Start From Emergency Doctor

Chapter 360

Almost no aortic constriction surgery has been done in the emergency department, and the postoperative care is definitely not experienced by the doctors in vascular surgery.

But Ding Mahui knew Tian Liang and had a lot of dealings, so Ding Mahui and his wife would definitely keep Xiao Ding and let Tian Liang take care of them.

Zhou Yuan said: “Pay special attention to bleeding and abnormal high blood pressure for a few hours after the operation.”

Bleeding is a very common complication after surgery. In aortic constriction surgery, it is mainly caused by thickening or tumor-like expansion of the intercostal artery, which is caused by the suture falling off or the blood vessel wall being cut after ligation and cutting.

In addition to this technical factor, it is also possible that the suture at the anastomotic site may be cut due to degeneration of the vessel wall.

Bleeding occurs, the problem can be big or small, it may be ordinary superficial wounds oozing blood, and in serious cases, leakage of internal sutures may occur, leading to internal bleeding. Therefore, as long as hemorrhage is found, Hungarian exploration is required.

However, postoperative abnormal hypertension is a relatively rare postoperative complication, and the incidence is only 5% to 10%.

Postoperative abnormal hypertension manifested as postoperative upper and lower limb blood pressure higher than before operation, but the aortic blood flow was not obstructed. The cause of the postoperative hypertension is unknown, and the cause of postoperative hypertension cannot be analyzed.

This complication is more common in patients with collateral circulatory dysplasia, or those who are older at the time of surgery. In severe cases, blood pressure can even rise to 180～200mmHg.

Once abnormal postoperative hypertension occurs, vasodilators must be given to reduce blood pressure as soon as possible to reduce the load on the heart and brain and avoid cerebrovascular accidents.

There are several more common complications, such as re-coarctation. The incidence of it is different in the literature. The incidence of re-coarctation in infants and young children who undergo coarctation resection and end-to-end anastomosis is significantly higher than that of patients of other age groups.

There are four reasons for re-narrowing: insufficient resection of the constricted section; the anastomotic stoma fails to grow with the growth and development of infants and young children, especially the continuous suture technique may limit the growth of the anastomotic stoma. Zhou Yuan paid special attention to this point before. He used intermittent sutures when performing sutures.

The third reason for re-narrowing is the remaining catheter tissue, which contains muscle fibers and extends to the wall of the aorta, causing it to become constricted again after fibrosis. The last point is the anastomotic embolism, which requires another operation to correct it.

There are also relatively rare diseases, such as spinal cord ischemic damage, the incidence is only 0.41%.

“Take it down.” Futian Liang nodded silently.

“Patients may experience abdominal discomfort after surgery, which usually lasts for a few days and can gradually recover.” Zhou Yuan added.

Abdominal pain is also a common sequelae of surgery. Normal abdominal pain is caused by the past of the anesthetic effect and wound pain, which can recover on its own.

A small number of abdominal pain is obviously accompanied by abdominal distension and weakened bowel movements, which may be caused by mesenteric arteritis causing small bowel necrosis or intra-abdominal hemorrhage. At this time, fasting, fluid supplementation and gastrointestinal decompression should be performed. Finally, if there is no relief, immediate laparotomy is required.

Tian Liang: “You know so much…”

Is there any surgery that Zhou Yuan can’t do?

At least for now, it seems that Zhou Yuan has not encountered a really challenging operation.

This is a terrifying thing, and it is impossible to imagine.(Read more @ wuxiax.com)

Those who work in the medical field know that although medicine is developing rapidly at this stage, it is still insignificant compared to the sophisticated human body.

On the road of studying medicine, who has not encountered a mountain that cannot be crossed?

A stage must have a stage of high mountains. For example, Wang Ziqiao, Liu Kai and others at the resident level are absolutely helpless in the face of third-level surgery. They can’t get past the third-level surgery at this stage. ‘

As for He Jianyi, Jiang Xiaoqi, and even Director Wu, they will be caught by top-notch total gastrectomy, etc., and it will take a long time to train before they can overcome them.

For Dean Yu Fang and even international hand surgeons such as Shen Yuanjing and Richard, toe transplantation and thumb reconstruction is a peak they cannot climb at this stage.

Diligence and pedantry, only by paying these things can they master it.

But what about Zhou Yuan?

Tian Liang has never seen Zhou Yuan’s limit so far.

In other words, until now, Zhou Yuan’s insurmountable mountains have not appeared.

Craniotomy, coarctation of the aorta, pneumonectomy, separation of the skull in conjoined children… It seems that there has never been any disease that can stump Zhou Yuan.

Except for those who have stepped into the ghost gate, only half of the fingers remain in the world, Zhou Yuan can pull it back!

Tian Liang’s mood at the moment is beyond words, and the look in Zhou Yuan’s eyes becomes deeper and more complicated.. ……

The latter became unpredictable in his eyes at this moment.

“It doesn’t matter if the female nurse is staring at me, why are you staring at me too?” Zhou Yuan couldn’t help but said to Tian Liang.

Tian Liang:…

He lowered his head and silently counted the gauze and surgical instruments several times.

This is something you must do as an instrument nurse. The instruments often need to be counted three or four times before they can leave the operating room.

Zhou Yuan took Jiang Xiaoqi and the vascular surgeon out of the operating room.

“Why are you still here?” Tian Liang looked at the Wangzi Bridge in doubt.

Wang Ziqiao was standing next to the operating table with a dull face, with his hands raised in front of Hungary, silently staring at his extremely clean hands.

“What am I doing in the operating room…” Wang Ziqiao lamented.

He has never had a clean glove after an operation, there is no blood at all!

Not to mention the blood stains, just the Wang Ziqiao gloves can be directly put back into the bag and reused next time!

Wang Ziqiao raised his hands throughout the whole process, maintaining a standard posture for waiting for the operation. As a result, he did not touch the equipment, let alone the patient. He was watching this operation completely!

At any rate, Tian Liang also helped hand over gauze. Wang Ziqiao wanted to help Jiang Xiaoqi. Jiang Xiaoqi said, “Go away, don’t disturb me.”

Run to the vascular surgeon, ready to help, the other party said: “Get out.”

Finally, he wanted to get to Zhou Yuan’s side, but Zhou Yuan silently took a scalpel from the surgical tray, squeezed the scalpel tightly, and glanced at Wang Ziqiao in a daze…

The look in his eyes seemed to pass straight away if Wang Ziqiao still hindered his operation.

What a pity, how can I be so embarrassed when I am a Misuke!

Tian Liang smiled: “Haha, so embarrassing…”

Prince Bridge:…

Wang Ziqiao took off his gloves, threw them into the medical waste bin, and walked out of the operating room blankly.

To be honest, it’s actually pretty cool…

I didn’t do anything, just mixed for a few hours, and then I can get the surgery, which cost hundreds of dollars?

For a time, Wang Ziqiao’s mood improved again. .