medical simulator

Zhou Chengcheng stepped forward and asked, "Teacher, can I also come to the stage to help?"

"Of course you are on stage. Hurry up and wash your hands!" At first, Fang Jingsheng only cared about his own affairs, so he forgot that Zhou Cheng was not from Huashan Hospital. To be on the operating table, he had to be approved by at least one chief surgeon, such as Fang Jing Lift.

And Fang Jingsheng was the one who knew Zhou Cheng quite well!

Zhou Cheng immediately ran out of the operating room, washed his hands, put on a surgical gown and went on stage.

When Fang Jingsheng had just opened a catheter sheath port for the femoral artery, Zhou Cheng happened to take over here, and Fang Jingsheng also put an embolism made of gelatin sponge particles.

In fact, in the past, this kind of arterial embolization for hemostasis was mostly used for internal iliac artery embolization of postpartum hemorrhage, and it was used for non-bleeding!

He has never used this method of directly embolizing the femoral artery to stop bleeding. It is a variant amputation to save his life.

According to his understanding, if it wasn't so urgent this time, and the patient hadn't been ordered to die by the hospital, he really wouldn't dare to let Zhou Cheng do this.

Even if Zhou Cheng is a bit capable.

However, under such circumstances, Zhou Cheng, who knows both orthopedics and vascular surgery, is indeed the best candidate.

Seeing Zhou Cheng take over, Fang Jingsheng immediately went to the opposite side to embolize other arteries, and Zhou Cheng left the arterial catheter sheath that Fang Jingsheng had just made.

Fang Jingsheng didn't ask any further questions, and left the catheter sheath behind.

Zhou Cheng started the operation position at that time. Although he can't see the direction of the blood vessels in the abdomen now, he can only see the blood vessels of the lower limbs, but with this vision, he can also insert the metal catheter to the common iliac artery. The common artery flows backwards, passes through the abdominal aorta, and reaches the position of the celiac trunk.

This is very risky, there is no vision at all, and you can only rely on the feel!There is also the control of the anatomical distance.

This blind feeling?

It's not too obscure, but it's not as smooth as other operations, and it's always a little awkward.

With no vision, Zhou Chengcheng probably felt the position of the lumen of the blood vessel, and then frantically tested it, finally!

Zhou Cheng felt that the distal end of the catheter went in a certain direction after reaching the celiac trunk.But it is necessary to control the catheter to the celiac trunk, pass through the first left gastric artery and the second common hepatic artery, and come to the position of the splenic artery!

It's not easy in such a professional place.

and!

In addition to reaching the splenic hilum, the splenic artery!

There are subgastroepiploic arteries and short gastric arteries!

What Zhou Cheng wants to do now is to block the splenic artery first, and then block the splenic artery!

People in the general surgery department have plenty of time to prepare for spleen removal or suturing.

And without the extremely fatal factors such as extremity arterial bleeding and spleen rupture, at least the life window can be extended from a few minutes to a few 10 minutes, and there is longer time to deal with it!

Such an opportunity is fleeting.

Zhou Cheng completely ignored the question of how to explain after the operation, and searched for traces of various branches in a frantic manner.

Finally, after a certain moment.

Zhou Cheng sent the tip of the catheter to the position of the splenic artery, and it crossed the left gastric artery and the common hepatic artery!

While preparing to put the embolism, he said to Fang Jingsheng over there: "Mr. Fang, should I embolize the splenic artery first?"

"Ah?" Fang Jingsheng was on the opposite side!

Hearing Zhou Cheng's words, the whole person was shocked.

"Wait, what did you just say?"

He thought there was something wrong with his ears, but just now Zhou Cheng seemed to say that he was going to embolize the splenic artery.

real or fake?

What are you talking about?

It took him a while to figure out the direction of the blood vessel.

Can you perform interventional surgery without interventional monitoring? ? ? ?

Do you know where the splenic artery is?

