Song Yi

Chapter 333 Blood Transfusion
All the people in the field exclaimed and gathered around to watch the excitement, but they were stopped by Li Pu with his guards and the yamen Zaoli.

Du Wenhao took his hand and touched it, and there was indeed a faint pulse beating, and he leaned down to listen to his breath, and he could feel a very slight breathing, and he was overjoyed immediately.

The old man hastily stepped forward to feel his pulse, and also cried out in surprise.

They were happy, but Du Wenhao didn't dare to be too happy.Restoring spontaneous breathing is only the first step in the Long March. If the acute abdomen problem is not resolved, life is still in an instant, and real death may occur at any time!
He immediately turned around and told Li Pu: "Hurry back to the inn immediately, and let my wives prepare for the operation immediately! Hurry up!"

Li Pu didn't know what the word surgery meant, so Zhang Huang asked, "Surgery...?"

"It's laparotomy! Hurry up! Just say it's an emergency!"

"Yes!" Li Pu was also very curious about this legendary magical skill, and immediately turned around and ran out. The old man hurriedly ordered the horse to be brought over to him. Li Pu flew on the horse and galloped away.

Du Wenhao said: "Hurry up and prepare ginseng soup to save the enemy, hurry up!"

Dr. Xie knew about the rescue of ginseng soup, and hurriedly urged: "Master Su! Hurry up, do as the imperial doctor told you!"

This old man's surname is Su, and he has several businesses in the city, he can be regarded as a big family, so naturally there will be no shortage of ginseng.Shopkeeper Su agreed repeatedly, and hurriedly ordered his servants to prepare.

Shopkeeper Su's family couldn't believe their ears and eyes. They saw that their relatives, who had already died, were breathing and had a pulse again. They were all trembling with excitement, crying and laughing, and they all gathered around to watch.Just now the girl took advantage of the chaos and asked Du Wenhao: "My lord doctor, my father... can he come back to life?"

"Well, but the condition is very critical now, and he may really die at any time." Du Wenhao turned his head to the old man and said, "Old man, I can perform a laparotomy on your son and try to cure his illness, but your son is very sick , I dare not guarantee that it will be cured. If you agree to my operation on him for laparotomy, please sign the consent form for laparotomy later, and promise that if the cure fails, don't blame me. Okay? "

Shopkeeper Su didn't know how to answer for a while, so he turned to look at his daughter-in-law.

The woman stayed there, because she found that the air she blew could make her husband breathe again. She didn't know the reason, so she was so excited that she didn't know what to say, but seeing that her husband looked like a dead man, a His heart was suspended again, and he stammered and said to Du Wenhao: "The imperial doctor..., the imperial doctor..., please save my husband..."

Shopkeeper Su gave her a kick: "Let's go! I didn't hear that the imperial doctor said that he would have a laparotomy to heal his son's illness. Why are you still yelling like this!"

The woman stepped aside.

Du Wenhao said: "Shopkeeper Su, are you willing to sign the consent form for caesarean section and allow me to operate on your son? If you agree, I will immediately transport your son to the inn, where I will have assistants to help and special equipment Medicine, I will try my best to save your son's life by caesarean section!"

Shopkeeper Su didn't know what the letter of consent meant, but since he had hope, it was better than taking care of his son's funeral. Don't say he didn't know what the letter of consent for the operation was. Even if he knew, he wouldn't have the choice , so hurriedly nodded like a chicken pecking at rice: "Okay! My lord doctor, everything is due, if you can save my son, I..., even if I go bankrupt, I will repay your great kindness!"

Without saying a word, Du Wenhao immediately ordered the patient to be put in a carriage and transported to the Emei Inn where he was staying.

The neighbors were all shocked, a dead person was actually brought back to life, all the people were surprised, happy and curious, they all gathered outside the courtyard of the Su family to watch the commotion.Fortunately, there were Yamen Zaoli officers to maintain order quickly, and the Su family's carriage was able to go out smoothly.

But those curious neighbors refused to disperse. Although there were no modern communication tools in ancient times, the speed of word of mouth was unmatched by modern society, so many people in the city soon knew that the imperial doctor came from the capital. , it was this imperial doctor who saved the eldest young master of the Su family, and wanted to open his stomach to treat his illness. They all started clamoring and moving, which was more lively than going to a temple fair. They buzzed behind them and came to the outside of the inn, stepping on their feet. Watch the excitement and discuss loudly.If it wasn't for the arrest of Zaoli from the state government office, I'm afraid they would rush in to see what happened.

