crazy scalpel

Cai Tianqiao's concerns are not unfounded.Arteriovascular anastomosis in the brain is indeed very difficult.But the reason why he finally agreed to Shayk's plan is that the blockage of blood vessels caused by inflammation will reduce or stop the local cerebral blood flow.

If this blockage occurs in other parts of the patient's body, it is not too dangerous.Even if it is the heart, it is much more convenient to build a bridge.It's just that the brain is special, because no tissue in the brain can be easily damaged.

Without surgery, however, nerve cells degenerate when regional blood flow to the brain drops below the ischemic threshold.If this degeneration cannot be corrected in time, irreversible necrosis will occur and lead to cerebral infarction.

The patient's treatment for vasculitis can only be anti-infection, but after a long course of treatment, a large number of nerve cells that should not be necrotic in his brain will be necrotic, and this consequence will be much more serious than vasculitis.

However, intracranial bypass can solve this problem.When the nerve cells around the infarct are not completely necrotic, there will be an ischemic penumbra.In other words, if cerebral blood flow increases, the function of ischemic brain tissue in the penumbra can be restored.Through the intracranial bypass, other blood vessels with sufficient blood supply are connected to the ischemic part, so that the ischemic brain tissue due to infarction can be supplied with blood, and the local cerebral blood flow can be improved, just like the ditching and shunting in water conservancy projects. .

Xie Ke's purpose of rebuilding blood supply for patients through intracranial bypass is not to target the focal point of cerebral infarction, which is the place where blood vessels are inflamed, but to improve the blood flow of the penumbra and brain tissue with insufficient cerebrovascular reserve, and improve their ability to ischemic tolerance.

The theoretical basis of this operation is very sufficient, and the curative effect on improving cerebral blood flow is also very positive, but why does Cai Tianqiao object?

Because the death rate is high!

In fact, the complications of the operation itself are extremely low, but because the blood supply artery is clipped for too long during the operation, it is easy to cause local necrosis of the scalp and focal epilepsy. Post-hemorrhagic stroke and heart attack are many!

Many people died within a year after the operation!Few people can survive five years, and even fewer people can survive ten years!Therefore, in Cai Tianqiao's view, unless he would die if he didn't do it, then he had to fight hard, otherwise he shouldn't have this surgery.

But Xie Ke has his own credentials. He not only wants to build a bridge for patients, but also builds a high-flow bridge!

There are two ways to bypass, one is low blood flow, 20 to 40 ml per minute, suitable for mild cerebral ischemia.Another is high blood flow, 80 to 90 milliliters per minute.However, the high-flow bypass surgery and its blood supply capacity correspond to complex operations and high technical requirements!

High-flow bypass surgery requires a section of blood vessel transplantation to anastomose the extracranial large blood vessel with the intracranial blood vessel. This is equivalent to performing two anastomoses, and there is a certain risk when exposing the large intracranial blood vessel, so most doctors will retreat. The second choice is low-traffic bridging.

But since Xie Ke has done it, he must do his best!Relying on his superb surgical skills and speed far beyond ordinary people, he has full confidence in high-traffic bridging!

"Stereotaxic Hypothalamic Hamartoma Destruction Target Positioning", "Cerebral Vascular Anastomosis Surgical Plan for Revascularization", "Whether Angiography Is Necessary for Cerebral Infarction Caused by Vasculitis and Correct Measures for Accidents During Inspection" , After Xie Ke sorted out the things on hand, he rubbed his forehead.

I originally thought that I would be very free after arriving at the outpatient clinic, but I didn't expect that there would be more work than in the inpatient department.Wang Lei often joked that Xie Ke has the physique of Conan, and wherever he goes, the operation will follow him.

But Xie Ke never refuses anyone who comes, the more the better.He got up and put away the documents by category, ready to heat up the milk, drink it before going to sleep.

When he came out of the kitchen, Xie Ke noticed that Li Shiguang's study door was not closed, and the dim light inside faintly leaked from a very thin door crack.

Xie Ke looked at the time, it was two o'clock in the morning, and the senior brother hadn't slept yet?What is he busy with, it's so late every day...

With curiosity, Xie Ke held a cup of hot milk with a sweet smell and pushed open the door.

Li Shiguang fell asleep in front of the computer, and took off his glasses and put them aside.

Seeing his sleeping position, Xie Ke pursed his lips, trying to wake him up and let him go to bed to sleep well.

Walking to Li Shiguang's desk, Xie Ke was attracted by a large pile of messy documents on his desk, all of which were materials about using physical means to treat mental illness.The laptop's screen was not closed, and a faint light shone on Li Shiguang's side face.

The senior brother is so handsome, Xie Ke felt as if a cat was tickling his heart when he looked at it, throbbing violently.He glanced at the computer screen, the desktop was displayed, and it was clean without any windows.Putting the milk on the table, Xie Ke intends to give it to Li Shiguang to drink, and then go back to the room to have a good rest after drinking, it seems that they haven't slept together for a long time, why don't we share the same bed tonight.

Anyway, there is sugar in the milk, Xie Ke thought to himself, I don’t like sweet food very much, why did I unconsciously put sugar in it just now?It must be because I wanted to cook it for my brother to drink.

Just as he was thinking, Xie Ke suddenly saw a white paper pressed under a new edition of the Diagnostic and Statistical Manual of Mental Disorders.Xie Ke felt that it was very familiar, so he reached out and pulled it out, and opened it to look at it.

