Severe trauma, infection, poisoning and mental trauma can cause the body's excessive stress response.

The principle is that a large amount of adrenal cortical hormones and adrenaline are released, which causes a large amount of glycogen decomposition, a large amount of energy consumption and a significant increase in metabolism, and a strong contraction of the arterioles, resulting in circulatory ischemia and multiple organ dysfunction due to insufficient blood volume.

If it is too intense and continues for a long time, the body may enter a state of exhaustion and suffer physiological and psychological dysfunction.

Milder ones are like gastrointestinal ulcers, which will directly pierce you, or mental problems.

In severe cases, disseminated intracapillary coagulation will occur, that is, DIC, renal failure, etc., with very serious consequences.

The stress response is in conflict with the current debridement work, and if you want to treat burns, debridement is only the first step.

If even the first step cannot be completed, the only thing waiting for mother and daughter is death.

The newly established burn surgery department of the Vietnam-China People's Hospital will also become a joke. You must know that although Chen Qi had a stroke of fame in Vietnam, how many doctors across the country are waiting to see his joke.

The debridement work of Ding Xinjuan and Song Yanzi had to be stopped, and everyone was thinking of ways to

The young doctor Wu Guonan suggested weakly:

"Dean Chen, Teacher Zhu, can we use general anesthesia so that the patient won't feel pain when changing the dressing and reduce stress reaction?"

Zhu Huoyan sighed:

"No, you don't need to look at the vital signs to know that the mother and daughter are on the verge of shock. If they are put under general anesthesia, the shock will be aggravated. There is another difficulty. Their respiratory tract has been damaged in the fire and they cannot withstand it at all.

Endotracheal intubation.”

This debridement operation cannot be performed within three or four hours, and without the coordination of endotracheal intubation, general anesthesia cannot be used.

Liu Min, the head nurse, made a suggestion: "How about trying sleeping pills? Let the patient fall asleep?"

This proposal was rejected by Zhu Huoyan again: "With such severe pain, any sleeping pills and sedatives are useless. As soon as we take action, they will wake up immediately."

Sedatives?

Chen Qi's eyes suddenly lit up when he heard these three words:

"Teacher Zhu, I have thought of a way. We can use artificial hibernation therapy."

"What hibernation?"

Many doctors in the ward were looking at each other, obviously not having heard of this concept.

Seeing everyone's clear and stupid eyes, Chen Qi knew that the concept of "artificial hibernation therapy" had been introduced early by him again, so he quickly explained:

"Artificial hibernation is actually very easy to understand. If you think about why animals can survive the entire winter by hibernating and survive without eating or drinking for several months, that's because animals enter a state of hibernation in winter, and their metabolic rates increase significantly.

reduce.

This means that their body temperature will drop, and their breathing and heartbeat will slow down, thereby reducing energy consumption. At the same time, the immune system will be adjusted, so that the animal's immunity will be improved to fight against the risk of disease and infection.

In the same way, artificial hibernation is how we artificially imitate the hibernation of animals and put patients in a state of hibernation. The benefit of this is to reduce the body's excessive stress response, reduce metabolism, reduce cell oxygen consumption, improve microcirculation, and prevent cells from He suffered serious damage and bought time for doctors to treat him."

The eyes of several young nurses and doctors were still confused.

After all, Zhu Huoyan is a senior director. He understands and understands this principle, but he still has a question in his mind.

"Chen Qi, I understand what you said. So the question is, how can we put the patient into hibernation mode?"

Yang Xiuxiu next to her also burst out laughing: "Dean, we humans are not bears and cannot hibernate."

Zhang Xing interjected at this time: "Others can't do anything, but Chen Tou must be able to do something!"

Everyone looked at the young deputy director of the department and gave him a thumbs up.

Chen Qi also thought that this honest boy had learned to flatter him after entering the officialdom, and finally grew up.

Everyone likes to hear good things, and Chen Qi is no exception, so he continued to explain in a happy mood:

"Actually, artificial hibernation therapy has been studied abroad. When I went abroad to visit and study, I colluded with foreign doctors. They don't have a complete theoretical system yet, but who am I, an international double director, who has secretly transferred their skills to Learned it."

Zhu Huoyan rolled his eyes at Chen Qi:

"Stop bragging. The patient is still waiting to be rescued. Quickly tell me how to use artificial hibernation."

"Oh, that's it. Hibernation therapy is actually very simple. It uses three drugs, petidine, chlorpromazine and promethazine, to form an artificial hibernation agent. Promethazine can enhance the sedation and analgesia of petidine. It has respiratory depression and vasodilation effects. After use, it can cause blood pressure to drop, tachycardia, respiratory depression, etc.

Add a dose of 1 mg per kilogram of body weight into a small infusion bottle and drip it intravenously. After half an hour, if the patient's breathing and pulse are stable, then intramuscularly inject the same dose once more, and the patient will fall into a deep sleep.

After the patient falls asleep, put ice packs on the groin and armpits, and use water 2°C to 3°C lower than the body temperature for warm wet compresses on the trunk to maintain the body temperature between 34°C and 35°C. The most suitable time to maintain low temperature is 16 to 24 hours. "

The young doctors listened as if they were reading from heaven.