In the inn, Du Wenhao's heart was very heavy. He had never encountered such a critically ill patient. He was revived after feigning death, and then underwent a laparotomy. It is unknown whether there will be multiple organ dysfunction, and he may die on the operating table. superior.After crossing over, so far, dozens of laparotomy operations have been performed, and none of them have failed, and no patient has died as a result.He doesn't want the record to be broken here.He wants to challenge the limits of his abilities.

All the way to the inn, he asked the patient about the symptoms before and after the onset of the disease. If the operation is to be successful, it is the key to accurately determine the cause of the acute abdomen. Only when the cause is identified can corresponding countermeasures be taken.

However, the old shopkeeper Su and the Su family couldn't tell exactly how the patient fell ill. They only said that when he came home from outside with his stomach covered that day, it was getting dark, and he said his stomach hurt, and asked him why it hurt. He couldn't explain clearly, but he couldn't be cured after seeing a doctor, his condition took a turn for the worse, and he fainted soon, and he died after two or three days. Fortunately, he met Doctor Du in the capital.

These circumstances made him feel even heavier. Now the situation he is facing is not optimistic at all. The cause is still unclear. The patient is deeply comatose and cannot be consulted. There is a lack of modern diagnostic methods, especially modern first aid methods. There is also a real problem—— No shadowless lights!

Starting from the capital, Du Wenhao thought that there might be emergency surgery, so he also brought his custom-made surgical lighting and fireworks light source. Although this lighting device is not as good as the modern operating room shadowless lamp, it can barely meet the lighting needs. .

When the patient was sent to the inn, Pang Yuqin and Xue Feier had already prepared the operating room and made preparations for the operation, including the lighting installation.This time they brought a full set of surgical equipment and medicines with them in the car, and both of them were familiar with the road. When Li Pu came back and told them to prepare for the operation, they began to make preparations in an orderly manner. When Du Wenhao and the others arrived, the operation The pre-preparation has been completed.

Ke Yao insisted on coming to watch the excitement, but was stopped by Lin Qingdai: "Laparotomy is no more than cutting a boil or something. It's a matter of cutting open the stomach. Brother Hao can't be distracted, so don't get involved."

Ke Yao also understood the power of it, although he was unwilling, he retreated to the next room and waited with his mouth pursed.

Du Wenhao asked the second daughter to send the patient to the operating table, and urgently took antibacterial and anti-inflammatory decoctions that mediate water, electrolyte, and acid-base balance, as well as anesthesia soup, and shaved off the hair in the surgical area and cleaned the skin.

After Du Wenhao washed his hands, Pang Yuqin helped him put on the sterile surgical gown.Taking advantage of this gap, Pang Yuqin asked in a low voice: "Master, what is the patient's disease?"

Du Wenhao said in a low voice: "It's not clear yet, but when I performed cardiac resuscitation on the patient earlier, I found that the deceased's body temperature was extremely low, he was in a severe coma, his lips and fingers were cyanotic, and after resuscitation, his pulse was counted. According to the medical history, it was initially judged as acute suppurative peritonitis."

Xue Fei'er came over and said, "Brother, that's not right, you told us before that in septic shock, there should be a strong fever, but you just said that his body temperature is extremely low, so it's not an infectious disease, it's not suppurative peritonitis .”

While wearing sterile gloves, Du Wenhao said: "That's right. In the early and middle stages of septic shock, there is indeed a continuous strong fever, and the body temperature is very high, but in the later stage, it will suddenly drop, which is lower than the normal human body temperature. Body temperature. When we took over, the patient was already in a state of suspended animation, so the current body temperature cannot be used to judge the condition. It should be combined with the medical history and asked on the road. At the beginning of the onset, the patient claimed to have severe abdominal pain, which was persistent pain. The specific location They didn't ask, and with the aggravation of breathing and coughing, severe pain soon spread to the whole abdomen. Nausea and vomiting occurred. These are all clinical symptoms of purulent peritonitis. —— But they didn't pay attention to whether the patient had a high fever .”

