Looking at the dirty blood in the abdominal cavity, Fang Pingzhu asked Ling Ran in surprise, "Where are you going to suture?"
"B-Lynch suture." Ling Ran was talking about a special suture method for the uterus. Its characteristic was that it was easy to perform. It could prevent bleeding while preserving the fertility of the uterus.
Ling Ran had only learned this surgical method by himself. He had never practiced it before, nor had he obtained experience and skills from the system.
However, Ling Ran's skills in suturing were enough to make up for his lack of familiarity with the surgical method.
This was not a complicated suture method, but the idea was quite ingenious. With Ling Ran's Master Level Simple Appositional Suture, it was very easy for him to do the relevant treatment.
Fang Pingzhu did not doubt Ling Ran's ability to perform the B-Lynch suture. As long as the doctor who knew this name was not a newbie, it would not be a problem for him to perform the appropriate suture.
The difference between high-end doctors and low-end junior doctors was that junior doctors did not know anything. Therefore, when they saw an unfamiliar surgical method, not only did they have to learn the method, but they also had to learn every step of the operation. High-end doctors only knew the surgical method, but it was not difficult for them to learn the method. Many scholars participated in an international conference and were recommended for a certain surgical method. After that, they could perform it to see the effect.
Of course, some complicated surgical methods could be performed on dogs first. For simpler or mutated surgical methods, they could directly do it. There was no need to sacrifice a dog.
In fact, B-Lynch suture, which meant that the anterior and posterior walls of the uterus were sutured and pressurized, could not only stop bleeding, but also help to preserve fertility. There was nothing special about it.
However, Fang Pingzhu did not think that it was appropriate to suture the uterus now.
Fang Pingzhu sorted out her emotions and said as calmly as possible, "Doctor Ling, if you suspect that the uterus is bleeding, the safest way now is to remove the uterus. The patient already has a child. "
"The effect of B-Lynch suture and hysterectomy is the same. Moreover, the prognosis of the suture is better. "Ling Ran insisted.
The effect of B-Lynch suture was, of course, better. Although the most important function of the uterus was fertility, it also affected the endocrine system of women. In short, after the uterus was removed, women would instantly enter menopause. The series of consequences caused by this were often very unpredictable.
In terms of prognosis, it was certainly not a good thing.
When it came to her profession, Fang Pingzhu still shook her head. She used the same words as before and said, "Shouldn't we be protecting ourselves first? Save your life first, then treat your illness. "
"The effect of the B-Lynch suture is not bad. It can still save lives."
"But you're not sure about the extent of the internal bleeding. What if it's outside the suture?"
"The probability is very low." Ling Ran pondered for a few seconds before he said, "The amount of blood loss is already very large. If the B-Lynch suture can't stop the bleeding, I don't think it will make a difference even if we add one or two hundred ounces of blood. It won't be too late to remove the uterus then. "
Fang Pingzhu had to admit that Ling Ran was right. If he were to ask the patient, not to mention one or two hundred milliliters of blood, even if it was 1,000 milliliters more, the patient would probably be willing to give it a try in order to retain the uterus.
However, this was not in line with doctors' habits.
In a place like the Obstetrics and Gynecology Department, if there was a problem with the uterus, they would remove the uterus. No one would perform two surgeries just to give the patient a try.
On the bright side, doctors had the ability to make decisions, and they were confident that they made a good judgment. On the other hand, on the negative side, hospitals were the same as other industries. They had a dark side that was not very glorious, and when these dark sides involved people, it would often make people feel that the hospital was a bottomless pit …
Fang Pingzhu was not a bottomless pit, but after working as a doctor for thirty years, she knew how to do things and what procedures to do.
Fang Pingzhu did not bother about suturing or removing the uterus. Instead, she said slowly, "You can't be sure that it's the blood loss in the uterus."
This was back to the problem of diagnosis and confirmation.
The reason why she always took the blood of pregnant women who had blood loss and sent it for testing was because she wanted to confirm the diagnosis of amniotic fluid embolism.
Diagnosis was just speculation, and confirmation was medical science.
However, it was only Fang Pingzhu's concept that she could not be sure.
Ling Ran said decisively, "There's no bleeding in the abdominal cavity. It must be the bleeding in the uterus."
Fang Pingzhu looked at the blood in the abdominal cavity and sighed. She said, "You only touched it once. How can you be sure that there's no bleeding in the abdominal cavity? There are many bleeding spots that are covered."
This was also a very natural thought. For most doctors, they might not even be able to find the bleeding spots that were exposed, let alone the ones that were not exposed.
