Start as an Emergency Physician

There are many ways to stop bleeding, Abbott artery is already very rare, even the doctor of vascular surgery has never seen it, and Jiang Xiaoqi is even rarer as the deputy director of the emergency department.

How to deal with it is a question.

Zhou Yuan pinched the Abbott artery in his hand, it was quite soft, "Thrombin stops bleeding." "

Tourniquets to stop bleeding, sutures to stop bleeding, and so on are not very reliable.

The Abbott artery is deep in the tissue and is relatively small, so it is certainly not possible to stop the bleeding with a tourniquet. Otherwise, how to remove the tourniquet in the later stage?

Suturing hemostasis is also inappropriate, and to suture hemostasis, the Abbott artery must be exposed, which means that the Abbott artery needs to be dissected again, which is bound to cause unnecessary harm to the patient.

Thrombin hemostasis is currently the most practical method of hemostasis.

Blood vessels themselves have a protective function of blood clotting, and it is enough to use thrombin to activate the clotting mechanism of blood vessels. In addition, Zhou Yuan had already completed the bare hand compression, and the blood clotting could be completed in a minute or two.

Jiang Xiaoqi nodded, took thrombin and sprinkled it on the place where Zhou Yuan signaled.

After a few minutes, Zhou Yuan let go of his hand slightly.

He could feel the blood flowing through the veins, which were pounding as if they were heartbeats.

The perfect-level compression hemostasis method is really perverted...

How can a normal person feel the pulse of this kind of tiny blood vessels and fine blood flow, and it is not a large artery such as the radial artery and carotid artery.

Zhou Yuan suddenly looked forward to it again.

I still have five mid-level treasure chests left, and I can exchange them for a perfect-level technique when I have a chance!

"It really stopped. Jiang Xiaoqi was slightly surprised.

Accustomed to seeing Zhou Yuan's incredibleness, Jiang Xiaoqi calmed down a lot.

For people who can stitch with a needle and have an artistic sense of sewing, it doesn't seem to be a big deal to complete a hemostasis.

"Keep your blood pressure under control. "

Zhou Yuan returned to the position of the main knife and continued to resect and anastomosis the coarctation of the descending aorta.

The anesthesiologist answered.

He kept an eye on his blood pressure.

Even if the left ventricular reflux perfusion method, which may lead to cardiovascular and cerebrovascular hypertension, is not used, the aortic coarctation surgery itself may have an accident of high pressure, and it is still necessary to pay special attention to and control blood pressure.

Zhou Yuan built a temporary vascular bridge, but it only reduced the risk.

After completing the hemostasis, Zhou Yuan began to focus on performing sutures at both ends of the excision.

After the coarctation of the aorta is removed, the length of the descending aorta will be shortened, but it will not affect the body much.

Finally, Zhou Yuan pierced through the aortic wall with a needle and drained the accumulated air in the lumen of the blood vessel.

Air residue in the lumen of blood vessels is common, and although gases dissolve in the bloodstream in most cases, there have been some fatal precedents.

Due to the residual air causing a gas plug, the air and the heart chamber mix to form a large amount of foam, which cannot be eliminated at the moment of cardiac contraction, so that it is blocked and leads to sudden death.

After completing the final exhaust work, Zhou Yuan pierced the aortic wall with the last stitch, quickly tied the knot, and completed the suture.

Zhou Yuan carefully clamped vascular clamps at both ends of the temporary vascular bridge to block the blood flow, and the blood flow flowed smoothly through the sutured descending aorta because of blood pressure.

The suture area is tight and tight.

Jiang Xiaoqi's eyes were full of light.

It's too good to grasp it...

When Zhou Yuan first performed the suture, she wanted to say that when the blood vessels are anastomized, the general doctor may also cross the two parts of the skin that need to be anastomized together, and the marginal area may be thicker, which can ensure the accuracy of the suture, but the shortcomings are also obvious, it will further shorten the blood vessels, and even the edge vascular tissues that overlap together in this part will form a dead space.

However, if this is not the case, due to the weakness of the marginal area, there is no overlap to ensure the thickness of the edge, the anastomosis may be torn due to tension during suturing, and the entire anastomosis may be directly disintegrated after the blood flow is restored...

Zhou Yuan seemed to be born with no problem with a collapsed wound, and after completing the anastomosis, the blood flow passed through the blood vessels smoothly.

If you don't look closely at the descending aorta, you won't even notice which part has just been sutured!

After Zhou Yuan confirmed that there was no bleeding, he blocked both ends of the descending aorta again.

Now it's time to dismantle the temporary vascular bridge.

This step was not difficult, and Zhou Yuan completed the removal of the vascular bridge and sutured the incision in ten minutes.

When the blood supply was restored again, and after watching the descending aorta, which originally had coarctation of the aorta, transport blood normally, Zhou Yuan and the others felt a sense of accomplishment in their hearts.

As a doctor, the spiritual satisfaction that comes from this moment is unparalleled.

Tian Liang counted the instruments.

"Gauze, one, two, three..."

"The surgical instruments are all in place. You can close your chest. "

After confirming that nothing was missing in the ribcage, Zhou Yuan picked up the needle forceps and began to suture Xiao Ding's ribcage layer by layer.

About ten minutes later, Zhou Yuan placed the needle forceps on the tray.

With a bang, everyone breathed a sigh of relief.

It's finally done...

There are many dangers involved in the procedure.

Zhou Yuan is on the descending aorta, the aorta is the thickest arterial tube in the human body, responsible for pumping blood to all parts of the body, although it is elastic, but the adventitia is very thin, and there is a layer of connective tissue surrounding, it is easy to be damaged.

Once damaged, it means that there is a problem with the large blood vessels that carry blood throughout the body, how can the patient's body not have problems?

Fortunately, Zhou Yuan perfectly avoided this problem.

As for the Abbott artery, it is a minor problem, this blood vessel is dispensable, even if it is removed, it is fine, as long as the blood circulation does not have problems in the Abbott artery.

In the end, Zhou Yuan chose to keep the Abbott artery, Xiao Ding has this artery in his body, and there is no problem, and rash removal will increase the risk of surgery.

"The operation is complete. Zhou Yuan glanced at the time and said.

Tian Liang, Jiang Xiaoqi and others smiled.

Tian Liang looked at Zhou Yuan in a daze, and said, "I have been with so many surgeries, and I really rarely meet a master surgeon like you, you are too skilled!"

Zhou Yuan smiled faintly, "If you think about it again, you rarely encounter it?"

Tian Liang was stunned for a moment, "Okay, I haven't ever encountered such a powerful main knife as you..."

Zhou Yuan smiled contentedly.

Coarctation of the aorta itself is a rare disease, and there are not many people who can perform surgery regularly, and even proficient doctors have at most expert level because of the lack of surgery.

Zhou Yuan's master-level coarctation segment excision end-to-end anastomosis, not blowing, no one in the entire Yanjing Traditional Chinese Medicine can fight him!

"Zhou Yuan, is there anything special to pay attention to?" Tian Liang asked.

He is now a nurse on duty in the emergency department, and the other nurses are ready to leave work at this time, and the nurse who has just gone to work is not familiar with the patient, and the final nursing work must be handed over to Tian Liang. _

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