芝加哥急救

Chicago Med S08E17

Part 4 April 12, 2023, 10:43 a.m.

这会帮助我们，森
Well, it could only help us, Sam.
待命
Standby.
好的，手术室2.0将决定
OK, so 2.0 would determine
截骨术是否在理想的深度、高度和角度
if the osteotomy is at the ideal depth, height, and angles
好完成矫正
to achieve correction.
可接受C7和T1截骨术
Acceptable C7 and T1 osteotomies.
可接受？这么做很完美
Acceptable? It's perfect.
你能解释一下这些激光对外科医生有什么帮助吗？
Can you explain how those lasers are helpful for the surgeons?
马素医生，你能解释一下吗？
Yeah, Dr. Marcel, could you explain that?
当然可以，你能挪过去一点吗？
Uh, sure. Yeah. Could you move over?
把你的相机对准屏幕
In fact, direct your camera towards the screen there.
你会看到手术室2.0会在脊椎上
You'll see that 2.0 will superimpose lines
叠加线条来帮助指导外科医生在哪里钻孔
onto the spine to help guide the surgeon where to drill
以及要移除的骨头的范围
and the extent of bone to remove.
艾布斯医生，我发现振幅下降了50%
Dr. Abrams, I'm seeing 50% decreases in amplitude
双腿的潜在危险增加了
and increased latency in both legs.
要进行确认
Running a motor.
将诱发电位反应显示在屏幕上
Put the evoked potential response on screen.
马素医生，有什么问题吗？
Dr. Marcel, is there a problem?
我们是否要担心脊髓损伤和压♥迫♥？
Are we concerned with cord injury and compression?
是的，因为我想我们的病人的目标
Yeah, 'cause I'm assuming that our patient's goal
不是瘫痪
wasn't to become paralyzed.
提高他的平均动脉压
Push his MAPs.
翻转所有可逆的因素
Reverse everything that's reversible.
看看术中神经功能监测的变化是不是真的
Find out if this IOM change is real.
如果是的话，替他缝合让他下手术台做磁力共振造影
And if it is, close him up and get him down for an MRI stat.
磁力共振造影？不对，等一下
MRI? No, hold on.
我们没必要移♥动♥他手术室2.0可以做术中电脑断层扫描
We don't have to move him. 2.0 can do an intraop CT.
对，但看不出
Yeah, which won't show me anything
有没有脊髓水肿或韧带屈曲
about cord edema or ligamentous buckling.
但如果我能把电脑断层扫描和术中超音波结合起来
But if I can merge a CT with an intraoperative ultrasound,
就有你需要的一切了
you'd have everything you'd need right here.
这样就行了，我们不需要移♥动♥宽宇
That would work, and we wouldn't have to move Kuan-yu.
听着，与其在病人身上做实验
Look, experiment with this thing on another patient.
我更想百分百确定
I want to be 100% sure.
森，我们有一百个理由
Sam, there are a hundred reasons
不应该移♥动♥他
why we should not move him.
随便说一个，感染风险
Pick one. Infection risk.
延长麻醉的时间
Prolonged time under anesthesia.
该死，他甚至可能会在移♥动♥后变得不稳定
Hell, he could even be unstable after the move
无法继续动手术
to even continue surgery.
那就做吧
Do it.
希望你是对的
Let's hope you're right.
不然你就会犯下终结职业生涯的错误
Otherwise, you're committing a career-ending mistake to film.
你真的不用任何东西吗？
You sure there's nothing we can get you?
-要不要吃点什么？-不用
-Maybe something to eat? -No.
现在情况如何？
How are we doing?
-有进展吗？-还没有
-Any updates? -Not yet.
我失陪一下
Oh, excuse me.
那是一块可爱的石头
You know, that's a lovely stone.
我之前跟你儿子说话的时候就注意到了
I was noticing it earlier when I was talking to your son.
从河里捡的
From the river.
宽宇小时候找到的
Kuan-yu found this as a child.
又滑又亮
It was smooth and shiny.
他认为这是宝石
He thought it was a gem.
那是他最后几次能活动
It was one of the last times he was able to move,
跟玩耍的日子
to play.
我做这个是为了带给他希望
I made this to give him hope
让他有一天能再次玩耍
that one day he would play again.
我答应过会帮他
I promised I would help him.
你确实遵守了你的诺言
Well, you have certainly kept that promise.
怎么了？
