Chapter 601 Diagnosis

"Take blood quietly and send it to the laboratory for a smear to check for amniotic fluid embolism." Fang Pingzhu asked the nurse to send the patient for amniotic fluid embolism as soon as he saw the patient.

For obstetrics, the highest mortality rate is amniotic fluid embolism.

Amniotic fluid embolism refers to the sudden entry of amniotic fluid into the mother's blood circulation during childbirth, which can cause serious complications such as acute pulmonary embolism, anaphylactic shock, renal failure, and sudden death.

Because the amniotic fluid contains a lot of fetal vellus hair, keratinized epithelium, vernix, and meconium, once it enters the blood circulation, it will immediately cause balance disruption.

In the First Department of Obstetrics and Obstetrics, Fang Pingzhu's policy is to immediately take blood from the veins for rapid diagnosis when he sees symptoms such as massive bleeding.

With such a policy, the capture rate is naturally not very high, but from Fang Pingzhu's point of view, amniotic fluid embolism can be diagnosed a few minutes in advance, and the patient's survival rate will be greatly improved.

However, this policy, which was originally popular in obstetrics, is currently only valid in obstetrics.

The directors of the Second and Third Departments of Obstetrics currently have their own priorities and are unwilling to spend a lot of manpower, time and money on screening for amniotic fluid embolism. This is also one of the reasons why doctors must find a way to become a director after they have reached a higher level.

Only when you become the chief director in power can you decide the direction of the department. In other words, you can let all the people in the department and the money of the whole department revolve around you, and all go to the fields you are interested in, good at, or have studied. In addition to obstetrics and amniotic fluid embolism, there are also high-risk pregnancy, prenatal diagnosis, placental early disc and other fields that can be involved.

Ling Ran has no experience in obstetrics, and does not judge the probability of amniotic fluid embolism.

He followed the flat car for a while, let Fang Pingzhu give orders, and entered the operating room before asking, "How much bleeding?"

"400ml of vaginal bleeding." The nurse reported seriously.

After working in the hospital for a long time, the nurses are also familiar with the main diseases and manifestations in the department. They are very pessimistic when they look at the patient who has just been carried to bed. As a woman, she just gave birth to a baby and was about to die... Apart from a serious expression, she didn't know how to behave.

Director Hong didn't follow in, and turned to comfort his elder brother and sister-in-law outside the operating room.

He is a physician, so he can't perform surgery. Even if he could, Director Hong probably wouldn't do it. If the director of the obstetrics department and Ling Ran were on the same stage, they wouldn't be able to save them, and the other surgeons would probably have a hard time making contributions.

"Exploring the abdomen?" Ling Ran's tone seemed to be asking Fang Pingzhu,

But actually quite sure.

The anesthetist couldn't help looking at Fang Pingzhu.

This is the operating room of the obstetrics department, and Ling Ran didn't bring anyone here, so it really depends on Fang Pingzhu whether he can use the knife.

Fang Pingzhu nodded slightly. From the moment she allowed Ling Ran to come over, she had no room to refuse.

General anesthesia was ready, and after a while, Ling Ran pressed the patient's skin twice, and said, "Laparotomy, abdominal exploration."

After speaking, he asked for a scalpel, and with a bow, he made a long cut in one breath.

Fang Pingzhu and the other doctors in the obstetrics department gasped.

Most of the surgeries performed in obstetrics are caesarean sections. With a horizontal cut, less cuts will not work, and too many cuts will definitely make the patient unhappy. When some women choose a doctor for a caesarean section, they always discuss the length of the incision.

However, no matter how careless an obstetrician is, he would not dare to make a long cut in one go like Ling Ran. If this is not done well, it will be a doctor-patient dispute.

"Doctor Ling's abdominal examination is a bit bold." Fang Pingzhu spoke in a very "tactful" manner.

The female doctor who was the third assistant thought that the director wanted to order Ling Ran, so she hurriedly said, "Doctor Ling, you made such a long incision, be careful not to be scolded by people blocking the office."

Ling Ran stared at the operation area in front of him, and said calmly: "If the patient can block the office and scold, the incision will not be in vain."

