Chapter 2171

"Lao Mu is in surgery. What's the matter?" Su Yun asked lazily.

"The patient's heart stopped!" The nurse shouted, turned and ran back.

Uh

Next door?

Su Yunhuo suddenly stood up, across the lead glass, saw Zheng Ren turn around, didn't even tear off the sterile clothes, opened the induction airtight lead door and strode out.

"Don't worry, Mr. Wu. I'll go with the boss." Su Yun strode away and didn't forget to explain to old Wu.

At that age, I'm really afraid that if he takes part in emergency first aid, he will make his heart attack first.

The intervention operating room of Pengcheng Development Zone People's hospital is small, with only five operating rooms. The airtight lead door of the operation room with the red light in the operation was closed, and a panic sound came from the operation room.

"Push the medicine! Atropine 1mg!"

Zheng Ren quickly walked over and immediately saw a pale system panel, on which the diagnosis had been blurred. The diagnosis of coronary atherosclerotic heart disease and carotid stenosis can be seen vaguely.

The doctor in the circulation department is doing cardiac compression, and the nurse is taking medicine and preparing for injection.

The surgical screen shows that the carotid intervention site is at the bifurcation of the right internal carotid artery, where the baroreceptor is more sensitive, and the reflex regulation is mainly to respond to the pressure sensor in a short time and a few seconds.

This is to do coronary stenting. The heart stops when the anterior surgery opens the carotid stenosis.

Zheng Ren glanced, saw the situation and directly entered the system operating room.

Su Yun quickly followed Zheng Ren. Seeing that the nurse was a little slow in taking medicine, he said, "Lao he!"

Lao he didn't answer, but walked over directly, silent and firm. He went to the rescue vehicle, broke open an atropine, pulled it into the syringe, opened the tee and directly pushed it in.

The test of emergency rescue is psychological quality and technical level.

The little nurse was just like a recruit on the battlefield. She was immediately frightened by the roaring gunfire. There was no veteran like Lao he who had experienced countless battles.

Originally, the technical level is average. If you panic again, there is really nothing left.

"Lao he, intubation." Zheng Ren suddenly said, "tour, push the ventilator. Su Yun, go to do heart compression, and increase the intensity and frequency."

Zheng Ren then tore off the sterile clothes, took off the sterile gloves, and turned to brush his hands.

Su Yun didn't hesitate. He walked to the operator's side and bumped his shoulder, pushing the operator away from the position where he pressed his heart outside his chest.

The operator was foolish.

However, at this time, when a doctor who can take over the rescue with confidence appears, she will not stop it.

At the beginning of the operation, the balloon was slightly opened, and the patient had cardiac arrest. The circulatory department is supposed to be very good at emergency first aid in this regard, but I didn't see my heart beating again after pressing for 30 seconds, so I was in a panic.

"You, go charge the defibrillator." Zheng Ren goes to brush his hands, and Su Yun takes over the rescue command.

He is an unscrupulous conductor and full of the style of a senior director.

One by one, atropine, dopamine and adrenaline were pushed in. Lao he completed the endotracheal intubation as soon as possible and handed the balloon to the assistant doctor.

Zheng Ren brushes his hands in and wears sterile clothes.

"Boss, what do you do?"

"Neck artery stenosis or to open, Lao mu?" Zheng Ren glanced and saw that Su Yun was doing extrathoracic cardiac compression at a frequency of 110 times / min. the waveform of ECG monitoring had not recovered. It was also a little urgent like in the system operating room.

"Boss Zheng, I'm coming." Mu Tao finished the last step of the operation and hurried in.

The doctor of the circulatory Department saw Mu Tao come in and finally saw the Savior. He hoarsely said, "Professor mu, the patient's heart stopped suddenly..."

"Boss Zheng, what do you do?" Mu Tao asked with a frown.

"You push the ventilator and I'll remove the bracket." Zheng Ren stood at the position of the performer and took a look at Su Yun.

"What do you think I'm doing? I'm not wearing lead clothes. Just hurry up." Su Yun kept his arms straight and continued cardiopulmonary resuscitation.

The airtight lead door closed slowly, and Zheng Ren began to step on the line at this time.