Fang Jingsheng was really a little scared!

If it is under the monitoring of interventional surgery, Zhou Cheng can accurately send the catheter or guide wire to the splenic artery.

Even branch arteries from the splenic artery to the splenic hilus.

Then Fang Jingsheng could believe it, but now?

Zhou Cheng didn't use any tools directly, but relied on the catheter.

The tip of the guide wire was sent to the splenic artery!

Is this believable?Can you believe this?

But in a situation like now, what can you do if you don't believe it?

Is the distance from the femoral artery to the splenic artery the guide wire is longer than the distance from the femoral artery to the dorsalis pedis artery?

The arterial bifurcations to be encountered in the middle are relatively large!

At most, the bifurcation in the celiac trunk is relatively small.

What about Zhou Cheng?That is the miraculous person who can perform thrombectomy across the arteries of the lower extremities that are thinner than the femoral artery. Can you still believe what he said?

"After the rupture of the spleen in acute abdomen, there will be a large amount of abdominal bleeding, which is very fatal."

"If the splenic artery is embolized in advance, it can reduce the amount of bleeding and buy us a lot of time for rescue." At this time, Zhou Cheng thought that Fang Jingsheng didn't understand, so he explained it this way to avoid too many disputes.

Fang Jingsheng felt that he was violated again!

Am I not understanding basic anatomy and anatomy?

He knew that Zhou Cheng must have said such a relatively basic explanation in order to avoid quarrels.

But although these words do not hurt much, they are extremely insulting!

After splenic rupture and bleeding, embolization of the splenic artery can stop the bleeding.

Don't say that you are a medical student, laymen know that wherever there is a leak, it will be plugged, and if the clothes are torn, they will be mended.

This is the same truth!

I am asking how you can find the splenic artery, not why you need to embolize the splenic artery.

Splenic artery embolization is much more commonly used than femoral artery embolization, but it is usually used as a first-line treatment for large spleen and hypersplenism.

For normal people, even if the spleen is completely removed, it will not affect the quality of life too much. It is a life-saving situation!

At this time, the ruptured splenic artery was blocked, which is naturally a very good thing.

Fang Jingsheng looked up at Professor Ni from the General Surgery Department, and then asked Zhou Cheng, "Is the splenic artery blocked?"

Zhou Cheng nodded and said, "Okay. What I'm going to do now is to embolize the brachial arteries of both upper limbs. The bleeding points in the brachial arteries are large and numerous, and the amount and speed of blood loss are the highest!"

"This minimizes blood loss from ruptured arteries in both upper extremities."

"Professor Fang, you continue your work."

Zhou Cheng's speech was inappropriately calm!

Deembolization of brachial artery bleeding from the femoral artery.

It seems that this is a basic operation that everyone knows!

Fundamental affairs 6, 6 must be titled!

In fact, Zhou Cheng was really speaking calmly, mainly to avoid quarrels, and to avoid confrontation and explanations with others.

Zhou Cheng didn't want to waste any more time, he just wanted to do a good job of this operation.

Although why Lu Ganzhou was injured, Zhou Cheng didn't know.

But this operation, no matter who it is, can't be dealt with casually when it comes to the stage. This is the professionalism of a doctor. At the same time, Zhou Cheng is trying his best to control his emotions.

……

About ten minutes later.

Fang Jingsheng just finished the operation, and Zhou Cheng completed a relatively large project.

The cause of this project is similar to an operation that Zhou Cheng experienced when he was in Changshi.

In the art of war, there are green mountains left to worry about no firewood.

When playing chess, there are such ways as throwing away the car to protect the handsome, and abandoning the thirteen moves.

But, after all, it was just a game of chess, and the sacrifice was nothing but a loss in the end.

In the actual medical treatment process, unless there is a problem with the brain, people will not think about embolizing all the major arteries of a person's limbs first. The first reaction is whether the patient can live and stop the bleeding?Amputation can save life?

