Start with the emergency physician

Lu Chenxi’s face changed: “Aortic dissection aneurysm is a major operation, I haven’t done it, I can only call Dean Fu over!” ”

Zhou Yuan calmly pressed Zhang Shan’s chest and said, “Immediately take morphine and tranquilizers to relieve pain, first relieve the patient’s pain, otherwise sooner or later he will faint in pain!” ”

Then looked at Lu Chenxi: “You haven’t done this operation, don’t you know how to treat it?” ”

Lu Chenxi quickly replied: “The initial treatment goal is to control the systolic blood pressure at 100~120mmHg, and the heart rate is 60~75 times per minute!” ”

Zhou Yuan looked at the little nurse Yang Yu: “Immediately reduce myocardial contractility, slow down the left ventricular contraction rate and peripheral arterial pressure.” Zhang Shan has hypertension, and the intravenous intermittent administration of propnelol and intravenous drip of nitroprusside sodium can reduce blood pressure to clinical treatment indicators! ”

The more Lu Chenxi listened, the more wrong it became, until he saw Zhou Yuan’s hand holding the hospital bed ready to push, and asked in a panic: “What are you going to do!” ”

“The diameter of the patient’s aortic dissection aneurysm is close to ten centimeters, the severe deformity of the blood vessels has worsened, and the aortic regurgitation and high blood pressure, and now if there is no direct surgery, there is only one way to die!”

Lu Chenxi said anxiously, “But I haven’t had such a bad operation!” ”

“Top up!”

Zhou Yuan did not continue to argue with Lu Chenxi, turned his head and asked Yang Yu: “Is the operating room ready?” ”

Yang Yu immediately nodded: “Operating Room No. 1 has been vacated, and all the instruments have been prepared.” ”

Zhou Yuan nodded, “Take the handle, push it over!” ”

After speaking, he said to Lu Chenxi: “Start the preoperative preparation immediately, don’t think too much, I will go and ask for the signature of the patient’s family now.” ”

Aortic dissection aneurysm resection is an extremely complex operation, even if Zhou Yuan has mastered the master-level technique, it is impossible to complete it alone.

The effort of discussing with the family just made Lu Chenxi adjust his state.

Coming to the waiting room, Zhang Shan’s daughter was already crying red eyes, and as soon as she saw Zhou Yuan come out, Zhang Shan’s daughter immediately ran over.

When Zhou Yuan said about the aortic dissection aneurysm, Zhang Shan’s daughter was obviously stunned, she couldn’t understand.

“Let’s put it this way, comparing the blood vessel wall to a three-layer plywood, after the rupture of the inner membrane layer of the blood vessel, the blood flow enters the middle membrane, resulting in the weakness of the outer membrane, and its biggest harm is that blood vessels are easy to rupture after increased blood pressure or rapid changes in heart rate, bleeding, and then leading to death.”

“And now, there is also an aneurysm with a diameter of about ten centimeters on the aorta, plus a series of complications, your father’s condition is now more critical, and he must be operated on as soon as possible!”

“Doctor, although I didn’t understand, I believe you!”

After Zhang Shan’s daughter said this, she immediately signed.

Zhou Yuan was silent for a moment, stared at the informed consent form, and hurried to the operating room.

In the operating room.

Everything is ready.

Lu Chenxi also quickly adjusted his state and prepared to open the operation.

At this time, Zhou Yuan took the scalpel and glanced at Lu Chenxi: “Stay aside.” ”

This girl won’t think she’s the main knife, right? Naive.

Zhou Yuan smiled and glanced at the time: “The operation begins.” ”

Lu Chenxi was shocked, “What are you messing around!” Now is not the time for jokes! Human life is at stake! ”

Zhou Yuan’s face was calm: “It is precisely because human life is at stake, so I can’t let you go on.” ”

“Is the ‘elephant trunk’ ready?” Zhou Yuan asked.

Lu Chenxi also wanted to stop the messy intern Zhou Yuan, who directly yelled “another noisy injection for you to stabilize” before quieting down.

“Trust me.” Zhou Yuan’s voice carried a sense of confidence.

Lu Chenxi thought of Zhou Yuan’s previous incredible suturing and hemostasis, and a little flame of hope suddenly appeared in his heart, and he said: “Instrument nurse, immediately prepare the full-program support elephant trunk technique.” ”

Lu Chenxi spoke, which also means that from this moment on, the main knife in the operating room has become Zhou Yuan, and all orders are subject to Zhou Yuan.

The “elephant trunk” technique is a surgical method for the treatment of extensive aortic pathology, that is, artificial blood vessels are inserted into the descending thoracic artery to replace human blood vessels for blood transfusion. This section of artificial blood vessel is called an elephant trunk.

In general, the true cavity of aortic dissection is often very narrow, it is difficult to put artificial blood vessels in, and the soft elephant nose tube will interfere with the blood supply of branch arteries, and when replacing the aortic arch, support artificial blood vessels are often selected, that is, the full program support elephant trunk technology in Lu Chenxi’s mouth.

Zhou Yuan quickly opened the chest cavity, incised the aortic arch at the middle of the sternum and the proximal end of the left subclavian artery, and with the assistance of Lu Chenxi, inserted a stent vessel about ten centimeters long and about twenty-six millimeters in diameter into the true lumen of the descending aorta.

Next is the stage that Zhou Yuan is best at.

He took the needle forceps, built the proximal end of the artificial blood vessel, and continuously sutured it with the residual descending aortic vessel, and after anastomosis, the anastomosis of the head, brachial plexus and proximal aorta was reconstructed on the artificial blood vessel in turn.

This again attracted the amazement of the little nurses in the operating room, and the eyes of some beautiful little nurses looked at Zhou Yuan.