争分夺秒（2015）

Critical S01E11

Part 4 Jan. 6, 2021, 2:22 p.m.

Packing isn't controlling the bleed. We have to reclamp the aorta.
主动脉被钳闭的时间已经够久了
That's a long time for the aorta to be clamped.
总比死了好
Better than being dead.
请将主动脉完全钳闭
Let's fully re-clamp the aorta, please.
完全钳闭
Fully re-clamped.
降低血压
Reduce the blood pressure.
撕裂口稍微大了点我需要钳闭下腔静脉并修复
Tear is slightly bigger. I'm going to clamp the IVC and fix it.
血管钳
Vascular clamp.
我要把上面的长钉拔♥出♥来♥ 给你更多的空间
I'll pull the top spike, give you a little bit more room.
好我会拔出半厘米
OK, I'm going to pull it out by half a centimetre.
你准备好了吗准备好了
Are you ready? Ready.
拔
Pulling.
我看不清里面到底怎么了慢点
I can't quite see what's happening. Slowly.
好的
Yeah.
看起来像是它带动了下腔静脉再拔一次
It seems to be pulling the IVC. Back up.
停
Stop.
纱布和镊子
Swab and forceps.
尖端带钩
It's hooked.
刺穿下腔静脉了
It's torn the IVC.
该死
Shit.
撕裂口大约2厘米
The tear is approximately 2cm.
哦拜托血压直线下降
Oh, come on! BP crashing.
主动脉钳无异常
The aortic clamp is in place.
长钉刺穿胸膜腔进入肝脏纱布
There's back bleeding into the liver. Pack.
用掉一块纱布
One pack in.
一共用掉六块
Six packs total.
比利? 来了
Billy? Yes.
梅克提夫人我需要你按住下腔静脉
Mrs Murkherjee, I need you to compress the IVC
来阻止背部出血
to stop the back bleeding.
我可以缝合撕裂处
I can close the tear
但是有长钉挡着我无法按住下腔静脉
but I can't compress the IVC with the spike in the way.
我无法拔♥出♥来♥ 也无法夹住
I can't pull it out and I can't clamp it.
我不能让钩子穿过肝脏那样会毁了它的
I can't pull the hook through the liver. It will destroy it.
他不可能今晚接受肝脏移植的
There is no possibility of him getting a liver transplant tonight.
或许你可以切开肝脏把长钉拿出来不行
Maybe you can open the liver and lift the spike. No.
他会流血致死的
He'll bleed to death.
面对现实吧这手术无法进行下去了
Let's face it, we can't proceed surgically.
我们已经技穷了
We've reached the end.
你好
Hello.
请坐
Please take a seat.
其中一根长钉刺穿了爱德华的肝脏
One of the spikes went through Edward's liver.
如果要救他的命我们显然要移除长钉
In order to save his life, obviously we need to remove the spike.
但是如果拔♥出♥来♥
But pulling it out
那将几乎无法避免地摧毁他的肝脏
will almost certainly destroy his liver.
恐怕现在的供体肝中没有和他组织相配的
I'm afraid there's no tissue match for an available donor liver.
如果我们再进行下去
And any further efforts
就有可能危及他的生命弗兰克
we make run the risk of killing him, Frank.
你们要放弃?
Y-you're giving up?
这对外科医生来说实在是进退两难
It's an impossible dilemma for a surgeon.
所以你们就要放弃?!
So you're giving up?!
我们能做的只有把这里收拾干净
All we can do is tidy this up.
我是格林医生请留言该死
'Dr Green...Please leave a message.' Shit.
你好老大如果你在未来几分钟内听到这条留言
Hi, boss. If you get this message in the next few minutes,
能请你来创伤科手术室吗
can you come down to trauma theatre please
因为我觉得这人会死在手术台上
cos I think this one's going to go tits up on the table.
格伦?
Glen?
我需要人来帮我系带子准备矫形外科器械包
I'm going to need tying. Orthopaedic instrument set.
好吧我们要做什么
OK. What are we going to do?
我要试着把长钉的尖端剪掉
I'm going to try and cut the tip off of the spike.
