Start From Emergency Doctor

Chapter 42

“The patient has had cerebral ischemia!”

Zhou Yuan immediately said, “Circuit!”

“Which?” the ocean asked hurriedly.

Diversion tubes are mainly divided into two types: balloon type and non-balloon type. The diversion tube with a balloon can be better fixed, easy to enter the far part, and reduce the anatomical length. The straight non-balloon diversion tube can provide a clearer vision, with a smooth tip and easy insertion.

Both diversion tubes are suitable for the current situation, and each has its own advantages. The ocean cannot determine which one should be used.

Zhou Yuan glanced a few times and said, “Balloon type!”

The ocean nodded and asked while installing the balloon-type bypass tube: “Why don’t you choose a straight non-balloon type, do you not need a field of view?”

Zhou Yuan shook his head and said: “The patient’s condition is very bad, and the metabolism of the elderly is slow, and it takes longer for the wound to heal. We should try to avoid opening the mouth. The balloon type can reduce the anatomical length and reduce postoperative complications.”

“However, I can do this because I am sure to complete the operation with poor surgical fields, but it does not mean that others can. If you are not skilled, it is better to choose an easy-to-operate straight non-balloon diversion tube. ”

He Jian touched his head: “Why do I think this sentence is so familiar?”

Zhou Yuan smiled and carefully cut a small cut in the carotid artery bifurcation. After receiving the balloon-type diversion tube from the ocean, he quickly and gently inserted the outflow section of the diversion tube into the normal internal carotid artery. In the lumen.

Next, Zhou Yuan quickly filled the balloon and opened the valve, allowing the returning arterial blood to drive out the air in the bypass tube, and then inserted the injection end of the bypass tube into the common carotid artery.

Inflate the balloon for the second time and adjust the valve after fixing to allow the blood flow to drive out the air at the injection end. Finally, adjust the valve to restore carotid blood flow.

“The carotid artery is blocked for four minutes and twenty seconds. The bypass tube has been connected to the cerebral blood vessel, and the cerebral ischemia has been relieved!” He Jianyi also breathed a sigh of relief.

“Teacher, please install a brain drainage tube to drain the fluid in the patient’s ventricle.” Zhou Yuan raised his head, his tone a little weak.

Before the carotid endarterectomy, Zhou Yuan had completed a high-intensity operation, and Zhou Yuan turned pale.

He Jianyi was a little distressed and nodded: “I’ll deal with the effusion in the ventricle, you continue to clean the carotid artery intima!”

Zhou Yuan smiled: “It’s okay. The anesthesiologist, the patient’s blood pressure and heart rate.”

“Operation is possible.” The anesthesiologist directly reported the results.

“it is good.”(Read more @ wuxiax.com)

After speaking, Zhou Yuan continued to possess his body and carefully separated the thickened inner membrane from the outer membrane with a peeler, carefully removing the tiny fragments and floating tissues on the peeled surface.

Some floating distal endometrium Zhou Yuan was directly sutured and fixed.

“It’s sour.” Zhou Yuan smiled bitterly.

Kneeling for dozens of minutes, the weight of the whole body is on the knees, can it not be sore?

The nurse who was in charge of keeping everyone’s cell phone not far away saw this scene and unconsciously took out the cell phone to take a picture of it. She prepares for the operating table and uploads this picture to the circle of friends!

Zhou Yuan did not notice this scene.

On the other side, He Jianyi’s voice also rang.

“Zhou Yuan, the brain drainage tube is installed and I am ready to drain the effusion.”

“Okay.” Zhou Yuan stopped the movement of his hands, “Under the negative pressure state, draw the effusion.”

After a few minutes, the ventricular fluid was emptied.

Zhou Yuan asked the nurse next to him to wipe his sweat, “Teacher, come on, sew it up. The inner membrane on my hand has not been peeled off.”

He Jian nodded.

Finally, after ten minutes, the operation is about to end.

“Withdraw from the bypass pipe.” Zhou Yuan said.

He slowly emptied the distal balloon, withdrew the outflow end of the bypass tube, and then blocked the internal carotid artery.

After the blood flow was blocked, Zhou Yuan continued to withdraw the injection end of the bypass tube and blocked the common carotid artery.

Finally, the internal carotid artery is opened to expel the air in the blood vessel, and the suture is performed here. After the suture is completed, the internal carotid artery is blocked again, the external carotid artery, the common carotid artery are opened in sequence, and the internal carotid artery is finally reopened.

“Blood circulation.”

Zhou Yuan put the needle clamp in the surgical tray and asked.

“Blood circulation is unimpeded.” Ocean reported with some joy.

He Jianyi: “The blood circulation in the brain is not hindered, the cerebrovascular obstruction has disappeared, the symptoms of cerebral infarction have alleviated, and the patient should wake up soon.”

Zhou Yuan nodded, and the long-lost smile appeared on his face again.

“Finally saved it!”

Next is the suture of the neck skin.

“You guys have a good look at me!”

The patient’s dangerous period passed, and He Jianyi’s mood improved, reminding Haiyang and Liu Kai to pay attention to Zhou Yuan’s suture technique.

Zhou Yuan didn’t sew fast this time. On the one hand, it is to ensure the effect of stitching, and on the other hand, it is also a learning opportunity for Haiyang and Liu Kai.

Otherwise, if you really want to pursue speed with Zhou Yuan’s master-level butt suture technique, Zhou Yuan has already completed the next stitch before the ocean can figure out why it needs to be stitched here.

Just as Zhou Yuan concentrated on stitching, He Jianyi’s voice rang again.

“Ocean, Liu Kai, have you two noticed the characteristics of Zhou Yuan stitching?”

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The fourth one is sent! The fifth start! .