Start From Emergency Doctor

Chapter 32

Lu Chenxi’s expression changed: “Aortic dissecting aneurysm is a major operation. I haven’t done it before. I can only call Dean Fu over!”

Zhou Yuan calmly pressed Zhang Shan’s chest, and said: “Immediately take morphine and tranquilizers to relieve the pain, and first relieve the patient’s pain, otherwise the pain will pass out sooner or later!”

Then he looked at Lu Chenxi: “You haven’t had this operation, don’t you know how to treat it?”

Lu Chenxi quickly replied: “The purpose of the initial treatment is to control the systolic blood pressure at 100~mmHg and the heart rate at 60~75 beats per minute!”

Zhou Yuan looked at the young nurse Yang Yu: “Immediately reduce myocardial contractility, slow down the left ventricular contraction speed and peripheral arterial pressure. Zhang Shan has high blood pressure, and he uses intermittent intravenous administration of propranolol and intravenous sodium nitroprusside Blood pressure drops to clinical treatment targets!”

The more Lu Chenxi listened, the more things went wrong, until he saw Zhou Yuan holding the hospital bed ready to push, and asked in a panic: “What are you going to do!”

“The patient’s aortic dissecting aneurysm is close to ten centimeters in diameter, severe vascular malformation, aortic valve insufficiency and high blood pressure. Now if you don’t operate directly, there is only one dead end!”

Lu Chenxi said anxiously, “But I have never had an operation in such a bad condition!”

“Go on top!”

Zhou Yuan did not continue to argue with Lu Chenxi, and turned to ask Yang Yu, “Is the operating room ready?”

Yang Yu nodded immediately: “Operating room No. 1 has been vacated, and all equipment is ready.”

Zhou Yuan nodded, “Take a hand, push it over!”

After finishing speaking, he said to Lu Chenxi: “Start the pre-operative preparation immediately, don’t think too much, I will go and ask the patient’s family to sign.”

Aortic dissecting aneurysm resection is an extremely complicated operation, even if Zhou Yuan has mastered the skills, it is impossible to complete it alone.

The work of discussing with the family members just made Lu Chenxi adjust her state.

When she came to the waiting room, Zhang Shan’s daughter was already crying and her eyes were red. As soon as she saw Zhou Yuan coming out, Zhang Shan’s daughter ran over immediately.(Read more @ wuxiax.com)

When Zhou Yuan talked about aortic dissecting aneurysm, Zhang Shan’s daughter was obviously taken aback, she couldn’t understand it.

“Let’s put it this way, compare the blood vessel wall to a three-layered tri-ply. After the vascular intima layer ruptures, the blood flow enters the media, causing the outer membrane to become weak. Blood vessels can easily rupture, bleed, and cause death.”

“Now, there is an aneurysm about ten centimeters in diameter in the aorta. Coupled with a series of complications, your father is now in a more critical condition and must be operated on as soon as possible!”

“Doctor, although I did not understand, but I believe you!”

After saying this, Zhang Shan’s daughter immediately signed it.

Zhou Yuan was silent for a moment, stared at the informed consent form, and hurried to the operating room.

In the operating room.

Everything is ready.

Lu Chenxi also quickly adjusted his state and was ready to perform surgery.

At this time, Zhou Yuan took the scalpel and glanced at Lu Chenxi: “Wait and go.”

This girl doesn’t think she is the chief swordsman, right? Naive.

Zhou Yuan smiled and glanced at the time: “The operation has begun.”

Lu Chenxi was shocked, “What are you fooling around! This is not the time to make a joke! Life is dead!”

Zhou Yuan’s expression was calm: “It is because human life is a matter of life that I can’t let you go.”

“Is the’elephant trunk’ ready?” Zhou Yuan asked.

Lu Chenxi also wanted to stop the mischievous intern Zhou Yuan, who yelled, “I’ll give you a stable shot again,” before quieting down.

“Trust me.” Zhou Yuan’s voice was confident.

Lu Chenxi thought of Zhou Yuan’s incredible suture and hemostasis before, and a flame of hope suddenly appeared in his heart, and then said: “The equipment nurse, immediately prepare the full-program supporting elephant trunk technique.”

When Lu Chenxi spoke, it also means that from this moment on, the chief surgeon in the operating room has become Zhou Yuan, and all orders are subject to Zhou Yuan.

The “elephant trunk” technique is a surgical method for the treatment of extensive aortic diseases, that is, artificial blood vessels are inserted into the descending thoracic artery to replace human blood vessels for blood transfusion. This section of artificial blood vessel is called elephant trunk.

Generally speaking, the true lumen of aortic dissection is often very narrow, it is difficult to insert artificial blood vessels, and the soft elephant trunk can interfere with the blood supply of the branch arteries. When replacing the aortic arch, the supporting artificial blood vessel is often selected Chen Xi’s full-program supporting elephant trunk technology.

Zhou Yuan quickly opened the chest cavity and cut the aortic arch through the median sternum and the proximal end of the left subclavian artery. With the assistance of Lu Chenxi, a stent vessel about 10 cm in length and 26 mm in diameter was inserted into the descending main artery. The artery is really lumen.

Next is the stage that Zhou Yuan is best at.

He picked up the needle holder, constructed the proximal end of the artificial blood vessel, and continuously sutured the remaining descending aortic blood vessel. After the anastomosis was completed, he reconstructed the head, brachial plexus blood vessel, and proximal aorta on the artificial blood vessel in turn.

This drew the surprise of the young nurses in the operating room. The eyes of some beautiful young nurses looking at Zhou Yuan changed. .