After Song Zimo's careful treatment, Yu Shuilian finally did not have liver and kidney failure, her hemoglobin rose to more than 90GL, and her biochemistry, liver and kidney function, and coagulation function were all within the normal range.

The artificial liver and bedside hemodialysis machine that were prepared at all times were not put to use, and the wound was kept dry and clean, and more than a dozen drainage tubes gradually began to be pulled out.

When I was transferred from the ICU to the general ward, there was only one drainage tube left on my body, which was used for bilateral ureteral catheter stent renal pelvis drainage.

Cleanliness is an important aspect of quality assurance, and it is also applicable in medical activities, as it can reduce the occurrence of infections and prevent bacterial colonization and splitting, which is the same as removing stagnant garbage and reducing mosquitoes and flies.

As soon as there is a little contamination of the bed sheets with secretions or excrement, the nurse immediately changes the sheets, more than ten times a day.

If the wound was oozing, Song Zimo immediately took the nurse to change the dressing, sometimes the dressing change time was as long as an hour, and the medicine was changed more than a dozen times a day, so tired that the doctors and nurses couldn't straighten their waists.

Once the bacteria are cultured, Song Zimo will accurately use sensitive antibiotics according to the antimicrobial susceptibility test to eliminate the details and avoid the escalation of infection.

In order to allow the residual liver to gradually adapt to the function, Song Zimo accurately calculated the daily intake of intravenous nutrients to minimize the load on the liver.

Director Pan of the ICU asked Dr. Meng to make a PPT of Yu Shuilian's ICU treatment as a classic case and explain it repeatedly to the ICU doctors.

What it means to nip danger in the bud, what it means to observe in detail, and what it means to know the subtleties and take precautions are all explained in this case.

Finally, Yu Shuilian was transferred from the ICU to the Department of Comprehensive Orthopedics, Cai Qiaojun prepared a single ward for Yu Shuilian in advance, and selected three nurses to be responsible for Yu Shuilian's nursing work.

Yu Shuilian is about to start eating gradually, and the excretion of stool depends on the colostomy in the abdomen, but this fistula has no contraction function and cannot be controlled, without careful care, the stool will be everywhere, and the task of the ostomy is to manage the two fistulas on her body.

Another fistula is a cystostomy, where the current passage of urine is removed, and after the ureteral bladder has healed, the drainage tube left in the renal ureters will be removed.

Before the artificial urethra and anus are reconstructed, her excretory management is the responsibility of another ostomy theologist.

In the medical team, Song Zimo arranged a few people, because Zhang Lin Xiaowu had to take care of the patients, Song Zimo transferred Gao Qiao out, took him, and selected a few graduate students and trainees to form a full-time medical team.

In the ward of the comprehensive orthopedics department, Yu Shuilian finally saw her husband and son again.

The husband and son were haggard and emaciated, especially the son, standing beside the bed, looking pitiful, which made Yu Shuilian feel distressed.

"Have you had enough to eat these days?" Yu Shuilian touched her son's hand.

The son shook his head: "No, I will eat some cold rice in the morning, and at noon and evening, Dad's fried dishes are either very salty or burnt." ”

Fu Xiayang was on the side, he was very embarrassed by his son, and it was not false at all that he didn't say, these days, he was not at all, he didn't have the heart to do anything, and he was absent-minded when stir-frying, either a spoonful of salt was put in, or he forgot to turn off the fire.

"Wait for Mom, I'll make something delicious for you." Yu Shuilian touched the child's face, and her heart was like a knife.

Looking at her husband on the side, like a child making a mistake, Yu Shuilian said emotionally: "Thank you for your hard work, Xia Yang!" ”

"It's okay, we'll wait for you to get better." Fu Xiayang touched his son's head.

"Mom, I'll take a look." The son was about to lift the quilt, but Fu Xiayang immediately took his son's hand.

He was afraid of scaring the child, Yu Shuilian also made her eyes, and asked her husband not to let her son know, the son insisted on watching it, sooner or later he would know, paper can't hold the fire, Yu Shuilian sighed and signaled her husband to let go.

Fu Xiayang let go of his son's hand, and his son lifted the quilt and saw his mother, who was only half of her body, and there were still two holes in her stomach, followed by a bag.

The son is like a little man, "Mom, I'm not afraid, in the future, I will carry you, wherever you want to go, I will carry you, I will carry you to see the national flag and climb the Great Wall." ”

"Okay, well, you will take your mother to see the national flag raising and climb the Great Wall."

Yu Shuilian was moved, and the warmth of her family made her more convinced that she must live and must not give up on herself.

