In my anesthesia career, I have gone through too many unforgettable cases. One example is one that I have always had in mind.
This patient, only in his early 30s. However, fate seemed to have played a big joke on her: she had been looking forward to having a child. After a few months of "pregnancy", I was told by the doctor that it was not a child in the stomach, but a huge tumor.
Hearing the word "tumor", she felt that the sky would collapse at once. What made her even more desperate was that this matchmaking marriage also ended. In just a few days, her husband and in-laws disappeared without a trace.
Because there is no financial resource, I can only let my stomach grow day by day. Among them, it is not just the reason for the lack of money. The doctors in the ten miles and eight townships had all seen it, and they all shook their heads and said that there was no good way. I have also been to some hospitals and said that the risk is very high. Such a large "tumor", there will be a danger during surgery.
At seven months, the stomach was already several times the size of a "full-term child".
At this time, the huge consumption of the mass had made her unable to stand up. Even people who did not understand medicine at all could see at a glance that she was seriously ill. The deep eye sockets and thin arms make people feel that she is running out of time.
Just then, someone told her: Let's go to the hospital again! Previously, although all doctors suspected it to be malignant, there was no diagnosis. If you are diagnosed, recognize it again.
In fact, she did not recognize. However, she could not move. Looking at her elderly parents, her heart was crying all the time.
With the help of well-wishers, her parents dragged her by car to a hospital with better technical strength.
When she arrived at the hospital, despite the strong technical strength of the hospital, she couldn't help but feel frightened in the face of this stomach that was almost equal to her weight. The young doctor, even seeing this belly that seemed to be broken at any time, did not dare to lean forward.
At the key point of the discussion, it was agreed that there was a chance of complete resection, but there was a possibility of heavy bleeding during surgery. Once there is excessive bleeding during the resection process or a sharp drop in blood volume during the process of lifting the tumor, it may lead to the inability to get off the operating table.
Therefore, whether the operation can be successful or not, in addition to the close cooperation of all parties, but also the full support of the anesthesiology department.
The question was thrown to our anesthesiology department, and we immediately had a general discussion.
Until then, our confidence was very strong. It can be said that as long as the surgeon dares to do it, the anesthesiology department dares to numb. However, when they saw this patient, everyone frowned.
First of all, the nature of the tumor is unknown. If it is malignant, it is very likely that the blood circulation is very rich. Adhesions to surrounding tissues can cause a large amount of bleeding. This means that you need to be prepared for a large number of blood transfusions.
Second, even if it can be completely removed. Lifting this tumor of tens of kilograms is bound to cause the blood vessels under pressure in the abdominal and pelvic cavity to quickly return to a state of fullness. This process can lead to a sharp decrease in the preload of the heart, and even the occurrence of hypovolemic shock and cardiac arrest.
Again, even if she resisted the heavy bleeding, whether her body, which was only more than thirty kilograms, could digest a large amount of fluids and blood in time was a problem.
In short, as long as there is a problem in one link, it will definitely be abandoned.
Objectively speaking, no one can guarantee 100% technically. However, if the attitude of patients and families is resolute, it can also make everyone dare to take this job.
In the next communication session, what immediately increased everyone's confidence was that the patients and families had one attitude: handed over to the hospital. Whatever went wrong, I recognized it. Her father patted his chest and said: Never trouble the hospital, and dig a pit on the mountain. If it is not saved, it will be buried directly.
What reason can such patients and families refuse?
After a week of preparation, the surgery officially began.
In order to ensure that she could be transfused and rehydrated in a timely and effective manner, we performed a puncture catheter on her internal jugular vein. The catheter in this position can ensure that the drug or liquid reaches the heart quickly and works the fastest.
For such a large operation, arterial puncture is also essential. By monitoring blood pressure through the arteries, any fluctuations in blood pressure can be detected in time.
Before the operation, the function on the operating table was specially tested. When hypovolemia occurs, it is guaranteed to adjust to a low head anti-shock at the first time.
With the preparation of various vasoactive drugs and the preparation of 20,000 ml of blood, anesthesia began.
After the anesthesia began, the huge tumor quickly pressed into the inferior vena cava. Seeing that her blood pressure seemed to drop off a cliff, everyone quickly lifted her stomach on both sides. Rapid remission of blood pressure proves that you have just experienced supine hypotension syndrome.
In order to prevent this situation from happening again, the nurse found two leg supports and a thick sheet on the mat to get stuck and support the stomach.
After the operation begins, the surgeon carefully treats each "green tendon" on the belly. As we all know, the accumulation of small amounts into many, every blood vessel bleeding like a "green tendon" may be related to success or failure.
To everyone's delight, after opening the abdominal cavity, the tumor did not stick. The surface of the light not only indicates that the difficulty of surgery is greatly reduced, but also indicates that this may be benign. The difference between good and evil is a different fate.
Looking at this young face who has not yet experienced the taste of life, we all pray for her in our hearts.
After the tumor is completely removed, the stumps after the tumor are removed begin to gradually reveal its true face. The blood vessels that had been squeezed for a long time began to revive and begin to bleed.
In this way, while going all out to "rush repair", many groups of people and horses went all out to transfuse blood and maintain blood pressure.
Finally, half an hour later, the battle ended in our victory – she could step down safely.
Looking at the blood transfusion bags on the ground, everyone looked at each other and smiled. This smile heralded her rebirth.
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