Start as an Emergency Physician

"The patient had cerebral ischemia!".

Zhou Yuan immediately said: "Diversion tube!".

"Which?" asked the ocean urgently.

There are two main types of diversion tubes: balloon type and non-balloon type. A diversion tube with a balloon can be fixed better, allowing easy access to distal sites, reducing anatomical length. The inline non-balloon diversion tube, on the other hand, provides a clearer view with a smooth tip and is easy to insert.

Both types of diverters are suitable for the current situation, each with its own advantages, and the ocean cannot tell which one should be used.

Zhou Yuan glanced at it a few times and said, "Balloon-type!".

Ocean nodded, and while installing the balloon type diversion tube, he asked, "Why don't you choose the straight non-balloon type, which doesn't need a field of vision?".

Zhou Yuan shook his head and said: "The patient's condition is very bad, and the metabolism of the elderly is slow, and it takes longer for the wound to heal, so we should try to avoid opening a large mouth." The balloon type can reduce anatomical length and postoperative complications. "

"However, I was able to do this because I was sure that I could complete the surgery with a poor surgical field, but it doesn't mean that other people can. If you are not proficient, it is better to choose an easy-to-operate inline non-balloon tube. "

He Jianyi touched his head: "Why do I think this sentence is so familiar?"

Zhou Yuan smiled, carefully cut a small incision at the carotid artery bifurcation, and after receiving the balloon-shaped diversion tube handed by the ocean, he quickly and gently inserted the outflow segment of the diversion tube into the lumen of the normal internal carotid artery.

Then, Zhou Yuan quickly inflated the balloon and opened the valve to allow the refluxed arterial blood to expel the air in the diversion tube, and then inserted the injection end of the diversion tube into the common carotid artery.

The balloon is inflated a second time, and the valve is adjusted after fixation to allow the blood flow to expel the air from the injected end. Finally, the valve is adjusted to restore carotid artery blood flow.

"The carotid artery blocking time is four minutes and twenty seconds. The diversion tube has been connected to the cerebral blood vessels, and the cerebral ischemia has been relieved!" He Jianyi also breathed a sigh of relief.

"Teacher, please place a brain drain to drain the fluid in the patient's ventricles. Zhou Yuan raised his head, his tone a little weak.

Before carotid endarterectomy, Zhou Yuan had already completed a high-intensity operation, and Zhou Yuan's face turned pale.

He Jianyi was a little distressed, nodded and said, "I'll deal with the fluid in the ventricles, and you continue to clean the carotid artery lining!"

Zhou Yuan smiled: "It's okay." Anesthesiologist, patient's blood pressure, heart rate. "

"It can be operated on. "The anesthesiologist reported the results directly.

"Good. "

After speaking, Zhou Yuan continued to possess himself, carefully separating the thickened inner membrane from the outer membrane with a decorator, and carefully removing the tiny debris and floating tissue from the peeled surface.

Some floating distal periintimar elements are directly sutured and fixed.

"It's so sour. Zhou Yuan smiled bitterly.

Dozens of minutes of kneeling, the gravity of the whole body is pressed on the knees, can it not be sore?

The nurse who was in charge of keeping everyone's mobile phones not far away saw this scene and unconsciously secretly took out her mobile phone to take pictures of this scene. As soon as she prepares the operating table, she uploads this picture to the circle of friends!

Zhou Yuan didn't notice this scene.

On the other side, He Jianyi's voice also sounded.

"Zhou Yuan, the brain drain has been placed, and I'm ready to drain the effusion. "

"Good. Zhou Yuan stopped what he was doing, "Negative pressure state, extract the effusion." "

After a few minutes, the ventricular effusion emptied.

Zhou Yuan asked the nurse next to him to help wipe his sweat, "Teacher, come on with sutures, the lining on my hand has not been peeled off yet." "

He Jian nodded.

Finally, after ten minutes, the operation was about to end.

"Withdraw the diversion tube. Zhou Yuan said.

He slowly emptied the distal balloon, withdrew the outflow end of the diversion tube, and blocked the internal carotid artery.

After the blood flow was blocked, Zhou Yuan continued to withdraw the injection end of the diversion tube to block the common carotid artery.

Finally, the internal carotid artery is opened to drain air from the blood vessels, where sutures are performed. After the suture is completed, the internal carotid artery is blocked again, the external carotid artery is opened sequentially, the common carotid artery is opened sequentially, and finally the internal carotid artery is reopened.

"Circulatory blood flow. "

Zhou Yuan put the needle forceps in the operating tray and asked.

"The blood circulation is unimpeded. The ocean reported with some joy.

He Jianyi: "The blood circulation in the brain is also unhindered, the cerebral vascular blockage has disappeared, the symptoms of cerebral infarction have been relieved, and the patient should wake up soon." "

Zhou Yuan nodded, and a long-lost smile appeared on his face again.

"I've finally been saved!".

Next is the suturing of the skin on the neck.

"You've got me covered!"

After the patient's dangerous period passed, He Jianyi's mood also improved, and reminded Haiyang and Liu Kai to pay attention to Zhou Yuan's suturing skills.

Zhou Yuan didn't sew fast this time, on the one hand, to ensure the effect of stitching, and on the other hand, it was also to give Haiyang and Liu Kai a learning opportunity.

Otherwise, with Zhou Yuan's master-level butt suturing technique, if he really wanted to pursue speed, before the ocean could figure out why he wanted to put a needle here, Zhou Yuan had already finished stitching the next stitch.

Just when Zhou Yuan was concentrating on stitching, He Jianyi's voice sounded again.

"Haiyang, Liu Kai, have you two noticed what are the characteristics of Zhou Yuan's suture?"

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The fourth shift is on!The fifth watch begins!