tension between his eyebrows and eyes.

"Director Wu, what's the matter?"

The hearts of the doctors around were tightened.

"After removing the blood stasis, the blood in the patient's brain rushed out. Since there is no time to do angiography before the operation, it is not easy to find the bleeding point. If this bleeding cannot be stopped in time, the patient will die soon .”

Wu Baihe originally thought that based on his rich experience, he would be able to deal with any situation.

I didn't expect the bleeding point to be very secretive, and I couldn't find it after searching for it twice.

It has been more than three and a half hours since the rescue, and the patient's hope of resuscitation has gradually become slim.

According to international rescue experience, emergency surgery for brain herniation takes more than four hours, and death can basically be declared.

It has been rescued for nearly four hours now, but the bleeding point cannot be found, and the brain cells at the end of the blood supply will die due to ischemia.

This death of brain cells and brain tissue is irreversible.

After all, Wu Baihe was too old. He rushed to the hospital in the middle of the night for such a long operation, and his physical strength and energy were obviously exhausted.

But for endoscopic surgery, none of the deputy chief physicians and chief physicians under him are particularly good.

"Director Wu, why don't you let Zhou Can replace you for a while!"

Director Wen watched anxiously from the side.

Although the surgical team composed of so many chief physicians and deputy chief physicians is gorgeous, they are not capable at all.

The most is to help the anesthesiologist work together to stabilize the vital signs of the patient.

The main output of the operation was always only Wu Baihe.

"Is Doctor Zhou confident?"

Wu Baihe stopped the operation, and turned to ask Zhou Can, who had long wanted to volunteer under the operating table.

The superior doctor usually asks, are you confident?How sure are you?
Instead of asking like family members, can the disease be cured?How many days will it be?It must be saved, right?
Doctors are people who have performed surgery themselves and understand the hardships and uncertainties involved.

Families and patients do not understand this.

It is impossible to force the doctor to give an affirmative answer.

"Have!"

Zhou Can's answer was short and powerful.

"Come on, give it a try and see if you can find the bleeding point! I believe you have watched it with my endoscope probe just now, and the areas that have been probed can basically be ruled out. Be careful not to hurt the brainstem And important blood vessels and nerves under the arachnoid."

After Wu Baihe gave up the position of chief surgeon, he did not step off the operating table.

Instead, he stood by and watched.

Zhou Can secretly rejoiced that the hemostasis technique had just been promoted to level five not long ago, which made him dare to challenge the hemostasis task of this operation.

He had been watching from the audience just now.

If you guess correctly, the bleeding site is likely to be a brain hemangioma or rupture of a deformed blood vessel.

For larger hemangiomas, Wu Baihe's surgical experience is extremely rich, so he must have found them long ago.

For small hemangiomas, the amount of bleeding should not be so large.

Then there is only the last possibility, the cause of bleeding is the rupture of malformed blood vessels.

He manipulated the endoscopic probe to carefully explore the cranial cavity.

Different from Wu Baihe's detection method, Zhou Can deliberately did not suck up the new bleeding in the cranial cavity.Let it form a puddle of blood.

"Is this going to work? Why does it feel like he's playing!"

"It's a bit of a joke to let a Gui Peisheng operate it."

"Looking at it is really worrying. It's a pity that my endoscopic operation skills are not good. Otherwise, I should be able to find the bleeding point."

Many doctors at the scene were anxious for a while.

They thought it was absurd to ask Zhou Can to perform this operation.

Standing on the operating table, Zhou Can was not affected by the doubts from the outside world, but concentrated on staring at the endoscope screen.The endoscope in his hand slightly changed its angle and moved slowly.

He didn't know what abilities other doctors would have after their hemostasis was upgraded to level five.

Anyway, as early as when he had raised the hemostasis to the fourth level, he was able to trace the approximate location of the bleeding point through the flow of blood and the ripples on the surface of the effusion.

Suddenly, his eyes lit up.

"The bleeding point was originally hidden in the right brain ball, no wonder Wu Baihe has not been able to find it."

This location is easy to overlook.

Even if the probe is found nearby, it is easy to remove quickly.

"Hey, hey, how did the endoscope move in? It's dangerous!"

"Stop!"

Several chief doctors were frightened to death after seeing Zhou Can's operation.

Zhou Can didn't stop, but directly probed into the target position in the brain ball very firmly.

This operation process is actually very difficult.

Fortunately, his grasping and teleportation skills have all been upgraded to level four.This came in handy when removing some brain tissue to create a favorable space for endoscopy.

[Gripping experience +1. 】

[For the first time to successfully grasp important brain tissue, reward grasping experience value +100.]

[Transfer skill experience value +1.]

[For the first time, the successful transmission and pulling of important brain tissue will reward the transfer experience +100.]

Every difficult operation must be rewarded heavily.

Zhou Canle blossomed.

An even bigger surprise was yet to come, and the probe caught him an inspiring picture.

"The bleeding point has been found! It really is a deformed blood vessel ruptured and bleeding."

As soon as Zhou Can's probe reached the bleeding site, he saw blood rushing out, and the blood washed onto the probe.

The amount of bleeding is considerable.

The artery must have burst.

And it is not a small artery, but a cerebral artery with a relatively thick diameter.

No wonder patients are unable to stop the bleeding with their own blood clotting ability.

"Okay! Great! Finding the bleeding point means that the hope of the patient's recovery is much greater!"

Wu Baihe was extremely excited.

Those doctors who questioned Zhou Can shut their mouths one by one, feeling ashamed of their reckless words and deeds just now.

No one expected that Zhou Can could really find the blood vessel of the intracranial hemorrhage.

It took only 9 minutes.

At this moment, some people even thought that it would be more beneficial for the patient if Zhou Can could replace Wu Baihe as the chief surgeon earlier.

　Thank you book friends, Blossoms from the Other Shore for your support!

　　
　
(End of this chapter)