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Chapter 1473: 【1473】Various hemostasis



   In surgery, what to do with massive bleeding, block the source of the bleeding arteries and veins. In the current situation, doctors are not prepared to perform thoracotomy on the child until the last resort, making it impossible to do so. If you want to block the artery without opening the chest, there is another method, which is commonly used in interventional surgery to embolize the artery. This is an interventional procedure in breathing.

  There is no such intervention in the National Association for Respiratory Surgery, which is also why the National Association for Respiratory Medicine is called a weak department. Technically, it does not reach the height of gastroenterology and cardiovascular medicine, and the treatment of many diseases of the same disease cannot be compared with the traditional history and famous cardiothoracic surgery.

   The most painful thing about the Department of Respiratory Medicine is that he did not perform such an operation, and the Cardiovascular Medicine Department of his hospital was planning to grab the business. Last time, the Department of Cardiovascular Medicine had prepared for pulmonary artery thrombolysis. Not to mention Guozhi, who is well-known in the field of cardiovascular interventional surgery, his pulmonary interventional surgery technology is far better than that of the National Association of Internal Medicine.

   Back to the current case, intervention is impossible. There is no interventional surgery equipment such as an imaging machine in the dental operating room, and they do not carry out interventional surgery.

  You can't use new technology, you can only use old technology. Sometimes the most primitive technology is the most reliable. Because many new technologies are just developed on the basis of old technologies.

  In surgery, teaching medical students to stop bleeding, the first step is not to teach surgery, nor to use any hemostatic drugs, but compression to stop bleeding. The human body has its own coagulation mechanism to stop bleeding on its own. Compression hemostasis is the doctor's use of the body's own blood coagulation mechanism to make the blood vessel break smaller and blood flow slowed down, buying time for these coagulation substances such as platelet fibrin to coagulate at the break to form a thrombus to stop bleeding and reduce the thrombus from running around and unneeded. place to go.

  The first patient Xie Wanying came to China to help rescue was using compression to stop bleeding. Compression hemostasis is not limited to on-site emergency first aid. In surgery, doctors often use compression to stop bleeding.

   For example, the balloon mentioned before in endoscopic surgery and interventional surgery. The balloon is a magic weapon for doctors and has many uses. It can be used to dilate the lumen, dilate the inner diameter of the digestive tract and the inner diameter of the blood vessel to clear the blocked narrow mouth.

What is another function of   balloon? Xie Wanying had seen it when she went to practice at the Second General School of Foreign Studies. The three-lumen and two-capsule tube was compressed to stop the bleeding.

   Now, can I use a three-lumen two-capsule tube to cut a section to stop the bleeding? No, the tube is too thick. The human digestive tract is much thicker than the trachea, let alone the trachea of ​​children. It doesn't matter, the principle is general. Make a similar balloon yourself.

   So I thought of sterile gloves. Gloves are made into balloons to stop bleeding. There is a precedent in the surgical circle, which is in obstetrics. Obstetrics common water bladder hemostasis. The doctor injects normal saline into sterile gloves to tie it up into a spherical water sac, and puts it into the uterus of the bleeding mother to compress the bleeding uterine wall to stop the bleeding.

   Obstetricians no longer need such rudimentary self-made tools. Medical device manufacturers produce various obstetric hemostatic balloons for doctors to choose from according to clinical needs. Moreover, when this method was first invented, doctors did not use sterile gloves and water bladders, but catheters and condoms.

   (end of this chapter)


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