Chapter 948： Heart is bleeding

Zheng Ren did not say anything, just changing clothes in silence.

"Go, go and see the situation." Director Kong also took the time to change clothes, put on a sterile hat, and walked in quickly.

Before coming to the console, Director Kong began to read the images of the surgery.

During the process of taking the stent, the angle is slightly deviated, hitting the liver parenchyma, causing a small artery to rupture and bleed.

This is also the reason why the previous TIPS surgery only had one stent and never recovered.

The second retrievable stent, waiting for the patient to adapt to the blood ammonia situation, and then remove it, to expand the outflow tract is indeed a perfect idea. But the process of taking out the second recyclable stent has many difficulties.

Zheng Ren is an interventional skill tree that has reached the level of a master, and dare to do so. However, many details have not yet been taught to Zhu Liangchen, he tried to do it himself.

This thing...

In fact, it cannot be said that Zhu Liangchen was completely wrong.

However, this kind of mistake is completely unnecessary.

He stood behind the director of the hole and looked at Zhu Liangchen's image of the operation. However, he came to the system space and clicked on the surgical training.

The operating room of the system rose from the ground, and Zheng Ren did not hesitate to go in.

His heart is bleeding.

Although there is still a surplus of surgery training time, this is completely unnecessary consumption. Zhu Liangchen is so jealous!

Zheng Ren’s thoughts of hatred in his heart.

The heart is already bleeding, and he does not waste surgery time and start surgery directly.

In fact, with the intervention level of Zheng Ren, it is entirely possible to go directly to the stage. But this is an accident after all. I took over Zhu Liangchen’s surgery and did it myself. It is two concepts.

Zheng Ren still chose to purchase the training time safely. If there is any problem, still in the system operating room, let the experimental body bear it.

For this kind of complication, Zheng Ren has had research. Embolization is undoubtedly the best choice.

He first let the stent lick a little, angiography, and immediately saw blood flow.

Zhu Liangchen has already finished the work of puncture, and Zheng Ren began to over-select the artery.

In patients with advanced cirrhosis, the liver has atrophy, and the arteries have abnormal anatomical structures for various reasons. Coupled with the splenomegaly, the coagulation mechanism is not good, so one or two hours of stenting with a film stent to stop bleeding, and no effect.

The angiographic results show that the hemorrhagic arteriole is a four-level, five-level arterial junction. Very fine, the difficulty of over-selection is not that big.

However, for Zheng Ren, the difficulty of this super-selection is no more difficult than the intervention of the prostate.

The right and left hands are crossed, and Zheng Renchao is very skilled and meticulous.

Because patients with advanced cirrhosis have poor liver function and liver atrophy, they can have less embolism and less embolism, so as to avoid liver failure.

The guide wire enters, and the layer is superselected, and finally comes to the bleeding artery.

Almost the embolism of the bleeding point, Zheng Ren determined that even if his intervention level reached the peak level, he can only do this step.

There is nothing special about surgery, it is a test of super-selection.

Embolization, re-contrast.

Zheng Ren is fully grasped, but the system only gives 85% of the degree of surgery completion.

Strange, why is this?

After a few minutes of observation, Zheng Ren found that in addition to a small artery, the channel in which the stent was placed was continuously oozing.

This is the result of extensive contusion of the liver parenchyma after repeated friction.

Zheng Ren is also very helpless.

Zhu Liangchen's technique is wrong, resulting in greater surgical side damage.

What should I do? Zheng Ren was also helpless at one time. Embolizing small arteries can solve a lot of problems. The patient just stepped down and it was fine. The problem of oozing may soon get better, but it may also ooze blood, leading to deterioration of the state, and finally hemorrhagic shock.

Can't wait for the patient to heal itself, to solve this problem! Zheng Ren immediately made his own choice.

If you try your luck, don't do it. Although Zheng Ren has a lucky bonus, he is very disgusted in his heart.

Then over-selection, find a few blood supply arteries in the contusion position of oozing, superselection, embolization.

Zheng Ren faced a problem. The more detailed the over-selection, the smaller the range of hemostasis. In this case, more super-selection and embolization should be done.

How to get the most benefit, the point of least damage, is very difficult.

Fortunately, there are a lot of surgical training time, Zheng Ren has a little bit of temptation, a little bit to do.

Fortunately, this is the system operating room and can make mistakes.

As time went by, Zheng Ren gradually explored a balance point. The 3rd and 4th grade arterioles that embolize the position can avoid more damage to the patient, but can stop bleeding smoothly.

It’s just that the training time was wasted and Zheng Ren was somewhat distressed.

After fifteen hours, Zheng Ren finally saw the completion of surgery reached 97%.

That's it, no matter how much, it is hard to achieve.

After all, the patient's platelets are more than half less than normal. In this case, 97% of the surgical completion is almost at the limit.

He glanced at the experiment and some regrets.

Turned out of the system operating room and returned to reality.

Director Kong flipped through the process of surgery, Shen Sheng said: "The fifth, I and Zheng boss, you rest."

Zheng Ren quickly went to brush his hands.

With the director of the hole, he can't be like Professor Rudolf Wagner, waiting for the professor to be ready to go on.

For the old director, it is still necessary to express respect.

Seeing Zheng Ren running to brush his hands and preparing, Director Kong looked at Zhu Liangchen deeply and shook his head slightly.

Zhu Liangchen felt dry and a little embarrassed, but was somewhat dissatisfied with the arrival of Zheng Ren.

All kinds of complicated emotions interweave, he lowered his head and did not go to see Director Kong.

Director Kong also has nothing to do, brush his hand and go on stage.

"Zheng boss, you come to do it." After the director went up, he stood directly at Zheng Ren's hand and squeezed him into the position of the surgeon.

Zheng Ren did not continue to polite ~ www.novelhall.com ~ directly plugged the micro-guidewire into the super-selective angiography + arterial embolization.

In the operation room, Zhu Liangchen looked at the old and the small on the operating table through the lead glass.

Did you do something wrong? He doesn't think so.

It must be a problem with surgical design. Originally, there should be no two stents!

The second phase of surgery is very difficult and completely contradicts the criteria for doing TIPS surgery for so many years.

Zhu Liangchen tried for a long time, not too violent operation. All the doctors, who have done hundreds of TIPS surgeries, know that violence can't solve the problem.

It may be possible to violently remove the stent, but it will always be accompanied by major bleeding. Until the end, Zhu Liangchen had no choice but to call the director of the hole and asked for help.

He can stop bleeding successfully, Zhu Liangchen began to look forward to.

As for the future, TIPS surgery, still do not touch. Even if it is improved, the risk is too great.