Chapter 2686

Interventional operating room, patient prone position. The incision of the appendix will certainly be affected, but the problem is not big.

It's just that the patient doesn't understand what happened and keeps asking.

On the DSA machine, Zheng Renxian did a simple CT. The technical level here is average, but the DSA machine is newly bought with CT function.

CT of vertebral body showed that a strip-shaped slightly high-density shadow could be seen on the right side of the spinal canal at the level of chest 7 ~ 12. The abnormal density shadow seemed to extend out of the body at the level of chest 12, and the soft tissue at the posterior edge of thoracic 12 spinous process was swollen.

"Boss, do you think the catheter falling in is only about 6cm? It has to be at least 10cm!" Su Yun looked at the image and said contemptuously.

"No, at least 13cm." Zheng Ren pointed to the CT image and said.

Su Yun no longer said anything, but directly drove the operator away. He sat in front of the console.

"You can't work after drinking." Zheng Rendao.

"I don't want to move. You can do it alone. Just think there's no one outside. I'm just curious about how you're going to take out the broken catheter." Su Yun smiled and said as if there were no one else.

"Just think of it as a thicker blood vessel." Zheng Ren smiled and took Gao Shaojie to brush his hands and go on stage.

"Boss Zheng, how to do the operation?" Gao Shaojie asked as he brushed his hands.

"First do epidural angiography, then puncture at the original puncture point, lower the trapper and catch the broken catheter." Zheng Rendao.

Gao Shaojie didn't really want to understand. Although the whole process is probably like this, he has never heard of similar operations.

Cheer up! Gao Shaojie encouraged himself. He must take a closer look.

He quickened his movements, finished brushing his hands and went to lay the sterile sheet.

Because of the need for angiography, Gao Shaojie left two different operation areas. One in the sacrococcygeal region and one in the location of continuous epidural puncture.

Xiang Heping looked at it silently. He couldn't understand everything here. Two operation areas, how do you feel that the trauma surface is bigger than surgery!

"Lao Gao, have you done epidural angiography?" Zheng Ren asked.

"No, boss Zheng." Gao Shaojie replied honestly.

"Then I'll come." Wearing sterile clothes and gloves, Zheng Ren stood on the operating table.

He glanced at the instruments and then stared at peace. After 1.25 seconds, Zheng Ren's eyes became stern.

Boss Zheng looked at Xiang Heping. Until now, no one has told him about money. Coupled with director Zhang's persuasion, he also saw extremely professional judgment and operation, and the technicians were expelled.

They say they are liars. Now Xiang peace doesn't believe it.

What does boss Zheng look at himself for? Are you going to yell? It's not uncommon for a professor to become a person on the operating table.

For a moment, Xiang Heping's psychological drama was numerous, and even outlined a lot of pictures of himself being bullied by the operating room.

"Director Xiang, are you going to see the operation in the operation room?" Zheng Ren asked.

Xiang Heping nodded blankly.

My old man, can't I see the operation? No.

"Go and wear a lead coat." Zheng Ren sighed. The technical level of township hospitals is almost understandable. How can they even go into the intervention operating room and wear lead clothes.

At this level... It's hard to say.

Director Zhang of orthopedics, who was also preparing to watch the whole operation in the operating room, almost stuffed his head into his crotch.

It's really a shame. In boss Zheng's heart, how much does the Langshan county hospital have to do.

This old item is a disgrace to the extreme.

Zheng Ren said, seeing Xiang Heping hurried to wear lead clothes, he didn't pay attention to him, but began to puncture.

After local anesthesia, the No. 16 epidural puncture needle pierced the sacrococcygeal ligament at 45 ° with the trunk, and then Zheng Ren's hand changed the angle to 25 ° and slowly penetrated into the sacral canal.

"Lao Gao, pay attention here." Zheng Rendao, "because the subarachnoid space terminates at the second sacral plane, the puncture needle should not exceed the second sacral plane to ensure that it will not penetrate into the subarachnoid space."

Gao Shaojie nodded and wrote down the point.

Zheng Ren then pulled out the needle core, observed whether there was cerebrospinal fluid overflow, inserted the epidural anesthesia catheter into the lumbosacral epidural space, and then withdrew the puncture needle.

"Anesthetic." Zheng Rendao.

After the injection of anesthetic, Zheng Ren observed for 5-10 minutes, determined that the patient had no spinal anesthesia, and ruled out dural penetrating injury, which was the next step.

The airtight lead door closed slowly and Zheng Ren began angiography.

Because the epidural anesthesia catheter is hardly developed under X-ray, even with contrast medium, it is still very difficult to find a catheter with a thickness of a few centimeters.

"Lao Gao, combined with the CT image just now, you can find abnormal images in the position of chest 7-12." Zheng Ren gently explained to Gao Shaojie, "look, the position of the catheter is not close to the wall. You shouldn't have to pump gas into it."

"Well, boss Zheng, I can probably find a place." Gao Shaojie said.

"I won't let you do it this time." Zheng Ren went to the thoracolumbar operation area and began to puncture.

Gao Shaojie knew that this should be the first time boss Zheng met a similar patient. He knows enough about boss Zheng. Anyway, the young boss is here and his clinical practice is still weak.

Although with deep enough theoretical knowledge combined with virtual operation, there is often the idea of flying fairy outside the sky, such as the operation in front of us.

But the first operation must be done by himself, trying to avoid all accidents.

With the guidance of boss Zheng, Gao Shaojie has probably understood the operation process. Whether you can do it or not depends on the technique.

Gao Shaojie still has some confidence in this. At least he should accumulate more experience after seeing boss Zheng do it once.

The guide wire enters, and then the trapper also enters the epidural space. Gao Shaojie was absorbed, holding the end of the guide wire in his hand and staring at the opposite screen.

We should adjust the direction and then open the catcher. Gao Shaojie judged in his heart. This step is the most difficult. If you change yourself, you may have to do it more than ten times to successfully capture the broken catheter.

It is easy to say but difficult to do for a 3mm diameter catheter to be firmly grasped.

The trap just went down and the intercom rang.

"Director Xiang, someone is looking for you." The operating room nurse's voice came from the intercom.

Gao Shaojie is a little angry and bitter. Just now he is full of energy and spirit, and his state is almost burst. He firmly believes that boss Zheng will be able to see more details at one time.

The trouble of surgery is to be disturbed. Even the elegant Gao Shaojie's heart is full of disgust.

He looked at Xiang Heping, the "patient's family" with dissatisfaction, and everything was silent.