Start From Emergency Doctor

Chapter 359

There are many ways to stop bleeding. Abbott’s arteries are inherently rare and have not even been seen by a vascular surgery doctor. Jiang Xiaoqi, as the deputy director of the emergency department, is even rarer.

How to deal with it is a problem.

Zhou Yuan squeezed the Abbott artery in his hand, which was quite soft, “Thrombin stops the bleeding.”

Tourniquets to stop bleeding, sutures to stop bleeding, etc. are not very reliable.

The Abbott artery is deep in the tissue, and it is relatively small, so a tourniquet must not be used to stop bleeding. Otherwise, how to remove the tourniquet later?

Suture hemostasis is not appropriate. To suture hemostasis, the Abbott artery must be exposed, which means that the Abbott artery needs to be stripped again, which is bound to cause unnecessary harm to the patient.

Thrombin hemostasis is currently the most practical method of hemostasis.

The blood vessel itself has the protective function of blood clotting, and it is enough to use thrombin to activate the blood clotting mechanism of the blood vessel. In addition, Zhou Yuan has completed the pressure with his bare hands, and the blood clotting can be completed in a minute or two.

Jiang Xiaoqi nodded, took the thrombin and sprinkled it on the place Zhou Yuan signaled.

A few minutes later, Zhou Yuan released his hand slightly.

He could feel the blood flowing through the blood vessels, which were jumping suddenly, like a heartbeat.

The perfect compression hemostasis method is really abnormal…

How can a normal person feel the pulsation of such tiny blood vessels and fine blood flow? It’s not a large artery like the radial artery and the carotid artery.

Zhou Yuan suddenly looked forward to it more.

I still have five intermediate treasure chests left, and if I have a chance, I can exchange for a perfect technique!

“Really stopped.” Jiang Xiaoqi was slightly surprised.

After seeing Zhou Yuan’s unbelievable one by one, Jiang Xiaoqi has calmed down a lot.

For people who can sew an artistic sense even with a needle, it seems that it is not a big deal to stop bleeding once.

“Control your blood pressure.”

Zhou Yuan returned to the position of the main knife and continued the resection and anastomosis of the constricted segment of the descending aorta.

The anesthesiologist responded.

He is always paying attention to the blood pressure situation.

Even if the left ventricular reflux perfusion method that may lead to cardio-cerebral vascular hypertension is not used, the aortic constriction operation itself may cause high-pressure accidents, and it is necessary to pay special attention and control blood pressure.

Zhou Yuan’s construction of the temporary vascular bridge only reduced the risk.

After hemostasis was completed, Zhou Yuan began to focus on sutures at both ends of the resection.

After the constriction of the aorta is removed, the length of the descending aorta will be shortened, but it will not have much impact on the body.(Read more @ wuxiax.com)

Finally, Zhou Yuan pierced the wall of the aorta with a single needle, draining the gas in the vascular cavity.

Air remains in the vascular cavity is very dangerous. Although the gas will dissolve in the blood in most cases, there have been some fatal precedents.

The air embolism caused by the residual air caused the air to stir with the blood in the heart cavity to form a large amount of foam, which could not be removed at the moment of heart contraction, so that it blocked the pulmonary artery and caused sudden death.

After finishing the final exhaust work, Zhou Yuan made the last stitch through the wall of the aorta, quickly tied the knot, and completed the suture.

Zhou Yuan carefully clamped the vascular clamp on both ends of the temporary vascular bridge to block the blood flow. The blood flow smoothly flowed through the sutured descending aorta due to blood pressure.

The stitched parts are tight and tight.

Jiang Xiaoqi’s eyes are full of light.

You have a good grasp…

When Zhou Yuan was sutured, she wanted to say that when anastomosing blood vessels, the average doctor may also cross the two parts of the skin that need to be anastomosed, and the marginal area may be thicker, which can ensure the accuracy of the suture. But the shortcoming is also obvious, it will further shorten the blood vessel, and even this part of the overlapped edge blood vessel tissue will form a dead space.

However, if this is not the case, because the edge area is relatively weak and there is no overlap to ensure the thickness of the edge, the anastomosis may be torn due to tension during suture, and the entire anastomosis may be directly collapsed after the blood flow is restored…

Zhou Yuan seems to be born without the problem of collapsing wounds. After completing the anastomosis, the blood flow smoothly passes through the blood vessels.

If you don’t look at the descending aorta carefully, you won’t even notice which part has just been sutured!

After confirming that there was no bleeding, Zhou Yuan blocked both ends of the descending aorta again.

Now the temporary vascular bridge needs to be removed.

This step is not difficult. In ten minutes, Zhou Yuan completed the removal of the vascular bridge and sutured the incision.

When the blood supply was restored again and watching the descending aorta, which originally had aortic constriction, transport blood normally, Zhou Yuan and others felt a sense of accomplishment.

Being a doctor, the spiritual satisfaction brought by this moment is unparalleled.

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Tian Liang counted the instruments.

“Gauze, one, two, three…”

“The surgical instruments are all here. You can close your chest.”

After confirming that nothing was missing in the chest cavity, Zhou Yuan picked up the needle-holding forceps and began to suture Xiao Ding’s chest layer by layer.

About ten minutes later, Zhou Yuan put the needle holder on the tray.

With a bang, everyone was relieved.

It’s finally done…

There are many dangers during the operation.

Zhou Yuan is on the descending aorta. The aorta is the largest arterial tube in the human body. It is responsible for transporting blood to all parts of the body. Although it is elastic, the outer membrane is very thin, and there is a layer of connective tissue surrounding it. It is easy to appear damage.

Once damaged, it means that there is a problem with the large blood vessels that carry blood throughout the body. How can the patient’s body be free from problems?

0 ……. 0

Fortunately, Zhou Yuan avoided this problem perfectly.

As for the Abbott artery, it is a minor problem. This blood vessel is dispensable. Even if it is removed, it is fine, as long as the blood circulation does not cause problems in the Abbott artery.

In the end, Zhou Yuan chose to keep the Abbott artery. Xiaoding had this artery in his body, and there was no problem. Rushing to remove it would increase the risk of surgery.

“The operation is complete.” Zhou Yuan glanced at the time and said.

Tian Liang, Jiang Xiaoqi and others smiled.

Tian Liang stared at Zhou Yuan blankly, and said, “I have done so many operations, and I really rarely encounter a surgeon like you. I’m so skilled!”

Zhou Yuan smiled faintly, “Think about it again, you rarely meet?”

Tian Liang was stunned for a moment; “Well, I have never met you such a powerful master…”

Zhou Yuan laughed contentedly.

Coarctation of the aorta itself is rare, and there are not many people who can perform operations frequently. Even the proficient doctors are at most expert-level due to insufficient operations.

Zhou Yuan’s master-level constriction resection and end-to-end anastomosis is not a blow. No one in Yanjing Chinese Medicine can fight him!

“Zhou Yuan, is there anything special to pay attention to?” Tian Liang asked.

In the emergency department, only one of his nurses is on duty now, and the other nurses are ready to leave work now. The nurse who just went to work is not familiar with the patient again, so the final nursing work must be handed over to Tian Liang. Spoon.