Start as an Emergency Physician
Chapter 198
"Temporarily stop the heart beating and clear the coronary anastomosis of blood. "
Zhou Yuan's order came down, so that He Jianyi and the heart surgeon were all in the same place.
"This is—" The heart surgeon didn't understand what Zhou Yuan was going to do.
"The coronary arteries are so thin that the heart beats around and vibrates the blood vessels, and stopping the heart can ensure that the blood vessels are still. As for the clear blood, it is to provide a bloodless surgical vision. "
"Can this be?!" the heart surgeon was stunned.
"The perfusion of cardiac arrest fluid was performed before, and now it is just right to chemically induce cardiac arrest. Zhou Yuandao.
He Jianyi, on the other hand, began to clean the blood on the blood vessels, and glanced at the heart surgeon: "What are you doing in a daze?
"Syringes. "He Jianyi.
After sucking the saline with a syringe, He Jian carefully flushed the coronary anastomosis intermittently at first.
"The coronary arteries attract the head. Zhou Yuandao.
When He Jianyi flushed the blood, Zhou Yuan used the coronary artery suction head to further absorb the blood to help reveal the surgical field.
After completing cardiac arrest and vascular dissection, Zhou Yuan picked up the vascular bridge stored in papaverine heparin solution.
"Tissue scissors. "
Zhou Yuan carefully cut the vascular bridge into an inclined plane to facilitate anastomosis.
Aligning the intimal thickness at the anastomosis of the radial and coronary arteries, Zhou Yuan began to perform sutures.
The suture is a continuous seam suture.
On the one hand, it saves time. The heart can't stop beating for too long, otherwise it can be life-threatening.
On the other hand, seam closure only needs to be knotted once at the end, and the anastomosis of seam closure is tougher and more natural than intermittent sutures with multiple knots or other methods.
When suturing the vascular bridge, Zhou Yuan inserted the needle from the outside to the inside, and when suturing the coronary side, the needle was inserted into the lumen of the coronary artery, and the needle was inserted from the inside to the outside.
Before you know it, the operation has been going on for three hours.
Outside the operating room, Qian Wei's wife walked up and down the corridor uneasily, looking at the sign of "under surgery" with a worried face.
Over the years, Qian Wei has seen her love and what she has paid for her family.
From a young guy who just graduated from college, to socializing day and night, drinking until he vomited in order to sign a customer, to today, he is slowly flooding with beer belly...
All of this is to give her a future and give her peace of mind.
"Don't worry too much, it's the most skilled doctors in our hospital who do the surgery. "
Qian Wei's wife turned around and found a little nurse pushing an ambulance over.
Zhang Ling had just gone to the pharmacy to replenish the ambulance.
"Thank you..." Qian Wei's wife was relieved.
Lying in the operating room is the person he loves the most, no matter who did the operation, he can't rest assured until he wakes up.
Zhang Ling put the ambulance next to him, next to Wei's wife, and said with a smile: "Yesterday, when I went to nurse Qian Wei, he also told me the story of your college days. "
Qian Wei's wife was stunned for a moment, and her attention was diverted: "What's the matter?"
"That means you chased him back then. Zhang Ling smiled.
"This guy is talking nonsense! Back then, it was obviously him who was dead in the face, and he went to my dormitory to confess, which made the whole dormitory building coax, and I had no choice but to agree to him. Qian Wei's wife thought of the past and unconsciously smiled.
Zhang Ling sat down, "You can sit down too, let's wait slowly." "
Qian Wei's wife nodded and sat next to Zhang Ling.
"Then he told me that you also proposed to him back then?"
Qian Wei's wife burst into tears and laughed: "Obviously he hid the ring in the cake, okay! Have a good birthday, but he is a bastard who hides the ring in the cake, and I almost ate the ring!"
Zhang Ling sneered and said, "Do you know that our Doctor Zhou has received similar patients? "
Qian Wei's wife was stunned for a moment, and said in surprise: "Someone really ate the ring?"
Zhang Ling nodded: "Yes, but the way they hide the ring is very special, the man hid the ring in the stinky tofu." "
"What happened in the end?"
"Later, the woman went to wash her stomach, and I felt that she would never want to eat stinky tofu in her life. Zhang Ling couldn't help laughing.
Qian Wei's wife also said: "Thinking about it this way, my family's Qian Wei still plays cards according to the routine... If he gives me the whole barbecue hidden ring, I'll kill him!"
The two chatted, and Qian Wei's wife's worries gradually eased.
Zhang Ling saw that Qian Wei's wife had adapted to it, stood up, and said, "I'll go to work in the emergency department hall first, you don't have to worry, Dr. Zhou will definitely cure your husband! Besides, the success rate of this operation is very high!"
Qian Wei's wife also stood up: "Thank you!"
She suddenly felt that the hospital was not so bad, at least, there was such a considerate little nurse to comfort herself.
After Zhang Ling left, Qian Wei's wife was in a much better mood, and sat down quietly, looking at the door of the operating room.
In the operating room across the door, everyone was silent.
The operation has reached a critical stage, and no one dares to be distracted.
Zhou Yuan carefully carried out the anastomosis of the distal end of the vascular bridge, He Jianyi held the tissue forceps to help provide a good surgical field, and the director of cardiac surgery controlled the blood circulation of each blood vessel and controlled the heart pulse.
When performing coronary artery anastomosis, there are four basic parts to choose from: the left anterior descending artery, the right distal coronal, the marginal branch of the left circumflex branch and the posterior descending artery.
The selection can be based on the surgical member's familiarity with blood vessels and understanding of anatomy.
After completing the anastomosis between the distal end of the vascular bridge and a coronary artery, He Jianyi and the others thought that Zhou Yuan would stop, but Zhou Yuan's voice sounded again.
"Scalpel. "
"Tissue forceps. "
"Needle forceps. "
I saw Zhou Yuan open again on another branch of the coronary artery and anastomosis again.
The director of cardiac surgery was stunned for a moment: "Are you planning to perform a sequential anastomosis?!"
The so-called sequential anastomosis is the use of one vascular bridge to anastomosis two or more coronary arteries.
The advantage of this anastomosis method is that it requires fewer vascular bridges and anastomosis, so the operation time is shorter, and the patency rate of the vascular bridge is significantly improved because there are more connected blood vessels.
But...... The coronary artery itself is a very thin blood vessel, and it is difficult to suture on it, and most doctors will avoid suturing it multiple times.
Zhou Yuan even specially chose a sequential anastomosis to establish a vascular bridge channel on the coronary artery many times?!_
Feilu reminds you: there are three things to read - collection, recommendation, and points
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