"Sun, a similar operation, the role of intervention is to open the blood vessels, is there any other use?" Xie Ning asked.
"Ning Shu, it is very remarkable to be able to open the blood vessels. Especially the traumatic thrombosis of this critically ill, where to open, which limbs ... can go up 5-10cm." Sun explained: "But the intervention The operation of taking the plug is difficult to do. The thrombus is more than 6 hours. It is especially difficult to take the plug. I don't understand it if I don't engage in it."
Xie Ning nodded and did not speak. Looking at Zheng Ren’s surgery, she thought thoughtfully.
Soon, the screen between the operating rooms lit up.
The guide wire extends down the femoral artery, but it does not go far, and the catheter is placed in a good position. At the moment the screen lights up, angiography has begun.
The contrast agent did not go far, it was blocked. Below the 1/3 of the injured thigh, the vascular occlusion was severe and blank. This means that the thrombus is constantly forming and has spread from below the knee to 1/3 of the thigh.
Ischemia, exudation, edema, and the condition of the injured limb is continuously deteriorating.
In the past two days, there have been too many similar injuries, and Sun has been numb.
If you bet on emotions, even if there is only one trace, the doctor is afraid that the emotions will collapse early, so that more people cannot be treated.
Now, all doctors are only concerned with the condition, not the other circumstances of the injured.
Being able to live alive from the front is already a blessing in misfortune.
On the screen, after the angiography was completed, the surgeon did not stop stepping on the line, but pulled out the ordinary catheter, and the plug catheter immediately went in.
The key to surgery, Sun always knows.
Embolization has been formed for at least 6 hours, or even 36-72 hours. It is not a fresh blood clot. It is extremely difficult to remove.
However, the surgeon insists on doing it, and should be able to take out an embolism. Sun has this confidence.
In the current situation, people who are not at the level are absolutely afraid to waste time trying again and again. The wounded people on the outside are a huge pressure.
In this case, it is not a time of reluctance. This is the key to doing what you can.
"Hey? Ning Shu? You are not busy, how come you have time?" Su Yun's voice passed from the door of the operation room.
"Su Yun, let me see the situation on this side, and do what I know. Are you okay on that side?" Xie Ning smiled and said: "Do you have a quick operation?"
"It’s the boss’s surgery is fast, it has nothing to do with me.” Su Yundao: “Mu Tao can only do one in forty minutes, and the slow one is like a cow pulling.”
Su Yun said that Mu Tao came, no pressure, as if he had nothing to do with him.
Amount... Sun is always amazed.
Forty minutes of a severe pelvic fracture interventional surgery? Already flying fast, okay?
How did it become slow to pull the car with the cow?
He looked at the person who came in and looked at him. He was a handsome young man.
The tone is really big, do young people now talk like this? When I was in emergency room, did I have any serious words?
Perhaps this is the style of their operating room? possible. In the operating room of each hospital, the atmosphere of chatting is different. In short, the simpler and easier it is, the better. But what kind of doctor is this, how can it be so serious?
"It's very good." Xie Ning laughed.
"Director Jiang, what is the boss doing?" Su Yun asked.
"Take the operation." Director Jiang replied.
"Oh, did he sleep for a while?" Su Yun asked.
"I just slept for about ten minutes."
"Do it, get tired of this dog day in the morning and evening." Su Yun said.
The people standing in front of the console were all in a hurry. At least 36 hours of surgery had been busy. Before that, they also carried heavy injuries to the mountains. Su Yun said the truth.
But what about that?
There are still more than a dozen seriously wounded people waiting for amputation. If the thrombectomy procedure is successful, it means that the limb will try to retain a section.
Mr. Sun stunned God and felt awkward in his heart. Looking back at the screen, I suddenly found that the catheter was not in the femoral artery.
Is the operation mistake? Definitely is.
Drowsiness is like this, and mistakes are inevitable, not a big deal.
However, it seems that there are some differences in the image.
