"Director Zhang, I remember Qin Feng is still an intern now."
Just when Qi Fang was able to read the inspection report, Qian Cheng, the deputy director of internal medicine, looked at Zhang Fan with a frown and asked,
"Can he really get on the operating table?"
"Hehe~ Qin Feng is already the official doctor of our first hospital, and has the right to sign the operation specially approved by the director, what do you think?"
Zhang Fan laughed lightly when he heard the words, and his calm tone was full of pride.
Click!
Hearing his words, both of them were shocked!
The look in Qin Feng's eyes suddenly became serious and unbelievable!
The right to sign the operation specially approved by the dean?
You must know that the right to sign for surgery is a power that only the deputy chief physician level and above can have!
This is also to manage the surgical procedures in the department and strictly control each operation.
And Qin Feng has actually obtained the power that every ordinary doctor dreams of!
Is this guy really an intern?
"Of course, I don't know if he will have brain surgery, wait."
Seeing that the two were sluggish, Zhang Fan followed up.
Poof~!
Deputy Director Qian Cheng and Director Shen Yan almost spit out an old thank you.
Isn't this bullshit?
What can I do without brain surgery?
"Zhang, are you kidding us?"
Deputy Director Qian Cheng couldn't help but said solemnly,
"This is a brain surgery, and a little carelessness can lead to death!"
About two or three minutes later, Qin Feng put down the inspection report and fell into contemplation.
"How about Qin Feng, can you do it?"
Zhang Fan asked nervously.
"The patient's intracranial hemorrhage should have exceeded 30 minutes, accompanied by intracranial pressure, and the situation is really not very good, and a craniotomy is required."
Qin Feng raised his head and glanced at the monitoring data of the wounded, and then looked at the three and said,
"Give me an out-of-brain instrument nurse, I need assistance."
"it is good!"
When Zhang Fan heard his answer, he couldn't help but feel ecstatic, and immediately pointed to a nurse and said,
"Quick! Go to brain surgery and find an experienced instrument nurse!"
The nurse nodded and ran out of the operating room immediately.
According to the inspection report, Qin Feng has understood the specific situation of the injured person, and has formed several surgical plans in his mind.
At present, the patient's blood pressure is 134/72mmhg, which is already somewhat unstable.
GCS score (Glasgow coma index evaluation, including eye opening response, verbal response and body movement, mild coma 13-14 points, moderate coma 9-12 points, severe coma 3-8 points, less than 3 points Brain death, above 14 points is normal):
8 points (severe coma)!
Furthermore, there was an 8cm gap at the top of the skull pillow, reaching the skull with active bleeding.
Brain contusion and laceration appeared in the head examination, and the subarachnoid meninges were also damaged to varying degrees.
Qin Feng began to choose the most suitable surgical method in his mind.
At present, the most effective surgical methods for solving cerebral hemorrhage include three kinds.
The first, minimally invasive!
The advantages are local anesthesia, less trauma, easy operation and quick recovery.
However, the disadvantages are also great, the hematoma is not clear completely, the intracranial decompression is not sufficient, and because of the small surgical field, once the thrombosis is formed, the risk of thrombosis is great.
The second, the small bone window!
It is to cut a small window at the site of congestion, and to remove the hematoma by craniotomy. Generally speaking, hemorrhage of the nucleus nucleus is used, and the trauma is smaller than that of a craniotomy with a bone flap.
Moreover, the surgical field of view is large, and the hematoma can be removed under direct vision, decompression, and hemostasis.
The disadvantage is that it is not suitable for patients with a tendency to herniation (displacement and compression of other tissues).
The last one: Bone flap craniotomy for hematoma removal (lifting the skull): the most perfect surgical plan for doctors, with a complete field of view, complete removal of the hematoma, complete hemostasis, and adequate decompression.
But the disadvantage is that the trauma is too great!
Of course, there is a fourth, stereotaxic suction surgery.
This kind of operation is more advanced and is a new technology developed in recent years. Qin Feng can do it, but it is also not suitable for patients with brain herniation.
And most importantly, none of the hospitals in Jiangcheng have such equipment.
It's too expensive!
The patient in front of me has obvious tendency of brain herniation, and is not suitable for the first, second, and fourth surgical options at all.
Now only the craniotomy remains.
Moreover, according to the GCS score, 8 points also meet the scope of [bone flap craniotomy for hematoma removal surgery].
It's decided, so be it!
Qin Feng has already decided the operation plan in his heart.
About ten minutes later, the nurse who left did not come back, and another nurse came, the head nurse of brain surgery!
"Doctor Qin, I'm here."
