medical road high rise

Chapter 192 Be sure to keep it!

Chapter 192 Must Keep!

The entire observation room fell into silence, and everyone kept silent about the pregnant woman's words.

"But the director of the obstetrics and gynecology department said on the phone that if the hysterectomy is not performed, the bleeding will be difficult to stop." Hospitalization in the emergency department is always a bit embarrassing.

Yue Fangfang nodded approvingly from the side and said, "That's true. If we don't remove the uterus, it will be very difficult for us to stop the bleeding."

Qin Feng kept frowning and studying the placenta until Lin Xue bumped him lightly, then Qin Feng raised his head and found that everyone was looking at him, as if they were waiting for him to make up his mind.

"Maybe there is no need to remove the uterus." Qin Feng said in surprise.

Everyone looked at Qin Feng in surprise, but they didn't expect Qin Feng to say this.

"Brother Qin, this is a hemorrhage. It's not a joke. If you are not careful, you will die." Lin Xue reminded.

Qin Feng said: "I know, but there is a defect in this placenta, which proves that there is a problem with the blood coagulation function in the pregnant woman. As long as the thrombin is infused into it for treatment, good results can be achieved, and there is no need to remove the uterus."

In this case, it is generally because the placenta is not completely separated and the uterine contraction is weak, which causes the blood vessels on the endometrium to be unable to contract and close tightly, which induces diffuse bleeding and causes the coagulation function to fail to keep up.

"Doctor Qin, are you sure?" Yue Fangfang asked with some doubts, frowning.

Thrombin can indeed treat postpartum hemorrhage, because thrombin can stop bleeding. For general postpartum hemorrhage, after local application, it can quickly form a stable blood clot on the wound surface, thereby controlling capillary venous bleeding and playing a better hemostasis effect.

However, when postpartum hemorrhage occurs clinically, the situation is generally very critical, and blood volume needs to be replenished in time. A reasonable treatment plan should be selected according to the specific situation. When the life of the parturient is endangered, the priority of hysterectomy is higher than that of blood coagulation. enzymatic.

Hysterectomy can successfully stop bleeding 100%, but it is only possible with thrombin, it is just a guess.

In the hospital, doctors seldom gamble and guess, unless the family members strongly request it.

"I'm sure." Qin Feng said firmly.

For his own judgment, Qin Feng is very firm, and at the same time, he is very sure about his hemostasis method. Coupled with his understanding of the human body structure and blood vessels, Qin Feng has 90.00% confidence in judging that there is a problem with the blood coagulation function.

"But……"

"The patient doesn't have much time left. If the thrombin fails, we will resort to hysterectomy." Qin Feng said.When the husband of the pregnant woman heard Qin Feng's words, he also expressed his approval.

"Okay." Yue Fangfang agreed with Qin Feng's approach, and regarded it as Qin Feng's attempt, "Then what thrombin are you going to use?"

"Prothrombin complex and fibrinogen are both needed, and some cryoprecipitate and fresh plasma, including platelets, should be taken at the same time," Qin Feng said.

Qin Feng squatted down and began to clean up the uterine cavity and the birth canal, expelling some remaining fragments of the placenta and endometrium.

"Zhao Qi, we are going to install an external drainage tube. The family members please go out first." Qin Feng said urgently.

Lin Xue sent the pregnant woman's husband out to prevent the family members from seeing the operation and acting aggressively.

Surgery usually involves a bloody scene, so the doctor will not let the family members see this scene, the human heart is full of flesh, seeing his wife in pain, any normal man can't help it , which is also to prevent problems before they happen.

After the extracorporeal drainage tube was placed, the accumulated blood was drawn out along the way. Qin Feng was also relieved to see the dark red drainage tube.

"Brother Qin, the two thousand milliliters of blood has been transfused." Lin Xue said suddenly.

Qin Feng's face became serious again, "Immediately prepare two thousand units of prothrombin complex and one hundred milliliters of normal saline, and continue to infuse."

After the normal saline enters the pregnant woman's uterus with the prothrombin complex, the amount of bleeding will be significantly reduced in about 10 minutes. After an hour, the second perfusion will be performed, and platelets, plasma, etc. that promote blood coagulation will be infused. , complete hemostasis can be achieved.

This is Qin Feng's psychological expectation and estimation. The specific situation depends on the situation of the pregnant woman.

"Brother Qin, the patient's blood pressure can't be measured."

Just after the infusion was arranged, another bad news came from Zhao Qi.

"Rescue, don't let the patient go into hemorrhagic shock." Qin Feng said seriously.

Qin Feng's mind was running fast, the current situation of the pregnant woman, whether to insist on thrombin infusion or hysterectomy.

If the uterus is removed, it means that the woman has lost the most basic characteristics of a woman, including fertility and menstrual periods.

However, thrombin infusion is very dangerous when the patient has already undergone hemorrhagic shock and has been infused with more than [-] milliliters of blood.

Zhao Qi hurriedly took Lin Xue to carry out rescue measures. Qin Feng couldn't make a move at this time, so he had to pay full attention to the uterus.

1 minute later.

"Blood pressure appeared, and the patient was rescued." Zhao Qi said.

Qin Feng nodded and said: "Continue to the next step."

The first thing the pregnant woman said after waking up was: "Doctor, you must keep my uterus! If you want to remove the uterus, you might as well let me die."

The pregnant woman's mood fluctuated a lot. Lin Xue and Zhao Qi pressed one arm of the pregnant woman respectively to ensure that the pregnant woman would not get emotional and cause the pipe to fall.

Qin Feng didn't understand why the pregnant woman was so emotional, and finally Yue Fangfang explained.

"Oh, this is normal. In the small city of Taoshi, if a woman does not have a uterus, she will definitely be rumored everywhere and personally attacked. Her family will feel ashamed. Even if her husband loves her very much, but There is a lot of gossip on the side of my natal family, and the final outcome of the two is divorce."

"Doctor, please." The pregnant woman cried.

Qin Feng said: "Don't worry, I will try my best to save your life and at the same time keep your uterus."

After speaking, Qin Feng looked at Zhao Qi and Lin Xue.

"Let's prepare for the second thrombin infusion and dilute it. At the same time, increase the amount of blood preparation and blood transfusion, and intermittently transfuse platelets and plasma."

Zhao Qi nodded, and gave Zhao Qi the prothrombin complex prepared by Lin Xue.

Qin Feng looked up at the external drainage bag, and the blood inside had reached [-] milliliters, half of the volume of the external drainage bag, and it was still increasing.

A blood loss of [-] milliliters is already considered serious intraoperative bleeding in a normal operation.

Fortunately, the blood transfusion was prepared in advance, and the blood loss of [-] ml was still within the acceptable range.

Qin Feng took a needle, sucked up the prepared diluted prothrombin complex and injected it into the patient's uterine cavity.

(End of this chapter)