medical road high rise

Chapter 238 Preoperative Cerebral Hemorrhage?

Chapter 238 Preoperative Cerebral Hemorrhage?

Qin Feng took the periosteum separator, thinking about separating the muscles and tendons on the occipital bone attached to both sides.

"Retractor."

Qin Feng placed a retractor at the incision, which is a surgical instrument used to retract tissue and expose the surgical range. In abdominal surgery, it functions as a retractor.

After completing the incision, Qin Feng continued to open the window.

A small incision cannot provide a surgical field and a good operating space, so a bone window must be opened.

However, the patient was in a lateral position, and the drill bit in Qin Feng's hand could not penetrate the surface of the skull vertically, so Qin Feng placed a bone pryer underneath to prevent the drill bit from slipping down and causing damage to other parts of the skull.

Although Qin Feng drilled a hole and opened a window from the lower edge of the external occipital prominence and transverse sinus, the director of the brain surgery department was stunned for a moment.

"Doctor Xiao Qin, you prescribe such a small surgery? Can you do it?"

The surgical field Qin Feng opened was too small, and the director of the brain surgery department would definitely not be able to do it.

Suddenly, a bang came from the patient's spine.

Qin Feng looked at the orthopedic doctor, and the orthopedic doctor gave him a sorry expression.

"The patient's condition is so serious that it has become a spinal burst fracture."

"hiss!"

Qin Feng gasped. This burst fracture is also a huge challenge for orthopedic surgeons.

It should be known that for burst fractures, it is generally possible for bone fragments to squeeze into the spinal canal.

Once the spinal canal is damaged, the patient basically faces high paraplegia.

"I suggest you use spinal canal fracture fragments to remove, and bone graft fusion at the same time." Qin Feng said two orthopedic procedures.

As an orthopedic surgeon, I am very familiar with these two surgical procedures. Although I may use them less often, I am very familiar with them.

Qin Feng is equivalent to lighting a bright light for orthopedic surgeons. He has been a little confused before, and he hasn't figured out which surgery method is better.

Now that Qin Feng's suggestion comes out, using this technique is the best choice.

The technique is determined, and the rest depends on the level of the practitioner.

Normally, this orthopedic surgeon would not dare to challenge himself, but now that Qin Feng has set an example, he is on stage, so it is naturally impossible to shrink back.

Qin Feng didn't know that he had influenced a doctor invisibly.

"Get ready to hold the needle forceps, I'm going to cut the dura mater." Qin Feng said.

There is a cerebellar falx in the midline of the dura mater in the posterior fossa, and there is a circular sinus in it. It is necessary to suture to stop bleeding immediately after the incision.

Qin Feng asked the director of brain surgery to prepare needle-holding forceps in advance for suturing. After incision, Qin Feng quickly fixed the suture site with forceps, took the needle-holding forceps and stopped the bleeding under blind operation.

The director of brain surgery stared wide-eyed.

"Doctor Xiao Qin, your grasp of the hemostasis point is too good."

"Fortunately."

Qin Feng then opened the incised dural flap toward the transverse sinus, revealing the structure inside, and soon discovered the problem.

The patient's brain contusion was accompanied by traumatic intracranial hematoma.

Cerebral contusion is a relatively serious closed craniocerebral injury, including rupture of cerebral blood vessels, tissue necrosis and so on.

Intracranial hematoma is usually accompanied by brain contusion and laceration. Intracranial hematoma will directly compress brain tissue, hindering cerebral circulation and cerebrospinal fluid circulation, which will aggravate the degree of brain compression and form a vicious circle.

Qin Feng thought for a while and decided to deal with the brain contusion first.

First use an aspirator to suck out the surrounding cells and tissues, which are all necrotic tissues scattered around.

Then the brain compression plate is used to pull the brain tissue and expose the surgical field.

