Looking at the blood in his abdominal cavity, Fang Pingzhu asked Ling Ran in surprise: "Where do you want to sew?"

"B-lynh suture." Ling Ran was talking about a suture method specifically for the first uterus. It is characterized by being simple and easy to perform. While stopping bleeding, it can preserve the fertility of the second uterus.

Ling Ran had only learned this technique by himself and had never practiced it, nor had he gained any experience or skills from the system.

However, Ling Ran's skills in suturing were enough to cover his unfamiliarity with the technique itself.

This is not a very complicated suturing method in the first place, but the idea is quite clever. With Ling Ran's master-level interrupted suturing technique, it is very simple to do the relevant processing.

Fang Pingzhu did not doubt Ling Ran's ability to perform b-lynh suturing. As long as a doctor who could name him was not a newbie, he would have no problem performing proper suturing operations.

The difference between high-end doctors and low-end junior doctors is that junior doctors don’t know anything. Therefore, when they see unfamiliar surgeries, they not only need to learn the academic techniques, but also learn every step of the operation. High-end doctors

It's just the technique that you don't know. It's not difficult to operate it after learning the method. Many scholars attended an international conference and were inspired by a certain technique. They can then practice it at home to see the effect.

Of course, some complex ones can be done on the dog first. For simpler ones, or just variations, you can just start doing them directly. There is no need to sacrifice another dog.

In fact, there is nothing special about b-lynh sutures, which means sutures and pressure on the front and back walls of the uterus, which can both stop bleeding and help preserve fertility.

However, Fang Pingzhu does not think that it is appropriate to suture the third uterus now.

Fang Pingzhu calmed down and said as calmly as possible: "Dr. Ling, if you suspect bleeding in the fourth uterus, the safest way now is to remove the fifth uterus. The patient already has a child."

"The effect of suturing with b-lynn is the same as that of hysterectomy. Moreover, the prognosis of suturing is better." Ling Ran insisted on his opinion.

The effect of b-lynh suture is of course better. Although the most important role of the 5th uterus is fertility, in addition, it also affects the female endocrine system. Simply put, after the 6th uterus is removed, women

Menopause is entered in an instant, and the series of consequences it brings are often difficult to predict.

In terms of prognosis, this is certainly not a good thing.

Speaking of his profession, Fang Pingzhu still shook his head and said in Shicai's words: "Isn't it time to save your life first? Save your life first and then treat the disease."

"B-lynh's suturing effect is not bad, and it can also save lives."

"But you're not sure about the internal bleeding range. Could it be beyond the suture range?"

"The chance is very low." Ling Ran pondered for a few seconds and then said: "The amount of bleeding is already very large. If the b-lynh suture can't stop the bleeding, I think it won't matter if there are another one or two hundred milliliters of blood.

The difference. It won’t be too late to remove the sixth uterus at that time.”

Fang Pingzhu had to admit that Ling Ran was right. If he asked the patient, let alone one or two hundred milliliters of blood, even if it was 1,000 milliliters more, the patient would probably be willing to try it in order to preserve the seventh uterus.

It's just that this is not in line with doctors' habits.

In places like obstetrics, if there is a problem with the uterus, the uterus is removed. No one would do one operation into two operations, just to let the patient try it out.

On the good side, doctors have the ability to make decisions and are confident that they have made good judgments. On the other hand, hospitals, like other industries, have a dark side that is not so glorious, and when

When these dark sides involve people, it often makes people feel that the hospital is completely dark...

Fang Pingzhu is not bad, but after thirty years of working as a doctor, how to do things and the process of doing things have long been deeply rooted in his bones.

Fang Pingzhu no longer struggled with suturing or excision, but said slowly: "You are not sure yet that it is blood loss in the uterus."

This is back to the issue of diagnosis and confirmation.

Why does she always collect blood for pregnant women who have lost blood and send it for examination immediately? In fact, it is to diagnose amniotic fluid embolism.

Diagnosis is just guessing, diagnosis is medicine.

However, it's not certain, it's just Fang Pingzhu's concept.

Ling Ran said decisively: "There is no bleeding in the abdominal cavity, it must be bleeding in the uterus."

