The spleen was shattered like tofu. Xie Wanying recalled the test questions that Senior Brother Tao gave to surgical students. The real surgical scene was much more severe than Senior Brother Tao's test questions. Now this spleen was not something she could sew back together with a few needles.
For grade three or four spleen rupture, the only option is complete splenectomy.
If the entire spleen including the splenic hilum is removed, the doctor needs to consider it more carefully considering the child's young age and future growth space.
Xie Wanying remembered what she had said to Guo Wengui. Although she spoke rationally to the family members, she still couldn't bear it emotionally.
"Teacher Nie. The child's OPSI is very high, higher than that of an adult, probably because the spleen was completely removed. If the spleen is retained, it will be more meaningful for the child. The spleen not only stores blood, but also has hematopoietic function and irreplaceable immune function for a period of time for children, as well as anti-tumor function in the future." After Xie Wanying said these words, she also knew that there was only this little time for the teacher to consider. Now it all depends on how the teacher decides. The teacher has more experience than she does, and I believe he can make the best choice for the child.
Complete resection is a one-time solution. If you want to save the spleen, you can only do autologous spleen tissue transplantation. The biggest problem with autologous spleen tissue transplantation is the postoperative period.
It is true that children need to pay more attention to OPSI than adults, but autologous spleen tissue transplantation also has the risk of necrosis and infection. In addition, it is necessary to observe the child's spleen function for a long time after surgery, which requires the supervision of professional doctors.
If the patient had the surgery in their own hospital, everything would be easy to follow up. But now it is not the case. It is hard to say whether the patient can be guaranteed to have a professional doctor to take care of the follow-up treatment. He saw the condition of the county hospital with his own eyes tonight.
Taking these into consideration, Nie Jiamin had already made the decision before the operation that if this problem could not be solved, she would have to undergo a total resection.
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What he didn't expect was that the student opposite him suddenly asked him this.
"Haven't you considered other issues?" Nie Jiamin asked her deliberately. Because he knew she had the ability, he hoped to guide her to be more thoughtful and careful as a doctor in the future.
"Teacher Nie." Xie Wanying did not stop cooperating with the teacher's hands. The cooperation between the teacher and the students was to free the spleen pedicle, and this step had to be done regardless of whether it was an autologous spleen tissue transplant. At the same time, she continued, "If it is a postoperative problem, I personally don't think there is any need to worry too much. This place is not far from the capital, so it is okay to let them come to the National Association for follow-up treatment."
It seemed that she knew what he was worried about. He was not very clear about how domestic patients were transferred to other hospitals and whether they could be transferred after surgery. She asked, "Do you think she can be transferred to the National Association?"
"She was the victim of a car accident, and the medical bills are to be paid by the driver who caused the accident."
The first criterion for whether a domestic patient can be transferred to another hospital is whether they have enough money. Nie Jiamin understood what she meant and told her, "For overseas patients, it depends on their insurance."
Maybe Teacher Nie was touched when she heard about Qian, and she was deeply moved, so she talked to her about the situation abroad.
The obstacle was resolved, and the child was given an autologous spleen transplant. Three vascular clamps were used to clamp the splenic pedicle close to the splenic hilum, and the splenic pedicle between the two hemostatic clamps near the spleen was cut open. The spleen with the vascular clamps was placed in a balanced solution prepared at 4 degrees Celsius outside the body.
First, the blood vessels of the splenic pedicle were double ligated to stop the bleeding. The blood finally stopped gushing out like a fountain. The abdominal cavity was explored and no other organs were ruptured and bleeding. The child's blood pressure stabilized.
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