Reasoning diagnosis: Big brother, your wife has been prescribed medicine!

Chapter 203 Another Intense Surgery!

Immediately afterwards, a young woman also came up and said anxiously to Lin Yi:
"Doctor, my husband was still able to talk to me just now, why is he suddenly silent now?"

"No matter how much I call him, he won't wake up. What's wrong with him! Is his condition getting worse?"

Lin Yi didn't care about answering her question, but went up directly to check on his situation.

This man is the patient with subdural hemorrhage that Lin Yi focused on before his last operation.

Lin Yi first checked the patient's pupils.

It was found that his left pupil had reached [-] millimeters and had no reflection to light.

On the other hand, the pupil on the right side is [-] millimeters in size and has a slow response to light.

The patient suddenly fell into a coma, and the pupils on both sides were unequal. It was obvious that the patient had increased subdural hemorrhage!

Now that the brain herniation has formed, a craniotomy must be performed as soon as possible.

Otherwise, the patient will die!
Patients like this are conscious when they are admitted to the hospital, the diagnosis is clear, and the bleeding is not much, so they cannot meet the surgical standards.

But within 24 hours, close observation must be carried out.

Because the possibility of continued bleeding will be great.

If the observation is not careful, it may be mistaken for the patient to fall asleep.

That would be a big mistake, and even become a medical malpractice!
Lin Yi gave a detailed explanation to the family members as to why the patient suddenly fell into a coma.

And made it clear to them that the patient must undergo surgery immediately, otherwise his life would be in danger.

Now the patient only has unilateral mydriasis. If the operation is not done in time, there will be no need for surgery after the bilateral mydriasis is dilated.

Because at that time, he was already brain-dead, and there was no point in rescuing him.

At this time, the patient was at the critical point of life and death, and the family members did not dare to hesitate after hearing what Lin Yi had said, so they immediately signed the consent form for the operation.

The patient was then pushed into the operating room by nurses.

It took less than half an hour for Lin Yi and Song Borui to get off the operating table, and then they re-entered the operating room.

Song Borui couldn't help but smiled wryly: "Brother Yi, today's car accident is really busy for us, the whole rescue is really too tortuous!"

"Yes."

Lin Yi was also very helpless about this.

It's late at night now, and it's already past the time to get off work.

All the medical staff on duty can't even take care of food.

Like the current patient, an operation must be performed immediately, and Lin Yi and Song Borui couldn't care less about eating.

After the two washed their hands and disinfected, they stood on the operating table again.

Brain injury surgery, for Lin Yi, only needs two people.

After all, it's an operation on the head. There are too many people not only can't sit down, but also can't be used.

Because of the craniotomy, the doctor did it while sitting on a stool.

Then, the operation begins!
They first prepared the skin on the head and drew a line to determine the location for the operation.

After general anesthesia with tracheal intubation took effect, the patient was placed in a supine position with his head turned to the right.

Song Borui sterilized the whole head three times with iodophor, and then spread the towel.

Lin Yi sat on the right side of the patient's head, and Song Borui held the bipolar coagulator on the left side.

On the right occipital of this patient, a 4x4cm scalp abrasion with exudate surface was seen.

Local scalp swelling, extended to the right parietal, right temporal, the scalp swelling area is about 15X15cm.

Immediately afterwards, Lin Yi made an incision in the skin from the large left bone flap, cut the scalp, and turned the muscle flap to the face, and removed the bone flap about 8x9 cm with a milling cutter.

The dura mater is exposed and is purple-blue.

Normally, the dura mater is white.

And now it is purple-blue, which means that it is caused by subdural hemorrhage.

Lin Yi said to Song Borui who was staring intently:

"You poke the dura with your finger and see what it feels like."

Upon hearing this, Song Borui immediately poked it with his finger.

"This membrane is very hard! It feels like a rubber ball!"

Lin Yi nodded and said: "It's because the pressure in the brain is too high and the tension is high. Let's open the meninges to decompress him now."

As Lin Yi said, the scalpel made a small cut in the dura mater.

Immediately see the dark red blood clot gushing out of the subdural.

Song Borui had sharp eyesight and quick hands, and hurriedly used the suction device to suck up the gushing blood clots.

In fact, Song Borui's role is mainly to stop bleeding by electrocoagulation, blood sucking and ligation.

He doesn't know the main technical moves, and Lin Yi will do all of them.

When the blood clot was almost removed, Lin Yi cut the dura with a "C"-shaped knife and removed about 50ml of hematoma.

The dura mater was suspended around, and the brain tissue was slightly bulged, and the frontal lobe and temporal lobe could be seen with flaky contusion and inactivated brain tissue.

The brain at this time is like a tofu brain wrapped in intestines.

It is dotted with bright red filaments, and it is accompanied by a pulsation in sync with the beating of the heart.

One drum and one drum!

Deactivated brain tissue, like a smashed milkshake, has no effect and must be removed.

Lin Yi directed Song Borui to use bipolar coagulation and aspirator to remove the inactivated brain tissue.

But more bleeding.

For a while, Song Borui couldn't stop the bleeding with electrocoagulation. From time to time, blood still came out on the surface of the brain.

"You're not good at this speed!"

As Lin Yi said, he took the bipolar coagulation from Song Borui's hand, and quickly coagulated several bleeding points completely.

This completely stopped the bleeding.

Afterwards, Lin Yi immediately checked carefully whether there were other bleeding spots.

Surgery for craniocerebral injury sounds grand and bluffing.

In fact, such an operation is not difficult.

Just uncover the cranium, open the dura mater, remove the bleeding inside, remove the necrotic brain tissue, and completely stop the bleeding, the operation is considered complete.

It's that simple!
Because the brain injury caused by this kind of trauma, the bleeding is basically on the surface of the brain, so the operation is not difficult.

It's just that people who don't know how to do it or their family members will be terrified when they hear that there is an operation on the head.

After all, the human brain is the most important organ in the body.

Once an operation is performed on the head, it is no small matter!
Lin Yi checked the surface of the brain again in detail, and there was no bleeding point.

After being rinsed and clarified with normal saline, gelatin sponge was applied to the brain tissue wound.

This thing has a hemostatic effect.

Use normal saline again to rinse the brain surface and the operative field, and check again for no bleeding points.

Cover the surface of the brain with the uncovered dura mater, place a subdural drainage tube, make another incision from the left top, lead out and fix it.

This decompressive craniectomy has been considered complete.

Then count the equipment, and there are a lot of them.

The incision was sutured layer by layer.

Of course, the palm-sized skull that was removed before the operation will not be stitched back.

The patient's skull was shown to the patient's family members for review, and they would either keep it in their custody or dispose of it as medical waste.

If the patient recovers, three months later, he can use titanium plates for cranioplasty.

Otherwise, the part where the operation was performed on the left side would be sunken into a big pit.

It looks like a piece of the head is missing, which is very scary.

(End of this chapter)