PD :: Volume #6

#542: Right forearm amputation technique

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Dongda Attached Hospital, wound bone surgical department. 东大附属医院,创伤骨外科。 Here every day will diagnose many orthopedics disease patient, the joint wound, bone fracture and arthroscope and joint replaces, orthopedic wait/etc abnormally, is the Dongzhou wound bone surgical department administrative offices second to none, more than 30 doctors, many experts are also large Teacher Bo of Dongda Medical School. 这里每天都会诊治大量的骨科疾病患者,关节创伤、骨折、关节镜、关节置换、畸形矫形等等,是东州首屈一指的创伤骨外科科室,有三十多位医生,其中许多专家也就是东大医学院的硕博导师。 The amputation technique operating room here is the common matter, most times are the emergency medical treatments, sometimes are the pathological changes. 截肢术在这里的手术室是常有的事,多数时候是急诊,有时候是病变。 Head physician Chen transport/fortune prepares to mount the stage straightly a right upper limb amputation technique, this surgery is not special, patient 36 -year-old, the male, contracted the extremity/limb to create a large area of severe burns because of the accident/surprise of workshop work, before transferring here, treated in the town-level hospital, because the wound inflammation could not be under the active control, had not had the condition to perform the skin grafting surgery, presented the tissue-necrosis, suppuration and blood stream to be impeded, the epluchage was not suitable, now the situation can only the amputation. 主任医师陈运平正准备上台一台右上肢截肢术,这台手术并不特别,患者36岁,男性,患肢因为车间工作的意外而造成了大面积的严重烧伤,转来这里之前在镇级医院医治,因为伤口炎症得不到有效控制,还未有条件进行皮肤移植手术,就出现组织坏死、化脓、血流不畅,清创术也不适用了,现在情况只能截肢。 Such case, Chen Yunping the first time was not faced, the right forearm amputation technique, had the surgery difficulty, but grasped in a big way, generally will not leave accidentally/surprisingly. 这样的病例,陈运平也不是第一次面对了,右前臂截肢术,有手术难度,但把握大,一般不会出意外。 However in the conference before the technique, their surgery team was informed suddenly, the secret bureau medicine section sent, must observe and emulate this surgery, the head of Gu Jun belt/bring. 不过就在术前会议上,他们手术团队忽然被告知,天机局医学部派人来了,要观摩这台手术,顾俊带的头。 Now in Dongzhou University and Dongda Attached Hospital, Gu Jun is a celebrity, the pride of Dongda. 如今在东州大学、东大附属医院,顾俊都是一个名人,东大的骄傲。 This news security processing, is known by administrative offices these young nurses, possibly signed the masterpiece to take excitedly. 要不是这个消息保密处理,被科室那些小护士知道,可能签名笔都激动地拿出来了。 Chen Yunping is also quan good, anesthetist Ji is also good, as well as helps, two help and others, does not understand the secret personnel goal. 陈运平也好、麻醉师纪泉也好,以及一助、二助等其他人,都不明白天机人员此行的目的。 Medical section's that side person said seriously: „Because of this surgery, is not others needs to observe and emulate a right extremity/limb amputation technique. Has not told us the reason, the matter of secret bureau, cannot manage. You according to usually such completed your surgery to be good, must have a preparation at heart, may have any unusual circumstance, felt in any case had anything strangely saying that really had an accident, that side the secret personnel will take over.” 医务科那边的人郑重说:“不是因为这场手术,是人家需要观摩一台右肢截肢术。没告诉我们原因,天机局的事情,管不来。你们按平时那样做好自己的手术就行了,也要心里有个准备,可能会出什么异常情况,反正感觉有什么古怪就说出来,真出事了,天机人员那边会接手。” What Gu Jun brings is teams that has more than ten medical personnel, can on it is said at any time the surgery table. 顾俊带着来的是一支有十多位医护人员的团队,据说都是可以随时上手术台的。 In addition one group of fully-armed personnel, but has not worn the white coat, should be the secret personnel of other departments. 另外还有一群全副武装的人员,但没有身着白大褂,应该是其它部门的天机人员。 