"Section chief Wu..." President Zhou had finished the operation, but he was still wearing surgical clothes and stood in front of the stage to observe Wang Chengfa.
When he heard footsteps, he saw Wu Mian coming in and said quickly.
Wu Mian didn''t speak. He first glanced at the ventilator and monitor. Seeing that the value was stable, he glanced at Wang Chengfa lying on the operating table.
Wang Chengfa has changed to general anesthesia, with a ventilator inserted, and his chest rises and falls with the rhythm of the ventilator.
On his lips and corners of his mouth, he could still see the blood that had just been wiped off and had not been wiped clean in a hurry.
"Section chief Wu, director Wang is in a stable state," said the director of the court Zhou, knowing that Wu Mian was angry.
Wu Mian opened the sterile sheet, glanced at Wang Chengfa''s abdomen and asked, "did the incision on the pubis do?"
"Yes, yes."
"President Zhou," said Wu Mian in a deep voice, "I''m not complaining about you. You''re also an old urologist. You''ve done at least hundreds of prostate operations. How can you not even know the electrosurgical syndrome?"
"..." President Zhou looked like a child who had made a mistake, lowered his head and said, "I usually do suprapubic incision, and the patients who open the bladder are very stable. Who knows what happened this time."
Wu Mian sighed and said, "tell me about the specific situation."
"After Lao Wang was admitted to the hospital, blood routine: hb96gl, renal function: creatinine 378.0umoll, urea nitrogen 21.83mmoll, blood glucose 9.2mmol, abnormal renal function. Considering the long-term post renal obstruction, the urinary catheter was reserved, and the renal function was rechecked after 1 week: creatinine 147.4umoll, urea nitrogen 11.75mmoll."
* preoperative diagnosis: 1. BPH. 2. chronic urinary retention. 3. chronic renal insufficiency.
While talking, President Zhou peeked at Wu Mian. For fear that he didn''t say anything right, section chief Wu stuck himself to the wall.
The blood splashed by traffickers is still vivid. President Zhou thinks he is in good health, but he can''t carry chief Wu''s feet.
However, Wu Mian was noncommittal after hearing these medical histories. President Zhou could only go on with his words.
"Electric prostatectomy was performed through suprapubic incision under hard anesthesia. 5% mannitol flushing solution was used during the operation. Lao Wang coughed about 35 minutes after the operation. At that time, I asked him if he had any special feelings, and Lao Wang said there was nothing uncomfortable.
The vital signs monitored during the operation were stable, the operation went smoothly, and there was not much bleeding. About 45 minutes later, when the operation was about to end, Lao Wang suddenly began to agitate.
Tell him not to speak, he is out of his mind, and there is pink blood foam in his mouth and nose. "
According to the medical history report... Wu Mian resisted his unhappiness and asked, "how much salt water was used to rinse?"
"Er..." Dean Zhou was stunned.
Wu Mian glanced at the itinerant nurse.
"Section chief Wu, 5000ML normal saline." the nurse''s brain was still smart and hit ten bottles of 500ml normal saline, which was not difficult to calculate.
"How much?" Wu Mian continued.
Dean Zhou and the nurse all looked confused. Chu Zhixi hurried to the bucket of the attractor and said after calculation, "brother, draw out about 3150ml."
"Dean Zhou, do you know what is electroresection syndrome?" Wu Mian asked.
"..." President Zhou was speechless.
Wu Mian didn''t explain either. He moved a chair and sat next to the ventilator and said, "check the blood gas analysis. Have you seen the serum ions?"
"No..."
"Cha, call the laboratory department and let them get the results as soon as possible. Give 250ml mannitol and another sodium bicarbonate. Match the blood and give 200ml plasma as soon as possible." Wu Mian whispered.
The itinerant nurse just relaxed, but when she saw that director Wu''s face was not good, she also beat the drum in her heart. She tried to remember the various doctor''s orders just said by section chief Wu. People ran directly and began to take blood without touching their feet.
Venous blood was drawn out smoothly, and the needle could not enter when collecting arterial blood gas.
Chu Zhixi whispered, "I''ll come."
The nurse looked at Chu Zhixi gratefully and saw that she skillfully touched the position of the femoral artery, disinfected, injected, and extracted arterial blood at one go.
"Xiao Chu, you are so skilled," the nurse whispered.
"Send blood quickly and tell the laboratory to give the results as soon as possible." Chu Zhixi told him.
"Oh." the itinerant nurse immediately ran out. Director Zhou was worried and called to tell the laboratory department to hurry up.
After 20 minutes, the results returned one after another.
Electrolyte na119mmoll, cl84.7mmol, blood gas analysis tips: ph7.22, po249mmhg.
After a series of disposal, Wang Chengfa''s consciousness recovered, so that he could open his eyes.
The peripheral blood oxygen saturation was maintained above 95%, and the reexamination return was ph7.24, po275mhg, na120moll.
The heart rate on ECG monitoring was 97 minutes, 18 breaths, bp8963mmhg, spo296%.
"Use the ventilator for another day." Wu Mian frowned and said, "do any nurses below understand the ventilator?"
Dean Zhou shook his head.
"Girl, call Li Qiong and ask her to help." Wu Mian said.
"OK."
With that, Wu Mian stood up, "Dean Zhou, this pass should be over. Urethral resection of the prostate syndrome, also known as diluted hyponatremia.
It refers to diluted hyponatremia caused by massive and rapid absorption of postoperative flushing fluid through the surgical wound during transurethral resection of the prostate, and excessive blood volume as the main clinical symptoms. "
"Yes." President Zhou didn''t know whether he understood Wu Mian''s words, but he replied repeatedly.
"Pulmonary edema, brain edema, heart failure and disturbance of consciousness are the main complications. Watch it carefully." Wu Mian thought, "girl, ask Wei Dabao what to do and let him come and see it for a day."
"If tomorrow''s review results are all right, pull out the tube." Wu Mian said, "President Zhou, have an operation..."
Wu Mian wanted to say a few words, but when he looked back, he saw President Zhou lowering his head. He seemed to be listening to himself carefully. He couldn''t help but feel depressed.
He sighed.
It''s not appropriate to leave at this time. At least wait until Wei Dabao and Li Qiong come.
Conveniently picked up the medical record on the anesthesia flat car, turned and sat down. While looking through the medical record, he said, "President Zhou, go back and read the book first. If you don''t understand anything, ask me at any time."
"Yes, I know chief Wu." President Zhou still said yes like his third grandson.
As soon as he finished speaking, director Zhou suddenly felt that the air around him was stagnant, and the sound of ice could be heard vaguely.
This is... Director Zhou raised his head suspiciously and didn''t know what had happened.
Wu Mian sat on the stool in the operating room, turned and held the medical record in his right hand. The paper signed before the operation appeared in front of President Zhou.
"Dean Zhou, why didn''t you sign before the operation?" Wu Mian asked in a tight voice.
A thunder fell on President Zhou''s head, roaring, and there was a blind sound in his ears.
There was no operation signature, and the patient had an accident. Isn''t it that the house leaks and rains at night!
How? There is no possibilities!
President Zhou quickly recalled everything in the past.