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

Zhou Chao asked again cautiously: "Lin Yi, can you really do it?"

After all, it is a matter of life and death, of course it is best to be cautious.

He didn't question Lin Yi, he just wanted to be more sure.

After all, it is cerebral hematoma evacuation and decompressive craniectomy, not just a surgeon can do it.

Because no matter what surgery Lin Yi will have, he never said it in advance, but he only said it when he met a related patient.

So the Zhou Dynasty had to confirm it again.

After all, the operation is no joke.

Furthermore, the old man is now in a very critical condition and needs immediate surgery.

Lin Yi also understood Zhou Chao's thoughts.

He nodded again and said solemnly:
"I don't have any problems with the hematoma evacuation and decompressive craniectomy for this patient. Don't worry, as long as you can use our department's emergency fund to solve the urgent needs first and let the old lady feel at ease. I can do it."

"Well, any of you can be my assistant."

As soon as they heard that Lin Yi was looking for someone to be his assistant, Wu Jiang and Yin Liang immediately came together and said to each other:
"I'm coming, I'm coming!"

The two of them were so active like studious interns, which left Wang Qiaoya and the others speechless.

The two attending doctors actually want to rob them of their work, what are these interns doing!

Because this is a very good learning opportunity, how could Wu Jiang and Yin Liang let it go?

Even if Yin Liang is a few years older than young people like Lin Yi, he still has to compete with Wu Jiang and must not give up this opportunity.

Unexpectedly, Zhou Chao stood up immediately and said:
"Why are you two arguing? This is my patient. I must be the assistant. You all stand aside."

Hearing what Zhou Chao said, Wu Jiang and Yin Liang immediately became listless like deflated balls.

Zhou Chao was the patient's first doctor, and it was only natural for him to go to the operating table.

And he is the director of the emergency department, so if he asks, can he fight with him?
Then, the operation begins!
After anesthesia.

Lin Yi first pinched the patient's skin with tweezers, and the patient did not show any neurological reactions, indicating that the anesthesia had already taken effect.

The patient is lying down, with the left shoulder raised and the head tilted slightly to the right. Lin Yi sits on the left side of the patient's head, and Zhou Chao sits on the right side as the first assistant.

The others stretched their necks one after another, stood on tiptoes, and watched Lin Yi's operations carefully.

Lin Yi used a scalpel to incise the left frontotemporal arc-shaped flap that had already been positioned.

Then the scalp and subcutaneous layers were cut in layers, the scalp clips were fixed, and the skin flap was peeled off to expose the skull.

There was a lot of bleeding on the scalp, and Zhou Chao used electrode clips to coagulate it.

Although Zhou Chao doesn't know how to do brain surgery, he uses electrode clips to coagulate blood vessels that are bleeding, which is a basic operation.

Lin Yi looked up at Wang Qiaoya and the others, and explained: "The blood vessels on the scalp are particularly rich. You must stop the bleeding at all the hemostasis points, otherwise it will affect your surgical field of view."

Wang Qiaoya and the others nodded their heads half-understood.

Regardless of whether you can understand or not, you can do it or not, just nod and you're done.

Otherwise, you don't have to say that you don't know anything.

Lin Yi took out the magic drill to drill a hole, and milled a bone flap about 6*8cm in size with the milling cutter.

Brain surgery is definitely not as simple as just opening the scalp.

The skull must have to be removed in order to gain access to the brain for surgery.

Lin Yi explained to Wang Qiaoya and other interns while continuing the operation.

Regardless of whether they could understand what Lin Yi said, Wang Qiaoya and the others listened with gusto.

After all, it was Lin Yi's on-site teaching.

Even if you don't understand, it's not easy to come in to observe the operation. Others can't come if they want to.

Check that the dura mater is intact, but the tension is very high, as hard as a basketball.

High tension is caused by bleeding.

Just like a rubber ball, you just need to inflate it to a certain pressure.

But if you inflate it to two pressures, it can be seen how high the pressure of the ball is, and it may burst at any time.

Of course, the human dura mater will not rupture due to excessive tension.

Because the outside of it is the skull.

There is no external force on the human skull, so it is impossible to explode by itself.

Therefore, no matter how high the intracranial pressure is, the human dura mater will not rupture.

However, the limited space will only increase the intracranial pressure and squeeze the normal brain tissue, thereby forming a brain herniation and causing the death of the patient.

This means that if there is a lot of intracranial hemorrhage, surgical decompression must be performed as soon as possible, otherwise it will be difficult for the patient to save his life.

