My medical skills are a billion points

Asked again: "Xiao Chu, should we transfer this patient to the neurointerventional department?"

Xiao Chu immediately came back to his senses, waved his hands and said: "We have spent so much effort on this patient to make a clear diagnosis, so of course there is no need to transfer to the neurointerventional department.

"I can do the embolization of the cerebral aneurysm. You sign the consent form for the operation. We will operate on him right away."

"Okay, I'm going to talk to the family members now!"

Gao Yingjun was very happy, and went to talk to his family members!

He also didn't expect that Xiao Chu could even perform neurointerventional surgery.

Really surprised again!

It seems that Xiao Chu's ability is naturally suitable for working in the emergency department!

What the patient has to do is an aneurysm embolization, which is an interventional treatment.

Now that the cause was determined, Gao Yingjun immediately explained the situation to the patient's parents and asked them to sign a consent form for the operation.

Now it's time to get off work in the afternoon, and Li Xiang, the night shift doctor, has already taken over.

But for emergency doctors, as long as there is an operation, there is no concept of off work.

Even when it's off-duty time, it's commonplace to have another seven or eight hours of surgery.

Soon, the patient was pushed onto the operating table.

Chapter 256 Interventional Surgery Cannot Be Done

The rupture of this cerebral aneurysm causes subarachnoid hemorrhage, and the sooner interventional surgery is performed, the better.

Due to the rupture of the cerebral aneurysm, there is a possibility of secondary bleeding.

If it bleeds again, the condition will be very critical, and it may be life-threatening in severe cases, so surgery should be performed as soon as possible.

In fact, this kind of brain aneurysm interventional surgery is difficult and easy to say.

This type of intervention requires only two people.

So Xiao Chu only brought Gao Yingjun with him, and the others had already returned home from get off work.

Because Xiao Chu is the main operator, and Gao Yingjun's role in this operation is to learn from experience, pass some equipment, and do some small favors.

All important operations are done by Xiao Chu.

Of course, now Gao Yingjun only needs to follow Xiao Chu to perform surgery on the stage, and he will do all the work of disinfecting and laying the towels.

After all the preparations were done, Xiao Chu stood next to the patient's right thigh.

Cerebrovascular interventional surgery generally chooses femoral artery puncture.

After all, the first is safety here, and the second is that the blood vessels are thick and easy to operate.

"See my movements clearly!"

While talking, Xiao Chu began to puncture the patient.

"In the patient's right inguinal ligament, the femoral artery 1.5cm below the midpoint is the puncture point."

As Xiao Chu said, he used the Seldinger technique to puncture the right femoral artery.

One shot was a success.

For Xiao Chu, this kind of piercing action was like a drizzle!

Close your eyes and you can do it.

And Gao Yingjun also stared at Xiao Chu's movements without blinking.

This kind of learning opportunity is also relatively rare. Of course, he must seize every minute and every second of technical skills.

Now Xiao Chu is an all-around expert, there are almost no surgeries he can't do.

If Gao Yingjun wants to learn interventional surgery, he must also go to the neurointerventional department to study.

And now that he follows Xiao Chu, he can achieve his goal.

Even if he knows it at a glance, he will be useless once he learns it!

He still has to learn!

After all, art is not overwhelming!

While explaining, Xiao Chu used the replacement guide wire to insert the 6F catheter sheath.

Then intravenous injection of heparin 30mg anticoagulant.

"You must not forget to take heparin, otherwise the possibility of blood coagulation will easily occur."

Xiao Chu would remind Gao Yingjun of all the key points of operation.

And Gao Yingjun accepted it humbly.

Although Xiao Chu is relatively young, but after all, his ability is much higher than him.

It can be said that in Gao Yingjun's heart, he regards Xiao Chu as a teacher.

Xiao Chu continued to operate while explaining.

Under the guidance of a 0.035-inch guide wire, a 6F guiding catheter was inserted along the catheter sheath to the right internal carotid artery.

Then, pointing to the image on the monitor, Xiao Chu said to Gao Yingjun: "At this step, be careful, don't puncture the internal carotid artery, otherwise the patient will die immediately!"

This step is the key point among the key points.

If the operation force is too strong and the carotid artery is punctured at that time, it will immediately cause massive hemorrhage of the carotid artery and endanger the life of the patient.

So this embolization seems to be very simple, but there are many key points in it, which need to be careful and careful.

Xiao Chu said, withdrew the guide wire.

Guide the catheter along 6F, use RebarTM-18 intravascular stent delivery system, first SOLITAIRETM-AB

(4mm×20mmev3) intravascular stent, placed in the neck of the aneurysm, adjacent to the internal carotid artery, and fixed the position of the stent.

