medical simulator

Brother, you are using the catheter in the femoral artery, why don't you go to get the thrombus on the moon?

Cai Dongfan also heard Zhou Cheng's anatomical structure, and immediately looked at the position of the groin and the dorsalis pedis artery that he usually touched, and scolded Zhou Cheng in his heart for being inappropriate!

And it's a real dog!

Usually they have more contact with Huangshinan. Huangshinan can reach the farthest end of the thrombus removal from the popliteal fossa, which is the distal end of the posterior tibial artery, peroneal artery and anterior tibial artery. Vascular surgery is relatively a blind spot.

There are too many blood vessel branches, even anatomical incision and thrombectomy will take too much time!

Zhou Cheng came up and called Huang Shinan to take the branch of the peroneal artery. Isn't this embarrassing Huang Shinan?

Of course, Zhou Cheng didn't mean it either. As long as everyone doesn't explain it clearly, it's fine.

"It's from the dorsalis pedis artery." Zhou Cheng was very sure, and then he saw Director Chen and winked at himself.

Zhou Cheng immediately understood: "Director Huang, why don't I continue to operate, and you can guide me from the side? This way I will feel more at ease."

So Huangshi Nanpei didn't have any thoughts for nearly four or five seconds, and then was interrupted by Zhou Cheng's speech, but he didn't dare to have the slightest temper, nodded and said: "Learn from each other, learn from each other!"

Huang Shinan immediately understood that Zhou Cheng was trying to save face and treated him politely.

Before, Zhou Cheng had experience in incision and thrombectomy. That was a limitation of the equipment, not that Zhou Cheng could not do it.

The others, Huang Shinan, don't know, but even Professor Zhang from the Department of Vascular Surgery at the Second Affiliated Hospital of Shonan University can't guarantee 100% access to the dorsalis pedis artery from the groin.

Although he didn't know how Zhou Cheng did it, Huang Shinan didn't dare to ask. He couldn't do it even if he asked, and he might not even understand it.Why bother?

At this time, Cai Dongfan also interjected: "Director Huang, you still have to work hard for Xiao Zhou, our orthopedic department. Dean Zeng, what do you think?"

Cai Dongfan knew that he wanted him to support Zhou Cheng at this moment. Everyone can say anything about the patient's success, but if there is any problem, Zhang Hongsheng needs to authorize him in the name of the hospital to avoid danger.

"Is it possible to keep these two legs?" Zhang Hongsheng asked Huang Shinan and Cai Dongfan.

He still has an understanding of the anatomy of the lower limbs, and he also knows what's going on with the dorsalis pedis artery, but it sounds futile, and he wants to get a solid answer.

Huang Shinan said conservatively: "If the thrombus in the dorsalis pedis artery and the medial and lateral plantar arteries can be removed, the possibility of limb salvage will increase by at least 50.00%. In the end, you don't need to be hospitalized to go to the orthopedics department. Just transfer to our vascular surgery department." !"

If Zhou Cheng could remove the arterial thrombus during the operation, then he would dare to dissolve the thrombosis after putting the filter in the vein!

In this case, the chances of giving it a go are still very high!

The patient lives in the vascular surgery department, which is still very good.

After all, even if you bleed after surgery, you can have another operation to stop the bleeding!With anticoagulation, everything will be fine.

Zhou Cheng didn't talk nonsense, and it wasn't time for nonsense at this time, he immediately inserted the catheter into the blood vessel again, and everyone couldn't see anything, but Huang Shinan, as the director of vascular surgery, saw that Zhou Cheng had turned at least four or five times. This means that Zhou Cheng has gone through at least three or four crossroads!

Oh my god, little brother, you really came here to mess with me, you did it so casually with the vascular catheter, it's like walking on the main road and turning four or five times.

If you pretend to be aggressive, you will be struck by lightning, don't you know?

Immediately afterwards, Huang Shinan saw that Zhou Cheng pulled the small thrombus out of the blood vessel twice, and in the process of pulling it back, he turned four times again, and it was obvious that he was Scalp numb!

These operations may seem ordinary to Cai Dongfan and others, but at this moment, Zhou Chengcheng is creating a miracle!

After the thrombectomy, Zhou Cheng and Huang Shinan started suturing together. After the suturing was completed!Free the proximal end of the femoral artery!

Huang Shinan immediately ordered the roving nurse very nervously to come up with a syringe needle!

At this moment, the blood vessel has penetrated from the femoral artery. If Zhou Cheng takes out all the thrombus, it means that the blood circulation at the end has been opened!

Hold the needle and poke it down from the thigh!

After piercing, traces of blood slowly flowed out one after another, it was dazzling bright red.