While listening to Lin Yi's explanation of the operation steps and details, everyone watched Lin Yi's movements attentively.

After Lin Yi suspended the dura mater, he cut the dura mater crosswise, and the brain tissue bulged out of the dura mater border.

White flowers, really like tofu brains.

Carefully separate the dura mater and brain tissue and protect the draining vein;

Because of the high cerebral pressure, the draining veins of the temporal lobe were avoided, and a cortical fistula was made in the superior temporal gyrus under the microscope.

Blood clots were seen 3 cm below the cortex, and the blood clots were relatively tough. They were crushed and sucked with forceps, and the wound cavity was repeatedly washed with a large amount of normal saline.

Remove about 45ml of blood clot, blood clot thoroughly sucked clean.

The bleeding in the operation area was completely stopped, the gelatin sponge was filled, and the fibrils covered the wound surface, and the brain pressure was significantly reduced.

In fact, the removal of brain hematoma is not difficult.

As long as the skull is opened, the dura mater is cut, and the blood clot is seen to suck out the blood clot, the operation is basically over, as long as there is no more bleeding.

But after all, it is to operate a knife on the human brain, and it is still impossible for a professional doctor to do this.

When Lin Yi was explaining, he had 4-0 absorbable sutures in his hands, and he had already started suturing the dura mater, the stronger artificial dura mater 7*9 to repair the dura mater defect coverage, 2 Synthes connectors, and 2 Stryker cover holes One and titanium nails were returned to fix the bone flap.

A subcutaneous drainage tube was placed and fixed, the subcutaneous layers were sutured, the skin was stapled with a nailer, and the wound was bandaged with gauze dressing.

The blood loss during the operation was only 50ml, and there was no need for blood transfusion at all.

Done work!

Lin Yi took off his gloves and looked up at the time.

"Well, it took 50 minutes, so-so!"

Wu Jiang came over and patted Lin Yi on the shoulder, looked at Lin Yi and said:

"Brother Yi, you are too low-key!"

Lin Yi couldn't help smiling and said:
"I'm just feeling casually."

If Lin Yi did not explain to them while performing the operation, then his operation time could be reduced by 10 minutes.

Lin Yi stared at Wu Jiang, and said lightly:

"Five 10 minutes is fast? I think it's already slow, okay? At my normal pace, I can take 10 minutes off."

"I'm going, brother Yi, please don't hit our little hearts again, okay?"

Wu Jiang immediately clutched his chest, looking distressed.

"Do you know how long it will take for the chief of neurosurgery to do this brain hematoma removal?"

Wu Jiang made an exaggerated gesture.

"His fastest time was an hour and a half. And you only took five or ten minutes, which is still too slow. Are you still letting people live?"

Lin Yi didn't know that it took the director of the neurosurgery department an hour and a half to perform this brain hematoma removal operation.

For Lin Yi, if he was allowed to do this operation for an hour and a half, he would go crazy.

It was as slow as a snail.

After all, the level of this operation is not too difficult for him.

Lin Yi didn't look like he was showing off his short surgery time at all.

For him, this operation can only be said to be a normal performance.

Zhou Chao couldn't help but patted Lin Yi on the shoulder.

He said to him: "Lin Yi, you are really good. I didn't expect you to do neurosurgery operations so beautifully. In my opinion, they are better than their department directors."

"Don't say anything, you will be responsible for all brain surgery operations in the future. In the future, we will ask the directors of other departments to come to our emergency department and ask you to learn from them."

Zhou Chao thought about it, and couldn't help rubbing his hands excitedly, and it was difficult to conceal the excitement in his heart.

Judging from Lin Yi's current surgical ability, there are almost no surgeries he can't perform.

It can be said that Lin Yi is now in the emergency department, and he is definitely a hot god-level figure.

After all, Lin Yi's ability is too strong now, and he, the director, is already unable to compare with Lin Yi in terms of technical means.

As for the director of neurosurgery, he is quite aware of his ability to perform brain surgery.

Now that he has observed Lin Yi's brain surgery all the way, he immediately knows that there is still a big gap between the director of neurosurgery and Lin Yi.

At least in terms of operation time, Lin Yi was a few blocks ahead of the director of neurosurgery.

After all, it takes one and a half hours for the director of neurosurgery to perform brain surgery, but Lin Yi only needs five to ten minutes for the operation.

And according to Lin Yi, it can be shortened by 10 minutes.

