Start with the emergency physician

He Jianyi smiled and said, “I am relieved to have your words!” ”

“Teacher, so I started?” Zhou Yuan asked.

“Let’s get started.”

“General anesthesia.” Zhou Yuan said.

Waiting for the anesthesia to take effect, Zhou Yuan glanced at the time and announced: “The operation begins!” ”

The ocean has long pushed electroencephalograms.

Electroencephalogram 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 to ensure cerebral blood supply at the same time as surgery.

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

“Intravenous heparin.”

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

Carotid endarterectomy requires systemic heparinization.

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

At the same time, Zhou Yuan said: “Report the patient’s bilateral arterial pressure, the degree of cervical vascular stenosis, the cerebral collateral circulation, and the basic functions of organs.” ”

“The arterial pressure is 165mmHg, the degree of vascular stenosis is 67%, part of the cerebral collateral circulation is blocked, and liver and kidney function are impaired.”

Zhou Yuan’s face became solemn.

Fortunately, obstruction of the collateral circulation of the brain is the most lethal here.

Once there is cerebral vascular ischemia, brain cells will die in groups, and brain cells that die of ischemia cannot be saved in any way!

After the opening exposed the stenosis of the carotid artery, Zhou Yuan’s face became even worse.

The so-called carotid artery stenosis is when atherosclerotic plaques that occur in the carotid artery compress the carotid artery vessels. The cause is that under the influence of risk factors such as hypertension, hyperlipidemia, unreasonable exercise and eating habits, smoking and drinking, and emotional stress, lipids are deposited on the inner wall of blood vessels, forming “scaly” sclerotic plaques. As the lesion progresses, some plaques gradually enter the lumen, causing 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 said they couldn’t do it.

He Jianyi and others were also startled 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 opened the blood vessel.

This step requires special care, the requirements for surgical technique are very high, the knife will break the blood vessel with a little force, and the slightly smaller one cannot cut the 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 have an irreparable situation.

So, the master-level suturing technique gave Zhou Yuan not only the power of suturing, but also the finesse.

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

“Oops, the operating table is not in the right position.”

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

Originally, the position was just right, but everyone overlooked the point that the need to clean carotid vascular plaque is low!

He Jianyi’s face changed: “Who adjusted the operating table!” I don’t know if 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 injury to the patient.

And now in this position, no matter what posture Zhou Yuan uses, there will be a dead angle when holding the scalpel, unable to take care of it, and it is very uncomfortable.

If the operating table is high, it’s okay, it’s a big deal to put something under the foot of the main knife, but now the operating table is too low!

The cleaning process can take tens of minutes, and if the position is not suitable, it is not a good thing for the main knife 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 the others present, and directly lying on the operating table in a kneeling position.

This location, just enough for surgery!

Facing the side eyes of the 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 in the slightest.

“It’s really much more convenient…” said Zhou Yuan easily.

He carefully cleaned 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 separate from the bloodstream and migrate to smaller arteries in the brain, causing widespread cerebral infarction.

As long as the lining of the arteries affected by the plaque is peeled off and blood supply is restored, there is basically no problem.

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

“The patient has cerebral ischemia!”

——

The third more sent, the fourth change, ask for data support!