Start with an emergency physician
Chapter 101
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Zhou Yuan looked serious, and without further explanation, he quickly said:"Inject saline coolant immediately to replace the blood!"
Although Lu Chenxi and others were puzzled, the anesthesiologist, instrument nurse, etc. had followed Zhou Yuan in many operations, so they did not doubt it. The nurse immediately injected the patient with saline coolant.
"Low temperature containment technology. It mainly lowers the patient's body temperature and slows down the blood flow, which can reduce the amount of bleeding."
Zhou Yuan said.
After the saline coolant was injected, Zhou Yuan said:"Stop the heart function, maintain it first, and transfuse a small amount of blood!"
Today's detection methods cannot ensure that the blood in the blood bank does not have any viruses. Under the current circumstances, transfuse as little blood as possible.
Lu Chenxi and another director of thoracic surgery started immediately.
Zhou Yuan continued to separate the brain.
Although the brains of the conjoined twins did not grow together, the surrounding blood vessels were crossed, which required careful separation.
Moreover, because it was an intracerebral blood vessel, Zhou Yuan did not dare to block the blood flow rashly.
Once brain cells die due to lack of blood and oxygen and cannot regenerate, it will cause permanent side effects to the two children.
"Director Xiao, separate the blood vessels. Zhou Yuan said.
Xiao Xuebao nodded and walked up.
After more than an hour, the right cerebral hemisphere was successfully separated.
Seeing the originally stuck brain separated in half, everyone in the operating room felt much better.
""There's still half."
Zhou Yuan said, and began to carefully compress and isolate.
Not only the blood vessels, but also the brain nerves need special attention.
Because the patient's brain is close, many blood vessels and nerves are tangled together, and Zhou Yuan and Xiao Xuebao need to determine the owner of the blood vessels and nerves.
Therefore, they can only follow the direction of the blood vessels to find the source.
"It’s too difficult… This is the first time I’ve performed a skull separation surgery on such a young child." Xiao Xuebao said.
Zhou Yuan carefully searched for the source of the blood vessels and said,"Have you done this before?"
"
Well , I did, but I died.……
"This was not a surgical accident. The babies were conjoined at the abdomen. The livers of the two children were fused together, and six large blood vessels were crossed together for blood transfusion. The situation was not as complicated as this. The team I led completed the separation, but the two children also had incomplete heart development and died one after another a few months after the separation."
Zhou Yuan nodded silently.
"I was the one who was trying to save the two children when they passed away. In one night, I sent critical illness notices to their families thirteen times in a row. I was scared to death, not to mention their families. Unfortunately, they were not saved in the end."Xiao Xuebao shook his head and sighed.
"Don't worry, although this operation is difficult, the patient is in good physical condition. As long as the operation is completed and postoperative care is paid attention to, there will be basically no major problems." Zhou Yuan seemed to be comforting. The operating room fell silent again.
Zhou Yuan was very fast. After completing the blood separation on his side, he began to help Xiao Xuebao.
Lu Chenxi and another thoracic surgeon had restored the patient's heartbeat. Excessive blood loss was also effectively alleviated.
This made the people present a little incredible.
This method is not unprecedented, it is often used in cardiac surgery, but... this is the first time it has been used in skull separation surgery!
Three hours later, the other half of the brain was finally separated.
Zhou Yuan did not relax and said:"Start the separation of the superior sagittal sinus."
This is also the most worrying part.
Once there is an uneven distribution, the baby with less superior sagittal sinus will have more skull defects and more severe brain softening. At the same time, the neurological function and brain development will not be complete.
The baby with more superior sagittal sinus will not have a higher IQ. On the contrary, his development will be slower than that of normal children, but he can still reach the level of normal people in the end.
Therefore, the best situation is that both of them are just right, which is beneficial to everyone.
"The shared upper sagittal sinus is relatively large, so we can try to separate it." Zhou Yuan took a look and said
"Use a head frame to fix the patient's head."
During separation, if there is relative movement between the brain and the skull and the superior sagittal sinus, the cranial nerves passing through the skull base may be seriously damaged. In addition, the cortical meridians returning to the dural sinus may also be damaged due to brain displacement, resulting in subdural and subarachnoid hemorrhage.
"Wait, the intracranial arteries do not need protection."Zhou Yuan stopped Xiao Xuebo.
"Why?"
"The surgery will not touch the intracranial artery. Moreover, the wall of the intracranial artery is relatively tough and rarely damaged. If you block the intracranial artery, you will damage the patient's brain for no reason.
Although the damage is small, it still exists. It should be avoided if possible.
"I understand."Xiao Xuebo was stunned and nodded.
""Blood clamp." Zhou Yuan said again.
Then, Zhou Yuan used blood clamp to block the emissary vein.
This is a vein that allows blood to flow into the superior sagittal sinus. Once blood flows into the superior sagittal sinus during the operation, it may cause blood infection, thereby causing venous sinus thrombosis.
After Zhou Yuan blocked it, he quickly started cutting.
Soon, the patient's superior sagittal sinus was completely separated. Zhou Yuan quickly restored the patient's blood flow to prevent it from affecting brain function.
"Completely separate."
Zhou Yuan said, and he and Xiao Xuebo slowly separated the two patients.
Soon, the two patients were successfully separated, but part of their skulls were missing.
""Repair the superior sagittal sinus." Zhou Yuan said.
This step was handed over to Xiao Xuebao and another neurosurgeon.
Zhou Yuan carefully examined the patient's brain.
After confirming that all blood vessels and nerves were correctly assigned, Zhou Yuan began to suture the cranial nerves.
The others were now idle and carefully stared at the busy three people.
He Jing and Wei Lili were stunned by Zhou Yuan's smooth movements.
"It's really... every time you see it, you'll be amazed!" Wei Lili said
"Yeah, so handsome.……"He Jing's eyes were dull, staring at Zhou Yuan motionlessly.
Wei Lili:……
"It feels like we two are here just to observe the operation. But it's okay, the two of us are here, which means that there is a problem with the patient. Now nothing has happened, which is a blessing."Wei Lili said.
He Jing smiled and nodded,"It's because Dr. Zhou's skills are better!"
Wei Lili nodded, and asked,"He Jing, do you want to go to the emergency department?"
He Jing was stunned:"Director, why do you say that?"
"I see you keep talking about Zhou Yuan, your mind is not on obstetrics and gynecology." Wei Lili joked. He
Jing blushed immediately:"No, it's because Dr. Zhou's skills are really good! If it weren't for his good skills, something might have gone wrong!"
Hearing this, Zhou Yuan's face darkened:"Don't be such a pessimist!……"_Feilu reminds you: Three things to do when reading - collect, recommend, and share
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