Start as an Emergency Physician

There are almost no coarctation surgeries for the aorta in the emergency department, and the post-operative care is certainly not as experienced as the vascular surgeons.

But Ding Mahui and Tian Liang know each other and have dealt with each other a lot, so Ding Mahui and his wife will definitely leave Xiao Ding behind for Tian Liang to help take care of him.

Zhou Yuandao: "Pay special attention to bleeding for a few hours after surgery, abnormal high blood pressure. "

Bleeding is a very common complication after surgery, and in coarctation of the aorta, it is mainly caused by thickening or aneurysmal dilation of the intercostal arteries, detachment of sutures after ligation and severing, or severing of the blood vessel wall.

In addition to this technical factor, there is also the possibility of a degenerative change of the vessel wall that leads to a fragmentation of the anastomosis suture.

Bleeding can be a small problem, ranging from an ordinary superficial wound to a leakage of the internal suture, resulting in internal bleeding. Therefore, whenever bleeding is found, it should be investigated.

Postoperative paradoxical hypertension is a relatively rare postoperative complication, with an incidence rate of only 5%~10%.

Postoperative paradoxical hypertension is manifested as higher blood pressure in the upper and lower limbs after surgery than before surgery, but there is no obstruction of aortic blood flow, and the cause is unknown at present, and the cause of postoperative hypertension cannot be analyzed.

This complication is more common in patients with collateral dysplasia or older age at the time of surgery. In severe cases, blood pressure can even rise to 180~200mmHg.

Once postoperative paradoxical hypertension occurs, vasodilators must be given as soon as possible to reduce the workload on the heart and brain and avoid cerebrovascular accidents.

There are also several more common complications, such as re-coarctation, the incidence of which has been reported in the literature, and the incidence of re-coarctation in infants and young children who have undergone coarctation segment resection end anastomosis is significantly higher than in patients of other ages.

There are four reasons for re-coarctation, such as insufficient resection of the coarctation segment, failure of the anastomosis to grow with the growth and development of the infant, and the use of continuous sutures may limit the growth of the anastomosis. Zhou Yuan paid special attention to this point before, and he used intermittent sutures when performing sutures.

A third cause of re-coarctation is the presence of ductal tissue, which contains muscle fibers that extend into the wall of the aorta, causing fibrosis and re-coarctation. The last point is anastomotic embolism, which requires another operation to correct it.

There are also some rarer conditions, such as spinal cord ischemic injury, which occurs in only 0.41%.

"Noted down. Ryo Takada nodded silently.

"Patients may experience abdominal discomfort after surgery, which usually lasts for a few days and then recovers gradually. Zhou Yuan added.

Abdominal pain is also a common sequelae of surgery, and normal abdominal pain is caused by wound pain due to the passing effect of anesthetics, which can be recovered on its own.

A small number of abdominal pain is obviously accompanied by abdominal distension and decreased intestinal peristalsis, which may be due to mesenteric arteritis leading to small intestinal necrosis or intra-abdominal hemorrhage.

Tian Liang: "You know so much..."

Is there any surgery that Zhou Yuan can't do?

At least for now, Zhou Yuanhao has encountered really challenging surgeries.

It's a terrible thing, and I can't think about it at all.

Although the medical field is developing rapidly, it is still insignificant compared to the delicate human body.

On the road to studying medicine, have you ever encountered a mountain that you can't cross?

There must be a stage of mountains at a stage, such as Wang Ziqiao, Liu Kai and others at the level of resident doctors, who will be absolutely helpless in the face of tertiary surgery, and tertiary surgery is what they cannot cross at this stage. ‘

As for He Jianyi, Jiang Xiaoqi and even Director Wu, they will be stumped by top-notch total gastrectomy and so on, and it will take a long time to temper before it is possible to overcome it.

For Dean Yu Fang, and even international hand surgeons such as Jing Shenyuan and Richard, toe transplantation and thumb reconstruction is a peak that they cannot climb at this stage.

Diligence, genius, only by paying these things can they master it.

But what about Zhou Yuan?

Tian Liang has not seen where Zhou Yuan's limit is so far.

In other words, until now, the insurmountable mountains of Zhou Yuan have not appeared.

Craniotomy, coarctation resection of the aorta, double pneumonectomy, skull separation in conjoined children... It seems that there has never been any disease that can stump Zhou Yuan.

Except for those who have already stepped into the ghost gate, only half a finger remains in the world, and Zhou Yuan can pull it back!

Tian Liang's mood at the moment was indescribable, and his eyes looking at Zhou Yuan became deeper and more complicated.

The latter became unfathomable in his eyes at this moment.

"It's okay for the female nurse to stare at me, why are you staring at me too?" Zhou Yuan couldn't help it and said to Tian Liang.

Tian Liang: ...

He lowered his head and silently counted the gauze and surgical instruments several more times.

This is what you have to do as an instrument nurse, and the instruments often need to be counted three or four times before they can leave the operating room.

Zhou Yuan walked out of the operating room with Jiang Xiaoqi and the vascular surgeon.

"What are you still doing here?" Tian Liang looked at the Prince Bridge on the side suspiciously.

Wang Ziqiao was standing beside the operating table with a dull face, his hands raised in front of Hun and staring at his clean hands silently.

"What am I doing in the operating room?" Wang Ziqiao lamented.

He has never had an operation and the gloves are still clean, and there is no blood at all!

Not to mention the bloodstains, just the gloves of the prince bridge can be directly stuffed back into the packaging bag and reused next time!

Wang Ziqiao raised his hands the whole time, maintaining a standard surgical waiting position, and as a result, he didn't touch the instruments, let alone the patient, and he was completely watching this operation!

The bad guy Tian Liang also helped hand over the gauze, Wang Ziqiao wanted to help Jiang Xiaoqi, Jiang Xiaoqi said: "Go away, don't disturb me." "

I ran to the vascular surgeon, ready to help, and the other person said, "Get out." "

In the end, he wanted to rub Zhou Yuan's side, but he saw Zhou Yuan silently take a scalpel from the surgical tray, clench the scalpel, and glance at Wang Ziqiao in a daze...

It seemed that Wang Ziqiao was still hindering his operation, and he would go straight to the knife.

What's the matter, why are you so aggrieved when you are a third helper!

Tian Liang smiled: "Haha, it's so embarrassing..."

Prince's Bridge: ...

Wang Ziqiao took off his gloves, threw them into the medical waste bin, and walked out of the operating room in a daze.

To be honest, it's actually pretty cool...

I didn't do anything, I just messed around for a few hours, and then I could take the surgery and ask for it, and it would cost hundreds of dollars, right?

For a while, Wang Ziqiao's mood improved again. _

Feilu reminds you: there are three things to read - collection, recommendation, and points