There was silence in the room, only the ticking sound of the clock pendulum on the wall moving the pointer clockwise, which was very arrogant to brush the sense of existence.The sound of the machinery made the silence even more serene. Although Li Shiguang's sleeping position lying on the table was not healthy, his breathing was so shallow that people almost ignored his existence.

Although the hanging lamp on the ceiling was adjusted to a hazy yellow light, it was enough for the users in the room to see the text on the page.Li Shiguang can do it, and so can Xie Ke.

At this time, in addition to the breathing of one more person in the room, there was another sound—the rustling sound of paper being turned.

Xie Ke looked at the document with a blank cover page by page, and the more he looked at it, the more serious his face became.It wasn't until he finished turning over the last page, which had Li Shiguang's and his own signatures on it, that he was sure that the document was authentic and valid.He confirmed the date again, it was a month ago.

Xie Ke held the document in one hand, and took it back with the other hand - he planned to use it to wake up Li Shiguang.Xie Ke stared blankly at half of Li Shiguang's profile. He was thinking, before reading this document, what exactly was Li Shiguang that attracted him all the time.

Xie Ke tried his best to recall everything that happened between him and Li Shiguang, but he tragically found that those memories had become extremely blurred.Perhaps the only thing he can be sure of is that he really loves Li Shiguang, and Li Shiguang loves him too.

Perhaps it was because the sweet smell of milk was too tempting, Li Shiguang's eyelids trembled.Shek carefully replaced the white paper in its place and moved the new DSM over and over it.

"Brother?" Xie Ke pushed Li Shiguang: "Why did you fall asleep lying on the table?"

Li Shiguang raised his upper body, opened his eyes and saw him, and smiled: "Why are you up so late?"

Xie Ke squeezed between Li Shiguang and the table, sat on his lap, and hugged his neck: "I've been very busy recently, and I have to write reports, so I stayed up for a while. You are here every day Why are you working so hard to study these things? You have to do your work slowly. Here, I boiled milk, it is the taste you like, and I will drink it for you."

Li Shiguang took the cup handed over by Xie Ke, held it in his hand for a while, and then took a sip. He smiled and said, "You always remember that I love sweets."

"Well," Xie Ke looked into his eyes and said, "As long as it is about you, I will remember it firmly."

Li Shiguang paused as he drank the milk, Xie Ke saw his eyelids go down quickly to cover the look in his eyes, his heart hurt like being bitten by a poisonous insect, and he almost shed tears.But Li Shiguang's absence was only for a moment, he quickly drank the rest of the milk, and then looked at Xie Ke with a smile: "Shall we sleep together today?"

Seeing that there was a circle of white milk clothes on his lips, Xie Ke lowered his head and kissed them one by one.The two quickly developed from biting their lips to a more intense and passionate war of words.Li Shiguang held Xie Ke's waist with both hands to prevent him from falling, and Xie Ke simply changed from sitting sideways to straddling.

Xie Ke hugged Li Shiguang's neck condescendingly, and kissed every inch of Li Shiguang's face carefully, like a cat licking a food bowl.Xie Ke's fiery lips were left on the cheeks, chin, nose tip, and forehead.

Li Shipan enjoyed letting Xie Ke draw pictures on his face with saliva, and the occasional low laughter from his throat because of itching showed his extremely happy mood at this time.In the end, Xie Ke bit his lip and refused to let it go, rubbing repeatedly until both of them felt their lips were hot, as if they had eaten chili.

Li Shiguang held Xie Ke's face against the dim light, raised his head and closed his eyes, and pressed a light kiss on Xie Ke's chin.He can only gently, otherwise his lips will be broken.

Xie Ke: "Why are you closing your eyes? Look at me."

Li Shiguang opened his smiling eyes: "Do you still use your eyes to see what you look like? It's all in my heart."

Xie Ke twisted a bit and sat even further forward. Li Shiguang only felt his thighs tremble, and was about to stand up to end the intimacy, but Xie Ke firmly held him down.

Shayk then began to undress.He was only wearing a pajamas at first, and it was gone as soon as he took it off, revealing a very beautiful body with lean and streamlined muscles.The pajama pants are actually very thin. Where the two of them touch, the body heat definitely exceeds 39c.

Xie Ke almost stuck to Li Shiguang and asked, "Do you like it? Do you want it?"

Li Shiguang pinched his shoulder and said with a wry smile, "It's too late today, let's do it next time. Let's go to bed."

Xie Ke moved forward another foot, and there was almost no gap between the two of them. Xie Ke leaned his head on Li Shiguang's shoulder, bit his ear and said, "If you don't do it, I'll go out and find someone else. Find Feng Daqiang or Cai Tianqiao, no matter how bad it is for Tong Wenjie or Tan Yilin, they are adults anyway. If they can’t do it, I’ll spend money to find someone who sells it, and the head office will do it..."

What Xie Ke said was angry at the beginning, but the more he said it, the more it seemed to be serious. How could Li Shiguang bear it anymore? With a force in his hand, he directly picked him up and put him on the empty space beside the table. The cup was hit by him and fell to the ground.Fortunately, because of the carpet on the floor, the cup was rolled twice and it didn't break.

Li Shiguang didn't have time to take care of the cups anymore, and even didn't have time to take care of the documents and computers on the table, so he went back to the room with Xie Ke in his arms.When he entered the room, he didn't know if it was to show how much he was irritated by Xie Ke's words just now, he kicked the door hard, then threw Xie Ke on the bed, and threw himself on it.

Xie Ke smiled happily: "Brother, you are so strong!"

Li Shiguang gritted his teeth: "I'll let you know what strength is after a while!"