Chapter 413 Li Dongshan’s temper!

Lu Cheng was already familiar with the key points of treating open fractures. Even if he was dealing with similar patients today, there were at least seven or eight of them.

The patient's injuries were on the limbs, but the real fractures were in the lower limbs and pelvis. It took Lu Cheng just over half an hour to complete the debridement, suturing and external fixation of the limbs.

"Dr. Yang, how are you treating the blood clot there? I'm going to do pelvic debridement now. If I make an incision on your opposite side, will it affect your operation?" Lu Cheng asked Yang Zi.

Yang Zi was stunned for a moment, then looked at the wounds on her limbs that had been treated by Lu Cheng. After a while, she nodded and said, "Oh, no, no."

Then he stepped back a little bit.

Lu Chengcheng said: "Dr. Yang, although the vascular trauma of the patient's lower limbs has been treated, there are still certain problems with the distal blood supply of the right lower limb. Although I have sutured the injured anterior tibial artery,

But you still have to remove the blood clot so that the leg can be saved."

"Oh, there may also be some problems with the distal blood supply of the right upper limb."

Lu Cheng was afraid that Yang Zi would misunderstand that he wanted her to get out of the way, and then give him the task of vascular surgery as well.

Yes, Lu Cheng and Zhang Yuewei have a certain personal relationship, and Zhang Yuewei also asked Lu Cheng to help in the vascular surgery department when Lu Cheng was free in the past, but the premise was that Lu Cheng had no clinical tasks that he should undertake.

The last time Zhang Yuewei called Lu Cheng to the stage, it was Li Dongshan who went to the operating room late at night to take care of orthopedic matters for the patient.

Later, Lu Cheng reflected on it, and still felt that as the chief resident of the trauma surgery department, he should not do this. As the administrative director of the trauma center, the reason why Li Dongshan came to the operating room to treat him at night was

After all, it's because I am his student.

If it were another person, and the chief resident of the Department of Orthopedics said that he was going to undergo vascular surgery, Li Dongshan would have scolded him to death.

Everyone has their own job, and they must do their job well so that they can have room to help others. Otherwise, when you are proud, someone will carry the burden for you.

In fact, Zhang Yuewei had a good idea. He just wanted to save a patient and save his legs.

However, the orthopedics department is not a subordinate department of the vascular surgery department. The orthopedics department does not need to completely obey the instructions of the vascular surgery department. Moreover, the clinical role that Lu Cheng now assumes is that of a very authentic and professional clinician from an orthopedic department.

"Ah? Oh." Yang Zi reacted belatedly, then approached the operating table and continued her surgery.

But in the process of doing it, she felt a little aggrieved.

In the past, if vascular surgery encountered similar patients and it was difficult to remove the thrombus, then they would only need to go to the orthopedics department to ampute the limb. The blind thrombectomy like now was done by you, Lu Cheng, for

The burden has been added to our subordinates in the vascular surgery department.

It would be fine if you weren't here, but now that you are right in front of me, you don't know how to help.

Yang Zi is usually very busy with consultation tasks and emergency surgeries in the general hospital. How can she have so much time and energy to study what the department director is currently studying? She has to do her own thing well first.

Yang Zi glanced sideways at Lu Cheng and thought in her mind that Lu Cheng had actually done enough.

He is just an orthopedic surgeon. If he encounters a blood vessel injury during the operation, he can leave it alone and not deal with it, then clamp it with a blood vessel clamp and directly call the vascular surgery department to suture it.

This is the most standard and currently the most popular method of emergency consultation surgery in China.

But Lu Cheng didn't do that. Instead, he solved some minor problems he encountered by himself, and he acted very quickly. But since Lu Cheng's movements were so fast, it didn't matter if he came to help him. This patient Lu Cheng

After the successful operation is completed, if the thrombus is not removed due to one's own reasons.

If a leg and a hand were lost in vain, then the patient would be too pitiful.

While Yang Zi was still thinking, Lu Cheng had already started to cut the skin, and then went to the depth of the pelvis for debridement. I saw that he entered very quickly, using an electric knife to stop the bleeding while cutting.

The electric knife, which looked very dull, was flying in Lu Cheng's hands, as if he was not afraid of damage to blood vessels and nerves at all.

How on earth did he become so confident?

What is the structure of the pelvis that ordinary people dare to enter?

Indeed, the structure within the pelvis is very complex, and the departments involved include not only general surgery and orthopedics, but also urology or gynecology.

However, in Lu Cheng's eyes, this was not the case.

Most of the movements of nerves are accompanied by the movements of blood vessels. The blood vessels in the pelvis happen to belong to the limbs and are within Lu Cheng's controllable area. So basically, he only needs to look at the movements of blood vessels and avoid large blood vessels and nerves.

, when trying to save life, even if some small nerves and blood vessels are cut off, what will happen?

In emergency surgery, the bleeding volume of a pelvic fracture can reach up to 5000ml, which is a fatal bleeding volume. If the fracture or blood vessel damage can be cleared early, both the patient's life and the amount of blood transfusion will be greatly controlled.

Before the fracture, there is a rough outline of the pelvis on the plain radiograph, and the location and type of the fracture are also known on the CT plane.

However, the main purpose of Lu Cheng's incision this time was not to deal with the problem of pelvic fracture. This patient's pelvic fracture was an extremely complex C3 type. This type of fracture can be treated during this operation.

Leave it alone, and then Lu Cheng can go straight to the injured blood vessel.

