Start From Emergency Doctor

Chapter 307

“Where is Doctor Zhou?” Yisuke directly asked the nurse on duty.

The nurse pointed to the operating room, “Operation is in progress…Does your department also have patients who need Dr. Zhou’s help?”

“What’s the name…” Yizu was taken aback for a moment.

“Oh, many departments have come to see Dr. Zhou recently, but they are not very urgent, and their own doctors are fully capable of doing it independently. It is purely for Zhou Yuan to be a teaching demonstration…” said the guard , The tone is a bit complaining.

These nurses know Zhou Yuan’s hard work best.

Just taking care of this patient is so tired, they can’t believe how Zhou Yuan persisted…

“No, I’m a life-saving operation, can you go into the operating room and say something?” Ichizu said solemnly.

The nurse on duty stared at Yishi for a few seconds, then nodded, “Okay, I’ll go in and let me know.”

After finishing the disinfection work, the nurse entered the operating room, and Ichiko followed.

“Aortic dissection, chronic obstructive pulmonary disease?”

Zhou Yuan frowned after listening to Yisuke’s explanation.

Zhou Yuan is not proficient in chronic obstructive pulmonary disease, but he has previously mastered double lung transplantation-this is the most advanced technology among lung diseases.

I have all the experience in double lung transplantation. Although I am not proficient in the treatment of chronic obstructive pulmonary disease, it is still passable, at least at an expert level.

“Zhou Yuan, what should I do here?” Wu Guohui’s expression also became heavy.

The elderly on the thoracic surgery side are in danger, and the patients on the Zhou Yuan operating table have lost two toes even if the operation fails. There is no need to judge which one is more serious.

The doctor’s thinking is very simple-the most important thing is to save more people.

Zhou Yuan lowered his head to think, then raised his head a moment later and looked at Wu Guohui: “You do it.”

Wu Guohui was stunned: “I won’t!”

He has only seen the operation for ten days. Although he is the first assistant and has learned the most, he still has a lot of difficulty in the main operation.

Zhou Yuan: “The operation has just begun, and the toe separation has just been completed. You should choose the less difficult blood vessel suture first, and I will finish the operation as soon as possible~ “!”

As he said, he put down the scalpel and looked at Wu Guohui: “Think of the patient as the 322nd generation of Dabai. Relax.”

Wu Guohui was silent for two seconds before hesitatingly said: “My 321 generation Dabai is not dead yet…”

Zhou Yuan:…

At this time, Zhou Yuan can’t control whether Wu Guohui can be counted in the system count for surgery, life is at stake.(Read more @ wuxiax.com)

After explaining several key surgical procedures, Zhou Yuan followed Yizhu to the thoracic surgery department quickly.

…

Dididi.

Dididi.

There was no sound in the operating room, only complicated and sophisticated medical instruments resounded.

Every sound made the doctors in the operating room deeper.

The patient’s condition is getting worse, and if you delay it, it is a question of whether you can walk off the operating table alive.

The chief physician looked gloomy at the moment, and he was blaming himself.

There are not no such cases in the world. Before this time, there were six other operations involving chest fire.

The environmental conditions in these cases all involved dry surgical kits, rising oxygen levels, working electric cautery, and patients with lung diseases…

This type of case is very rare. He also specifically marked it at the time. He didn’t expect that he didn’t recall it in time during the operation…

If there is no chest fire this time, perhaps the operation has been completed, and the patient does not need to experience so much pain!

“Director, Zhou Yuan is here!”

With a sound as if light pierced the darkness, the chief physician Huo Ran raised his head and looked at the door.

Zhou Yuan walked in slowly holding up his two sterilized hands.

The nurse hurriedly put on the surgical gown for Zhou Yuan.

“Zhou Yuan!”

The chief physician also didn’t explain that he was excited for no reason.

He only knew he was relieved and knew he couldn’t, but Zhou Yuan might be able to…

The chief physician does not have the ability to rejuvenate.

In the hospital, there is a very strange phenomenon. The success rate of many director-level doctors is not as good as that of the attending doctors or even residents.

It’s not because their technology is not good, but their high status means that they will be exposed to more difficult operations, and some operations are beyond the reach of manpower…

“You finally came!”

The chief physician silently retreated to the position of first aid, and reported without waiting for Zhou Yuan to ask questions.

“Patient Zhao Mingshi, age 61, was diagnosed as Stanford-A type aortic dissection after hospitalization, combined with chronic obstructive pulmonary disease, hypertension, hyperlipidemia, and heart disease. When Stanford-A aortic dissection was performed, The electrocautery equipment accidentally touched a dry scalpel in a high oxygen concentration environment, which caused an instant fire. We immediately put out the fire, but the artery has been damaged and it is impossible to determine the rupture of the aortic intima…”

Zhou Yuan nodded silently.

Stanford-A aortic dissection is a relatively rare disease, with an incidence between one in 100,000 and one in 200,000 per year.

In type I aortic dissection, the aortic wall stripping site starts at the root of the ascending aorta, and the tear of the intima generally starts from the proximal anterior wall of the ascending aorta and extends to the distal aorta to the descending aorta. Some start from the aortic arch or even the descending thoracic aorta, retrogradely separate to the aortic root and distally involve the rest of the aorta.

This kind of patient is often due to the expansion of the aortic valve annulus or the expansion of the dissection to the proximal end, causing the valve to lose support and cause aortic valve insufficiency.

“¨ˇAcute or chronic?” Zhou Yuan asked.

Acute aortic dissection is very different from chronic aortic dissection.

Acute dissection is generally arterial dissection that occurs within 2 weeks, and after 2 weeks of onset, it is called chronic arterial dissection.

In terms of clinical manifestations and prognosis, acute aortic dissection within 48 hours due to aneurysm rupture or acute cardiac tamponade, etc., the fatality rate can reach 36% to 72%, and the fatality rate within 2 weeks is 57% to 89% . In the chronic phase, the number of deaths due to rupture is significantly reduced, but 90% of patients die from rupture of arterial dissection within six months of onset.

The former is emergency diagnosis and surgery, mainly life-saving, followed by treatment. The first task of the latter is treatment.

Although the operation methods are different, one thing is clear…this is a disease with a very high fatality rate.

“Chronic. The patient has been onset for three weeks.”

Zhou Yuan stepped forward and looked at it carefully, “Only a median sternum incision was made? Are cardiopulmonary bypass and myocardial protection ready?”

The chief physician shook his head slowly: “It’s too late. Just after the chest was opened, we just prepared the electrocautery incision for separation and it caught fire… What do you think should be done now?”

The surgical field is not good, the patient is critically ill, the cardiopulmonary bypass has not been established, and can only be maintained by a ventilator, and the peripheral arteries have also been clamped, and the blood supply has stopped… The current situation can not be described as an exaggeration. a few.