My Medical Skills Give Me Experience Points

Chapter 1351: Chapter 535: Accident Triggered by Anesthesia, One Person’s Strength Is Ultimately Limited_2

The translation of the provided text is as follows:

"When I examined the patient earlier, I pressed his swollen area on the left side, and it was hard, like stone, with limbs feeling cold. This indicates that the muscle tissues have already necrotized, and the optimal treatment window has long been missed."

During the examination, it seemed he was just casually pressing around, but Zhou Can, relying on his extensive diagnostic experience, directly assessed the patient’s condition.

"That’s correct; your analysis is very pertinent. You believe the kidney failure is related to the compression injury on the limb, right?"

Director Lou nodded in deep agreement after hearing this.

The young doctors nearby quietly took notes, recording Zhou Can’s analysis to be referenced for future learning and as a lesson.

"Due to the necrosis of the muscle on the left side, the swelling hardens, which leads to significant local exudation or bleeding and eventually results in a reduction in overall blood volume. The patient’s low blood pressure serves as the best evidence of this. When the overall blood volume decreases, the renal blood perfusion diminishes, leading to ischemia. Additionally, toxic substances released from necrotized muscle tissues due to compression further exacerbate renal poisoning. At this stage, myoglobin deposits occur, directly blocking the renal tubules and leading to acute renal failure in the patient."

Zhou Can meticulously dissected the complete process of renal failure, deeply impressing Director Lou with his analysis.

Other doctors and nurses looked at Zhou Can with eyes filled with admiration and respect.

"It’s a pity the patient is so young, with a life so delayed. If complications had been addressed timely post-surgery, there might have been a chance to save him. Now, he has entered an irreversible stage of acute renal failure and respiratory failure; it’s beyond remedy, gravely ill."

Zhou Can did not openly state that the Third Hospital had delayed the patient’s life.

However, one could clearly see the lapses and errors in the Third Hospital’s treatment process from his analysis.

This is a typical severe medical accident.

...

In the evening, after finishing surgery in the Emergency Department, completing rounds, and eating the delicious food delivered by Su Qianqian, Zhou Can hurried to the Cardiothoracic Surgery.

A heap of matters awaited his attention.

The old cadre had already agreed to surgery; how exactly the family was persuaded is unclear.

This is typical in hospitals; families and patients have to adapt to the hospital’s diagnostic and treatment protocols, rather than follow their own desires.

This old cadre’s medical expenses can be reimbursed almost entirely; his family is not short on funds either. His daughter-in-law is adamant about choosing the safest ’best’ surgical method, implementing vascular stenting to resolve the issue.

The doctors can’t go along with her idea.

How many stents would need to be placed?

Moreover, the effect will not be satisfactory.

Using an artificial blood vessel to complete a bypass would solve everything directly.

The costs are much lower, and it’s more worry-free and labor-saving, with scarcely any concern about future problems with this vascular segment. The only issue with an artificial vessel is aging, and leakage caused by improper anastomosis.

Let’s first address the aging issue.

The lifespan of an artificial vessel is at least over ten years, with good ones lasting over twenty years.

In fact, using one for thirty years would likely pose no problem.

Because it is sealed within the human body.

Aside from corrosion by blood and bodily fluids, it basically doesn’t have issues with exposure to external air. This undoubtedly can greatly extend its lifespan.

The old cadre is already sixty-five; even if he lives to a hundred, he only has thirty-five years left.

A replaced artificial vessel should suffice for that duration.

Even if there is a problem, he could always come to the hospital for a new one.

Patients who develop arteriosclerosis and systemic conditions like this seldom live to a centenarian age.

Often living to eighty is considered longevity.

The patient’s abdominal aorta, including cardiovascular and cerebral arteries, will continue to worsen. By then, possibly a cerebral hemorrhage or myocardial infarction could strike them down directly.

In the Cardiothoracic Surgery operating room, Zhou Can himself performed surgery on this old cadre.

The patient’s family waited outside the operating room.

How Xue Yan specifically communicated with them, Zhou Can was unaware. He only knew the old cadre requested Zhou Can personally undertake his surgery.

The more distinguished the patient, the more they demand treatment from renowned doctors.

Following Zhou Can’s intraoperative exploration, he ultimately selected an artificial vessel measuring 38CM in length and about 8mm in diameter to perform a bypass from the right femoral artery to the popliteal artery for the patient.

Considering the necrosis and blackening seen in the fourth toe of the right foot, preservation was no longer possible.

Preoperatively, with the patient’s and family’s consent, an amputation surgery was conducted.

This was considered to minimize the harm.

Other hospitals suggested a right leg amputation to save his life.

With Zhou Can here, removing just one toe truly represented the best outcome.

Postoperatively, testing revealed restored blood flow in the right foot, popliteal artery, and dorsal pedal artery. With detectable speed through the naked eye, the patient’s right foot’s skin surface began to show a hint of redness.

Compared to its previous pallor and coldness, it now had some tint of blood.

This indicates that the blood flow in the right foot has been restored smoothly.

With nourishment and supply of qi and blood, the right foot shouldn’t suffer from necrosis further.

"After surgery, ensure thorough anti-infection treatment and closely monitor the right foot’s condition. If ischemia or further necrosis occurs, handle it promptly."

Zhou Can instructed the circulating nurse.

"Understood."

The circulating nurse respected Zhou Can deeply.

The Cardiothoracic Surgery operating room is essentially Zhou Can’s territory. The nurses and doctors here highly recognize Zhou Can’s prowess and deeply trust him.