PD :: Volume #4

#339: The polyether ether ketone in head 【Asked a monthly ticket】

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The multi- country joint forces reappear in Isla Salas y Gómez, in local time on September 18 , 2021. 多国联合部队重新出现在萨拉戈麦斯岛,是在当地时间2021年9月18日。 That evening 18 : 12, rescued the team to start to give Gu Jun in the operating room to make ecmo ; He in 18 : 37 resumes the weak cardiac impulse, reflected that ventricle the ef value of contraction pump blood function only 10, but the normal value is 50-70 ; Because its right side temporal lobe large surface area hemorrhage, the neurosurgery department team of Sikou prominent chief surgeon in 18 : 42 starts to make the temporal lobe to open the skull technique to him. 这天傍晚的18:12,抢救团队在手术室开始给顾俊做ecmo;他在18:37恢复微弱的心脏搏动,反映心室的收缩泵血功能的ef值仅有十,而正常值是50-70;因为其右侧额叶大面积出血,司寇显主刀的神经外科团队在18:42给他开始做额叶开颅术。 Makes the margin, opens the skin flap, the skull drill hole, opens the bone petal, removes the bone petal, cuts open the dura mater, eliminates the haematoma, sutures, drainage. 做切口,开皮瓣,颅骨钻孔,开骨瓣,去除骨瓣,切开硬脑膜,清除血肿,缝合,引流。 Because considered on his condition, if retains the bone petal, initiating the skull to press, technique back of the head edema and other risks of complication to be bigger high, that needed two surgeries, that may crash his life, therefore the team chose the elimination bone petal. His right volume some skulls did not have, under the scalp is the dura mater, looks that the less than half side forehead collapsed softly. If he can support, later makes the repair a skull technique. 因为就他的病情考虑,如果保留骨瓣,引发颅压高、术后脑水肿等并发症的风险更大,那就需要二次手术了,那可能会压垮他的命,所以团队选择去除骨瓣。他的右额一部分头骨没了,头皮下就是硬脑膜,看着小半边额头软绵绵地塌了下去。如果他能撑得过来,以后再做颅骨修复术。 Because he does not have other brains to frustrate the lacerated wound, therefore this opened the skull technique only to use for 4 hours to complete, the surgery ended on this day 22 : 56. 由于他没有其它的脑挫裂伤,因此这场开颅术只用了四个多小时就完成,手术结束于这天22:56。 The orthopedics team that orthopedics expert Wang Hui Kang Dailing received the neurosurgery department the surgery table main force position. 紧接着,骨科专家王辉康带领的骨科团队接过神经外科的手术台主力位置。 They conducted clear of many soft tissue to create the suturing to Gu Jun, in the double upper limb palm, phalanx, oar, ulna, the left lower limb shinbone platform and other bone fracture incisions of positions repositioned the pexia, shoulder joint dislocation open reduction. 他们给顾俊进行了多处软组织的清创缝合术,双上肢掌、指骨、桡、尺骨、左下肢胫骨平台等多个位置的骨折切开复位内固定术,还有肩关节脱位切开复位术。 The doctors can judge from his these injuries, Gu Jun crashed from the upper air at that time is both hands is first well-grounded to support the brace, then the right volume knocked, the left leg supported the brace, therefore the upper limb injury was serious, but the lower limb injury was less serious. Also because just the right lower limb does not have bone fracture, gave ecmo ideal v-a to turn the intubation position. 医生们从他的这些伤势可以判断出,顾俊当时从高空坠落是双手先着地撑了撑,然后右额磕了一下,左脚撑了撑,因此上肢伤势重而下肢伤势轻。也正因为右下肢没有骨折情况,给了ecmo一个理想的v-a转流插管位置。 These surgeries do one after another, does is 22 hours, when to orthopedics team numerous stops, is night of September 19 21 : 25. 这些手术陆续地做,一做就是22个小时,到骨科团队众员停下来时,已是9月19日晚上的21:25。 During this period, Liu Mingfeng brings the ecmo team has been making the observation and adjustment to the plant parameter. These surgeries brought more difficult problems to the stable running of ecmo, is good has the rich experience because of the team, the cardiopulmonary support to Gu Jun and limbs blood maintains good for and backflow. 在此期间,刘明峰带着的ecmo团队一直对设备参数做着观察和调整。这些手术给ecmo的稳定运行带来了更多的难题,好在团队有着丰富的经验,对顾俊的心肺支持、肢体血供及回流都维持良好。 