When she saw Qin Feng, she walked up to him at first sight and said in a deep voice.
"it is good."
Qin Feng nodded and glanced at the three people in front of him with a serious tone.
"Everyone, let's get started."
"it is good!"
Zhang Fan answered without hesitation, and immediately stepped onto the operating table.
The other two directors of the second city hospital looked at each other, and both saw the helplessness in each other's eyes.
But nothing to say. Because the dean has already ordered, no matter what happens, resolutely obey the arrangements and scheduling of the first hospital.
The two could only walk to the stage silently, looking at Qin Feng with doubts in their eyes.
Does this really work?
5 minutes, all preparations are completed.
Zhang Fan also looked at him with blocking pliers, as if waiting for an order.
"I will open the craniotomy first, and then you will perform the operation after the pressure relief is completed."
Qin Feng said, reaching out to the head nurse outside his head.
The head nurse handed him a cotton pad soaked with 3% iodine.
Disinfection~
"Lay the drape and lift the patient to immobilize."
Qin Feng said while working with the head nurse at the same time,
"Push the brain power system over. (Craniotomy instruments)"
The head nurse immediately assembled the brain power system, selected a suitable drill to connect it to the handle, and handed it to him.
Qin Feng took it and put it in the side and nodded.
The head nurse attaches the other end to the main unit and assembles the milling head on the spare table.
Secure the aspirator to prevent the suction head, electrocautery, and bipolar coagulation.
Turn on bipolar coagulation, adjust the size of bipolar coagulation...
everything's ready!
Step 2: Craniotomy!
Qin Feng picked up the round knife and cut the skin and subcutaneous aponeurosis according to the craniotomy arc.
Lift the skin with scalp clips and hold the scalp to stop bleeding.
Subsequently, the periosteum was incised and peeled away.
Qin Feng put down the knife, held the brain power system skull drill, and pressed the switch.
squeak squeak~~~
The blade of the blade slowly sinks into the skull along the edge, while the skull is opened, the bone hole is soaked with saline drip with a syringe, and the bone wax simultaneously stops the bleeding...
At this time, the entire operating room was extremely quiet.
Everyone held their breath, for fear that the movement would be too loud and disturb Qin Feng.
This is a craniotomy. If you are a little careless, the operation may be over with a shake of your hand.
Sew directly, cover with white cloth and push into the morgue.
The three of Zhang Fan also stared at his every move nervously, especially Qian Cheng and Shen Yan, their hearts were in their throats.
They really don't know what Qin Feng will do!
Fear!
After about ten minutes, the bone flap was basically separated, and Qin Feng used a periosteal peeler to gently pry the bone flap apart.
Wet gauze wrap, and then hemostasis the wound, irrigates the incision, and opens the surgical field.
Finally, a wet brain cotton piece was gently placed into the skull to protect the brain tissue.
"Whoo~"
Seeing this scene, everyone breathed a sigh of relief.
Qin Feng also stopped, took off his gloves, washed his hands again, and put on new gloves to eliminate the risk of infection.
And the two directors Qian Cheng and Shen Yan couldn't help but be more surprised, this method is too skilled.
No brain surgery?
If they say it, no one will believe them!
...
"Okay, I'm going to clean up the accumulated blood and relieve the pressure on the patient."
Qin Feng looked up at the three and whispered,
"Director Qian, Director Shen, you can start the operation, Director Zhang, wait a moment."
"it is good."
Zhang Fan nodded, Qian Cheng and Shen Yan heard the words and stepped into the operating position, and started the operation within their respective scopes.
Because once the heart is blocked, the brain will enter a state of hypoxia and ischemia, so heart surgery cannot be done now.
"Line 1."
Qin Feng stretched out his hand, and the head nurse immediately handed over the small round needle, threading it into the dura mater, and suspending the dura mater.
The first...
The second root...
The third root...
Until the tenth, his speed gradually increased, and the eyes of those who saw it were bright and pleasing to the eye.
Next, Qin Feng cut open the dura, used the meninges to lift the meninges, then cut a small opening with the blade and used the meninges to expand.
Among them, bipolar coagulation was used continuously to stop the bleeding, and the meningeal forceps were used to wipe the residual blood.
At this point, the craniotomy has been completely completed!
At the operation site, many people had never seen the craniotomy, including the three directors.
I can't help but feel my scalp go numb when I see this process!
When Qin Feng opened the meninges, a darkened hemorrhage appeared in front of him.
There are many! It is estimated to be 50mL, and it begins to flow out slowly.
Qin Feng took a deep breath and his eyes became solemn.
As soon as possible!