The bright red that looks bloody may not necessarily represent horror and nightmares sometimes, it may also be the miracle of life.

For the embolized lower limbs, especially the feet, isn't the blood dripping out at this moment a miracle of life?

Chapter 196 It's time to learn more!

On weekends, at the point of non-official work, but Annan is still processing documents in the unit.

In the afternoon, I called my wife and said that An Ruo was going home for dinner today, so he planned to leave early.

But who would have thought that just when he was about to go home, he received an urgent call.

After listening for a while, Annan quickly asked:

"Where is Xiao Wu now? Where are you going to send him?"

"Eighth Hospital? How did you send it to Eighth Hospital? Emergency department? How long will it take? Okay, I'll come right away." Annan asked as he walked outside...

When Annan arrived at No. [-] Hospital, he had already been sent to the operating room.

Then Annan looked at the almost brothers and sisters and Fang Linxiang next to him: "What the hell did Xiao Wu do?"

"Don't you all know? Lin Xiang, tell me!"

Fang Linxiang faltered, hesitated for a long time, and then said: "Little uncle, I can talk, but don't be angry."

"Tell me quickly! What's going on!" A man of Annan's age was about to die of anxiety.

The little five in their mouths is everyone's seniority, and the third is Fang Linxiang.From An Ruo's point of view, Fang Linxiang belongs to the third aunt's family, the third.

Xiao Wu is the youngest son of his uncle's family!

Annan is the youngest in this generation, with three older brothers and two older sisters.

He was the youngest, and gave birth to An Ruo, who was seven years old.

The eldest brother and the second brother are twins, and they have two sons, the eldest, the second, the fifth, and the sixth.

After Annan gave birth to An Ruo, no second child was allowed.

Of the seven children, except for An Ruo, who is the youngest, they are all elder brothers.

"Say it quickly!" Everyone else showed fierce eyes.

Fang Linxiang hurriedly said: "Well, uncle, grandpa, wasn't it Xiao Qi's birthday a few days ago? It happened to be two rounds! Our family passed one, and our brothers thought about it, and we got together in private for Xiao Qi's birthday." Have one outside."

"As a birthday present for her, Xiao Wu took a week off. She didn't tell her family because she was afraid that you would leak the news. After her birthday, she planned to catch a flight to the airport."

"How do you know?" Fang Linxiang lowered his head, clutching his head tightly.

Annan was so angry!

"You are afraid that your uncle and uncle will die too peacefully, right?" Someone immediately scolded.

The eldest brother of Annan's generation is no longer around. He failed to come back during a flood fight. Later, his two sons also went to the army, especially Xiaowu, who was a national defense student. Now he is directly leading the team after graduation. officer!

Deputy company level, real power.

He is the best kid in the family, but he never expected that after playing and playing, he got into a car accident, and the adults didn't even know he was back home safely.

Anwen was originally not called Anwen, but named Anwu. Later, the boss Anton disappeared, and everyone thought the word Wu was too sharp, so they changed it to Anwen, hoping that Anwen could be stable all over.

But later, although Anwen’s name was not sharp, he was very high-profile in his work. Since he was a child, he was very principled and self-disciplined. He persuaded his two uncles and two aunts to study national defense.

I thought it would be okay.

But who knew that Anwen ran back secretly, and something like this happened.

Annan's three elder brothers are Anton, An Xing and Anbei.Anton is the big brother, gone.

Annan's father never came back after crossing the river.

So, at present, it is basically the second brother An Xing and the fourth brother An Beixing University!

Xing has the character "Xing", but Anxi is not very pleasant to hear, so I added the word "star" and called it "An Xing".

"Don't you guys know how to give it away?" An Xing asked bitterly.

Originally, these little guys didn't do anything wrong, hey, they're all adults, and they didn't hide it for the sake of messing around.but?

Who wants such an accident to happen?

"Fourth Uncle, we were all drinking at the time, and thought it would be okay to take a taxi." Fang Linxiang explained.

An Xing raised his hand to hit someone, but luckily Annan persuaded him, saying: "The children didn't do it on purpose, no one is to blame for this kind of thing. Let's think about what to do first."

"If you hit the third child, can you solve the problem of the fifth child?" Annan persuaded.

An Ruo's 24th birthday is indeed commemorative. They also joined forces and held a relatively large birthday dinner for An Ruo.It is true that they are elders, but the elder brothers are of the same generation as An Ruo, so it is not wrong to want to surprise An Ruo.

And when Anwen graduated, he was the deputy company, and now he is a battalion-level cadre. He has one month of annual leave every year. He came back from vacation to celebrate his sister's birthday, and there was nothing wrong with him.