"No way? Is it easy to detect a fever?"

"Well, maybe I didn't pay attention, but body temperature changes are not the only basis for judgment." Du Wenhao walked to the operating table and stretched out his hands to massage the patient's abdomen: "According to the patient's obvious abdominal distension and disappearance of abdominal breathing, it also suggests that it is purulent." Peritonitis. However, this is only a suspicion and cannot be confirmed because the patient is in a coma and cannot be consulted."

"What should we do now?"

"The etiology is unknown and time is short, so we can only open the abdomen immediately and decide on the next operation according to the situation. Fei'er, you must always pay attention to the patient's pulse, respiration and body temperature."

"Ok."

Du Wenhao picked up the scalpel and was about to open the abdomen for exploration. Suddenly he let out a cry, put down the scalpel, and stretched out his hand to press on the upper abdomen. There, there was a purple scar!

Before, he checked through his clothes, but now he took off his clothes to prepare for the operation, only then did he realize that he quickly pulled up the surgical drape, revealing the whole purple spot.

This is an oblong subcutaneous hemorrhage area, in which several ecchymosis points are obvious.

Du Wenhao is a graduate of forensic medicine. He can tell with just one glance that this is subcutaneous hemorrhage caused by a blunt trauma!The location is in the liver!

A flash of inspiration flashed in Du Wenhao's head, and he immediately understood everything - the patient was not in abdominal infection shock, but hypovolemic shock!No wonder the family members of the patient did not notice the strong fever characteristic of abdominal infection. The real cause is likely to be the internal bleeding caused by the rupture of the liver caused by trauma to the liver!

The texture of the liver is fragile, and it is particularly easy to rupture when it suffers trauma. In the ancient times when surgical methods were lacking, rupture of internal organs basically meant terminal illness.

However, if it is a liver laceration, Du Wenhao is not sure how to cure it, because the direct consequence of liver laceration is massive bleeding in the body. Since the blood coagulation mechanism declines after liver damage, blood transfusion is almost required for this kind of operation, and liver protection treatment is also carried out. .And Du Wenhao has never had blood transfusion treatment!

Especially the patient has been ill for a few days, and has gone into shock due to hypovolaemia, indicating that the blood volume is already very low. In this case, without blood transfusion, the patient may die due to blood loss before the operation can be completed by closing the abdomen. On the operating table!
Although this is only a preliminary judgment, and there is no time to think about it, it is obvious that he can only bite the bullet. Du Wenhao immediately decided to perform a laparotomy on this trauma to determine whether it is a liver laceration. As a last resort, or not.

However, before that, he wanted to leave evidence, and immediately asked Pang Yuqin to bring a thin piece of glutinous rice paper, cover it on the purple spot, and draw the shape of the purple spot, especially the darker bruised spots.

After finishing, Du Wenhao fixed the incision skin with one hand, and cut open the patient's abdomen at the purple spot, while Pang Yuqin used gauze or forceps to help stop the bleeding.

As soon as the abdominal cavity was opened, a strong bloody smell rushed up, Du Wenhao's heart sank, he was bleeding internally!Nine times out of ten, the liver is lacerated!

Liver laceration is often accompanied by other organ damage, and the mortality rate is relatively high under modern surgical conditions. I really don't know if I can pass this level.

Du Wenhao asked Pang Yuqin to use a self-made simple rainbow suction device to simply extract the accumulated blood in the abdominal cavity, while he stretched his hand directly into the abdomen, into the hole of the lesser omentum, pinched and blocked the hepatoduodenal ligament, so as to control the bleeding. Prevent further deterioration of the bleeding state.The other hand is initially checked for liver damage.

After a preliminary examination, it was found that there was a laceration on the surface of the liver!
Du Wenhao asked Pang Yuqin to press the wound with a gauze pad to stop the bleeding, and then began to check the liver and other organs for other injuries.

The results of the examination made Du Wenhao feel relieved, except for the relatively shallow laceration on the surface of the liver, there was no central rupture, bile duct injury and other organ injuries. Fortunately, it was only this small laceration that allowed the patient to survive the continuous bleeding in the past few days.

