Start with an emergency physician

He Jian smiled and said,"I feel relieved when you say this!"

"Teacher, shall I start?" Zhou Yuan asked

"let's start"

"General anesthesia." Zhou Yuan said.

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

Haiyang had already pushed the EEG.

The EEG is used during the operation to monitor the occurrence of cerebral ischemia. If there is a sign of cerebral ischemia, a shunt tube must be used to temporarily divert blood to ensure cerebral blood supply during the operation.

Otherwise, even if the patient completes the carotid endarterectomy, he will die from cerebral ischemia.

"Intravenous heparin infusion."

Heparin is mainly found in the liver and is a polysaccharide sulfate. It is an anticoagulant substance that can enhance the function of antithrombin and inhibit platelet adhesion.

The prerequisite for carotid endarterectomy is systemic heparinization.

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

While Zhou Yuan was operating, he said,"Report the patient's bilateral arterial pressure, the degree of cervical vascular stenosis, the condition of cerebral collateral circulation, and the basic function of the organs."

"Arterial pressure is 165mmHg, vascular stenosis is 67%, part of the cerebral collateral circulation is blocked, and there is a blockage, and liver and kidney function is damaged."

Zhou Yuan's face became solemn.

Other things are easy to say, but the blockage of cerebral collateral circulation is the most fatal.

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

After the operation exposed the stenosis of the carotid artery, Zhou Yuan's face became worse.

The so-called carotid stenosis refers to the compression of the carotid artery by atherosclerotic plaques in the carotid artery.

The cause of the disease is that under the influence of risk factors such as hypertension, hyperlipidemia, unreasonable exercise and eating habits, smoking and drinking, and emotional tension, lipids are deposited on the inner wall of the blood vessel to form"scaly" sclerotic plaques.

As the lesion develops, some plaques gradually enter the lumen, causing the lumen to narrow.

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

No wonder the director of neurology, neurosurgery and Jiang Xiaoqi said that 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.

""Continue." Zhou Yuan said calmly.

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

This step requires special care and high surgical skills. If the knife is slightly too strong, the blood vessels will be broken, and if it is slightly too small, the blood vessels cannot be cut.

Moreover, because the old man is very old and has high blood pressure and high blood lipids, the condition of the blood vessels is not optimistic and it is easy to become irreversible.

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

After more than ten minutes, the carotid arteries were exposed one by one.

"Oops, the position of the operating table is wrong."

At this time, Zhou Yuan, who was about to start cleaning the carotid artery plaque, was stunned.

The position was just right, but everyone overlooked one point. When cleaning the carotid artery plaque, it needs to be low!

He Jianyi's face changed:"Who adjusted the operating table! Don't you know that the operating table should be lower!"

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

In this position, no matter what posture Zhou Yuan uses, there will be a blind spot when holding the scalpel, and he cannot take care of it. It is very uncomfortable.

If the operating table is higher, it will be fine. At most, he can put something under the feet of the surgeon, but now the operating table is too low!

The cleaning process lasts for dozens of minutes. If the position is not suitable, it is not a good thing for both the surgeon and 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 expression remained unchanged. He ignored the opinions of others present and knelt directly on the operating table.

This position is just right for surgery!

Facing the sidelong glances of others in the operating room, Zhou Yuan slowly said,"It doesn't matter what position I use. In my opinion, as long as I can save people, it doesn't matter even if I kneel."

While speaking, Zhou Yuan's hands did not slow down at all.

"It is much more convenient……"Zhou Yuan said this easily.

He was carefully cleaning the plaques. These plaques are the cause of cerebral infarction and transient cerebral ischemia.

Plaque accumulation can cause stiffness and narrowing of the carotid artery, and plaque deposits can rupture and break, causing damage and leading to thrombosis. The clots and plaques will separate with the blood flow and migrate to the smaller arteries in the brain, causing large-scale cerebral infarction.

As long as the intima of the artery affected by the plaque is peeled off and the blood circulation is restored, there will basically be no problem.

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

"The patient suffered cerebral ischemia!"

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