The female doctor who was the third assistant couldn't help being taken aback.

"Pull the hook," Ling Ran reminded.

"Oh, oh... yes." The female doctor glanced at Ling Ran secretly, and couldn't help thinking bitterly: The men I went on a blind date with were not only not as handsome as Dr. Ling, but also less beautiful than others. No, One hundredth, no, one ten thousandth...

Fang Pingzhu also softly praised Ling Ran's words: "The doctors taught by Director Huo, don't say how good they are, but their medical ethics are still acceptable. First save lives and then treat diseases, right?"

Huo Congjun has been in Yunyi for so many years, and his famous words have long been remembered.

Ling Ran smiled.

Fang Pingzhu continued: "The current environment is different from that of your Director Huo back then. Back then, when we encountered an emergency, sometimes we did it without waiting for the family members to sign. The women and children who were saved I don’t know how many there are. Now who dares, some doctors are not at ease when they see a signature, and they must be signed by both the man and the woman. Tell me, how do you choose to cure the disease and save the patient?”

Ling Ran still just smiled, and had no interest in discussing such a topic at all.

Ling Ran was doing the operation seriously.

"Quicken the suction." While Ling Ran was speaking, he inserted his hand into the patient's abdominal cavity.

The abdominal cavity is full of blood, so you can only touch it with your hands. This is a strategy to save time, and ordinary doctors can't use it at all. Just by looking at the amount of blood drawn by Gudu Gudu, you can tell that the inside must be a mess. It is really unbelievable to try to find out the state of the organization with your hands.

However, because we don't know what's going on in the abdominal cavity, now we have to cut open the abdominal cavity, and after the pressure is relieved, we need to explore as soon as possible.

Just like the two armies confronting each other, the scouts sent out will definitely be lost, but if they are not sent out, the loss may be even greater.

Fang Pingzhu just watched from the sidelines, feeling nervous. She now somewhat understands why Director Hong asked Ling Ran to take action.

She had heard that Ling Ran was very strong before, but it was only when she met him that she realized how strong he was.

Although the human body is just such a little thing, no matter how many doctors change the tissues and organs, they may not be able to recognize it clearly. It is so difficult to find the bleeding point in a pool of blood.

Fang Pingzhu couldn't help thinking, if someone could save this patient in this state, maybe it was really the young and over-the-top Doctor Ling in front of him.

Ling Ran's moving arm paused for a moment.

Fang Pingzhu couldn't help showing a look of anticipation.

Ling Ran raised his head slowly, looked at Fang Pingzhu and then at the others: "There is no bleeding point."

Fang Pingzhu froze for a moment, feeling helpless, there was no bleeding point, why are you so serious?

Ling Ran's expression was solemn: "It means that it's not bleeding from an exposed organ."

"Maybe I didn't find it." Fang Pingzhu retorted.

"Impossible." Ling Ran shook his head decisively. If the perfect level of hemostasis with bare hands cannot touch the bleeding point, the patient's abdominal cavity will not accumulate so much blood at all.

As far as this point is concerned, his unarmed exploration just now has ruled out many possibilities.

"What do you think?" Fang Pingzhu was not unhappy because of Ling Ran's attitude. The Department of Obstetrics and Gynecology in the hospital sequence has always been known for its rough work, not to mention the comparison with complicated hepatobiliary surgery. Compared with general surgery, the operation of Obstetrics and Gynecology is not difficult. There is nothing wrong with technology.

Ling Ran didn't even care about the psychological activities of the assistants, he just thought briefly, and said: "There is no bleeding point outside the organ, considering the patient's condition...the bleeding in the uterus caused by disseminated vascular coagulation."

"Then the second uterus will be removed." Fang Pingzhu did not comment on Ling Ran's diagnosis. A simple diagnosis is meaningless, the key lies in how to confirm the diagnosis and how to give the correct treatment.

Ling Ran shook his head slightly. He had never had a hysterectomy before, so unlike doctors in obstetrics and gynecology who always wanted to cut the uterus every now and then, Ling Ran stretched out his hand and said, "Absorbable thread."