bookpower Chapter 434
Chapter 434
Here's what I said,
Difference between X-ray and CT.
As a simple example, let's now look at the shape of an apple.
The naked eye can see that the apple looks like this, only the appearance of the apple, not the inside.
· X-ray:
Looking at the apple, it is like swatting the apple flat, you can only see one photo, and there is no way to distinguish between the front and back.
With more details, it looks even more chaotic.
· CT：
CT is like cutting an apple piece by piece to see what is in each cross-section, and in which corner there are abnormalities.
Then a total of dozens and hundreds of pictures came out, each of which clearly reflected what was in each layer.
This is not enough, but also a three-dimensional reconstruction, combining all the photos to produce a three-dimensional image.
In this way, it will be clearer whether there are insects in the apple, where they are, how long they are...
......
The CT teacher operates the CT machine and sweeps it layer by layer.
The look was serious.
"I saw a lot of bleeding, just in the temporal lobe position, when there was a large amount of blood in the ventricles, it was mostly high-density casting, and the intracranial pressure increased, and the ventricles enlarged... There was a herniation..."
It's the same as Lin Feng's judgment.
Lin Feng: "How much is the amount of bleeding?" "
CT teacher: "About 80 ml..."
Lin Feng turned to the emergency department doctor: "Are you prepared for mannitol?" "
Emergency Department Doctor: "Yes! "
Lin Feng: "Immediately drip mannitol..."
At this point,
Lin Feng began to command.
The doctor in the emergency department is a chief doctor, but he subconsciously obeys Lin Feng's command.
It is really Lin Feng's surgical control aura that has been formed over the years, which makes people can't help but obey.
......
Next, it's how to treat it.
Lin Feng: "The patient's bleeding is not small, so it is necessary to carry out the emptying operation as soon as possible, otherwise it may cause serious consequences such as mass brain tissue necrosis, and there is a high probability of direct brain death..."
Attending physician Wang Hua: "Our brain surgery has 2 detection instruments, which can do brain emptying surgery..."
Lin Feng: "Ask the brain surgery, how long will it take to do this operation?" "
Wang Hua nodded: "Okay, I'll call and ask right away..."
Make a call on the spot.
soon
The Department of Brain Surgery gave an answer.
"Preparation time for surgery 1 hour..."
When Lin Feng heard this, he immediately shook his head: "It's too slow, no... The patient bleeds a lot, and the patient will die directly..."
Attending Wang Hua: "Doctor Lin, do you mean, empty-handed drainage?" "
Lin Feng nodded: "That's right, it's the empty-handed drainage technique." "
Wang Hua frowned: "This operation... I'm afraid that no one can do it in our emergency department, and the big doctors are generally very full..."
Lin Feng: "It's okay, I'll do it..."
Wang Hua was worried: "This is too dangerous..."
Lin Feng shook his head and firmly: "It is precisely because of the danger, so I will do it..."
The attending doctor was a little embarrassed.
Because Lin Feng is not from the Ditan Hospital, although it can be operated on in accordance with the law, he is afraid of provoking the leader. After all, Lin Feng is from Harmony Hospital.
He consulted the director of the emergency department.
The director of the emergency department, along with two other doctors, soon arrived at the CT room.
"Lin Feng..."
"Ahhh... Teacher Chen?! "
Lin Feng was surprised to find that the director of the emergency department turned out to be one of the teachers of Lin Feng's graduate course.
Cognitive.
The other two doctors saw Lin Feng and greeted each other.
"Doctor Lin!"
"Doctor Lin!"
Lin Feng: "Hello..."
Then introduce the condition...
One by one, the doctors showed their embarrassment.
This patient, they can't do it!
At this time, the attending doctor of the brain surgery came to consult.
It also showed difficulty.
"Empty-handed discharge surgery, only the deputy director and above can do it (in fact, it is very difficult and risky), but every doctor above the deputy director is very nervous, and I am afraid that it is a little difficult all of a sudden..."
Lin Feng: "It's okay, I'll come..."
Director Chen nodded: "Okay, Lin Feng, you will arrange... Anything, you just do what you command..."
Lin Feng: "The operation is directly arranged in the CT room..."
The CT room, just like that, was occupied.
After 10 minutes,
All things, according to Lin Feng's orders, were ready.
......
Lin Feng took over the patient,
Start the official rescue!
Surgery begins!!
Step 1,
Shave your hair...
Using CT, the length is measured to determine the depth of penetration of the puncture drain: (hematoma length + length of the puncture point from the anterior end of the hematoma)
After determining the location of the borehole,
Start positioning the patient (lateral decubitus position).
Step 2,
Routine disinfection, laying and local infiltration anesthetizes scalp puncture points...
Start drilling...
Three holes were drilled into the skull (within the hematoma cavity)...
And then a series of complex needle threading operations ...
Push the drainage tube to the calculated puncture depth, then pull out the needle core...
Then insert a 10ml syringe and slowly aspirate the hematoma ...
When the red blood, little by little, is constantly drawn out and enters the syringe,
The doctors and nurses in the entire CT room breathed a sigh of relief.
This step,
It means that the depth of the search is correct and the puncture is successful.
It basically indicates that the whole operation is almost successful!
Next
Lin Feng very patiently pumped out about 30%-40% of the total hematoma, and then slowly injected a small amount of normal saline to rinse the hematoma cavity...
The purpose of this is to eliminate strong negative pressure suction.
Repeated several times,
The position of the drainage tube is adjusted in the middle.
After 10 minutes, all the hematomas were finally suctioned out.
Check the total drainage volume, if it is not much different from the amount of hematoma calculated by the preoperative CT scan, it means that the surgery is almost complete.
Then use urokinase, normal saline into the hematoma cavity ...
After doing this,
Lin Feng breathed a sigh of relief...
"Okay, after half an hour of closure, let go of the continuous drainage and pump out the saline... At that time, check whether there is bleeding, if there is no bleeding, it means that the operation is successful..."
Director Chen patted Lin Feng's shoulder and gave a thumbs up.
The other doctors and nurses were impressed.
"Doctor Lin, awesome!!"
(The drain tube will have to wait at least a few days to be unplugged...) ）
......
Outside the CT operating room,
A few off-duty nurses hid behind the door,
"Is Dr. Lin out?"
"It seems that it is still in surgery..."
"I heard that it is empty-handed discharge, and many doctors can't do it..."
"Look... The door opened... Wow, Dr. Lim is out! "
"Wow, so handsome!"
"Take a picture, take a picture!"
"Director Chen of the emergency department seems to be familiar with Dr. Lin Feng? With a smile on his face, it should be a successful operation, right? "
"The operation was successful..."
"Successful man, the most handsome!"
That night, the news spread like a wind throughout the Ditan Hospital.
The handsome photo spread throughout the Ditan Hospital.
The story of a successful difficult operation also spread throughout Ditan Hospital.
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ps: End of update today...
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