I'm a god of medicine

Chapter 238
Craniotomy is no more difficult than laparotomy.

For laparotomy, one must also keep in mind the anatomical structure of the abdominal wall, which muscular layer the midline incision passes through, and what important blood vessels need to be avoided between the muscular layers, what is the median incision in the lower abdomen, and what paramedian incision is there? Rectus abdominis incision, subcostal transverse incision...

But craniotomy is not that complicated.

Under the scalp, fat, under the fat, the skull, inside the skull is the dura mater, and inside the dura mater is the brain tissue.

That is to say, when a hole is opened in the skull, it passes through the four layers of tissue, namely the scalp, subcutaneous fat, skull and dura mater.

Although the blood supply of the scalp and sub-scalp fat is abundant, the capillaries are dense, and "innumerable" bleeding points can emerge from a single cut, but these capillaries are not important, and there is no need to consider preservation during the operation, and the electric coagulation knife is used directly. Electrocoagulation is used to stop bleeding while cutting.

As for making a hole in the skull, it sounds fantastic, but it is actually very low. It is similar to the need to make a hole in the wall for an ordinary person to install an air conditioner, except that the electric drill in the hands of the doctor is smaller than the electric drill in the hands of the air conditioner, and it is more accurate. Some, a little more expensive, that's all.

The craniotomy is simple, and it is not difficult to open the craniotomy to drain the congestion. You only need to determine the location of the bleeding, then choose the right access, insert a catheter, and drain the congestion. One operation is considered complete.

As an assistant to the operation, Dean Lin was cooperating with Yang Xi's operation while thinking that this kind of operation is really not difficult, just like what is said in the book. The surgical treatment for bleeding was taken down, why is Mao himself timid?I bought the equipment but put it in the warehouse, so I dare not try it anyway.

Alas, Yang Xi still has the guts!
While feeling emotional, he inadvertently met Yin Wei's eyes, and Dean Lin immediately found a reason for himself. Why is Yang Xi so kind? Isn't it because he has an expert anesthetist like Yin Wei to escort him? ?If I had such an anesthetist, I would definitely be worse than you, Yang Xi, worse... too much.

According to the textbook, progressive coma occurs in delayed intracranial hemorrhage, the prognosis is generally not very good, and the mortality rate is very high.Although Dean Yin Weilin and the two had no clinical experience in brain surgery, the two of them remembered clearly what was written in the textbook, which was the main reason why they were quite worried about Yang Xi along the way.

To be selfish, in this disaster, the performance of Liuquan Town Hospital has been quite excellent. If we stay for another 24 hours and monitor the 10 wounded patients through the critical postoperative period, then, if the full score is 100, Liuquan Town Hospital will be able to do so. The score of Quanzhen Hospital must be at least 98 points, and the 2 points deducted are nothing more than roll marks. Who makes the hospital's hardware conditions insufficient?
However, it was a thankless choice for Yang Xi to take the initiative to take the wounded who were kept under observation in the Dawu Town Hospital to him.If the wounded man was lucky enough to be saved, there would be no additional points to be awarded, and if the wounded man died on the operating table, then the responsibility would be on Yang Xi's head and he could not shake it off. The 98 points he had already got It is also possible to be deducted for a sum.

Of course Yang Xi also understands this truth.

However, human life is at stake, so there is no room for him to ignore and prevaricate.Regardless of whether it is acute intracranial hemorrhage or delayed intracranial hemorrhage, conservative treatment can be given unless the amount of bleeding is not large. Otherwise, craniotomy and drainage one minute earlier will give the wounded more hope for survival.From the Liuquan Town Hospital, the car drove faster, that is, it took 1 minutes to get there, but if it was necessary to transfer people from the county or send the wounded to the county hospital, it would take more than an hour.

The difference of four to 10 minutes is just a class for students and a report for leaders, but it is a prerequisite for doctors and patients to overcome death.

As for why Yang Xi's realm and professional ethics have suddenly been raised to such a high level?

Cough cough, everyone who questioned the young master please shut up, what, the young master has always been a kind person, loves world peace, has lofty ideals and beliefs... Goose, it's a bit embarrassing, it seems that few people are willing believe.

It doesn't matter whether anyone believes in it, and it doesn't matter how many people believe in it. The important thing is that Yang Xi's luck is so good that he has opened up.

In other words, Lord Yan forgot to write down the wounded man's name in his book of life and death.

When the accident happened, the injured man took off his helmet and was hit in the head by a carbon stone.The density of carbon stone is not as good as that of rock, and its structure is relatively loose. It was hit on the head, but there was no obvious trauma. However, the structure of carbon stone is relatively loose, which is also compared to rock. The ball is generally loose.

The wounded suffered a blow with his bare head, and a subdural hematoma occurred at that time, but the hematoma was not large enough to cause obvious signs of increased intracranial pressure.

The doctors at the Dawu Town Hospital thought that these miners were all wearing hard hats, so the possibility of head injuries was not high, so they focused on the chest and abdomen injuries and bone injuries, and did not give these injured people Issue a head CT checklist.

Delayed hemorrhage did occur in the brain parenchyma of the wounded, but the bleeding speed was not fast and the amount of bleeding was not large, but there was a previous and growing subdural hematoma that pressed the brain tissue. The wounded showed clinical manifestations of severe intracranial hemorrhage.

In fact, when Yang Xi instructed Dawu Town Hospital to take head CT scans for the wounded and at the same time give mannitol to reduce intracranial pressure to stop bleeding and prevent acid and enhance the blood coagulation ability of the wounded, the general condition of the wounded has improved considerably. improvement.Otherwise, how could Yin Wei have nothing to say when he rushed into the operating room and checked the vital signs of the wounded?

Can you still be the doctors of Dawu Town Hospital?

The subdural hematoma can be punctured to draw blood. After the congestion is exhausted, a small amount of high-concentration hemostatic drugs are injected. The amount of cerebral parenchymal hemorrhage is only 6 to 7 ml. It can be ignored, but Yang Xi still has drainage for safety.

One hour, two and 10 minutes later, the operation was declared over.

It's a bit embarrassing that the operation took so long, but for the benefit of the wounded, Yang Xi performed the craniotomy very carefully so that the wounded's skull can heal more tightly when performing autologous cranioplasty in the future.Since it is fine, it will take more time.

After stepping off the stage, Yang Xi ignored Dean Hou who had been guarding the operating room, but went straight to the lounge, where the two leaders of the county and Dong Junhui should be waiting anxiously.

"How is it?" Dong Junhui asked eagerly as soon as he saw Yang Xi.

Yang Xi remained silent, took the cigarette handed over by Hu Shuji, lit it, took a puff, and then responded: "It's not a big problem."

(End of this chapter)