It's okay for Anwen and the others to drink a little wine together before Anwen leaves.

If it is really a responsibility, it can only be said that An Ruo should not have been born at this time.

"But big brother?"

"Ask the doctor first."

"Why didn't you think about going to the Affiliated Hospital of Shonan University?"

"I called and asked, and they said it was the weekend, and most of the professors went out to hold the annual meeting. You said that they were all going to the annual meeting without doing serious business?"

"Orthopedics is opened in the province, and other departments are opened outside the province. If you are full, you will not be able to do your job well."

"Is that so?"

……

Zhang Hongsheng is the executive director of the Eighth Hospital.It can be said that if it weren't for the patient's special situation and status, let alone the weekend, even if it was a weekday, he would definitely not appear in the emergency department.

Zeng Yi who rushed over also asked: "Director Guo, what is the situation here? Why did you call me suddenly? What is the situation?"

Director Guo is the director of the emergency department. Guo Haoran: "The situation is a bit complicated. About half an hour ago, our emergency department received two patients in a car accident. It was a big car that crashed into a taxi. The driver of the big truck was driving tired. , just tow the goods from Guangdong Province and get off the elevated shelf!"

"The taxi driver was gone when he got into the ambulance, and there was an active soldier sitting in the back seat."

"The relationship between the family is somewhat connected. It is said that they have already contacted the experts from the Affiliated Hospital of Shonan University and the Second Hospital. They are on the plane back from Shanghai, and they have already sent someone to pick him up at the airport..."

"However, after being consulted by Director Huang Shinan of the Department of Vascular Surgery, the risk of being temporarily transferred to another hospital is extremely high. Otherwise, both lower limbs will be necrotic and amputated. In addition, the patient also has trauma to the abdomen. Surgery must be performed immediately, and he has already been sent to the operating room."

……

At the door of the operating room, Huang Shinan said to a group of people: "I'm really sorry! The embolism of your nephew's lower limbs is too serious. We have cleaned up the embolism of the large blood vessels, but the blood supply at the distal end of the knee joint has not been smooth."

"It's still useless. There is necrosis at the far end, and it may still be life-threatening."

"I suspect that there is an embolism in a small branch artery, but the blood vessel is too thin, and now the patient is lying in the operating room, and there is no way to do an angiography. If you guess blindly, it will only cause additional damage to the patient."

"It even increases the risk of death. I have already discussed it with Director Kang of the Orthopedics Department. This situation is still suitable for amputation!"

Zhang Hongsheng also took the words and said: "The abdominal symptoms are relatively stable now, there are quite a few bleeding spots, but they should all be handled well, but the two legs."

"Our Director Huang has already tried his best."

How could Annan and others accept such a result?But fortunately, they are still qualified!

Instead, he asked: "Director Huang, how long do you think this leg can last? Can it last until the experts from the Second Affiliated Hospital of Shonan University arrive? We have already arranged for someone to pick it up at the airport."

He was not in Shashi, others went to a meeting, and no one expected Anwen to have such an injury in advance, so it would be nice if he could come here in time.

Huang Shinan shook his head helplessly and said: "After acute embolism of limb arteries, the average necrosis time is about six hours. But the individual situation is different, and the patient's current condition still has crush injuries!"

"When the experts arrive, even if the blood is drained again, it will cause reperfusion injury! Whether the muscle tissue can withstand it at that time is also a question."

"Unless the embolus is opened right now to restore the remote blood supply, otherwise, amputation will do more good than harm to save the patient's life."

Everyone knows how important legs are to a person.What's more, Xiao Wu is still a soldier. Once he loses his legs, not to mention his future, even basic life will be difficult.

They don't want to risk their lives unless they have to!

"Dean Zhang, Director Huang, can you think of other ways? I know this is difficult for you, but is there even a slight possibility?"

"Please think about it again." Annan was almost pleading.

Huang Shinan's face was bitter, but his expression was blocked by the mask, only showing a pair of helpless eyes.

……

When rushing from the door of the operating room to the operating room, Huang Shinan said to Zhang Hongsheng next to him: "Dean Zhang, this operation is extremely risky, and the identities of the patient and his family are so special. You said that if we didn't If you can complete the task of limb salvage, will you be able to walk around without food?"

Zhang Hongsheng took two deep breaths and said, "Do your best and listen to the destiny. Secretary An doesn't look like such a person."

"We also have to work hard to find a way, please help to think about it, who else, who else can."

After Huang Shinan heard this, he said to Zhang Hongsheng: "Dean Zhang, I really thought of someone..."

……

"It's done!" Huang Shinan shouted in a good mood.