– Yeah? – Yeah.
调度中心呼叫空中转运队
Dispatch to air transport.
北岸大学移植团队正在空中
North Shore University Transplant Team is airborne.
飞行时间1小时11分钟 完毕
Flight time one hour, 11 minutes. Over.
现在它正在粗略预估所需的时间
Right now, it’s just trying to approximate the timing.
在我们看到肝脏 确定肝脏合用之前
We don’t want to do anything with our patient that’s getting the liver
我们不会对接受肝脏的病人做任何事
until we see the liver to make sure it’s suitable.
有了肝脏之后 手术可能需要14个小时
With a liver, we can go 14 hours.
我们希望不超过10个小时
We prefer it less than 10.
越快将肝脏植入并且再灌注血液 肝脏的功能就越好
It works better the faster it gets in and it gets reperfused with blood.
我们去取肝脏
We’re going to get the liver.
还有人去取心脏、胰腺和肾脏
There’s going to be someone taking the heart, pancreas, and kidneys.
所以会有三个团队一起去取器官
So, there should be three teams there all working together to get the organs.
但我们各取各的 不会互相妨碍
But we’re each going to do our own thing, so we won’t get in each other’s way.
我们要飞行1小时20分钟
We’re talking about an hour-and-twenty-minute flight,
外加开车去医院 然后回到我们医院的时间
plus driving to the hospital, and then getting back to our hospital.
所以时间紧迫
So these are all the time constraints
我们要尽可能控制时间 缩短用时
that we have to try to minimize as much as we can, whatever we can control.
有几次我们降落后 没有车送我们去医院
It’s happened a few times where we land and there’s no transportation.
所以我们必须与协调员做好协调工作
That’s why there always has to be coordination with the coordinator
确保一切顺利
to make sure that everything’s good.
-他们把我们送到了错误的机场 -怎么了?
– They took us to the wrong airport. – What’s up?
有谁知道从这里到医院要多久?
Anyone knows how long to go from here to the hospital?
-我不知道 -我们问问救护车上的人
– I wouldn’t know. – We’ll ask the ambulance.
嘿 手术室那边耽搁了 现在要等到12点半
Hey. Our OR is a little delayed, till 12:30 now.
有一个团队要晚点才能到
Guess one of the other teams had a delay in getting here,
有消息我再通知你
-so I’ll keep you updated. – Okay.
跟这么多团队合作会产生一个问题
One of the problems when working with so many teams,
时间会受到影响
times get affected.
Unlike kidney failure where there’s dialysis,
不像肾功能衰竭可以做透析
不存在肝脏透析这一说
there’s no such thing as liver dialysis,
除了移植 肝脏没有别的替换办法
and there’s no replacement for a liver other than a liver transplant.
佩雷斯小姐处于肝性昏迷状态
So, Miss Perez is in hepatic coma,
肝性昏迷患者坚持不了太久
and you can’t be in hepatic coma for that long.
各位 切开了
Guys, we have incised.
把吸管给我
Suction over here to me.
她出血真厉害
– She’s a bleeder. – Mm-hmm.
She dumped a lot.
出了好多血
她可能出现脑疝
She can herniate her brain.
有小一点的补片吗?
Do we have smaller patches than this?
一毫米厚度的怎么样?
So we want the one millimeter thickness, we think?
-适合1.8公斤早产儿用的 -嗯
– I think for a 1.8 kilo preemie. – Yeah.
相对于这个婴儿来说 我们要修补的洞显得很大
The hole we’re going to try to fix relative to the baby is big,
但其实只是个小口
but in the real world it’s a tiny little opening.
麻醉师和手术医生需要紧密合作
There’s going to be teamwork between the anesthesiologist and surgical team,
因为我们要推按心脏、肺和肝脏
’cause we’re pushing on the heart, the lung, pushing on the liver.
这可能会影响循环系统
All of that can affect the circulatory system
严重危及婴儿的生命
and really put the baby’s life at risk.
我需要他的小胳膊保持静止
So I need to do something with his little arm still.
我们要在胸部的这个位置切开 以便扭转肝脏
We’re going to open up here, the chest, to be able to torque the liver,
which we think is up here, down towards the belly.
我们认为在这里 向下对着腹部
现在这里没有肝脏
There’s no liver in here right now.
这种手术就是有这个问题
This is one of the things about a surgery like this.
You can’t really get MRIs and fancy CT scans like we do in big grown-ups.
你无法像对成年患者那样 为他做核磁共振和CT扫描
所以我无法确定会发现什么
So I don’t 100% know what I’m about to find.
We’re about to just pop into the chest, so we just did there.
我们将伸进胸腔 刚刚完成了
现在我们要打开空间 这种情况很少见
Now we’re going to open up space, and this is an unusual thing.
打开胸腔后见到肠子
We open up the chest and we see intestines.
我现在不想见到它们 因为我不想损伤它们
I don’t really wanna see them now because I don’t wanna hurt them,
所以我要试试 看能否把它们塞到一边
so I’m going to try to see if I can tuck them away from us a little bit
同时又不会对里面的心脏 造成太大的压力
without putting too much pressure on the heart inside.
现在我要把里面的东西放回腹腔
I’m going to try to reduce the contents into the belly now.
好 那是心脏
Okay, there’s the heart.
可以再给我一把这种剥离器吗?
Can I have a second kittner like this?
我要为肺和心脏施加一点压力 需要松开的话就告诉我们
Putting pressure on the lungs and heart. Let us know if we need to take it off.
