Start as an Emergency Physician

Lu Chenxi's face changed: "Aortic dissection aneurysm is a major operation, I haven't done it, I can only call Dean Fu over!"

Zhou Yuan calmly pressed Zhang Shan's chest and said, "Immediately take morphine and tranquilizers to relieve pain, and relieve the patient's pain first, otherwise sooner or later he will faint in pain!"

Then he looked at Lu Chenxi: "You haven't had this surgery, don't you know how to treat it?"

Lu Chenxi hurriedly replied: "The initial treatment goal is to control the systolic blood pressure at 100~120mmHg and the heart rate at 60~75 beats per minute!"

Zhou Yuan looked at the little nurse Yang Yu: "Immediately reduce myocardial contractility, slow down the left ventricular contraction rate and peripheral arterial pressure." Zhang Shan has hypertension, and the intravenous intermittent administration of propranolol and intravenous intravenous infusion of nitroprusside sodium were used to reduce blood pressure to the clinical treatment index!".

The more Lu Chenxi listened, the more wrong it became, until he saw Zhou Yuan holding his hand on the hospital bed and preparing to push it, and asked in a panic, "What are you going to do!"

"The patient's aortic dissection aneurysm is nearly 10 centimeters in diameter, the blood vessel is severely deformed, and the aortic valve is not closed and hypertension

is high

Lu Chenxi said anxiously: "But I haven't had such a bad operation!"

"Go up!".

Zhou Yuan didn't continue to argue with Lu Chenxi, turned his head and asked Yang Yu, "Is the operating room ready?"

Yang Yu immediately nodded: "The No. 1 operating room has been vacated, and all the instruments have been prepared." "

Zhou Yuan nodded, "Take a hand, push it over!"

After speaking, he said to Lu Chenxi: "Start preoperative preparations immediately, don't think about it too much, I will go and ask for the signature of the patient's family now." "

Aortic dissection aneurysm resection is an extremely complex operation, and even if Zhou Yuan has mastered the mastery of technology, it is impossible to complete it alone.

The effort of discussing with the family just allowed Lu Chenxi to adjust his state.

When she came to the waiting room, Zhang Shan's daughter was already crying and her eyes were red, and as soon as she saw Zhou Yuan coming out, Zhang Shan's daughter immediately ran over.

When Zhou Yuan talked about the aortic dissection aneurysm, Zhang Shan's daughter was obviously stunned, she couldn't understand.

"Let's put it this way, the blood vessel wall is compared to a three-layer plywood, after the intima layer of the blood vessel ruptures, the blood flow enters the media, resulting in the weakness of the adventitia, and its biggest harm is that the blood vessels are easy to rupture and bleed after the blood pressure rises or the heart rate changes rapidly, which leads to death. "

"And now, there is also an aneurysm about ten centimeters in diameter on the aorta, plus a series of complications, your dad is now in an even more critical condition and must be operated on as soon as possible!".

"Doctor, I didn't understand, but I believe you!"

After Zhang Shan's daughter said this, she immediately signed.

Zhou Yuan was silent for a moment, stared at the informed consent form, and hurried to the operating room.

in the operating room.

Everything is ready to go.

Lu Chenxi also quickly adjusted his state and prepared to operate.

At this time, Zhou Yuan took the scalpel and glanced at Lu Chenxi: "Stay and go." "

This girl doesn't think she's the main knife, is she?

Zhou Yuan smiled and glanced at the time: "The operation begins." "

Lu Chenxi was shocked, "What are you messing around! Now is not the time to joke! Human life is at stake!".

Zhou Yuan's face was calm: "It is precisely because human life is at stake, so I can't let you go." "

"Is the 'elephant trunk' ready?" Zhou Yuan asked.

Lu Chenxi also wanted to stop the nonsensical intern Zhou Yuan, who directly yelled "I will give you an injection of diazepam again" before quieting down.

"Trust me. Zhou Yuan's voice carried a sense of confidence.

Lu Chenxi thought of Zhou Yuan's incredible sutures and hemostasis, and a little spark of hope suddenly appeared in his heart, and then said: "Instrument nurse, immediately prepare the whole process of supporting elephant trunk technology." "

Lu Chenxi spoke, which also means that from this moment on, the chief surgeon in the operating room has become Zhou Yuan, and all orders are subject to Zhou Yuan.

The "elephant trunk" technique is a surgical method for the treatment of extensive aortic disease, that is, artificial blood vessels are inserted into the descending thoracic artery instead of human blood vessels for blood transfusion. This section of artificial blood vessels is called the trunk.

Generally speaking, the true lumen of aortic dissection is often very narrow, it is difficult to put artificial blood vessels into it, and the soft elephant trunk tube will interfere with the blood supply of the branch arteries.

Zhou Yuan quickly dissected the thoracic cavity, made an incision in the middle of the sternum and the proximal end of the left subclavian artery, and with the assistance of Lu Chenxi, inserted a stent vessel about 10 centimeters long and about 26 millimeters in diameter into the true lumen of the descending aorta.

Next is the stage that Zhou Yuan is best at.

He picked up the needle forceps, constructed the proximal end of the artificial blood vessel, and continuously sutured it with the remaining descending aorta vessel, and after the anastomosis was completed, the anastomosis of the head, brachial plexus, and proximal aorta was reconstructed on the artificial vessel.

This attracted the amazement of the little nurses in the operating room, and the eyes of some beautiful little nurses changed when they looked at Zhou Yuan.