The Li to become, Zhang Zeli of heart internal medicine department and heart surgical department and other expert personnel do not dare to have one minute/share one second of lax. 心内科和心外科的李成、张泽丽等专家人员也不敢有一分一秒的松懈。 Although Gu Jun restored the independent heartbeat, but the end circulation and putsation are extremely bad, the hemodynamics fluctuation is big, such a is only the heart of 22 -year-old young people, moreover previous physical examination result his heart can jump to 120 years old simply, now actually looks like wants the myocardial infarction and heart failure momentarily. 顾俊虽然恢复了自主心跳,但是末梢循环及搏动极差,血流动力学波动大,这么一个才22岁年轻人的心脏,而且上次体检结果他的心脏简直可以跳到120岁,现在却像随时要心肌梗塞和心力衰竭。 However under the team fights bravely strongly, in technique he has not had two hearts to stop suddenly, the hemodynamics tends to be steady, the ef value of heart rose 20, resumed the weak autonomous respiration. 不过在团队竭力奋战下,术中他没有发生二次心脏骤停,血流动力学趋于平稳,心脏的ef值上升到了20,也恢复了微弱的自主呼吸。 By this time, rescued the team finally saying that oneself won recaptured the Gu Jun first weaponry from the dark abyss. 到了这个时候,抢救团队终于可以说,自己打赢了从黑暗深渊中夺回顾俊的第一仗。 The operating room and everyone loosen on the control center and corridor has the one breath slightly, but after afterward matter proved the technique, is the long test. 手术室、指挥中心、走廊上的所有人都微微松出一口气,但后来的事情还是证明了术后是漫长的考验。 On the morning of September 20, the Gu Jun ef value dropped to amp again ; lt ; 10 th, the sternum showed that his two-sided chest cavity has a lot of fluids, the double lung seeps out the inflammation to infect, electrolyte disorder and other symptoms...... the rescue team arrived at the surgery table to handle these complications again, this another fought bravely is more than 30 hours. 在9月20日上午,顾俊的ef值再度下降至amp;lt;十,胸片显示他双侧胸腔有大量积液,双肺渗出有炎症感染,还有电解质紊乱等症状……抢救团队再次到了手术台边处理这些并发症,这又一奋战又是30多个小时。 Was this year Mid-Autumn Festival on the 21 st, they passed in the operating room, Wu Shiyu and egg uncle and the others also passed on the destroyer. 21日就是这年的中秋节,他们是在手术室中度过的,吴时雨、蛋叔等人也都在驱逐舰上度过。 The Gu Jun opening skull technique completes the quality to be high, after has not presented the technique, complication, this perhaps was only two good deeds. 顾俊的开颅术完成质量高,没有出现术后并发症,这也许是唯二的好事了。 Another good deed is his ecmo sets at the manages place not to have the oozing of blood, has not created to the right lower limb swelling. 另一个好事是他的ecmo置管处没有渗血,也没给右下肢造成肿胀。 Supported had started these days, the Gu Jun condition toward a good direction went, but the team is continuing the care. After technique, one week of time , the ef value climbed to 30 on the 25 th, was separated from the specific weight to decrease ; Again after technique, October 2 of two weeks of time, the ef value climbed to 40, decreased mildly, the heart is out of the danger. 撑过了开始这几天,顾俊的病情就朝着好的方向去了,而团队继续着护理。到了术后一周时间的25日,ef值升至30,脱离重度减低;再到术后两周时间的10月2日,ef值升至40,轻度减低,心脏已是脱离危险。 The other targets of his body have also stabilized, therefore ecmo 14 days later, the team gave him to remove outside this individual to circulate, and changed over to the icu hospital ward him. 他身体的其它指标也已稳定,于是在ecmo十四天之后,团队给他撤除了这个体外循环,并把他转入icu病房。 At this time, Gu Jun they were also shipped back the secret bureau headquarters in Dahua city to conduct the follow-up treatment. 这个时候,顾俊他们也被运回大华市的天机局总部进行后续的医治。 Deng Ximei had waked when September 23, although some headache symptoms, but the intelligence does not have the issue, does not have the danger, but she is very silent. 邓惜玫在9月23日时就已经醒过来了,虽然有些头痛症状,但神智没问题,也无生命危险,不过她很沉默。 