godfather of surgery

Chapter 155 The Last Time
Yang Ping didn't have time to eat, so he rushed to the Overseas Chinese Building. Director Kong took Yang Ping to the emergency ward, which was already full of people.

Upper gastrointestinal bleeding, the hemoglobin is only 45g/l, because of the use of artificial liver and magic lung, continuous anticoagulation, now massive bleeding, relying on the self-coagulation function of the human body, it is impossible to stop the bleeding, so conservative treatment is difficult to work, must be endoscopic stop bleeding.

Mr. Ning has already received a blood transfusion, and Director Gan of the Department of Gastroenterology, along with doctors, nurses and anesthesiologists, has pushed the gastroscope equipment to the bedside, and is about to do emergency bedside gastroscope to stop bleeding.

Life is very fragile, but also very tenacious. Things in life are sometimes unpredictable.

With such a low hemoglobin level, Mr. Ning was actually quite awake, but his face was pale, and his forehead was covered with sweat, which was very greasy.He was lying on his side, his body kept twisting slightly, one hand was held in the palm of Miss Ning, and the other hand was firmly grasping the bed sheet, he was doing the final struggle by himself.

The anesthetist wanted to administer propofol for general intravenous anesthesia, but he refused.

"What time is the plane? Qiqi!" Mr. Ning was very weak and seemed to die at any moment.

"The plane flew at 15:55 pm yesterday, Canada time, and arrived at Nandu Airport at 21:30 tonight. It should be 11 pm when we arrived here." Ms. Ning helped her father wipe the sweat on his forehead, which was very greasy.

"I can't last long, I know, I really can't last this time! Help me! Can you help me last until night? I'm really afraid that I won't be able to wake up after anesthesia. I'm sorry, Dr. Yang, please stay tuned." Can you stay beside me?" Seeing Yang Ping appear, Mr. Ning grabbed Yang Ping's hand.

Every time, Yang Ping can pull him back from the god of death. In his heart, Yang Ping is a god who can protect the fire of life and make it burn longer.

"It's okay, I'll stay here!" Yang Ping patted the back of Mr. Ning's hand with the other hand.

"It won't work without anesthesia, it's very painful."

Director Gan and his assistants have already put on a disposable sterile gown, a sterile cap, a mask and sterile gloves, quickly prepared the instruments, and applied lubricating oil to the lens.

"I can do it!" Mr. Ning was very stubborn.

Miss Ning's eyes were full of tears. She really wanted to say goodbye this time. She suddenly grabbed Yang Ping's hand and said, "Doctor Yang, please, think of a way."

She wanted her father and younger brother to meet for the last time, untie the ten-year knot in her father's heart, fulfill his last wish, and leave this world without regret.

She found that she was too excited and lost her composure, and immediately let go, Yang Ping nodded: "Don't worry, I will find a way! Director Gan, no anesthesia, let's start, he can do it."

What can I do, I can only let him have hope and comfort at the last moment.

Mr. Ning nodded and lay on his side. The colleagues in the gastroscopy room moved quickly and skillfully. The nurse had already spread the disposable sterile sheet and sat beside him, supporting Mr. Ning's head.

"Open your mouth!"

After Mr. Ning opened his mouth, Director Gan skillfully put the lens into the lens. The lens, like a snake, immediately penetrated into the throat, sucked out some sputum, and then entered the esophagus. The esophagus may be stimulated by the air, and Director Gan did not wait. The peristaltic wave passed, directly and deftly pushing the gastroscope into the stomach.

"This kind of emergency gastroscopy is very risky, especially without anesthesia. The stimulation of the gastroscope will cause vomiting, and vomiting will cause aspiration!" Director Gan said while doing it.

"Don't be afraid, his lungs have almost stopped working now. They are replaced by magic lungs. Let's do it." Yang Ping stood aside, looked at the screen, and put on a sterile gown, hat, mask and gloves.

Ms. Ning also encouraged Director Gan: "We have signed the informed consent, and we are willing to bear the consequences if anything happens."