In the conference before this technique, Chen Yunping they and Gu Jun and the others was meeting, conducted the communication on the patient situation and surgery. 就是在这场术前会议上,陈运平他们和顾俊等人见着面,就患者情况和手术方案都进行了沟通。 „Director Chen, was we disturbs.” Gu Jun is very of modest, the rack no secret hero, Chen Yunping, although is not a professor, actually is also Dongda Medical School postgraduate candidates comes out, is the Gu Jun senior, now truly feels the respect from opposite party. “陈主任,是我们打扰了。”顾俊很是谦虚,没有什么天机英雄的架子,陈运平虽然不是教授,却也是东大医学院博士生出来的,是顾俊的前辈,现在确实感受到了来自对方的尊重。 „No, we understand that the matter of your secret bureau is important.” Chen Yunping said, the sincerity thought so, according to the custom had not asked. “别,我们明白的,你们天机局的事情要紧。”陈运平回道,真心这么觉得,按规矩没有多问。 Gu Jun nods, „is the accident sentiment, but here environment is safe, Director Chen you felt relieved that does.” 顾俊点点头,“是出了点事情,但这里环境还安全,陈主任你们放心做吧。” At present 5 Alien Hand Syndrome patients are the Dongda Attached Hospital emergency medical treatment and orthopedics outpatient service admitting, 目前有五位异手症患者是东大附属医院急诊和骨科门诊收治的, However Chen transport/fortune the equal person is not clear, is duty doctor of knowing the circumstances of the matter, was told should be the biid patient. 不过陈运平等人不清楚,就是知情的当值医生,也被告诉应该是biid患者。 The number of Alien Hand Syndrome patient is still increasing, that side the medicine section base and other patients to Zhou Yibao conducted the artificial stupor, patient's life symptom in stupor is steady, this move also calculates temporarily has the alleviation pain effect. But their right hands still active, but also is struggling, but also is deteriorating. 异手症患者的数量还在增多,医学部基地那边对周毅宝等多位患者进行了人工昏迷,患者在昏迷中的生命体征平稳,这一招暂时还算有缓解痛苦的效果。但他们的右手依然能动,还在挣扎,还在恶化。 Now, that burn amputation patient has been waiting in the operating room, matter cannot be delayed, the group go to outside during operating room changing clothes immediately, changes the aeroseal exposure suit that the secret team brings, prevents the possible accident/surprise. This a little will naturally affect on the flexibility of body, but Chen Yunping received living with the confidence. 现在,那名烧伤截肢患者已经在手术室等着了,事不宜迟,一行人当即前往手术室外面的更衣间,都换上天机团队带来的气密型防护服,防止可能的意外。这对身体的灵活性自然会有一点影响,但陈运平怀着信心接下了活。 Gu Jun had days not to enter the orthopedics operating room, luminous of shadowless lamp, surgery bed, anesthesia machine and monitor...... 顾俊是有一段日子没有走进骨科手术室了,无影灯的光亮,手术床、麻醉机、监护仪…… Had lain with the supine decubitus by the patient of general anesthesia on the black-brown surgery bed, the nurse his sickness side body advance by means of contacts close to the surgery table edge, is abducting as far as possible the sickness extremity/limb, even Zhi on another minor surgery stage, the upper arm is setting at the gasification tourniquet, the life symptom is steady. 已被全麻的患者以仰卧位躺在黑褐色的手术床上,护士把他的病侧躯干缘尽可能地靠近手术台边缘,外展着病肢,平置在另一个小手术台上,上臂置着充气止血带,生命体征平稳。 Gu Jun saw trouble extremity/limb that that only large surface area burns, only then a small section of upper arm is complete, in addition, from the upper arm to the elbow section, the entire small arm, wrist/skill and palm, the skin is black and red, swells and bulge, in the injured area has the sanie everywhere...... 顾俊看到那只大面积烧伤的患肢,只有一小截上臂还算完好,除此之外,从上臂到肘部,整条小臂、手腕和手掌,都皮肤又黑又红,又肿又胀,创面上到处有着脓液…… Even got used to seeing the thing of contamination, even just dissected that to want the strange hundred times of mutton legs, 即使看惯了污秽之物,即使刚刚解剖完那条更要怪异百倍的羊腿, When he has had more than one unprecedented palpitation, because only, in this limbs is linking on the body, has a face of person, the lethargic sleep face. 他还是有过一股多时未有的心悸,只因为在这只肢体连着的躯体上,有着一张人的面孔,昏睡的面孔。 An ordinary middle-aged man, has usually not met with him. 