medical simulator

However, this situation has already returned to the familiar scene of Zhou Cheng.

"What are you going to do next?" Fang Jingsheng felt a headache at the moment. Although the temporary life-threatening part was temporarily resolved, how should the embolism in both lower limbs and upper limbs be treated?Now even if the embolized thing is removed, the blood probably won't be able to flow, and the bleeding will not come out.

But ischemic necrosis should come, if not dealt with in time, if muscle necrosis occurs in the limbs, then the patient will die, unless it is amputation to solve all the troubles at once.

Zhou Cheng said: "Professor Fang, now we will make another small incision at the farther part of the entrance of the femoral artery sheath, and then take out the thrombus in the artery, and then pass through the bleeding point collected by the previous MRA. , Selective and precise hemostasis, and then take out the embolus. If the bleeding point is really difficult to deal with, it is enough to open the local hemostasis."

The meaning of this is very simple, take out the emboli, and use the unimportant bleeding points to continue to stop bleeding through the remaining emboli. The important bleeding points are precisely located at the bleeding point after the thrombus is removed. Embolization to stop bleeding.

The injury caused by Fang Jingsheng's words made the vascular surgery doctors standing beside Fang Jingsheng start to be partial, and helplessly smiled wryly!

And this kind of wry smile is the kind of bitterness where the bile is flowing backwards.

Zhou Cheng's words were calm, but the professional difficulty was beyond the comprehension of others.

Can you stop talking so casually?

However, it seems that their reaction at this moment is not as big as before. After all, everything has a process of getting used to it.After getting used to it, it wasn't as shocking as before.Zhou Cheng even blindly drilled the femoral artery into the cerebral blood vessels. Isn't it easy to blindly perform a lower extremity arterial embolectomy?

Why should they be surprised?

Fang Jingsheng opened and closed his mouth slightly, nodded, and stepped aside: "Then you start first, starting from the upper arm I have embolized last, there may be fewer embolisms to encounter, and the operation will be more difficult. Lower."

"Professor Ni, can you help me make the port of the inferior arterial sheath? I haven't done it yet." Zhou Cheng answered very quickly, but he was also a little bit embarrassed.It seems a little shy.

But Zhou Cheng's words immediately made Fang Jingsheng and several vascular surgery staff, and even the neurosurgery staff who knew what an introducer tube was, cursed in their hearts.

You are paralyzed!

Insulting people should also pay attention to the lower limit?

Zhou Cheng was being modest, but it was just a little too much.

However, Fang Jingsheng could also understand that Zhou Cheng was doing this to give them a better sense of participation.Don't let everyone's appearance be so ugly.

While saying this, the door of the operating room was pushed open.

Then a large number of middle-aged and elderly people wearing green clothes, surgical masks and hats squeezed in.

The leader was an old man with gray sideburns. After he entered the door, he shouted: "Professor Fang, how is the patient's condition now? I happened to invite an expert from Fuwai Hospital in Kyoto to Shanghai on a business trip. "

"Then this is Professor Nong from Tiantan Hospital in Kyoto. Him."

The speaker was the director of Huashan Hospital. When he spoke, Du Li and Fang Jingsheng were still working.

Fuwai Hospital is the best hospital for vascular surgery, and the best hospital for neurosurgery is Tiantan Hospital in Kyoto.At least officially, that's how it's defined.

However, the comprehensive strength of neurosurgery in Huashan Hospital ranks second in the country, and Professor Du Li is a well-known top expert and professor.

Dean Wang had just finished speaking, and the professor Nong introduced by him, an old man with clear eyes but senile plaques all over the bridge of the nose, spoke: "Dean Wang, I will not be on stage anymore, with Professor Du here. The current operation It's going well."

"Vital signs have also stabilized."

But the professor of vascular surgery frowned slightly, looked at Lu Ganzhou's limbs, and said in disbelief: "Professor Fang, the blood supply to these limbs is cut off so neatly, could this be caused by trauma?"

"That doesn't look like it?"

Obviously, he also knew Fang Jingsheng. There were many international conferences in Kyoto and Shanghai, and there were even more collisions and exchanges between top professors, so basically the big shots in the world knew each other.

Fang Jingsheng said politely: "Professor Lu has good eyesight. The patient's blood vessels in the extremities are cut off. We did it ourselves to stop the bleeding quickly and easily."

"At that time, there was a rupture of the splenic artery and an intracranial hematoma. It was already difficult to maintain the balance of blood flow by debridement and precise hemostasis, so Xiao Zhou and I chose violent devascularization!"

"We're now planning to reopen it."

Professor Lu frowned when he heard the words: "Saving a limb to save life is not a choice. Keeping the green hills alive will not worry about firewood."

