Start as an Emergency Physician

Under the microscope, the structure of the blood vessels is very clear.

Except for the infection and swelling at both ends of the saphenous vein, there seems to be nothing wrong with the whole vein...

But soon, Zhou Yuan's eyes lit up.

"Director, take a closer look at this vein. Zhou Yuan dialed the saphenous vein.

The director of vascular surgery looked at it for a long time and didn't see anything wrong.

"Wait, you can see it when you compare it with the blood vessels in the patient's arm. "

Zhou Yuan said, putting the saphenous vein together with the patient's own radial artery and so on.

The director of vascular surgery looked at it for a few seconds, his expression became more and more surprised, and said, "The saphenous vein has become thinner..."

"Yes, compared to the radial artery next to it, the saphenous vein has a thinner wall because it has been stretched!"

"Stretched?!"

Both vascular surgeons' eyes widened.

Zhou Yuan recalled all kinds of knowledge about vascular grafting in his mind, and soon found the answer, explaining:

"The reason why the saphenous vein I chose before was longer than needed was because I soaked the saphenous vein in heparin saline, which caused the saphenous vein to retract, that is, the length of the saphenous vein I took was actually the same length as I needed after retraction. "

"Then why did it get longer this time, and how to explain it, if the blood vessels I transplanted were retracted, they could only be shorter, how could they be longer?"

Zhou Yuan smiled and said, "This is the crux of the matter. At that time, I was anastomosed to a vein, and the venous blood flow was smooth and the lumen was relatively large, so the length of the transplanted blood vessel would not be changed. And you're anastomosed now with an artery..."

"Due to the high pressure of the arteries, after the blood flow is restored, under the influence of the arterial pressure, the veins will extend to a certain length, and the pressure in the radial artery can elongate the saphenous vein by about 10 percent..."

The director of vascular surgery was stunned.

The doctor who had been in charge of the surgery was also sluggish.

"I... No, it's never happened like this!"

"Because you didn't soak in heparin saline, right?" Zhou Yuan looked at the chief surgeon who had failed the operation.

The Failed Master Knife nodded blankly, with a look of consternation on his face, "How would you know..."

"I'm guessing you accidentally intercepted it at the required length... In general, the saphenous vein that we need to amputate should be longer than the original, and then retracted and retracted by heparin saline immersion to reach the length we need, while preventing blood clotting and protecting the blood vessels. "

"You should have taken longer than the original length needed, and you could only do the graft after retraction, but you actually took a little less, so you skipped the retraction step..."

The main knife of defeat was shocked: "Yes... I sped up the operation in order to make up for the inability to preserve blood vessels with heparin saline..."

Zhou Yuan nodded and said, "It's the problem here." The liver has a role to prevent blood vessels from spasm! Your blood vessels are not soaked in heparin saline, so there is spasm outside, which leads to a large blood flow, which makes the blood pressure on the blood vessels increase, causing the blood vessels to be elongated..."

"So that's the case..."The main knife of defeat looked at Zhou Yuan in a daze.

No wonder the surgery fails...

"Well, doctors, you've been discussing it for two minutes, and I haven't had a general anesthetic yet," the patient suddenly spoke.

Zhou Yuan came back to his senses, continued the operation, and comforted: "It doesn't matter, it's just a minor operation." "

The patient breathed a sigh of relief.

"I've heard you say a lot, and I don't know what you're talking about, but... It feels like you're amazing. "The patient was a little happy.

He was naturally relieved to be able to let a powerful doctor operate on him.

"Artificial blood vessels. "

Although autologous vascular transplantation is more advocated, artificial blood vessels also have certain advantages since they exist.

For example, it fits into the current situation.

In addition, artificial blood vessels have stable physical and chemical properties, appropriate mesh porosity, and certain strength, and are easier to suture than blood vessels during transplantation surgery, and have less blood leakage than human blood vessels when blood vessels are connected and bloodletting.

After the artificial blood vessel was treated, the director of vascular surgery anastomosed the artificial blood vessel to the radial artery, and Zhou Yuan began to suture it.

Zhou Yuan glanced at the failed master knife and found that the latter was very disappointed.

"Anyone will fail, and the patient's life is not in danger, so you can pay attention to it later. Zhou Yuan comforted.

The director of vascular surgery scolded solemnly: "Next time, don't reduce the steps privately! Every step is the best result obtained by the experience of the predecessors, and countless people may die in the exploration of each step!"

The patient shuddered: "Just don't use me to explore the steps..."

Zhou Yuan sutured the distal end of the artificial blood vessel with the proximal end of the artery, and the proximal end was sutured with the distal end of the artery, and at the same time cleaned the infected area next to it.

The anastomosis of artificial blood vessels is much simpler than that of human blood vessels, and Zhou Yuan, who has no pressure to suture human blood vessels, is as easy as a joke to deal with artificial blood vessels.

After the sutures were completed, Zhou Yuan picked up the tweezers and gently pulled the sutures to tighten the sutures.

Next, tie the knot and complete the final stitching.

Zhou Yuan began to deal with the surrounding blood vessels again.

After completing the secondary vascular grafting of the radial artery, there were minor problems all around, and after more than ten minutes, the blood vessels in the arm returned to their original position and everything returned to normal.

Zhou Yuan breathed a sigh of relief and said, "Restore the blood supply." "

The director of vascular surgery removed the vascular clamp, and the radial artery blood suddenly poured into the artificial blood vessel, and irrigated the entire palm along the vascular network, and finally returned to the heart...

Everything is normal at the vascular anastomosis, there is no bleeding, and the blood circulation is unimpeded!

Zhou Yuan said: "Give more anticoagulant drugs after surgery. "

In general, anticoagulants are not required after vascular grafting, but patients have a precedent for vasospasm and infection, and anticoagulants must be given to prevent recurrence.

Next, Zhou Yuan began to suture the skin of his arm.

Not long after, Zhou Yuan put down the needle forceps, looked at the time, and said, "The operation is complete." "

The patient and Zhou Yuan and others breathed a sigh of relief at the same time.

Zhou Yuan took off his mask and walked out of the operating room with the doctors of vascular surgery.

Soon, the patient was pushed out of the operating room and taken to the ward.

Before Zhou Yuan returned to the hall of vascular surgery, the little nurse who was swiping her mobile phone suddenly screamed.

"Doctor Zhou, Doctor Zhou, come and see!"

The little nurse ran over with an excited face and swiped her phone to show Zhou Yuan. _

To see the ununderlined version of the novel, please download the Feilu Novel AP