As long as the internal femoral artery, which was cut by the sharp edge of the pelvic fracture, is dealt with, and a small ruptured blood vessel around the pubic bone is dealt with, the patient's chance of death due to shock will be greatly reduced.

But whether he will die due to other factors or whether his limbs will be amputated because the blood clot cannot be removed is beyond the scope of Lu Cheng's consideration. Today, there are still more than a dozen moderately ill patients in the six wards of the Department of Orthopedics.

Injured patients and more than 20 mild patients who needed to go to the operating room were not treated.

In the initial diagnosis process, although the injury is moderate to mild, once it is delayed, it cannot be ruled out that it will develop into a serious injury.

During this emergency rescue process, Lu Cheng figured out one thing. Even Lu Cheng, even the best doctor, must be willing to give in during clinical tasks. At the critical moment, he can only

Take care of one side.

In the face of human life, everyone is equal. If you can choose to give more people a possible chance of survival in the shortest time, Lu Cheng feels that the latter may be more important.

The problem Lu Cheng needs to deal with now is a fatal problem caused by orthopedics. He doesn't have to treat him thoroughly until all the injuries are perfected.

Matters in other departments are the tasks of doctors in other departments. Lu Cheng believes that in the Second Xiangya Hospital, there will be many experts and professors in Crouching Tiger, Hidden Dragon, who will also share his thoughts and try to get as many people out of the hospital as possible.

Pull back from the hand of death.

Thinking of this, Lu Cheng's speed became a little faster. After almost another seven or eight minutes, Lu Cheng opened an opening that could suture the blood vessel, and then used the vascular clamp to accurately clamp the proximal and distal ends of the internal femoral artery.

At the heart end, special blood vessel sutures were used to thread the needle and thread, and the two large and small blood vessels were quickly sutured.

Of course, in addition to this, Lu Cheng also cleaned up some of the fractured fragments of the pelvic fracture to a position away from the blood vessels.

To do a pelvic fracture, the current manpower is definitely not enough. If there are not three or four more assistants, this pelvic fracture machine will definitely not be taken down, so Lu Cheng can only take emergency measures and break some fracture pieces into pieces.

Stuff it into the broken end and leave it for the second stage of treatment.

After doing this, Lu Cheng quickly sewed up the innermost layer, then took off his gloves directly and said, "Xiao Zhou, sew up the wound, and then sew two layers on the outside, one under the skin, and one under the skin."

"When it's done, call me and I'll tell you which operating room it's in."

"Okay!" The surgical team following Lu Cheng said a little tiredly.

"Lu..." Yang Zi spoke the first word when she saw Lu Cheng's operation was finished. Lu Cheng had already disappeared outside the door of the operating room and went to no one knows where.

Yang Zi continued to take blood clots depressedly, feeling extremely anxious...

The anesthesiologist comforted him and said, "Don't worry, don't worry. After the young man's debridement was completed, the patient's blood pressure has slowly risen. You have quite a lot of time now."

Yang Zi smiled helplessly, that's all we can do, let's deal with it slowly.

…

It's six o'clock in the morning.

Lu Chengcai slowed down his pace a little, sat at the door of the operating room, and opened a bottle of glucose.

The anesthesiologist from Room 4 saw Lu Cheng four times in a row and thought he must be a little hungry, so he gave it to him.

Lu Cheng sat on the stool and drank slowly and in small sips. His whole body was extremely tired.

Both eyelids were a little sleepy, but he didn't let himself fall asleep. At this time, eating and drinking in large quantities would definitely be bad for the stomach, so Lu Cheng could only take small sips to avoid sudden secretion of a large amount of gastric acid in the stomach.

Just when I was halfway through drinking the glucose, a man suddenly broke into the operating room.

After stepping on the sensor door of the operating room, he came directly in front of Lu Cheng, knocked Lu Cheng on the head, and said angrily: "I heard Xiao Fang said that you didn't eat last night?"

Lu Cheng felt the strength in Li Dongshan's hand when he hit him on the head.

He touched his head with his left hand and carefully protected the glucose on his chest with his right hand. He nodded: "Yes."

"Then you performed more than 20 debridements last night?" Li Dongshan continued to ask.

Lu Cheng didn't say anything. He raised his hand and asked for a drink of water. He was really thirsty and hungry.

Surgery is not a simple matter. No matter what kind of surgery it is, it requires physical and mental energy to a certain extent. Let alone more than 20 surgeries, even two surgeries in one night. Most people will feel weak all over.

"You are really not afraid of sudden death!"

"What the hell did I do? I accepted a stupid student like you, but you don't have a mobile phone, right? Can't you order takeout? Can't you order something to eat?"

"Do you still need your teacher to teach you how to remember to eat?"

"Brother, you are now in your twenties and thirties, don't you know this common sense? Ah?"

"Do you want me to bring food and drink to you, feed it to you, and then say, Professor Lu, please eat?" Li Dongshan's roar resounded throughout the operating room, and he almost lost his voice.

The anesthesiologist who stayed up all night was sent away on the spot.

However, the anesthesiologist, who had taken a nap with squinted eyes, finally woke up, and everyone in the operating room looked at Lu Cheng in amazement at this pervert.

One night, more than 20 debridement machines are performed, one every half an hour on average. Is this a cow?

Of course, they would probably be even more shocked if they knew that Lu Cheng only took on the task of being the surgeon since close to early morning.

Lu Cheng licked his lips, which were slightly dry but had been moistened by water, and remained silent.

Li Dongshan didn't let Lu Cheng go yet, he still pointed at Lu Cheng's forehead and scolded: "Are you talking? Don't you know how to speak? Don't you dare to speak?"
To be continued...