"The high pressure cliff fell to 50+, and it can be rescued. This really requires a very high level."

Professor Lu glanced at the blood pressure display on the anesthesia machine.

Professor Chu said: "Thanks to the limited blood loss, otherwise, the patient's heart rate would definitely be in ventricular fibrillation now, and it jumped to 160 at the highest point, and he was cardioverted not long ago."

After replying, Professor Chu immediately followed his students: "Continue pumping electrolytes, replenishing so much blood, we must pay attention to hyperkalemia and metabolic alkalosis."

"Bring two more dopamine, and adjust the speed of the intravenous medication."

"The oxygen flow can be adjusted down..."

"How much is the rehydration?" He was already busy.

Dean Wang and others didn't care about Professor Chu interjecting and leaving it alone, but just to be on the safe side, Dean Wang still asked: "Professor Lu, Professor Nong, you must not refuse, today's TV station The operation is an extremely difficult emergency operation, and I sincerely request the two professors not to hold back anything because of scruples."

This is a bit sweet, but also a bit awkward.

However, everyone who came in didn't respond to his words. People from other specialties went to the direction of the film reader and were carefully reading the condition.

However, Fu Youhan from the Orthopedics Department recognized the identities of these people, walked over silently, and said in a low voice, "Director Tong, Teacher Zhang, and Zhou Cheng, a student of Teacher Zeng Diwei, are on stage."

"What?" Tong Dawei immediately turned his head and looked at the operating table.

Zhang Xingze, who was next to Tong Dawei, also felt that the word Zhou Cheng was more familiar.

"Zhou Cheng, he has already gone to the operating table for surgery, and he has embolized the arteries of his limbs first, saying that the treatment will be delayed." Fu Youhan continued to explain.

After Tong Dawei saw Zhou Cheng's figure, he lowered his head and explained to Zhang Xingze: "Mr. Zhang, this Zhou Cheng is..."

In this way, the two people in the orthopedics department will no longer participate, and the operation is still going on.

……

Chapter 4 The birth of a miracle lies in the perfection of the smallest details!

Zhang Xingze knew Zhou Cheng, but he only met Zhou Cheng once, and that was at Zhou Cheng's defense meeting last year. Although he had heard of this name occasionally, after all, he didn't have deep contact with him.

It was a coincidence that Zhou Cheng was now armed with a mask and a hat. It was indeed normal for him not to recognize Zhou Cheng's identity.

However, although he has not personally contacted Zhou Cheng, as one of the few bigwigs in the field of orthopedics, he has heard Zhou Cheng's name too many times.

Today, the development of the medical industry can break the current deadlock to the point where it is now. It can be said that it is the Zhongzheng Group’s credit on the surface, but behind the scenes, the biggest contributor is Zhou Cheng’s team.

Zhou Cheng is not alone, because all research must be carried out in a team as a unit to complete and smoothly.

"Dean Wang, since Xiao Zhou is here, Professor Zhang and I don't have to go on stage." After seeing what Zhang Xingze was looking at, Tong Dawei took the initiative to tell Dean Wang.

It would be best for him to mention this, otherwise he might be thought Zhang Xingze was putting on airs.

Moreover, even if Zhang Xingze is an academician, such a code name is not used in regular chats, and he is more often called a professor.

Dean Wang is not a fool, there must be a reason for so many professors to speak for such a young man.

He didn't come on stage, he wasn't from the surgical system, but he was watching quietly from the side.

Then he said: "Professor Nong and Professor Zhang, thank you for making a trip today, I just hope to delay you a little longer."

They called people over to help. Although they are not on stage now, Dean Wang still doesn't want to remove these people directly.

It's one thing for Zhou Cheng to be very powerful, but in case of any accident, these few people must be the best powers to save lives.

With them around, you can feel more at ease, not to worry about Zhou Cheng, but to increase insurance.

It is not a good thing that there are too many chief surgeons on the operating table. Each has his own ideas, one chief surgeon and several assistants. Now that several people on the operating table have formed a team, it is difficult to dismantle them again.

Everyone is watching the operation process quietly...

After the vascular embolization, Professor Fang Jingsheng of the Department of Vascular Surgery suddenly felt that there was not much to do.

The reason why I talked about how to complete the circulation after arterial embolism was just opening my mouth out of desperation.

Currently, the only arteries embolized in Lu Ganzhou are the femoral artery and the brachial artery. However, the arteries on the heart can communicate with the blood vessels in the head, and the arteries and veins of the lower limbs can also form a return flow through the internal iliac artery and a series of veins in the pelvis. Unicom.

In this way, there is no need to worry about the circulation in the body.At least not as scary and terrifying as when I first heard this statement!

And the next most important thing.

It is how Zhou Cheng will solve the problem of multiple embolisms in the arteries after being embolized.