Fang Pingzhu looked at the blood in the abdominal cavity and sighed, and said, "How can you be sure that there is no bleeding in the abdominal cavity just by touching it? There are many bleeding points that are covered."

This is also a natural thought. For most doctors, exposed bleeding points may not be found, let alone unexposed ones.

Ling Ran did not argue with her about his judgment. He changed his perspective and said, "The patient's uterine contractions are very poor. This should be an indicator."

Blood loss in different organs will have symptoms. Fang Pingzhu doesn't know anything else, but the uterus is very familiar with it.

Now that Ling Ran reminded him, Fang Pingzhu immediately took action and pressed on the bottom of the palace.

"The contraction is relatively weak, but..." Fang Pingzhu was still a little hesitant.

To be honest, if she was asked to have a hysterectomy, she would probably do it, but she would not want to have b-lynh suture. Because the only explanation for b-lynh suture is intrauterine bleeding, and now it is not 100% sure.

There is a possibility of functional bleeding and even amniotic fluid embolism. Therefore, there is a risk of misdiagnosis when performing b-lynh suture.

On the contrary, if a hysterectomy is performed, and the patient's bleeding stops, she can explain the intrauterine bleeding and perform the removal. If the bleeding does not stop, she can also explain that there are other complications. Anyway, the evidence has been removed.

Ling Ran didn't know these little self-protection skills of doctors, nor did he pursue the ability to communicate with the other party through language to reach an agreement.

In Ling Ran's experience, the understanding gap between people is huge. The efficiency of verbal communication between people who are not familiar with each other is so low that it can kill 300 people with hemorrhage.

"Speed ​​up the suction to expose the surgical field." Ling Ran ordered, minding his own business.

Fang Pingzhu stepped aside without saying a word, completely giving up his right to be the surgeon and his responsibility.

Ling Ran didn't wait for all the blood in the abdominal cavity to be emptied. He took the needle-holding forceps and cut into the front wall of the uterus, pulled it directly to the bottom of the uterus, and then went around to the back wall...

Although it was an unfamiliar surgery and an unfamiliar organ, Ling Ran was so familiar with abdominal anatomy that when he mentioned the uterus, it was as skillful as lifting the gallbladder. His liver was still inferior to him.

I have done hundreds of cases and become more familiar with it.

"The intra-abdominal bleeding was 1800 ml." The female doctor who was the second assistant was automatically upgraded to the first assistant and finally sucked out the blood in the abdominal cavity.

The big bottle next to the operating bed was half full of thick blood, like an old wizard's secret treasure.

Ling Ran said "Yes", sewed a figure 8 on the front wall, and said: "Pay attention to fluids and crystals."

"Yes. 1000 ml of colloid, 2000 ml of crystalloid, and 400 ml of plasma have been transfused..." the female doctor reported. Some surgeons like to control these details themselves, while others will delegate power to subordinate doctors.

Fang Pingzhu said from the side: "Carboprost trometamol can be injected into the uterus to help postpartum hemorrhage..."

"Okay." Ling Ran was reminded and expressed his agreement, then began to tie the sutures.

The b-lynh suture is completed.

Everyone in the operating room focused their attention on the wizard's bottle.

"There seems to be bleeding." The female doctor whispered.

"Take another look." Ling Ran's expression relaxed. The amount of bleeding at this time was already very small. Even if there was still bleeding, it would be a waste of a few sutures and nothing more.

.

Several people present were stunned and quickly realized that the bleeding was under control, which was a good thing.

Jingle Bell.

The phone in the operating room rang.

The circulating nurse went to pick her up, turned around and said, "Director Fang. No evidence of amniotic fluid embolism was found."

If there is amniotic fluid embolism, there should be signs of vellus hair in the venous blood taken multiple times, which is the most direct pathological evidence.

Fang Pingzhu said "En" without any change in his expression.

Amniotic fluid embolism is a low-probability event. It is mainly because the mortality rate is too high that it attracts such attention. It is also because of the attention that amniotic fluid embolism has been reduced from about 90% before to 60% now. Deaths from amniotic fluid embolism in Yunyi Obstetrics Department before

The rate is 30%, which is much better than the average, and it all depends on screening one case at a time...

"The bleeding has stopped." the anesthesiologist reported again.
Chapter completed!