Start as an Emergency Physician

Zhou Yuan subconsciously glanced at the end of the corridor, turned the operating table, and pushed towards the operating room with his back to the end of the corridor.

Qian Wei's wife heard the movement, waited for another two seconds, and slowly lifted the mobile phone camera in the video state...

It wasn't until a minute later that Qian Wei's wife walked out, entered Qian Wei's hospital room, silently folded the quilt, and sorted out the things in the hospital bed.

At this time, Qian Wei's wife couldn't do anything for Qian Wei, and even the most basic companionship could become a dangerous factor for Qian Wei's death, so she could only hide behind her back and pay silently.

After cleaning the hospital bed, Qian Wei's wife sat on the hospital bed, turned on the mobile phone video, wiped her tears, and browsed from seven years ago to today, Qian Wei was pushed into the operating room by several doctors...

......

In the operating room.

The light of the shadowless lamp was very dazzling, making Qian Wei's eyes a little unable to open.

"Do you know that the former president of country M also had heart bypass surgery?" Zhou Yuan glanced at Qian Wei and found that he was a little nervous, so he found a topic to talk about.

"He did it too?" Qian Wei looked at Zhou Yuan in surprise.

Zhou Yuan nodded, "Yes, you also know that the people in country M like to eat junk food such as fried chicken and hamburgers, so many of them have high blood pressure and high blood lipids, which are one of the causes of acute myocardial infarction, and the heart is naturally prone to problems." "

"Is the heart bypass technology in country M as good as in our country?" asked Qian Wei.

Zhou Yuan frowned and said, "Actually, it's not better than us." They have the innate advantage of science and technology, and some equipment may be better than ours, but they have fewer people, fewer patients, and the doctors have not accumulated enough experience. "

"On the contrary, in our country, many doctors may perform four or five surgeries in one day, and in terms of surgical technology, I am confident that the doctors in our country are more powerful. "

Qian Wei smiled: "Great." "

"The equipment has been tested and the equipment is ready. The nurse said.

Zhou Yuan nodded and said to Qian Wei: "Find a comfortable position for you to lie down, we will anesthetize you immediately, and when you wake up, your heart problem will be solved." "

Qian Wei's mood relaxed a lot, nodded, and lay down on his back.

"General anesthesia, endotracheal intubation to maintain breathing. Zhou Yuandao.

The anesthesiologist and He Jianyi both walked up, one in charge of anesthesia and the other in charge of intubation.

"Is internal thoracic artery bypass or radial artery bypass?" asked, the chief of cardiac surgery.

If you have chosen an arterial vascular bypass, you need to choose which artery to choose next.

"Radial artery bypass. Zhou Yuandao.

The long-term patency rate after internal thoracic artery bypass surgery was good, with a 10-year patency rate of 90%. The internal thoracic artery can regulate the blood flow according to the physiological needs of the myocardial blood supply, and the chance of atherosclerosis is very small, but the length of the internal thoracic artery is limited, which is not suitable for Qian Wei.

Although the patency rate of radial artery bypass is not as good as that of internal thoracic surgery, there is no need to worry too much about the length.

Generally, doctors will perform internal thoracic artery bypass because of the patency rate.

However, under Zhou Yuan's technique, the shortcomings of insufficient radial artery patency can be overcome, and circumventing arterial bypass is obviously more suitable.

"The anesthesia is done. The anesthesiologist's voice rang out.

Zhou Yuan immediately raised his head and glanced at the time, "The operation begins." "

"Sanitization. "

Zhou Yuan and He Jianyi set out to disinfect the skin of their chests and upper limbs.

The anterior chest is used to open the heart and the radial artery is used as a bridge in the upper extremities.

The saphenous vein, radial artery, internal thoracic artery, etc., can be transplanted to other parts of the body as vascular bridges because the tissues, organs, etc., to which they are connected, have compensatory blood vessels.

For example, in the radial artery, the deep and superficial palmar arches in the palm of the hand can replace the radial artery and provide compensatory blood supply to the radial side of the hand, thus ensuring that the blood supply will not be affected in the absence of the radial artery.

Although it will definitely have a certain impact on the patient's body, such as not being able to do strenuous exercise, not putting too much burden on the palms, etc., it is nothing compared to saving life.

"Radial artery bridge extraction began. Zhou Yuandao.

The cardiac surgeon on the side handed over the scalpel and stared closely at Zhou Yuan's movements.

Zhou Yuan picked up the scalpel and made a few gorgeous cuts, exposing the radial artery.

The radial artery is actually the arterial blood vessel in the wrist, which is the site of clinical palpation of the pulse.

When Qian Wei recovers and is discharged from the hospital, he will go to see a Chinese medicine doctor again, and he will be scared to death if he is touched without a pulse?

Zhou Yuan almost laughed.

"Zhou Yuan, your vascular clamps..."He Jianyi looked at Zhou Yuan with a frightened face.

How can anyone smile while slicing under the knife, it's too terrifying...

The heart surgeon came up, "Lao He, how long has it been since Zhou Yuan touched a scalpel?"

He Jianyi was silent for a moment and said, "It's true that I haven't used a knife for several days..."

Zhou Yuan concentrated on the operation and ignored He Jianyi and the director of cardiac surgery.

After quickly blocking blood flow to the radial artery, Zhou Yuan began to measure the pulsation of the distal palm.

Theoretically, after the loss of the radial artery, the body can carry out compensatory blood supply through the deep palmar arch and the superficial palmar arch, but it is also necessary to prevent the special situation of the accident of the deep palmar arch and the superficial palmar arch and the disappearance of the compensatory blood supply.

"The distal pulsation was good, the oxygen saturation of the thumb artery was not significantly reduced, and the compensatory blood supply was good. "

This data suggests that the radial artery can be cut.

Although Qian Wei's coronary artery stenosis has reached 80%, there is no stenosis of multiple blood vessels, so only one hand, that is, a unilateral radial artery incision, is required.

Unilateral radial artery resection is generally used with a non-sharp hand, Qian Wei is right-handed, and his right hand is used more, so Zhou Yuan chose the left hand, which is relatively less used.

"Upper extremity abduction supination at right angles. Zhou Yuandao.

He Jianyi posed for Qian Wei.

After sterilizing the towel, Zhou Yuan picked up the scalpel again and began to dissect two centimeters below the elbow along the direction of travel of the radial artery.

When dissecting, Zhou Yuan's knife was biased towards the inside of the arm, which was to prevent damage to the blood vessels on the outside.

After the incision was completed, Zhou Yuan made another skin incision at the distal end, up to two centimeters above the wrist.

After the skin is incised, Zhou Yuan begins to separate the subcutaneous fat.

The outside of the blood vessels is protected by adipose tissue, superficial fascia, deep fascia, etc., and these things must be separated from the outside to the inside in order to reveal the blood vessels.

After subcutaneous fat separation, the brachioradialis muscle is exposed to the surgical field.

The brachioradialis muscle is a muscle in the forearm whose proximal two-thirds area covers the superficial layer of the artery.

Next to the brachioradialis muscle, the carpi radialis flexor muscle is attached.

Zhou Yuan dropped the knife again, cutting open the muscles and abdomen of the two muscles, exposing the deep fascia between the muscles and abdomen. _

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