For Lin Yi, this is simply supernatural!
After the operation, the patient was sent to the emergency intensive care unit.

After all, this patient had a very large amount of cerebral hemorrhage. Even if Lin Yi had expert surgical skills, he could remove the bleeding hematoma very cleanly.

But after all, the amount of bleeding is heavy, and the pressure on the brain tissue causes cerebral edema. The patient will definitely not wake up for a while, and the follow-up treatment is also very important.

Patients with massive cerebral hemorrhage and herniation of the brain need to continue to use mannitol, dehydration to reduce intracranial pressure, and anti-infective treatment with strong antibiotics even after surgery.

Even if Lin Yi's surgery had special effects, he couldn't take it lightly.

Because once the patient is in a coma and stays in bed for a long time, hypostatic pneumonia will inevitably occur.

As a result, problems such as fever and expectoration that are difficult to cure appear.

Moreover, some patients still experience upper gastrointestinal bleeding due to sudden severe illness that stimulates the stomach.

These are all complications after cerebral hemorrhage, and they are also very dangerous.

It is necessary to closely observe changes in the condition, and frequently monitor blood routine, liver and kidney function, electrolytes, blood gas analysis and other inspection items.

In short, like this cerebral hemorrhage patient, although he has undergone surgery, the follow-up treatment also requires careful observation and treatment by doctors.

Otherwise, once there is an intracranial infection, or the aggravation of hypostatic pneumonia, it will be difficult for the patient to wake up.

Fortunately, Lin Yi's special surgery will reduce the rate of intracranial infection by 50%, so the possibility of this patient being awake is very high in theory.

Of course, after this patient was sent to the emergency intensive care unit, Zhou Chao was still in charge of the bed.

Lin Yi was just operating on him, but not his bed doctor.

Yin Liang gave the patient a doctor's order and walked out of the intensive care unit.

After finding Lin Yi, he sighed and said:
"The amount of bleeding in this patient is too large. Although it is surgery, it is still very dangerous. After all, the subsequent complications are also unavoidable."

Lin Yi nodded and said in approval:
"I have already told the old lady about this situation, but you'd better communicate with the old lady more and let him accept the process slowly.

As doctors, we have tried our best. After all, we are not gods. Every patient will be cured completely, as long as we have a clear conscience! "

Seeing that Yin Liang was in a bad mood, Lin Yi hurriedly spoke to comfort him.

In fact, Lin Yi can understand Yin Liang's behavior.

His qualifications are no longer hidden, but he is an emotional person, and he still can't help being sad when encountering this situation.

After all, a living person suddenly became seriously ill and was bedridden and unconscious.

The doctors tried their best to bring him back to life, but it didn't work out as expected, which is very sad.

Doctors with poor psychological endurance are sometimes swayed by the patient's condition.

If this kind of mood cannot be adjusted, in the long run, the doctor may suffer from psychological depression, or he may not be a doctor.

Some people become doctors because they can't see the pain of patients, and there are not a few people who are depressed and change careers.

However, Lin Yi's psychological quality is very strong, although he also sympathizes with some patients' experience and family situation.

But he will not be affected by bad emotions, which will affect his mood and thus affect his work.

After the operation is completed, return to the consulting room.

A middle-aged man in his 50s walked in.

His complexion was a little bad, and as soon as he sat down, he began to tell Lin Yi about his medical history.

"Doctor, you see I've been nauseated and vomiting for several days, and I can't eat anything."

"I also had a gastroscopy in another hospital. They said it was chronic gastritis, and they prescribed me medicine to treat my stomach, but the medicine didn't work. I still felt nauseous and vomited..."

"vomit……"

As the patient spoke, he began to retch again.

Because he hadn't eaten when he came, he could only retch, but he couldn't spit out anything.

Nausea and vomiting caused by chronic gastritis, can not eat, is it so serious?
"Look, doctor, here are the results of my examination."

After the middle-aged man retched, he slowed down for a while, and handed Lin Yi a gastroscopy checklist.

However, as soon as he handed the inspection results to Lin Yi, the man leaned over and retched again.

In just 2 minutes, I retched twice.

Is the vomiting too frequent?

Chronic gastritis is not like this!

Lin Yi glanced at the middle-aged man suspiciously, then looked at the gastroscopy checklist in his hand.

Gastroscopy was done in other municipal hospitals, and it was done very clearly and described in detail.

The general description of the stomach and esophagus did not show any special circumstances, and the final conclusion was that chronic superficial gastritis with erosion.