Because the hematoma in the patient's brain was relatively hidden, Qin Feng could not see it with the naked eye, so he could only use the ventricular needle to gradually puncture into the brain, and judge the location of the hematoma by feeling.

Soon, the needle was somewhat obstructed.

After all, Qin Feng's strength does not come in one go, but slowly, and he will naturally stop when he encounters a hematoma.

After judging the location of the hematoma, Qin Feng quickly selected a puncture point in the non-functional area of ​​the brain. Tanning cut about 3cm of the cerebral cortex, and then used the brain pressure plate and suction device to gradually reach the hematoma in the direction of the puncture.

Then use a suction device to carefully suck out the hematoma.

Intracerebral hematoma is a relatively serious disease. Once it is not handled properly, the patient may experience headaches and vomiting, accompanied by mental disorders and even hemiplegia.

Qin Feng used electrocoagulation to stop the bleeding while attracting, there is no way to avoid it.

During the process of hematoma elimination, active bleeding of many blood vessels often occurs, so electrocoagulation must be performed after each suction.

This process is very cumbersome, but the operation cannot be deformed.

After all, the surrounding blood vessels are distributed in the functional areas of the brain. Once the blood vessels are damaged, it is very likely to cause damage to the functional areas.

As the hematoma disappeared, Qin Feng pulled the drainage tube again to suck out all the accumulated water in the brain. After checking again for no necrotic tissue and hematoma, Qin Feng directly closed the skull.

This operation cannot be opened for a long time like abdominal surgery. The longer the time, the more unfavorable it is for the patient's recovery.

When suturing, Qin Feng used great strength, because the dura mater is inconvenient to cut, and even more inconvenient to suture.

Why is it called dura mater?It is because he is tough enough!
When suturing the suboccipital muscles, Qin Feng became more rigorous. There are strict requirements for suturing this muscle, which must go through the entire layer of the muscle without leaving any gaps.

Once the suture is not tight, cerebrospinal fluid leakage or even pseudocyst will occur, mostly at the junction of muscle and fascia.

After the skull was divided, Qin Feng also breathed a sigh of relief.

Finally, he saved the teacher's life, and at the same time, Qin Feng stepped forward to help the orthopedic surgeon continue the spine operation.

With the addition of Qin Feng, the speed also became faster.

At the end of the operation, everyone let out a sigh of relief.

"Doctor Xiao Qin, today is thanks to you." The orthopedic doctor smiled.

"No, it's all thanks to everyone." Qin Feng shook his head and said.

The patient was sent to the ICU, and Qin Feng and others returned to the emergency department.

After finishing his work, Qin Feng went home to lie down and fell asleep.

Early the next morning, Director Dong called Qin Feng over.

"Director Dong, why did you call me here? Did any patient have an accident yesterday?" Qin Feng asked.

Director Dong nodded, and said seriously: "There is indeed an accident with a patient, and it is the operation of the culprit."

"The operation failed?" Qin Feng asked in surprise.

"No, the operation was successful." Director Dong said.

Qin Feng was stunned for a moment, what did he ask himself to do after the operation was successful, and he still had this serious expression.

"The operation was successful, so there's no need for such a big fight?"

"No, after the operation, I found some things, you can see for yourself." Director Dong handed the film to Qin Feng.

Qin Feng looked through it, and after a careful look, he took a deep breath.

"Is this an abnormality in the middle temporal gyrus?"

The brain waves in Qin Feng's hands are dominated by medium and high amplitude continuous wavelengths, and are limited to the middle of the temporal lobe, and the right side of the brain is obviously dominant, which is a typical manifestation of cerebral hemorrhage patients.

But now Director Dong shows himself what does this mean?
"The patient had cerebral hemorrhage before the accident?"

Director Dong nodded.

This is not good news, this person is the perpetrator after all.

If the hospital characterizes it as cerebral hemorrhage before the accident, then the patient is likely to evade legal sanctions. This is not a lie, but true, just like issuing a mental certificate.

(End of this chapter)