Otherwise, Lu Ganzhou's life might have been saved, but his limbs would not exist.

Although Fang Jingsheng was able to embolize the major arteries, but under the current circumstances, he was unable to unblock these arteries again.

Ordinary patients with embolism only have single or multiple embolisms.

That can still be handled easily. If a section of embolism is blocked like this, unless the blood vessel is dissected to remove the thrombus, and the entire limb is embolized, then the only choice is amputation.

This is the end stage of vascular embolism.

But no matter what, this at least complied with the instructions handed down by the dean, to save Lu Ganzhou's life at all costs.

Even if the limbs are gone, it is considered at all costs.

It’s just that interventional surgery, or difficult vascular thrombectomy, is the source of operability from theory to practice, because it can open up a one-way arterial sheath. With this sheath, even if it is directly Inserted into the artery, there is no way for the blood inside to flow back.

When the operation got here, not only Fang Jingsheng was worried, but Professor Lu who came from Fuwai Hospital was also quite worried about the current situation.

After all, the reason why he came to Huashan Hospital was not an invitation from President Wang, but a direct phone call from Kyoto. The reason why Lu Ganzhou is important is not only his life, but also his hands... …

Fang Jingsheng honestly acted as an assistant, and placed Zhou Cheng with a sheath catheter for blood vessel thrombus removal. He felt strange why Zhou Cheng required such a simple and traditional way of thrombus removal.

Now, there are many better, faster and more convenient thrombectomy methods than directly using the introducer sheath to remove the thrombus. Why did Zhou Cheng choose such a simple one.

Zhou Cheng didn't explain, his life was saved, and now he has to save his legs.

This is his specialty!

He has saved the amputated leg once, and he is very familiar with Lu Ganzhou's situation now.

Here begins the 'regular' intra-arterial thrombectomy!

For Zhou Cheng, this is becoming more and more routine, especially when he has the professional level of redefining the perfect blood vessel thrombectomy, it is more handy. This time, the thrombectomy process was very smooth and peaceful. Silky smooth, basically without any frustration...

When Zhou Cheng started the operation and took out a small section of thrombus, no one felt anything.

The whole process of thromboembolism, the difficulty of thrombectomy is not to remove the first thrombus.

Anyone can do it.

The chief resident can do it with his eyes closed.

The second and third items are still indifferent. Isn't this just the thrombus removal of the common brachial artery and the inferior radial ulnar artery branch of the brachial artery?

There is nothing amazing about this. Attending physicians and associate professors with better foundations can also complete it. The difficulty is not here!

But even so, Fang Jingsheng and Professor Lu from Fuwai Hospital have been paying attention to Zhou Cheng's operation. They didn't carry any personal emotions, but simply observed Zhou Cheng's operation process from their own professional perspective.

The technique is very skillful, and the process looks very silky.

Especially when the third thrombus was taken out, Professor Lu even clapped his hands and said, "Beautiful!"

"The micromanagement is good."

The voice was awkward, even a bit secondary, maybe except for Fang Jingsheng, no one else could empathize with him!

Because I don't understand!

Zhou Chengcheng just took out the thrombus in this way.

Zhang Xingze, Professor Nong next to him, and even Du Li and the others all looked at Professor Lu curiously.

Professor Lu knew that he had lost his composure, so he stopped speaking as a commentator.

During the operation, any actions and words that disturb the operation of the surgeon are cumbersome, even if it is the explanation and praise of the operation, it is still the same.

Especially in an extremely stressful surgical situation, no one wants to hear some nonsense.

However, Professor Lu still found that during the micro-manipulation, the micro-manipulation is also full, and the movements are swift, the rotation of the wrist and the movement of the fingers are very natural.

Well, this little Zhou's skills in operation are already extremely terrifying, so it's not too surprising that he can perform such an operation.

If he is allowed to continue to grow, it will definitely not be difficult to become a master of vascular surgery in the future.

Especially nowadays, the idea of ​​tumor embolization is becoming more and more popular!

Zhou Cheng was able to go blindly from the femoral artery to the intracranial, there may be basically no place in the whole body that Zhou Cheng could not go to.

If so, can Zhou Cheng switch to vascular surgery?

No, he must come to our Department of Vascular Oncology!

However, when Zhou Cheng got the seventh thrombus strip, everyone's expressions changed!

"Doctor Zhou, can you give me an explanation? Where did the thrombus we removed come from?" Fang Jingsheng immediately seized the opportunity and began to ask Zhou Chenglai.

He originally wanted to ask how Zhou Cheng did it?Can you, during the operation, just a little, uh, a little bit, not too much, as long as it doesn't affect Zhou Cheng's own operation speed.

After all, the current situation is special, and Lu Ganzhou's condition is urgent.