Start as an Emergency Physician

He Jian smiled and said, "I'm relieved to have your words!".

"Teacher, then I'll start?" Zhou Yuan asked.

"Let's get started. "

"General anesthesia. Zhou Yuan said.

When the anesthesia took effect, Zhou Yuan glanced at the time and announced, "The operation begins!"

The ocean has long pushed the EEG.

Intraoperative EEG is used to monitor the occurrence of cerebral ischemia, and if there is a manifestation of cerebral ischemia, it is necessary to use a diversion tube to temporarily divert blood at the same time as surgery to ensure cerebral blood supply.

Otherwise, the patient will die of cerebral ischemia even after carotid endarterectomy.

"Heparin is given intravenously. "

Heparin, which is mainly found in the liver, belongs to a polysaccharide sulfate, is an anticoagulant substance, can strengthen the function of antithrombin, can inhibit the adhesion of platelets.

Carotid endarterectomy is predicated on systemic heparinization.

"Heparinization is complete. Glancing at the indicators, He Jianyi said.

At the same time as Zhou Yuan opened the operation, he said: "Report the patient's bilateral arterial pressure, the degree of cervical vascular stenosis, the lateral branch circulation, and the basic functions of the organs. "

"The arterial pressure was 165mmHg, the degree of vascular stenosis was 67%, part of the cerebral collateral circulation was blocked, and the liver and kidney function were impaired. "

Zhou Yuan's face became solemn.

Otherwise, it is better to say that the obstruction of the lateral branch circulation is the most fatal here.

Once cerebrovascular ischemia occurs, brain cells will die in groups, and ischemic brain cells cannot be saved no matter what!

After the incision exposed the narrowing of the carotid artery, Zhou Yuan's face became even worse.

So-called carotid artery stenosis is when atherosclerotic plaques that occur in the carotid arteries compress the carotid arteries. The cause is the deposition of lipids on the inner wall of blood vessels under the influence of risk factors such as hypertension, hyperlipidemia, unreasonable exercise habits and dietary habits, smoking and drinking, and emotional stress, forming "scaly" sclerotic plaques. As the lesion progresses, some plaques gradually enter the lumen, resulting in a narrowing of the lumen.

But in such a narrow situation as this old man, Zhou Yuan also encountered it for the first time.

No wonder the director of neurology, brain surgery and Jiang Xiaoqi all said they couldn't do it.

He Jianyi and others were also shocked when they saw the condition of the inner wall of the carotid artery.

"Go on. Zhou Yuan said calmly.

After blocking the common carotid artery, internal carotid artery, and external carotid artery, Zhou Yuan carefully dissected the blood vessels.

This step requires special care and requires a high level of surgical technique, as a slightly stronger knife can break a blood vessel, and a smaller one cannot cut a blood vessel.

Moreover, because the elderly are very old, there are high blood pressure, high blood lipids and other phenomena, the condition of blood vessels is not optimistic, and it is easy to irreversible situation.

Simply, the master-level suturing technique gave Zhou Yuan not only the skill of suturing, but also the delicacy.

Ten minutes later, a section of carotid artery was exposed.

"Oops, the position of the operating table is not right. "

At this time, Zhou Yuan, who was going to start cleaning up the carotid artery vascular plaque, was stunned for a moment.

Originally, the position was just right, but everyone overlooked that what was needed to clean up the carotid plaque was low!

He Jianyi's face changed: "Who adjusted the operating bed!I don't know if the operating table should be lower!".

Now that the surgery has begun, it is impossible to raise or lower the operating table, otherwise it will cause secondary harm to the patient.

And now in this position, no matter what posture Zhou Yuan uses, there will be dead ends when holding the scalpel, and he can't take care of it, which is very uncomfortable.

It's okay if the operating table is high, but it's a big deal to put something under the main knife's feet, but now the operating table is too low!

The cleaning process takes dozens of minutes, and if the position is not suitable, it is not a good thing for either the chief surgeon or the patient.

He Jianyi was thinking about how to solve this problem, and suddenly saw Zhou Yuan kneeling down!

"Zhou Yuan, you..."

Zhou Yuan's face remained unchanged, ignoring the opinions of others present, and directly lying on the operating table in a kneeling position.

This position is just right for surgery!

Facing the sideways glances of others in the operating room, Zhou Yuan said slowly: "It doesn't matter what posture you use, in my opinion, as long as you can save people, it doesn't matter if you kneel." "

While speaking, the speed in Zhou Yuan's hand did not decrease at all.

"It's really much more convenient..."Zhou Yuan said lightly.

He carefully cleaned up the plaque. These plaques are the cause of cerebral infarction and transient cerebral ischemia.

Plaque buildup can stiffen and narrow the carotid arteries, and plaque deposits can rupture and rupture, causing damage and leading to thrombosis. Clots and plaques can separate with the bloodstream and migrate to smaller arteries in the brain, causing massive cerebral infarction.

As long as the intima, the arterial lining affected by the plaque is peeled off and blood vascularization is restored, and there is basically no problem.

Just as Zhou Yuan was concentrating on cleaning up, Haiyang, who had been monitoring the data of various instruments such as electrocardiograms, suddenly turned white.

"The patient had cerebral ischemia!".

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