"Could the family members go out for a while?" Director Gan heard Miss Ning's voice and found that there were still family members inside.

Miss Ning was unwilling to let go, Yang Ping said: "Let her inside!"

Director Kong has already greeted Director Gan. This patient trusts Yang Ping the most, and any treatment will be more convenient as long as Yang Ping is there.

Director Gan didn't say anything, and continued to do gastroscopy.

"Looking at the source of the bleeding, it should be the rupture of the esophageal and gastric fundus veins caused by portal hypertension. You can see that it is full of blood, and it is still bleeding. It is very violent. If it doesn't stop, blood transfusion is useless. The coagulation factor is quickly consumed, causing diffusion. Sexual intravascular coagulation is more dangerous." Director Gan asked Yang Ping to watch the screen.

The stomach on the screen was full of churning blood, and the suction was too busy, it sucked the blood and gushed out again.

"It's rare for the esophageal and gastric veins to come out so fiercely." Director Gan was not in a hurry, and his experience was there.

"Ice saline, with an adrenaline flush!"

The assistant was ready, and the iced saline was injected into the stomach along the forceps channel, that is, the instrument channel. It could have constricted the blood vessels to a certain extent, but now the effect does not seem to be great, just like before.

"It's still redblind, and I can't find the bleeding place." Director Gan's operation is very skilled, but in this case, it's really hard to find.

"Electric coagulation to stop bleeding can only be performed at approximate anatomical locations."

The special electric knife under the gastroscope extends into the instrument pipe and reaches the bottom of the stomach very smoothly. With his usual rich experience, Director Gan electrocoagulates the place where bleeding may occur a few times.

The emergency department has an emergency way of thinking, Director Gan has also encountered this situation, and he knows how to deal with it.

After several times of electrocoagulation, it was slightly better, but it immediately returned to the original state, which was still useless.

"Titanium clips to stop bleeding!"

This is the last resort, and it is also the most effective. The titanium alloy clamp is directly put into the stomach to clamp the bleeding place.

"It's really not possible. I'll send a few more clips in. They can always be clamped. First stop the bleeding and save lives. What's the blood pressure?" Director Gan held the operating end of the mirror with his left hand and the handle of the holder with his right, and put the titanium clips from the instrument channel. into the stomach.

"82/40mmHg!" Although there was no anesthesia, the anesthetist was in charge of monitoring.

Didi, there is only the sound of the machine in the room.

Estimate the approximate bleeding location, a titanium clip is clamped, and once the titanium clip is in place, the holder is pulled out.

"Continue, one more." Director Gan is very steady, unruffled in the face of danger.

The blood still came out. Director Gan put on three titanium clips in a row, but it still didn't work.

"What happened today?" Director Gan's confidence was shaken.

This is the case with doctors. When they send out all the tricks, but there is no expected response, their confidence will naturally be compromised.

Yang Ping does not engage in gastroscopy, and it is not easy to intervene, but the operation under the microscope has something in common. Every time the blood is sucked out, he can see the bleeding point. This is the acuity trained in the systemic physical examination.

"Look, that's a bleeding spot!" Yang Ping pointed it out to them.

"Where? Can't see clearly!" Director Gan followed Yang Ping's finger.

"May I try?" Yang Ping suggested.

This proposal is wrong, but there is no way, he believes that he can stop the bleeding, they can't see clearly, but he can see clearly.

Director Gan turned his head to look at Yang Ping. He is also a man of understanding. At this time, just give it a try. A dead horse is a living horse doctor. If you can't do it yourself, don't let others try it. He is the doctor most trusted by patients, and they all sign If the waiver is issued, perhaps the surgeon's hands are really flexible. He is so confident that he must have had a gastroscopy before. It would be good if multiple people participated and shared the risk.

"Come on, Doctor Yang, try it." Director Gan gave him the seat.

Yang Ping took the mirror and instruments in his hand, moved the instruments a little, and looked for the feeling, and soon he felt it in his hands. Arthroscopy and gastroscope have similarities, the basic principle is the same, and they are operated with hand-eye separation.