一个平凡的中年男人,与他素未谋面。 But that illusion feeling welled up, from dissecting black mountain sheep Youzai some illusion feelings...... 但那种幻象感又涌来了,从解剖黑山羊幼崽时就有的幻象感…… Bang, bang. 嘭啪,嘭啪。 He hears to have the sound that anything falls to the ground probably. 他好像听到有什么东西落地的声响。 „Director Chen, you start.” Gu Jun sees Chen Yunping they to look, said again: „Does not need to manage us.” “陈主任,你们开始吧。”顾俊见陈运平他们望了望来,再次说道:“不用管我们。” One side he and egg uncle, Zhang Huohuo and others, arrives. 他和蛋叔、张火伙等几人,都走到一边去。 But the Chen transport/fortune equal person arrives at that to set near minor surgery stage that contracts the extremity/limb, must say that suddenly some secret teams look in side, the pressure has not increased that is false, they return to normal the mood, strongly had the attention, took up the instrument, puts out own ability with experiencing. 而陈运平等人走到那个置着患肢的小手术台边,要说突然有天机团队在旁边看着,压力没有增大那是假的,他们把心情平复,集中起了注意力,拿起了器械,拿出自己的能力与经验来。 This is the forearm amputation technique, the truncation bone plane decides 1 / 3 in the upper arm, this position is quite ideal, the skin flap blood supply is good, after the technique, assembles the artificial limb is also suitable. 这是个前臂截肢术,截骨平面定在上臂中1/3处,这个位置比较理想,皮瓣供血不错,术后装配假肢也较适宜。 The first step of surgery, makes the margin. 手术的第一步,就是做切口。 At that moment, Chen Yunping before arranging technique the plan, and other long skin flaps around the scheduled truncation bone graphical design, then with the scalpel along the margin line incision skin, the subcutaneous tissue and deep fascia, drifts away to the near-end to the above of truncation bone plane again. At the same time , helping, two help, instrument nurse and the others, has busy respectively. 当下,陈运平按照定好的术前方案,在预定截骨平面设计前后等长皮瓣,然后拿手术刀沿着切口线切开皮肤、皮下组织及深筋膜,再向近端游离到截骨平面的上方。在这同时,一助、二助、器械护士等人,都各有忙碌。 Gu Jun stands in not far away is looking, not only does not hinder them to perform the surgery, and sees clearly to the situation in technique area. 顾俊就站在不远处望着,既不阻碍他们进行手术,又对术区的情况看得清楚。 Already arm of pyogenic infection, although does has settled to create, was still flowing rapidly the wealth, combines with the blood together. 已经化脓性感染的手臂虽然做过了清创,仍是涌流着脓水,与鲜血一同混杂。 Chen Yunping hand power is stable, has not come under many influences of aeroseal exposure suit, under it leads, the surgery team toward contracting the extremity/limb technique area shuts off the blood vessel, separates and cuts again to the nervus radialis, the median nerve and ruler nerve...... 陈运平的手力非常稳定,没受到气密防护服的多少影响,在其带领下,手术团队往患肢术区切断血管,再分离和切离桡神经、正中神经和尺神经…… In the operating room is very peaceful, the people concentrate on the middle of this surgery. 手术室里很安静,众人都专注于这台手术当中。 But Gu Jun hears bang and bang sound, is getting more and more heavy, seems falls on his heart, is stroking one by one. 但顾俊听到的嘭啪、嘭啪声,越来越重,好似是落在他的心头,一下一下地击打着。 He shakes at present suddenly in a flash, has what scene picture to flash through...... 他眼前骤然晃了一晃,有什么景象画面闪过…… This is the goal that he comes to here to observe and emulate the surgery, as if is also the energy, triggers the illusion...... 这正是他来这里观摩手术的目的,似乎也是能,触发幻象…… In that fuzzy shatter scene picture, there is a child form together to pat the rubber ball...... bang, bang, is sound that the rubber ball falls to the ground...... not, is not that child, is side another child, stands in not far away of basketball stand, looking. 那模糊破碎的景象画面中,有一道小孩身影在拍着皮球……嘭啪,嘭啪,是皮球落地的声响……不,不是那个小孩,是旁边另一个小孩,就站在篮球架的不远处,望着。 Child, without hand, under two sides shoulders that in the short sleeve T-shirt reveals, empty. 那小孩,没有手,在短袖t恤显露出的两边肩膀下面,空空荡荡。
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