Ling Ran did not argue with her about his own judgment. He changed his perspective and said, "The patient's uterine contraction is very poor. This should be an indicator."
Blood loss in different organs would show different symptoms. Fang Pingzhu did not know anything else, but she was very familiar with the uterus.
Now that she received Ling Ran's reminder, Fang Pingzhu immediately went forward and pressed the bottom of the uterus.
"The contraction is relatively weak, but …" Fang Pingzhu was still a little hesitant.
Honestly speaking, if she was asked to perform a hysterectomy, she would most likely do it. However, she was not willing to perform a B-Lynch suture. This was because the only explanation for the B-Lynch suture was intrauterine hemorrhage. Right now, it was not a 100% definite diagnosis of functional hemorrhage. There was even the possibility of amniotic fluid embolism. Therefore, there was a risk of misdiagnosis if she performed a B-Lynch suture.
On the contrary, if a hysterectomy was performed and the patient's bleeding stopped, she could explain that the uterus was removed because of intrauterine hemorrhage. If the bleeding did not stop, she could also explain that there were other complications. After all, the evidence had been removed.
Ling Ran did not know these little self-protection skills of doctors, and he did not seek to reach an agreement with the other party through verbal communication.
In Ling Ran's experience, there was a huge gap between people's understanding of each other. The efficiency of verbal communication between people who were not familiar with each other was so low that it could cost three hundred lives.
"Increase the speed of aspiration and expose the surgical field," Ling Ran ordered.
Fang Pingzhu did not say anything and retreated to the side. It could be considered that she had completely given up her authority as the chief surgeon, and she had also given up her responsibility.
Ling Ran did not wait for all the blood in the abdominal cavity to be emptied. He took the needle holder and cut into the anterior wall of the uterus. He directly pulled it to the bottom of the uterus, and then went around to the posterior wall …
Although it was a surgical method and an unfamiliar organ, Ling Ran was too familiar with abdominal anatomy. So much so that when he mentioned the uterus, he was as familiar as when he mentioned the gallbladder. He could not compare to the liver. He had performed hundreds of liver surgeries, so he was more familiar with them.
"There is 1,800 ounces of intrauterine hemorrhage." The female doctor who was the second assistant was automatically promoted to the first assistant. Finally, the blood in the abdominal cavity was sucked clean.
The large bottle beside the operating table was half-filled with thick blood. It looked like an old wizard's secret treasure.
Ling Ran hummed in acknowledgment and sutured a figure eight on the anterior wall. He then said, "Pay attention to fluid replenishment."
"Yes. We have already transfused 1,000 milliliters of colloid fluid, 2,000 milliliters of crystalline fluid, and 400 milliliters of plasma … "the female doctor reported. Some chief surgeons liked to control these details themselves, while some would delegate the power to their junior doctors.
Fang Pingzhu said at the side, "We can inject carboprost into the uterus. It's good for postpartum hemorrhage …"
"Sure." Ling Ran agreed when he was reminded. Then, he began to tie a knot on the suture.
The B-Lynch suture was completed.
Everyone in the operating theater set their eyes on the wizard's large bottle.
"It seems like there's still bleeding," the female doctor whispered.
"Let's observe it for a while more." Ling Ran's expression was relaxed. At this time, the amount of bleeding was already very small. Even if there was still bleeding, he could just cut the uterus again. It was just a matter of wasting a few sutures, and it was not a big deal.
A few people in the operating theater were stunned, but they soon realized that it was already a good thing that the bleeding was under control.
* Ring, ring, ring. *
The phone in the operating theater rang.
The circulating nurse went to pick it up. She turned around and said, "Department Director Fang. No evidence of amniotic fluid embolism was found. "
If there was amniotic fluid embolism, there should be signs of hairs in the venous blood taken many times. This was the most direct pathological evidence.
Fang Pingzhu hummed in acknowledgment, but her expression did not change.
Amniotic fluid embolism had always been a low-probability event. The main reason why they paid so much attention to it was because the mortality rate was too high. It was also because they paid so much attention to it that the mortality rate of amniotic fluid embolism was reduced from about 90% to the current 60%. The mortality rate of amniotic fluid embolism in the Obstetrics Department of Yun Hua Hospital was 30%. It was much better than the average because they screened one case at a time …
"The bleeding has stopped," the anesthetist reported again.
Fang Pingzhu was stunned. She could not help but sigh. The first thing that came to her mind was, 'In the future, if something happens to my family, I should look for Ling Ran first.'
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