Maintaining the human body in a hypothermic state to treat diseases? This is something they have never heard of. Although it makes sense in theory, no one dares to do it.

Zhu Huoyan understood, and his eyes became brighter and brighter:

"Chen Qi, if your approach works, it will not only be able to treat burn patients, but also those with febrile convulsions caused by serious infections, central hyperthermic heat stroke, toxic or traumatic shock, severe brain trauma, intractable pain, and high spirits. It seems to be useful even when you are nervous.”

Chen Qi gave a thumbs up, "How else could Teacher Zhu be my teacher? Look at Zhang Xing and the others, they are still confused now."

Director Luo Yuyang also looked ashamed after hearing this:

"Dean Chen, let alone Zhang Xing and the others, I am also confused. If according to what you said, this set of hibernation therapy is still in the theoretical research stage, but now we have two patients waiting for it in the clinic. This,

What to do?"

Medical theoretical research is only the first step. To apply it clinically requires a large amount of laboratory data and clinical data to support it. You cannot just give it to patients right away with a wild idea.

People are not guinea pigs, and death is a human life.

Others are others, and others are not time travellers. Our Dean Chen personally used hibernation therapy in his previous life.

In terms of domestic hepatobiliary surgery, Professor Wu Mengchao invented "hypothermia" to perform liver surgery, and it was even more cruel, directly putting people into ice water.

This is actually a kind of "sub-hibernation therapy", so hepatobiliary surgeons are relatively experienced.

"Head nurse, please contact the pharmacy immediately and get all three drugs: pethidine, chlorpromazine and promethazine. Today I will demonstrate it first. Let's evaluate whether it has any effect. Let's try to get it before the foreign experts do.

Publish the paper on hibernation therapy."

Once they heard that this operation could publish a paper today, everyone became more motivated to work.

Even an experienced expert like Zhu Huoyan is not immune to this.

If you say you use money to bribe Zhu Huoyan, he will probably kick you out.

But if you say that you have a surgical topic that is the first of its kind in the world and can be published in an international medical journal with the highest SCI impact factor, this is also full of temptation for Director Zhu.

"Okay, then I'll see you today."

The medicine was quickly fetched, and Chen Qi personally mixed the medicine in proportion. The head nurse was also preparing ice packs, and the air-conditioning temperature in the operating room was also set to low.

After a while, Ding Xinjuan and Song Yanzi, mother and daughter, reacted quickly.

The two people who were still screaming in pain just now began to feel drowsy. Chen Qi tried to prick Ding Xinjuan's wound. Although Ding Xinjuan still had conditioned reflexes, her reaction was already very slow.

Zhu Huoyan paid attention to the whole process and asked curiously: "Is this okay?"

Chen Qi personally put ice packs on the two patients, one big and one small, while smiling and nodding:

"Okay, let's seize the time to debridement."

This debridement took a full 4 hours to clean up. If there weren't many people taking turns to do it, Chen Qi would have been ruined again.

"Hurry up, let's calculate the amount of fluid rehydration needed."

There is a complete set of infusion formulas for burn patients. Chen Qi had already introduced this formula in Africa. After hearing this, Zhang Xing immediately took out a pen and paper to do the calculations.

Zhu Huoyan frowned as he watched the two patients turn from black to pink.

"Chen Qi, Mao estimates that the mother has almost 90% of the burn area, of which more than 30% are third-degree burns and the rest are deep second-degree burns. If the child is gentler, the total burn area is 83%. It is possible to save her.

Sex is very vague."

In the burn community, there used to be an unwritten rule: if the burn area exceeds 60%, there is almost no possibility of survival, and if the burn area exceeds 80%, death is almost certain.

Director Burns Koro also echoed:

"Director Zhu is right. Currently, in international literature and related papers, there is no record of patients with extensive burns surviving."

Just when Chen Qi was about to speak, Zhang Xing refused:

"Teacher Zhu, Director Luo, this statement is incorrect. When we rescued a burn patient in Africa, the total burn area reached 90%, and the burns were 3rd or deep 2nd degree. We were able to save his life."

Zhu Huoyan was a little surprised: "I thought you were bragging. You actually saved a patient with extensive burns. Why don't you publish a paper?"

Chen Qi was a little embarrassed:

"I submitted a paper, but it was rejected because I only had one patient at hand at the time, and solitary evidence was not counted, so the paper was not accepted, and my stinky tofu skin grafting technique was not promoted."

The medical conditions in Africa are so poor that even bacterial culture cannot be completed, so the quality of the paper cannot be improved.

In addition, Chen Qi had not thought about developing into burn surgery at that time, so after he learned that the paper was shot a few months after sending it out, he just let it go and did not continue to revise it before submitting it.

Hearing Chen Qi's words, there was a burst of laughter in the ward. It turns out that the omnipotent Dean Chen also has his manuscripts rejected sometimes.

Zhu Huoyan also laughed after hearing this and asked:

"Then how exactly do you perform this stinky tofu skin grafting technique?"

Chen Qi pointed at Ding Xinjuan on the hospital bed and said:

"You see, like this patient, a patient with extensive burns all over his body has burned away the entire back, limbs, and part of the head and face skin. While we are fighting infection and shock, the most important thing is how to protect the wound, which requires skin grafting.
To be continued...