我们开始把能够展开的东西展开 再往后一点
So let’s start unfurling what we can unfurl.
A little bit back here.
试着用肝脏挡住肠子
Gonna try to use the liver as a blocker for the bowel…
Uh-huh.
…as long as the baby will tolerate the torque.
只要宝宝能够承受这种扭转
你有长点的东西作为备用吗?
Do you have something longer if we need it?
能在那种时刻为有需要的人服务 这是我们莫大的荣幸
We have such a privilege to serve the people who need it in those moments.
我需要细点的
I need something finer than this.
我发现我在照顾孩子时 精神会上升到更高的层次
I found that when I took care of children, it took it to such another higher level.
因为当有人把他们的孩子交给你时
Because when someone hands you their child,
那份沉甸甸的责任 以及贡献一份力量的荣幸
the weight of the responsibility,
but also the tremendous privilege of making an impact,
对我充满了吸引力
that really called to me.
你不只是在挽救一个人的生命
The idea that you’re not just saving someone’s life,
想到患者是个孩子 你挽救的是他的一生
but when you think about a child, you just saved a lifetime.
我以为这些都在右上象限
I thought these were all in the right upper quadrant.
主要问题是从他腹部的临时覆盖物
Main concern is the fact that there’s still blood draining
导出的引流管中仍有血液流出
from the temporary covering that’s over his abdomen.
他的伤情仍然很重
You know, he still is very, very sick.
好的 小心点
– Okay. Alright. Careful there. – Slowly.
好 接着
Okay, here you go.
-天啊 这些环太糟糕了 -真的很糟糕
– Oh God, these rings are terrible. – Really bad.
天啊 就像抹了灰泥 可以看到广泛性肝损伤
Oh man, it’s like plastered. You can see quite extensive liver injury.
我没看到有出血
I don’t see any active bleeding.
话别说得太早 抬高
Don’t speak too soon. Lift up.
– One here too.
这里也有一处
我们得把这些棉纱取出来 它们暂时止住了出血
We have to get all these packs out. They were stopping the bleeding.
对 我们不要随便乱动
Yeah, let’s not rock the boat here.
那里在出血 看到了吗?那是新的出血点
It’s bleeding right there, see that? That’s fresh.
Okay.
别碰那个
– So let’s not touch that. – Mm-hmm.
这下面吸一下 就在那里
– Down there, suction. There.
-那是一个洞吗?-是的 不一样
– Is that a hole? – Yeah, different.
他的肠子里有很多血
We’ve got a lot of blood in his gut.
我们要把棉纱留在里面 因为它能暂时控制住肝出血
We’re going to leave the packing in here because it’s controlling liver bleeding.
然后我们冲洗干净 让其他东西稳定下来 过两天再来
We’ve washed things out, stabilized stuff, and we’re coming back in a couple of days.
希望到时候有足够的液体 流出身体 那我们就可以关闭腹腔了
Hopefully by then, enough fluid’s off the body and we can close the abdomen.
如你所见 现在腹腔很紧
As you can see, it’s tight right now,
我们需要关闭腹腔 看看是否有血涌出来
and we need abdominal closure to see if any blood wells up.
希望他的身体能恢复 然后我们就能关闭腹腔了
And hopefully his body will recover, then we’ll be able to close the abdomen.
那是我们期待的好消息
That’s the news we’re hoping for.
(莱诺克斯山医院)
好 头盖骨拿下来了
Alright, so bone is off.
-老天 -看起来都快脱落了
– Oh, baby. – It almost looks like it receded.
-感觉这是颅骨成形术 -对 就像…
– This looks like a cranioplasty. – Yeah, like a–
马科斯
Oh, Marcos.
– This is also… – Yeah. Send this for culture, dura.
对 把这个送去做细菌培养 硬脑膜
这个小肿瘤…
This little tumor…
现在越来越诡异了
Gets weirder and weirder, this case.
没有一样是正常的 这是肿瘤
Nothing looks normal here. This is tumor.
把手术台放到最低 我们用显微镜看看
Drop the table down all the way, we’re gonna go under the microscope.
这比之前更加令人不安
This is actually much more… …upsetting than before.
我觉得根据眼前的情况
I think with what I’m looking at,
结合肺部和头皮内的情况来看 外加肿瘤的生长速度
and what we have in the lungs,
and what we saw in the scalp, and the rapidity of what grew,
我看他活不过半年到一年
I don’t see how he can live more than six, twelve months.
我没想到疾病在颅内分布得如此广泛
I didn’t realize this disease was so extensive intracranially.
布莱恩 我们刚提交了飞行计划 我们即将开始降落
Brian, we just filed our flight plan. We’re going to start our initial descent.
很好
Okay.
(北岸大学医院)
-泰普曼医生?-嗯?
– Dr. Teperman? – Yes?
他们在15点09分摘取了器官
They clamped at 15:09.
-好的 谢谢 -这里吸一下
– Okay, thank you. – Suction over here.
他们又在给我打电♥话♥了
They’re calling me again.
Okay, great.
好的 很好
All right.
-格罗斯坦医生?-对 是我
– Dr. Grodstein? – Yeah, that’s me.
我刚和温尼克医生通完电♥话♥
I just spoke to Dr. Winnick.
他将在五分钟后离开医院
He’ll be leaving the hospital in about five minutes.
压力很大 等待肝脏期间 压力非常大
© 2014-2024 pabulika.com 版权所有