"Xia Yang, you are sometimes too busy in the morning, you take him to the breakfast shop next to our store to eat, or you simply let him go to school for breakfast, the rainy season is coming, the windows are closed, especially the wardrobe is closed, don't move the things in the vacuum bag, otherwise it is easy to get wet, there is half of the black chicken in the refrigerator, you get some longan lotus seed stew soup, and eat it with your son."

Yu Shuilian explained to her husband 1510, now that she is lying on the bed, she can only move her mouth, even if she moves her mouth, she can help her husband a little.

Looking at the two of them looking down-and-out without an owner, Yu Shuilian was really distressed.

Song Zimo, Xu Zhiliang, and Takahashi got together and discussed the next step of reconstruction surgery when they had time.

The function of the bladder is still there, and the function of urination is rebuilt, and only an artificial urethra needs to be rebuilt.

But anal reconstruction, Yang Ping plans to reconstruct an artificial anus that can control stool independently, how can it be done?

In order to complete the homework assigned by Yang Ping, the three of them felt that it was very difficult to design the surgical plan separately, so they decided to gather their wisdom to solve this problem together.

Bowel movements may seem simple, but they are a complex process.

When feces enter the rectum, receptors in the rectal wall are stimulated, and impulses are transmitted along afferent fibers in the pelvic and hypogastric nerves to the primary defecation center of the spinal cord and lumbosacral region.

At the same time, afferent impulses are also transmitted to the cerebral cortex, causing the urge to defecate.

If defecation is possible, impulses pass through efferent fibers of the pelvic nerve (parasympathetic fibers), causing contractions of the descending, sigmoid colon, and rectum and relaxation of the internal anal sphincter.

At the same time, the efferent impulses of the pudendal nerve are reduced, the external anal sphincter is dilated, and feces are excreted.

In addition, the nerves innervating the abdominal muscles and diaphragm are excited, the abdominal muscles and diaphragm contract, and the intra-abdominal pressure increases, which promotes bowel movements.

If the conditions of defecation are not permitted, the cerebral cortex sends out impulses, which descend to inhibit the activity of the primary center of the spinal cord and lumbosacral region, and inhibit the impulses from efferent fibers along the inferior abdominal nerve, so that the tension of the anal sphincter increases, the sigmoid colon relaxes, and the defecation reflex is inhibited.

In this way, the stool is temporarily left in the body and does not become uncontrollable.

Now that the patient has no anal sphincter and no rectum, and the walls of the sigmoid colon do not have rectum-like receptors to reconstruct the reflex arc, how can they simulate the normal process of defecation?

Xiao Chuanguo's Shaw reflex arc has discarded body nerves that can be used, and the bladder and anus are anatomically complete, that is, once connected, they have a complete nerve arc.

The patient's nerve arc has lost its receptors and no effectors, and the two indispensable terminals are gone, and the reconstructive surgery cannot be carried out at all.

Takahashi, an international trauma master, racked his brains and couldn't come up with a surgical plan.

"Dr. Song, Dr. Xu, unfortunately, I can't think of how to do this surgery for the time being, if I come to do this surgery, this patient will only have to defecate with an uncontrollable tube for the rest of his life."

Takahashi put down his pencil and leaned back in his chair in frustration.

There were only three of them in the conference room now.

Xu Zhiliang also shook his head: "I'm the same, I boldly imagined taking a part of the bladder sphincter to replace the anal sphincter, and then rehabilitating it, but even if this is possible, what nerve is used to complete the nerve connection of muscle contraction?" ”

Song Zimo was very happy, when Xu Zhiliang and Gao Qiao didn't come before, they discussed with Yang Ping? There was no need to discuss it, just to listen to his lectures.

Now, with Xu Zhiliang and Gao Qiao, Song Zimo is finally not alone, and there is an object to start a real discussion.

"What if an artificially made appliance with electronic components, such as a silicone appliance, is implanted at the end of the descending colon to fulfill the mission of the anus? Can this device be closed and opened according to a certain stimulus? Song Zimo stared at Xu Zhiliang and Gao Qiao.

"Artificial anus, you say?" Takahashi and Xu Zhiliang asked at the same time.

Song Zimo nodded: "Have we gone astray and walked into a dead end?" It is important to use the body's own structure to complete the reconstruction. ”

"If you follow this line of thinking, designing an artificial anus is no less difficult than using human structure to reconstruct it." Takahashi said.

Xu Zhiliang disagreed: "Although it is difficult to design an artificial anus, at least it can be done." ”

Song Zimo, Xu Zhiliang, and Gao Qiao, the trio, closed the door of the conference room, and the discussion was in full swing, and everyone felt that they had found a soulmate.

This kind of person who is usually in a high place is so fortunate to be able to find a soulmate.