Since there was no associated injury to other organs in the abdominal cavity, the hemorrhage in the abdominal cavity was not infected.Originally, the intraperitoneal blood could be reinfused with autologous blood, but unfortunately, the autologous blood must be filtered, centrifuged, and washed before it can be reinfused to the patient. Wen Hao didn't and couldn't make it, he could only watch the blood drain in vain.

Just when Du Wenhao had just stitched up the liver wound, Xue Feier, who was in charge of monitoring the vital signs, suddenly exclaimed: "Brother! It's bad, I can hardly feel the pulse, and if there is no pulse, my breathing is intermittent. of!"

Du Wenhao's heart felt cold, it's over, he bled too much and went into shock again.At this time, if there is no blood transfusion to replenish the blood volume, the patient will undoubtedly die!
The last move is to infuse the patient with his own blood!

Du Wenhao himself has type 0 blood. When he first started planning for abdominal surgery, he thought about using his own blood to transfuse patients in the event of an unavoidable situation in the future.He has also imagined countless times how to perform blood transfusions under ancient conditions without rubber products.And developed animal leather suture, after disinfection as a blood transfusion equipment, also personally designed and ordered a set of direct blood transfusion equipment.

He once used this equipment to conduct a blood transfusion test on a calf. The blood was drawn from a calf and then transfused back through this simple blood transfusion equipment. It is gratifying that the calf did not die, and did not even clotting or a blood infection disorder.This is due to his strict disinfection of instruments.

After several tests, he was convinced that the blood transfusion equipment was feasible.However, he has never used it in clinical practice.The main reason is the blood source.

At present, he only knows his blood type. Although he is a universal blood transfusion person, a healthy person cannot transfuse more than [-] milliliters of blood each time, otherwise it will be harmful to health, and more than [-] milliliters will cause serious damage to health. Two hundred milliliters would be life-threatening.In the case of massive blood loss, the blood transfusion volume should exceed [-] ml.This is tantamount to exchanging your own health for the lives of others.

Moreover, although the blood transfusion technology has been tested on animals, it has not been tested on the human body. It is not known what the consequences will be. Since there is no blood preservation and extraction technology, only whole blood can be transfused, and the risk of transfusion of whole blood is higher than that of its components. The blood is much bigger, based on various considerations, so, in the previous treatment process, Du Wenhao tried not to use blood transfusions as much as possible.But this time, he couldn't escape.

He decided to have a blood transfusion immediately.

To minimize the time the blood spends outside the body, he uses direct transfusions.Blood transfusion is performed by gravity.Fortunately, the liver wound had been sutured at this time, and the rest was to clean the abdominal cavity and close the abdomen for suturing.

Du Wenhao said to Pang Yuqin: "Qin'er, come and clean the abdominal cavity and sew up the abdomen, and Fei'er will help me transfuse the patient!"

The concept of blood, blood type and blood transfusion Du Wenhao had already told the second daughter in the previous teaching, and also carried out the animal blood transfusion experiment with the second daughter, the second daughter knew this method, but Du Wenhao also told the risk of this method There were two people, so when they heard that Du Wenhao was going to give the patient a blood transfusion, they were immediately taken aback.

Pang Yuqin was at a loss, and said, "Master, this..., this won't work, I've never done stitches before."

Du Wenhao said: "Believe in yourself, you can do it, I have taught you, and you have practiced many times."

"But, that was practiced on pork, I've never tried it with a real person!"

"Don't worry, I'm here, I'm watching from the side. Hurry up, it's too late! ——Qin'er, you first give the patient the Juni ginseng decoction, and then help me transfuse the blood. Hurry up!"

Fei'er said urgently: "Brother, you..., you want to transfuse your blood to him?"

"Yes, I am a universal blood transfusion person, and a small amount of blood transfusion is fine."

"Can you lose me?"

"I haven't tested your blood type. You know the consequences of transfusion without knowing your blood type. Don't be wordy! Hurry up!"

Fei'er stomped her feet, and ran to bring ginseng soup to rescue her, Qin'er also began to wash the abdominal cavity alone while trembling, while Du Wenhao fetched the direct blood transfusion device that had been strictly sterilized, and moved a high cabinet in the room to the operating table , I stepped on the stool and climbed up to the top to lie down, and stuck one end into my blood vessel, and fixed it.

