Start with the emergency physician

“The patient has cerebral ischemia!”

Zhou Yuan immediately said: “Divert pipe!” ”

“Which kind?” Ocean asked urgently.

There are two main types of flow tubes: balloon type and non-balloon type. Rotary tubes with balloons are better fixed, easy to access distant parts, and reduce anatomical length. The straight-running non-balloon diversion tube provides a clearer view with a smooth tip and easy insertion.

Both types of divert tubes are suitable for the current situation, each has 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, installed the balloon-type rotary tube and asked: “Why don’t you choose a straight non-balloon type that doesn’t need a field of view?” ”

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

“However, I was able to do this because I was sure that I could complete the operation in the case of poor surgery, but it did not mean that others could. If you are not proficient, it is better to choose a straight-running non-balloon type tube that is easy to operate. ”

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

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

Then, Zhou Yuan quickly inflated the balloon and opened the valve, allowing the returning arterial blood to drive out the air in the flow tube, and then inserted the injection end of the flow tube into the common carotid artery.

The second time the balloon is inflated, and after fixation, the valve is adjusted to allow blood to flow out of the air at the injection end. Finally, adjust the valve to restore carotid blood flow.

“Carotid artery occlusion time is four minutes and twenty seconds. The diversion tube has been connected with the cerebral blood vessels, and cerebral ischemia has been alleviated! He Jianyi was also relieved.

“Teacher, trouble to place a brain drainage tube to drain the fluid in the patient’s ventricle.” Zhou Yuan raised his head, and his tone was a little weak.

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

He Jianyi was a little distressed and nodded: “I’ll deal with the effusion in the ventricles, and you continue to clean the carotid artery lining!” ”

Zhou Yuan smiled: “It’s okay.” Anesthesiologist, the patient’s blood pressure, heart rate. ”

“It can be operated.” The anesthesiologist reported the results directly.

“Good.”

After speaking, Zhou Yuan continued to possess himself, carefully separated the thickened inner membrane from the outer membrane with a peeler, and carefully removed the tiny fragments and floating tissue of the peeling surface.

Some floating distal endometrium perimeters are directly sutured and fixed.

“It’s sour.” Zhou Yuan said with a wry smile.

Tens of minutes of kneeling posture, the gravity of the whole body is pressed on the knee, can it not be sore?

The nurse who was responsible for 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. She prepared the operating table and uploaded this picture to the circle of friends!

Zhou Yuan did not notice this scene.

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

“Zhou Yuan, the brain drainage tube is placed, and I am ready to drain the effusion.”

“Good.” Zhou Yuan stopped the movement on his hand, “Negative pressure state, draw the effusion.” ”

After a few minutes, the fluid in the ventricles is emptied.

Zhou Yuan asked the nurse next to him to help wipe the sweat, “Teacher, come on suturing you, the inner membrane on my hand has not been peeled off clean.” ”

He Jian nodded.

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

“Withdraw the transfer tube.” Zhou Yuan said.

He slowly empties the distal balloon, withdraws the outflow end of the diversion tube, and then blocks the internal carotid artery.

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

Finally, the internal carotid artery is opened to expel the air inside the vessel, where sutures are performed. After suturing, the internal carotid artery is blocked again, the external carotid artery is opened, the common carotid artery is opened, and finally the internal carotid artery is reopened.

“Blood flow circulation.”

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

“Blood circulation is smooth.” Ocean reported with some joy.

He Jianyi: “Cerebral blood circulation is also fine, cerebral vascular blockage has disappeared, cerebral infarction symptoms have been relieved, and patients should wake up soon.” ”

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

“Finally saved!”

Next is the suture of the skin on the neck.

“You guys show me!”

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

Zhou Yuan did not sew quickly this time, on the one hand, to ensure the effect of suturing, on the other hand, it was also a learning opportunity for Haiyang and Liu Kai.

Otherwise, with Zhou Yuan’s master-level butt suture technique, if you really want to pursue speed, before the ocean can figure out why the needle is placed here, Zhou Yuan has already finished stitching the next stitch.

Just as Zhou Yuan was concentrating on stitching, He Jianyi’s voice sounded again.

“Haiyang, Liu Kai, have you two noticed what characteristics Zhou Yuan’s stitching has?”

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Fourth, send more! The fifth more start!