Xiao Chu operated it with ease and ease.

But in Gao Yingjun's eyes, it was fast and dangerous.

He was always worried about Xiao Chu and accidentally punctured the patient's blood vessel.

But Xiao Chu can always solve the dangerous places that Gao Yingjun thinks are very dangerous.

This made Gao Yingjun couldn't help but appreciate Xiao Chu's medical skills, and in his mind, it has risen a few steps.

For Xiao Chu, the current cerebral aneurysm embolization is really not difficult.

After all, what he has mastered now is world-class technology.

And there are special effects.

The special effect is that there will be no complications such as intracranial infection and intracranial hemorrhage after surgery.

So this special effect will make Xiao Chu feel at ease to operate boldly.

Moreover, this interventional surgery mainly depends on the proficiency of the operation and the disposable consumables used.

Don't underestimate these guide wires of different lengths and spring coils the size of rice grains.

These are all imported from abroad.

These disposable consumables alone cost [-] to [-].

The operation is now halfway through.

All that's left is to place the four coils inside the ruptured aneurysm.

Xiao Chu then guided the catheter along 6F, and under the guidance of the SilverSpeed-14 (ev3) micro-guide wire, the EchelonTM-10 (ev3) micro-catheter tip was selectively inserted into the tumor through the right internal carotid artery.

经血管内弹簧圈栓塞术，放入Helix(8mm×30cm;ev3,Axium)、Helix(7mm×20cm;ev3,Axium)、Helix(6mm×20cm;ev3,Axium)、Helix(5mm×15cm;ev3,Axium)弹簧圈共4枚。

Because the diameters of these four spring coils gradually increase.

So put the one with the largest diameter first.

The coils have all been placed in the aneurysm, and the operation is basically complete.

The rest of the work is to do a contrast to see how the effect.

While injecting the contrast agent, Xiao Chu said to Gao Yingjun: "Did you see that the coils basically filled the tumor tightly, showing that the tumor disappeared.

The right internal carotid artery and the middle and anterior cerebral arteries were well developed. "

"At this point, we can release the stent!"

Xiao Chu said, and then released the bracket.

Then a contrast medium was created: it showed that the position of the stent was moderate, the wall was well adhered, and the right internal carotid artery and the middle and anterior cerebral arteries were well developed.

Angiography showed that there was no problem, and the operation was considered complete.

Only then did Xiao Chu pull out the contrast catheter and pull out the catheter sheath.

Then, apply pressure to the puncture site.

The whole operation process was very smooth, and the patient's speech and limb activities were normal after waking up.

Also, there were no more violent grand mal seizures.

During the entire interventional operation, Xiao Chu explained to Gao Yingjun in detail while performing the operation.

It seems that he wants to train Gao Yingjun into a doctor who can perform interventional surgery very urgently.

Gao Yingjun listened to it, but he didn't take it to heart at all!

Surgery is not something that can be done just by saying a few words.

It requires a wealth of clinical experience and countless cases to achieve incomparable skill.

Even though Gao Yingjun can do many operations now, he has never been exposed to cerebrovascular intervention.

No matter how detailed Xiao Chu said, it is impossible for him to perform an operation, and he will be able to do it himself immediately.

From Gao Yingjun's heart, he had no intention of learning to intervene at all.

He mainly puts his expertise in general surgery to good use.

Seeing Xiao Chu packing up his equipment, Gao Yingjun finally plucked up the courage to speak out what was in his heart.

"Xiao Chu, let's stop doing interventional surgery in the future."

Chapter 257 For the sake of the next generation, this surgery is fine

"Um?!"

Xiao Chu, who was packing up the surgical instruments, was stunned for a moment when he heard this crucial sentence, and stopped his movements.

"Why can't we do interventional surgery in the future?"

Gao Yingjun immediately tapped the lead jacket he was wearing.

"Xiao Chu, although I am a few years older than you, I am not married, let alone you. Although you have a girlfriend, you are not married either."

"If the two of us often go to the cath lab. I don't think we need to get married in the future."

Xiao Chu was startled suddenly.

Gao Yingjun's words reminded him.

In order to operate on the patient as soon as possible and relieve the patient's pain, I didn't think so much.

Now after being reminded by Gao Yingjun, I realized that if I often undergo interventional surgery, it will be very bad for my body.

It should be known that interventional doctors are, in principle, over 35 years old, and only when they are married and have children, are they allowed to perform interventional surgery.

Young men in their twenties and under the age of 30, who are not yet married, are not allowed to undergo interventional surgery at all.

The main reason is the fear of rays, which have an impact on the body.

The most important aspect affected is fertility.

Even if you are wearing a lead jacket, it still won't work.

If you often go to the cath lab, it is very likely to affect fertility.