2564 Chapter 2564 [2564]
For a long time, I couldn't remember what the knowledge point she said was. Fortunately, he is also a top student, so he is smart, knowing to run behind classmate Xie and ask, "What do you mean?"
He blushed a little while asking, he must have remembered the days when he laughed at Geng Lingfei, saying that he was an idiot for following classmate Xie, but now he is an idiot.
"The chest was not closed at the end of the operation." Xie Wanying is a modest person, she will not pretend to be arrogant and ignore her classmates, she will answer within the time limit for answering.
At this moment, Dai Nanhui's heart was suddenly touched.
The two ran to the next ward.
Xiaohui lying on the snow-white sheets, with a snow-white face, a ventilator connected to the endotracheal tube in the small throat, and other mechanical tubes connected to other parts of her body, like a broken doll that only relies on the machine to support its life. It's heartbreaking.
Xie Wanying carefully lifted the child's quilt with her hand, exposing the child's chest.
Seeing the transparent dressing on the child's chest, Dai Nanhui finally remembered the relevant knowledge: "It's the sternum that doesn't matter."
Delayed chest closure, as Mr. Xie said, the surgeon did not close the chest cavity of the patient according to the conventional surgical procedure at the end of the operation. The most important step in closing the chest is closing the sternum.
Why don't doctors close the sternum?
Most of the time, the doctor does not close it because it is found that the chest cavity cannot be closed after the operation.
so weird? Can the sternum not be pulled up? Can the deadlift be pulled up?
To be precise, when the chest cavity is closed, the patient's life will be lost, so it cannot be closed. This situation is specifically reflected in the fact that after closing the sternum, the heart may be compressed and cause a cardiac crisis. The large blood vessels of the heart may not stop bleeding and need to be stuffed with open chest gauze to stop the bleeding.
What are the benefits of not closing the median sternotomy and keeping the sternum open? It can expand the volume of the patient's mediastinum, reduce the pressure on the heart, mainly the external pressure on the ventricular wall, and increase the volume at the end of diastole, all of which are conducive to stabilizing the patient's blood circulation and breathing.
Delayed chest closure does not mean that the patient's sternum is really not closed, it just waits for the patient's critical situation to pass before closing the sternum.
What to do with the open heart without closing the breastbone? The doctor may sew the outer skin shut. In view of the critical phenomenon that such patients may need to be rescued at any time, many doctors now choose to only cover the wound with a layer of sterile transparent surgical film for protection.
If you look closely, through the transparent film, you can see that the unclosed sternum is being opened with a sternum spreader.
What should we do in this situation? Do chest compressions and defibrillation? Dai Nanhui's mind turned to this, and suddenly saw Xie Wanying in front of him in action, worried and shouted: "What do you want to do?"
Xie Wanying's eyes locked on the ECG data on the screen of the ECG monitor, and immediately rushed to the ambulance prepared by the nurses in the corner of the ward as quickly as possible, grabbed the sterile gloves on the upper layer, tore off the outer packaging, and skillfully put on the gloves .
"Do you want to give her chest compressions?" Feeling that she might do such an operation wearing gloves, Dai Nanhui was frightened and shouted anxiously.
There is no time to answer this time, and the things to be done may be a bit complicated and difficult to explain in a short time. Xie Wanying didn't speak, and in a blink of an eye she returned to the hospital bed wearing gloves, and gently lifted the film covering the incision to observe with both eyes.