In view of the fact that she performance in this action, she officially becomes one of the secret bureau incantation technique section. Master Tong and the others send to her with the great expectations, hopes that she can bring into full play oneself potential, makes up for Gu Jun not when the vacancy. But temporarily she also needs to accept restores to treat. 鉴于她在本次行动中的表现,她正式成为天机局咒术部的一员。通爷等人都对她寄以厚望,希望她可以充分发挥出自己的潜能,弥补顾俊不在时的空缺。但暂时她还需要接受很多恢复治疗。 Deng Ximei awakens makes everyone very happy, however on October 6, the mood of people fell into the valley. 邓惜玫的苏醒让大家都非常高兴,然而在10月6日,众人的心情又落入谷底。 After this is Xue Ba makes ecmo the 18 th day, presented the blood infection, the concurrent liver, kidney and other organ failures, the medical team is completely all methods with diligently, but ends in failure, at that night 23 : 36 point, the team announced the death of Xue Ba. 这是薛霸做ecmo后的第18天,出现了血液感染,并发肝、肾等多器官衰竭,医疗团队已是尽了一切的手段与努力,但还是以失败告终,在这天晚上的23:36分,团队宣布了薛霸的死亡。 This news regarding each of secret bureau, is very serious. 这个消息对于天机局的每一位来说,都是非常沉重。 Xue Ba, Dongzhou hunts for the demon person squad teams leader to come, has grown into incantation technique section- secret bureau the key talent, passes in 39 years old. 薛霸,东州市猎魔人小队队长出身,早已成长为咒术部-天机局-goa的重要人才,逝于39岁。 Gu Jun that side situation is not optimistic, the heartbeat breathed restored, the anesthetic had scattered, the consciousness had not actually regained consciousness, the electroencephalogram did not see what sign, all are aiming at the cognitive death possibility: His body is also living, but he will not wake. 顾俊那边的情况也不乐观,心跳呼吸都恢复了,麻药早就撒了,意识却一直没有苏醒,脑电图也不见有什么迹象,一切都在指向脑死亡的可能:他的机体还活着,但他再也不会醒过来了。 The issue of this cranial nerve, the experts could not reach an agreement, may be unable to awake forever, there is a possibility to awake tomorrow, or one year later, ten years later...... 这种脑神经的问题,专家们也都说不好,有可能永远醒不了,也有可能明天就醒,或者一年后、十年后…… The time passes by day-by-day. In his stupor's October 18 of 30 th day, has not woken up. 时间一天天地过去。在他昏迷第30天的10月18日,还是没有醒来。 On this day, the secret bureau held the funeral to Xue Ba, buries in Tianji the martyrs'cemetery. The people attended, but Gu Jun absence. 在这天,天机局给薛霸举行了葬礼,下葬于天机烈士陵园。众人都出席了,但顾俊缺席。 Enters 60 th day in his stupor, the shooting result showed that his bone fracture restores good, the medical team gave him to demolish the gypsum one after another. 在他昏迷进入第60天,拍片结果显示他的骨折恢复良好,医疗团队给他陆续拆除了石膏。 Even Gu Jun possibly is a vegetable, the recovery branch personnel in team may not have laxly, every day turns over/stands up, massages for him wait/etc fixed time, is maintaining his function as far as possible. Therefore although his whole person thin a great-circle, does not have the degree of whole body ischemic muscular atrophy. 即使顾俊可能已经是植物人,团队中的康复科人员可没有松懈,每天为他定时翻身、按摩等等,尽量保持着他的机能。因此虽然他整个人瘦了一大圈,却没有全身肌肉萎缩的程度。 In his stupor's December 18 of 90 th day, after the temporal lobe opened the skull technique technique, three months, the team made the repair a skull technique to him, what used is at present best skull-repair material polyether ether ketone ( peek ), with the human bones seamless connectivity, heat insulation, degree of hardness and other performance was good enough. 在他昏迷第90天的12月18日,额叶开颅术术后三个月,团队给他做了颅骨修复术,用的是目前最好的颅骨修补材料聚醚醚酮(peek),与人骨无缝连接,隔热、硬度等性能都足够好。 The surgery does very smoothly, henceforth in the head of Gu Jun were many polyether ether ketone, but there is a scalp to cover, the outward appearance cannot look, is that appearance. 手术做得很顺利,从此顾俊的头颅里多了块聚醚醚酮,不过有头皮掩盖着,外观是看不出来的,还是那个样子。 Time by December 31, this year last day, Gu Jun stupor 103 rd day, in 2022 soon arrived, but he still has not regained consciousness. 时间到了12月31日,这年的最后一天,顾俊昏迷的第103天,2022年快要到来了,而他依然没有苏醒。
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