"The baby's surgery has been successfully completed!"
"The baby's eyes are open!"
"The baby can breathe on its own now!"
On May 20, 2024 at 12 o'clock, a newborn baby girl who was only over 40 hours old was urgently admitted to the Neonatology Department of Xi'an International Medical Center Hospital. Her condition has touched the hearts of many people.
"Discovered convulsions in the child, rhythmic twitching in the left limb, blinking and smacking the lips." Director Wang Wenjing of the neonatal department and neonatal intensive care unit organized medical staff to quickly improve various physical examinations and examinations. Head ultrasound examination showed a large amount of bleeding in the right brain parenchyma! Urgent cranial CT scan shows: right temporal parietal lobe cerebral hemorrhage, cerebral hernia formation, subarachnoid hemorrhage, right frontal parietal temporal occipital subdural hematoma, bleeding volume of approximately 40ml!
Clear diagnosis: Neonatal intracranial hemorrhage!
The situation is urgent, Director Wang Wenjing immediately reported to Dean He Xijing and Assistant Dean Liu Jianzhou and requested multidisciplinary consultation. Upon receiving the urgent consultation notice from the neonatal department, Deputy Chief Physician Gao Yafei of the Neurosurgery Department quickly reported the situation to Vice President He Shiming of the Brain Hospital, and the two experts went to the neonatal department as soon as possible.
"When the ICU saw the child, vital signs could still be maintained, but the pupils on both sides had dilated, the light response was slow, and various nerve reactions were poor." Gao Yafei recalled the emergency situation at the time.
The consultation expert team analyzed the cause of intracranial hemorrhage based on imaging findings, and highly suspected that it may be caused by cerebral vascular malformation rupture, large amount of bleeding, midline deviation of the brain, formation of brain herniation, and the possibility of respiratory and cardiac arrest in the patient at any time.
Vice President He Shiming explained to his family that in order to have a chance of survival, he must undergo craniotomy surgery as soon as possible to remove the hematoma. However, due to the young age of the patient, the surgical risk is extremely high, and the mortality and disability rates during and after surgery are high.
"As long as the child has a glimmer of hope, please give it a try." The absolute trust of the family is the confidence of the medical staff to do their best.
There are currently few reports in China on craniotomy surgery for such a young newborn. The probability of intracranial hematoma in newborns is very low; Secondly, neonatal craniotomy differs from adult craniotomy in that it requires strong specialized and multidisciplinary collaboration abilities. Emergency craniotomy surgery for newborns is a great test of a hospital's comprehensive strength and specialized ability!
The neonatal pediatric medical team actively prepares for surgery, prepares blood and empties gastric tubes to avoid aspiration; Vice President He Shiming and Deputy Chief Physician Gao Yafei discussed the details of the surgery; Assistant Dean Liu Jianzhou arranges the work of returning to the neonatal intensive care unit after surgery; Yang Xiaohao, Deputy Chief Physician of the Department of Anesthesiology and Surgery, and Zhao Juan, Deputy Chief Physician, completed the preoperative anesthesia evaluation.
On the evening of May 20th at 8 o'clock, the child was safely transported from the neonatal ICU to the operating room.
The first challenge of surgery is anesthesia safety.
The child was born only 46 hours ago and the blood vessels were completely invisible to the naked eye, requiring extremely high levels of anesthesia. Under ultrasound guidance, four anesthesiologists used both hands and eyes to assist in establishing arteriovenous channels, tracheal intubation, and urinary catheterization, ensuring the safety of anesthesia for the patient during surgery.
The second challenge of surgery is to control bleeding.
The craniotomy hematoma removal surgery is a routine procedure for the main surgeon Gao Yafei, but today's surgery is quite remarkable. The child was born less than 48 hours ago, weighed 3.5kg, had a total body blood volume of only about 200-240ml, and had intracranial hemorrhage of about 40ml. The control of the bleeding problem was slightly careless, and circulatory failure, shock, cardiac arrest, etc. may occur at any time, with unimaginable consequences.
"The dura mater has just opened, and inactivated brain tissue and some blood clots have already emerged." Shortly after the surgery began, Gao Yafei's condition in front of him confirmed his preoperative judgment and was also the last thing he wanted to see - cerebral malformation, rupture of blood vessels, and bleeding.
For general intracranial hemorrhage, doctors only need to clean 60-70% of the bleeding volume to achieve intracranial decompression, but the bleeding caused by vascular malformation rupture is very dangerous! Congenital abnormal proliferation of arteries and veins is mixed together, and the blood vessels are like a pile of tangled threads. The abnormal blood vessel wall that bears high blood supply pressure is very fragile. Once any one of the blood vessels is damaged during the surgery, bleeding will instantly submerge the surgical field of view, and the result will be catastrophic.
"Every drop of blood in the child's body is precious." Under the microscope, Gao Yafei gathered his energy and led the surgical team through layers of blood mist, avoiding thorns and eliminating deformed blood vessels. The surgery was successfully completed at 1am on May 21st.
"Facing such a young child for the first time, it's quite lucky! The surgery went from 520 to 521, and I hope she can be favored by heaven, have a smooth life, and be healthy and safe." After getting off the operating table and practicing medicine for more than 20 years, Gao Yafei felt relieved.
The postoperative child safely returns to the neonatal ICU. Under the careful treatment and care of the medical staff in the department, on May 22nd at 10 o'clock, 33 hours after the surgery, the patient successfully removed the ventilator and breathed in every breath of fresh air, regaining the infinite possibility of life.
Life and death are at stake, relying not on miracles, but on hard work and accumulation!
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