It's different to directly tie the aorta to this Q thing!

First of all, although the limbs may not be preserved.

But at least, it will not add trauma and stress to the patient that is equivalent to amputation.

It can also achieve the effect of hemostasis.

This trick is called throwing your legs and hands to save your life!

However, under normal circumstances, if a person is alive without any limbs, then think about it again, where is the quality of life of this living body itself?

What is the meaning of his life? Besides being able to bring psychological comfort to his family, does he himself have to endure psychological suffering that is more terrifying than death for the rest of his life?

Some people will develop psychological stress disorder just by amputating a leg.There are all kinds of mental abnormalities, all of which are gone, and it takes a person of great courage to live to accept such a result.

After Zhou Cheng finished all this, he did not seek merit, but continued to read the current diagnosis of Lu Ganzhou, and then suggested: "Mr. Fang Jingsheng, and Mr. Du? Do you think we can treat the ruptured cerebral aneurysm now?" way, to deal with the hematoma in the brain?"

Zhou Cheng's voice was still very steady!

He didn't want to talk, quarrel, or pretend to be aggressive, he just wanted to save people.

However, upon hearing Zhou Cheng's words, Fang Jingsheng trembled and raised his head.Then Fu Youhan was also stunned, and looked at Zhou Cheng.The mouth covered by the mask opened slightly, choking on the words of swearing!

Malago Dogecoin Stuff!

What do you think you are here for?After finishing the vascular surgery, you want to teach the professor of neurosurgery?

and also?

What Fang Jingsheng thought was, can you stop asking me some words that even exceed my current understanding of the upper limit of healing?

Patients with high blood pressure or cerebral aneurysm can undergo minimally invasive interventional surgery after arterial rupture and bleeding, but it is all done under interventional monitoring!

If you do it blindly, you are really playing with fire on the line of life.

And this is the scope of neurosurgery, you should throw the problem to Du Li of neurosurgery, don't throw it to me, okay?

Zhou Cheng kid?

This patient can delay you to death, you know?

When Professor Ni heard Zhou Cheng's words, he looked at Neurosurgery Professor Du Li.

Du Li's expression immediately became very exciting.

Today's young people are really not ready to be human!

When you enter the door, you will directly kick the job of the anesthetist who monitors the vital signs. You don't need to monitor the arteries of the limbs, but directly monitor the CVP.You have no choice.

Then, he embolized the splenic artery of the ruptured spleen in Professor Ni's upcoming acute abdomen.

You embolized the splenic artery, and now I go in through the laparotomy, can I still call the emergency laparotomy to save the patient's life?

Originally, a ruptured spleen would kill a person, but now that you do it like this, Professor Ni will only become a part-time job!

It seems that his laparotomy is performed faster and slower, it is always just an operation, and has nothing to do with the patient's life or death!

It's as if the person who should be one of the protagonists has let go of his hands and feet and prepared the most exquisite acting skills.As a result, when he arrived on the set, he immediately became a dispensable supporting role...

But now, Professor Ni, who was obviously rushing to save his life, chose the upper left abdomen approach very anxiously, and then cut the subcutaneous part, and was dealing with the muscle layer.

After all, laparotomy is for surgery, not for stabbing people. Just take the knife and draw it directly into the stomach.

If opening the abdomen could be so simple, just anyone, a knife can solve it, how do you get in, how do you get out, external oblique muscles, rectus abdominis, you have to go through all these anatomical levels one by one processed.

His movements were already very swift, but he couldn't bear Zhou Cheng's misbehavior. Before he even got in, he took care of the most terrible movements.Because the first thing he did when he cut the spleen was to tie up the splenic artery.

This operation is similar to Zhou Cheng's operation of blocking the splenic artery to stop bleeding.

Not to mention Fang Jingsheng, from the moment Professor Fang Jingsheng heard Zhou Cheng say that he was going to embolize the splenic artery, his expression was dumbfounded...