At this time, Fei'er had already poured the patient's rescue ginseng soup, came over to take the other end of the blood transfusion device, followed Du Wenhao's instructions, waited for the blood to flow out of the other end of the needle tube, and after the air had been exhausted, she shivered and tried to use the needle into the patient's vein.She had never had a needle before. Under Du Wenhao's guidance, she tried several times before getting it in. Fortunately, the patient had already drank the anesthesia soup and felt no pain.

In order to control the speed of blood transfusion, the blood transfusion set designed by Du Wenhao has a tube made of translucent glass in the middle, so that you can barely see whether the blood is flowing and the flow rate.

After the Jiuni ginseng soup was poured down, the blood in Du Wenhao's blood vessels was continuously poured into the blood vessels of the young master of the Su family.Finally, Xue Feier, who had been nervously checking the patient's pulse, exclaimed in surprise: "Brother, it seems that the pulse is stronger than before, and the breathing is also stronger."

Du Wenhao smiled weakly. The blood transfused into the patient's body must have exceeded [-] milliliters, but he did not stop, saving people to the end, and sending the Buddha to the West.His hematopoietic function is sound, and it doesn’t matter if he loses a lot of blood, as long as he strengthens his care. So, until he feels irritable, his heart rate increases, his hands and feet are cold, his eyes are dark, and he feels drowsy. He has already gone into shock Xuefeier was asked to stop the blood transfusion when she had symptoms.

He didn't know that his blood transfusion was close to [-] milliliters!

At this time, under the guidance of Du Wenhao, Pang Yuqin had already finished cleaning the abdominal cavity, placing a drainage tube, and closing the abdomen layer by layer. This was the first time she completed the operation independently. The next step is completed, but it is enough to make him very happy.

Pang Yuqin happily turned to Du Wenhao and said, "Sir, my stitches are not bad...? Mr.! What's wrong with you?"

Only then did Pang Yuqin realize that Du Wenhao's face was pale, with cold sweat dripping from his forehead, he panicked and shouted, "Fei'er, what's wrong, Mr. Xianggong?"

Xue Fei'er also came over in a hurry and held Du Wenhao's hand, only feeling that his hand was like ice and trembling.

Du Wenhao tried his best to smile: "Don't...don't worry, I'm fine...quick! Give me Shenfu Lizhong Decoction frequently...quick!"

Shenfu Lizhong Decoction is one of the achievements of Du Wenhao and his School of Traditional Chinese Medicine's research on the integration of traditional Chinese and Western medicine. This decoction can quickly restore the hemodynamic stability of patients with hypovolemic shock, increase tissue oxygen partial pressure and oxygen content, and improve microscopic Circulation and tissue metabolism, promoting recovery from shock.

As a first-aid medicine, Du Wenhao has already told Pang Yuqin and Xue Feier the combination of this decoction and other relief medicines, and asked them to pay attention to preparing the corresponding medicines in order to avoid being too late.

These medicines were all cooked in advance, so Du Wenhao only said the name of the medicine, Pang Yuqin rushed out, and soon brought a big bowl, Xue Feier hugged Du Wenhao and leaned in her arms, Pang Yuqin was drooling Tears were fed to him spoon by spoon.

Du Wenhao blinked: "Don't cry, I'm fine...don't worry, there's no reason for a doctor to treat you...to put yourself to death...haha."

Hearing this, Pang Yuqin's tears flowed even more. While feeding him medicine, she sobbed and said, "Who is like you, who almost lost his life when he was cured! You will not be allowed to behave like this in the future!"

Xue Fei'er hugged Du Wenhao tightly in her arms, warmed his body with her body temperature, and cried, "That's right! If you don't think about yourself, you should also think about us!"

Du Wenhao drank the Shenfulizhong soup, felt his body gradually warmed up, and his eyes became much brighter, he moved his head in Xue Feier's arms, and nodded comfortably: "Okay..., I will listen to you from now on, don't be reckless It's..."

"Well! If you want to do this again, we won't agree!" Both girls said heavily.They regretted that they didn't stop Du Wenhao from doing this, because they didn't know the terrible consequences of excessive blood transfusion. Now that they found out, it was too late, and they just kept blaming themselves in their hearts.

(End of this chapter)