The long-term training of Yang Ping by the system can not only improve his skills, but also invisibly increase his talent value, so his self-confidence is not blind, and he really got started very quickly.

"Blood sucking, keep sucking blood!" Director Gan commanded, he wanted to find a place to go down, I'm here for a gastroscopy, I didn't get it, you get it later, and now the few words in my mouth, I have my own Credit is mainly a matter of face.

Taking advantage of the time when the blood was sucked away, in the blink of an eye, Yang Ping immediately pinched the bleeding point, hit it with one blow, and soon, as the accumulated blood was sucked out, the bleeding really stopped.

Snap on the titanium clip, exit the holder, a titanium clip solves the problem.

"No more bleeding, Dr. Yang, your hands are really amazing, you deserve to be doing five-segment replantation." Director Gan said bluntly.

"Where, I've had better luck these days, so I want to try it out. It can't be done without Director Gan's command. If it wasn't for your command, it would be difficult for me to complete it." Yang Ping said politely, giving a step in time.

"That's right!" Director Gan went down the stairs quickly.

"Blood draw, emergency blood test and complete set of DIC, once an hour, dynamic monitoring." Director Gan issued a verbal doctor's order, and the nurse immediately carried it out.

Miss Ning wiped away her tears: "Has the bleeding stopped?"

"Okay, stop it." Yang Ping handed the equipment to Director Gan.

Rinse it with ice-cold salt water. Director Gan checked carefully again. There was no other bleeding point. The gas in the stomach was pumped out, a gastric tube was inserted, and the mirror was pulled out.

Mr. Ning was retching all the time. When the mirror was pulled out, it was like vomit being pulled out by the mirror. He vomited violently, full of bloody salt water, all over the bed and floor.

The nurse got used to it, and immediately cleaned it up. The nurse next to her moved quickly and went to help.

Director Gan's assistant packed up the equipment and pushed the machine to evacuate. The nurse was busy cleaning up the garbage. The nurse aunt mopped the floor with a wet mop and then dried it with a dry mop. Except for the bed doctor and the doctor and nurse who managed the magic lung, everyone left the room .

Mr. Ning wanted to say something, but it was too strenuous to vomit just now. After the gastroscopy, he was overwhelmed and couldn't speak for a while, so he just pointed Yang Ping.

Miss Ning immediately caught up with Yang Ping: "Doctor Yang, please stop!"

Yang Ping stopped in his tracks: "Director Kong, I'll stay for a while."

Miss Ning felt guilty that she was always bothering him: "Sorry, Doctor Yang, Dad seems to have something to tell you."

This time it was Dr. Yang again who helped him through the danger. Mr. Ning and Ms. Ning have always watched and kept it in their hearts.

Yang Ping walked to the bedside, any patient, at this time, he would stop. In his eyes, there are no billionaires, only patients.

Mr. Ning's hand pointed down.

"Please sit down!" Miss Ning moved the chair.

Yang Ping sat down. What Mr. Ning needs now is comfort. When life is dying, people always want to catch something. Some people think of God, but what Mr. Ning thinks of is Yang Ping.

"Can you stay with me?" Mr. Ning prepared for a long time before he said this sentence, and he had to wait a long time for the next sentence.

Yang Ping nodded: "I've been sitting here, don't worry."

Mr. Ning nodded slightly, with a smile on his face.

Ms. Ning was a little embarrassed. She is a doctor, so let him guard her, but her father asked for this, and she had a satisfied smile on her face. She said, "Doctor Yang, it's really troublesome."

"It's okay! I'll sit here!"

Yang Ping knew that he had lost so much blood just now, and then lost a lot of blood, which might soon cause disseminated intravascular coagulation, and he couldn't survive tonight.

Really, this time I couldn't hold it anymore, why would I refuse a small request from a dying person?

"what time is it?"

"It's past one noon now."

"It's still so long."

Mr. Ning squinted and lay down.

(End of this chapter)