黛比请给我最大号♥的钢丝剪
Largest K-wire cutter you've got, Debe!
来了
OK.
听着抱歉打断一下
Look, I'm sorry to interrupt
但是他肠子的颜色看起来不健康
but that is not a healthy colour for bowel.
听着我们先不管肠子了我们需要继续下去
Look, we are losing the bowel. We need to get a move on.
谢谢
Thank you.
请你把左边让出来给我
I need space on your left, please.
没有位置了
There is no space.
把手伸进去拨开肝脏和横膈膜
Stick a hand in. Retract the liver and the diaphragm, please.
如果你损伤下腔静脉他会死在手术台上
If you damage the IVC, he will die on the table.
当心你的手指
Mind your fingers.
真是一点意义都没有
This is pointless!
再坚持几秒钟
Just hold on a few seconds.
他的器官已经长时间没有再灌注了
His organs have had no profusion for a protracted period.
你觉得还有几秒钟吗
Do you think we have a few seconds?
快啊!
Come on!
菲奥娜帮帮我
Fiona, help me, please.
加油
Come on.
托盘
Dish.
把长钉拔♥出♥来♥吧
Let's pull the spike.
你能看看我有没有损坏到下腔静脉吗
Can you see if I damaged the IVC?
谢谢
Thank you.
很好
Good.
好了
Got it.
谁来拿一下这个
Someone take this.
肝脏出血
We've got a bleed in the liver.
给我
Hit me.
给我
Hit me.
纱布用掉两块一共用掉八块
Two packs in. Eight packs total.
下腔静脉已钳闭我们控制住肝脏出血了
The IVC is clamped. We've got control of the hepatic bleed.
好现在修复撕裂口
OK, let's fix the tear
然后把这该死的主动脉钳拿下来呃?
and finally get this bloody aortic clamp off, eh?
不行
I can't.
你剪断钩子时在下腔静脉上开了一个3厘米的洞
Cutting off the hook made a 3cm diameter hole in the IVC.
缝合的话只会造成下腔静脉管腔狭窄
Stitching it would only stenos the IVC completely.
那就进行修补
Patch it.
我真觉得我无法按时补完
I honestly don't think I could do it in time.
我们已经做到这一步了
We've come this far.
能不能至少先试一下
Can we at least try?
20毫米宽的血管膜补丁片
20mm vasa tunica sheet.
谢谢
Thank you.
请把胸腔再打开些
I'll need more access to the chest, please.
这伤口被污染了
It's a contaminated wound.
我们稍后需要改成全自体移植
We'll need to revise later to a full autologous graft.
(自体移植: 用病人自身的皮肤血管或者骨骼从一处取出移植到另一处
自体移植组织愈合度更高不易产生排斥)
双头聚丙乙烯缝线和镊子
Double-ended fibro-prolene and forceps.
请帮我一起引导下来
Help me guide it down, please.
动脉血气分♥析♥
ABGs.
乳酸浓度19 酸碱度6.97
Lactating 19, pH 6.97.
好最多只能撑几分钟了
OK, it's down to minutes, at best.
有人有安全套吗
Does anyone have a condom?
我需要帮他的肝脏做一个临时球囊
I'm going to improvise a balloon tamponade for the liver.
有人有吗
Anyone?
把你从初中起就放在钱包里的那个给他
Give him the one you've had in your wallet since school.
不行用在你女朋友身上了
Can't. Used it on your girlfriend.
54号♥储物柜钥匙在我口袋里
Locker 54. The key is in my pocket.
你听到了吗
Did you get all that?
54号♥储物柜罗马斯女士的安全套
Locker 54. Miss Lomas' condoms.
赶紧去拿
Now, please!
大约什么时候好
ETA, please?
三分钟
Three minutes.
我需要你在两分钟之内完成
I need you to do it in two.
我做不到你做得到
I can't do it. You can do it.
你做得到
You can.
罗马斯女士的安全套给博伊尔先生
Miss Lomas' condoms for Mr Boyle.
比利请尽快拿过来
Billy. Quick as you can, please.
不是我的号♥ 我用超大号♥的
Not my size. I use extra large.
比利当我没说
Billy! Never mind.
另外说一句花很漂亮罗马斯女士
Nice flowers, by the way, Miss Lomas.
Foley管
Foley catheter, please.
准备一针管无菌水
Put a syringe in sterile water.
给我比利好