He looked closely and found that the thigh femoral artery seemed to be partially open, and the residual contrast agent was spreading at a visible rate in the adjacent capillary branch.
This means that the capillaries have not been completely blocked soon after the loss of blood supply. Once the femoral artery is opened, the blood flows down and the arterial pressure reopens the capillary network.
Just took the time to talk, took a embolus?
This speed... is too fast.
However, Sun is not surprised. The operation has just begun. The blood clot in the femoral artery can be said to be full. Only one section is taken out. It is not particularly helpful for the overall condition and subsequent surgery.
Specifically, you have to look again.
"Orthopaedic?" Su Yun came over and slapped Sun, and asked.
Uh... the tone of this speech is very unfriendly. Sun is very surprised. He does not seem to offend this person. Why does he talk to himself in this tone?
Somewhat awkward, but I can't make it because of this little thing, everyone is not too angry, Sun always knows. He nodded and said: "Well, I am the hospitalized general of the Provincial Department of Orthopaedics."
"In general, are your directors coming?" Su Yun asked in a lazy voice.
"The director stayed at home, I was the first time I was accidentally pulled over to the emergency department for emergency treatment." Sun was more annoyed with this gun, and he was perfunctory.
"The surgery you may not be able to do it..." Su Yun stretched his tone and then seemed to meditate.
"I have done it, I can definitely do it." Sun’s temper is no better, and he can’t hold it anymore, he said coldly.
"Oh." Su Yunhehe smiled, "Look at the angiography, the crush should be 5-6cm below the knee joint. The distance is extremely short, do you have the confidence to keep the knee?"
"Oh..." Sun always hesitated. In his opinion, the knee is definitely not sustainable. The efforts of the surgeons are to open the blood vessels as much as possible, to make the post-osteofascial syndrome lighter, to heal faster, and to cut a section of the thigh.
"And I see the boss's meaning, you should not use a tourniquet when you amputated." Su Yun looked at the screen with his eyes open, muttered his mouth.
What he said, even he himself did not believe very much. However, Zheng Ren laboriously took out the thrombus and opened the artery. The general condition was to be separated by at least 12 hours, and the capillaries were all opened before surgery.
This is a special event in a special period.
In normal times, patients who are crushed by heavy objects for more than one hour are rarely encountered. Now, 1 hour is considered a fresh crush injury. Most people are squeezed by heavy objects for about 1-2 days, and the traumatic necrosis is serious.
At this time, the capillaries are opened, and the necrotic tissue is absorbed into the blood, causing serious complications such as bacteremia and acute renal failure.
Therefore, you must not wait for 12 hours to do amputation surgery, but to seize the time, it is best to start amputation immediately after opening the blood vessels, remove necrotic body tissue, and minimize the possibility of complications.
Mr. Sun has lived, and does not have a tourniquet for amputation? What about the bleeding? That is the femoral artery. After the incision, the blood flows into the river.
"So, you look at it and look at people with higher levels." Su Yun held his arms and looked at the operation on the screen, admiring: "To say that the boss is doing this surgery, it is getting more and more sophisticated." It’s amazing."
Praising Zheng Ren’s tone is totally different from the tone of talking to Sun’s, as if he had changed someone.
Sun Zhenxing stunned, and this person is really turning his face faster than flipping a book. Is the surgery done well? Not necessarily. Although he did not understand the interventional surgery, he still couldn't help but swear.
He is a little angry, even if he is his own director, he has never been so screaming to talk to himself. Who is this person? Why are you so annoying?
But hate to hate, you can't argue with people in the operation room. Sun Zhenxing took a sigh of relief and tried to keep himself.
During a few breaths, Sun Zhenxing’s mood stabilized.
He stared at the operation and suddenly saw it... The catheter was taking a large section of the thrombus from the anterior tibial artery and was pulling out.
Have you already had a knee joint?
The kind of thrombus that was embolized for more than 48 hours, how did he get it out...