The position of the balloon changed a little. Zheng Ren sent it inside again. He found the place where the carotid artery was narrow, pushed open the narrow segment and sent it to Cristallo ideale-se 6-9mm × 40mm self expanding support.

With the opening of the carotid artery, Su Yun's action slowed down gradually.

The patient's ECG monitoring also gradually recovered to ventricular tachycardia, and after a few seconds, the sinus rhythm recovered.

Zheng Ren stopped stepping on the line and said, "wear lead clothes."

Su Yun glanced at the value of the monitor, nodded, and turned to wear lead clothes with Lao he.

"..." the operator of the circulatory Department stood beside him with a blank face.

"Xiao Sun, what's going on?" Asked Mu Tao.

"The patient was diagnosed as coronary atherosclerotic heart disease, exertional angina pectoris, arteriosclerosis of both lower limbs and carotid stenosis. I wanted to solve the carotid stenosis first and then remove the stent, but I didn't expect that the heart stopped as soon as the balloon went in."

Mu Tao nodded.

Significant carotid stenosis is an important risk factor for perioperative stroke in patients with coronary stenting. The incidence of stroke is as high as 3% ~ 11%, and is positively correlated with the degree of carotid stenosis.

The patient's condition was clear, and there was no problem in preoperative diagnosis and surgical indications.

The treatment is right. The operation is normal. We should solve the carotid stenosis first. It's just that the patient's cardiac arrest time is a little long, and this side is directly confused.

"Boss Zheng." Mu Tao asked softly.

"Tell me about the operation." Zheng Ren said, "there should be no big problem. Don't be nervous."

"The patient's condition is much better. Do you still use a ventilator?" Asked Mu Tao.

"Must be used." Su Yun came back wearing lead clothes and said contemptuously: "patients with coronary artery stenosis have stroke due to carotid artery stenosis during perioperative period, the prognosis is very poor, and the mortality is about 50%."

Mu Tao is an interventional doctor, not a doctor in the circulatory department. If he followed the rescue and coronary stent surgery, he would have no problem. But when it comes to more detailed things, especially pathology and physiology, he can't reach it.

"Talk about the process." Zheng Ren reminded me again.

"Preoperative angiography showed that 90% of the proximal end of the right internal carotid artery was narrow. I sent 8F mpai guide tube to the right common carotid artery with super sliding guide wire, spiderrx 5.0mm to the distal end of the right internal carotid artery and sapphire 4.0mm × 20mm balloon, 15atm. 5. Six seconds later, the patient's heart stopped. "

The operator should be the director of the circulation department of the people's Hospital of Pengcheng development zone. Under the pressure of Zheng Ren, he directly became a small doctor and began to report the operation process.

Emergency first aid, when there is little effect, someone comes forward, which is undoubtedly a relief for the operator.

In the face of cardiac arrest, it's useless to say how much higher the technical level is than yourself.

"Well, it's squeezed into the carotid pressure sensor." Zheng Rendao, "cardiac arrest after balloon dilatation, followed by ventricular fibrillation, and malignant arrhythmias are common complications."

"Boss Zheng, I thought I was going to give up the operation." Mu Tao said with a long breath.

"No. the cardiovascular activity center in the brain controls the activities of the heart and blood vessels through the sympathetic nerve and vagus nerve, so as to maintain the arterial blood pressure at a certain level."

"When the balloon dilates, the arterial baroreceptor immediately feeds back these information to the cardiovascular center through the afferent nerve, and the activity of the cardiovascular center will change accordingly, resulting in slower heart rate, peripheral vasodilation and lower blood pressure."

"Too fast pressure rise in the balloon, too large diameter, too high pressure, too long expansion duration and too sensitive baroreflex may be the cause of cardiac arrest."

"It's just a surgical solution. It can recover in a period of time." Zheng Ren smiled.

"Old mu, where's old Wu?" Su Yun suddenly asked.

"The teacher looked at the patient during the operation..." Mu Tao said.

"That's OK. The side is ready for the next operation. This side should be solved soon." Zheng Ren smiled.

"We don't need a heart stent. Let's go." Su Yun looked at the magician and asked.

"No... no, please." The performer whispered politely.

At this time, getting the patient back is also equivalent to getting himself back. The operator feels that he can't express his gratitude too much.

But she is still a little confused and still immersed in the nightmare of sudden death.