What's going on?
-我需要和达霞聊聊 -聊什么？
-I need to talk to Da-xia. -About what?
出现了并发症
There's been a complication,
好像是脊髓受压
something about a cord compression.
我需要拍下她的反应
I've got to get her point of view.
现在不是时候
Now is not the time.
葛云女士，他们知道
Ms. Goodwin, this is one of the major risks
他会面临这样的主要风险
they knew he was facing.
从视频叙事上来说这对他们的故事很重要
Narratively, that's important to their story.
这件事跟故事无关
Well, this is not about a story.
这是个涉及真人的复杂医疗程序
It's a complicated medical procedure involving real people.
戴顿先生有下令
I have a directive from Mr. Dayton.
她签了拍摄合同
She signed a contract to be filmed.
我说你能拍才能拍，不是积戴顿说了算
You film at my discretion, not Jack Dayton's.
你可以在医生提供最新情况后
And you can speak to Da-xia
再和达霞谈，现在不行
after the doctors provide an update and not before.
我要打给戴顿先生
Well, I need to call Mr. Dayton.
你打啊
Well, you just do that.
他有话要跟我说吗？
Did he need to speak to me?
他有最新的消息吗？
Did he have news?
没有什么具体的消息
No, nothing concrete.
但外科医生很快就会来跟你汇报了
But the surgeons will check in with you soon.
我们去我办公室等吧？
Why don't we go wait in my office?
就在楼上，你知道
It's right upstairs, and, you know,
在那里会比较舒服
we'll be more comfortable there.
-谢谢你，查理斯医生 -不客气
-Thank you, Dr. Charles. -You bet.
我没有看到明显的脊髓受压
I'm not seeing any obvious cord compression.
我也正在检查
That's why I'm also checking.
他的诱发电位看起来好多了
His evoked potentials look better.
好，我很满意
All right, I'm satisfied
脊髓只是被挤压到，没有受损
that the cord was merely compressed, not injured.
手术可以继续
We can continue.
-马素医生？-怎么了？
-Dr. Marcel? -Yeah?
你能让手术室2.0 准备接下来的截骨手术吗？
Would you ask 2.0 to prepare the next osteotomy, please?
当然可以，嘉丽丝？
Certainly. Grace?
韦？
Will?
我再打给你
I'll call you back.
你病人的结果出来了，卡拉
Results for your patient, Cara.
好消息，看起来不像产后子痫前症
Good news: doesn't look like postpartum preeclampsia.
坏消息是这并不能
Bad news is nothing definitive
解释她的症状
to explain her symptoms.
对，我觉得是压力
Yeah, I'm thinking stress.
毕竟她六周前才生下孩子
I mean, she did just give birth six weeks ago,
怀孕会让人的身体承受
and pregnancy puts the body at the literal limit
九个月的极限
of human endurance for nine months.
压力会在身体上表现出来是很合理的
Makes sense that stress would manifest physically.
好，我会查一下有没有其他检验要做
Yeah, I'll look into anything else to test her for,
但我觉得你说得没错
but I think you're right.
艾卓亚医生，你要坐这里吗？
Dr. Archer, do you want my seat?
不用
Uh, I'm good.
反正我也得去整理六号♥房♥
I got to turn six over anyway,
-所以没关系 -我的天啊
-so it's not a big deal. -Oh, for crying out loud.
听着，我不是病人
Listen, I'm not an invalid.
我很好
I'm fine!
-艾卓亚医生？-干嘛？
-Dr. Archer? -What?
云逊的电脑断层扫描结果出来了
I have Vincent's CT results.
他有盆腔血肿和出血
He has a pelvic hematoma with a blush.
他需要进行栓塞术但我们现在可以先替他把臀部复位
We need to embolize him. Now we can reduce his hip.
送他去介入性放射科
Send him up to IR.
你做过徒手复位吗？
You ever done an Allis reduction?
-我有看过一次 -好的
-I've observed one. -All right.
那你来协助我
Well, you're assisting me.
又怎么了？
Oh, what now?
我只知道徒手复位会很累人
I just know an Allis reduction can be physically taxing.
所以呢？
And?
我只是觉得你做这个手术
I just don't think it's the best idea
不是个好主意
for you to do this procedure.
我是主治医生
Yeah, I'm an attending physician
也是这个部门的主任
and the chief of this department.