Chapter 1063： The level of community hospitals, really

Xie Ning looked at herself as a "female girl" who still didn't know her identity. I found it very interesting.

The little guy looked a little stupid, and he was honest, but the surgery was really good. So young, you can go to Mayo, Heidelberg to do surgery, this is not the usual ability.

"Zheng Ren..." Xie Ning just screamed, and Zheng Ren’s cell phone rang.

Zheng Ren smiled apologetically, his face was full of fatigue and picked up his mobile phone.

"Fugui, we are going to eat, come with you." Zheng Rendao.

"Well? Ok, I will be there soon."

"No, I go faster, you pick me up at the door. Forget it, pick me up."

Zheng Ren finished, hung up the phone.

"Boss, what's the matter?" Su Yun is obviously not happy. The wine bureau, in Su Yun's opinion, will make more or less jokes. This is the point of laughing at Zheng Ren in the future.

However, this cargo gas is really good, and the professor seems to have encountered any problems. Su Yun thought, some regret.

"Fugui said that there is a thoracic aorta under the stent to the false cavity." Zheng Rendao.

Su Yun’s heart is dissipated and can’t help but see.

The aortic dissection is the kind of disease that Cui Heming is on the plane. As long as it is not type 1, it can be treated by interventional surgery. Now type 1 is OK, but the difficulty is too high, and few people do it.

However, when the stent is lowered, there is a complication - the stent is not in the thoracic aorta, but through the torn mouth, into the middle layer of the blood vessel, and the false lumen is opened.

In this way, the patient's condition will worsen and he may die at any time.

This kind of complication is extremely rare, and it is also because of the doctor's level of surgery. In China, it can be said that it is a very serious medical accident.

This level of complications can occur several times!

Zheng Ren’s heart groaned.

This kind of man-made damage, Zheng Ren has only seen similar reports in the magazine, how to treat it, there is still no count in my heart.

He smiled apologetically and said: "Ning Shu, you should go to dinner first, I will have an operation. If it is smooth, it is estimated that it will take an hour to go."

"Use me?" Su Yun asked again.

As a doctor, when I heard the emergency surgery, I changed myself into the game every time. This is a sense of mission.

"There are rich people, I will go see the situation, you will accompany Ning Shu." Zheng Rendao.

"Good." Su Yun should have come down.

Although a little regrettable, it is important to rescue the emergency. When he thought of the stent under the false cavity, the condition worsened... The blood flow of the aorta was madly poured into the mezzanine, and now it is feared that the vascular sandwich will tear directly to the tip of the toe.

MD, Fuguier's medical level is not so good, Su Yun thought.

Xie Ning looked at himself as a cheap and capable nun, even in Heidelberg, Germany, so busy, some helpless. However, it is an emergency rescue, and it is hard to say anything.

It is very capable, Xie Ning smiles.

"Dr. Zheng, don't call the car, take my car." Zou Jiahua said.

"Then I am welcome." Zheng Ren directly responded.

In fact, when he said to Professor Rudolf Wagner, he had this idea. Zou Jiahua is a human being, and it is impossible to not know what he meant.

Just sitting on the extended Lincoln to do the surgery, will it be too swaying, this point Zheng Ren did not think about.

And Xie Ning and Zou Jiahua said apologetically, Zheng Ren turned and left. A follower by Zou Jiahua followed Zheng Ren to the extended Lincoln.

The car was very stable. Zheng Ren sat in the car and entered the system space, ready to do surgical training.

The operating room of the system rose from the ground. After Zheng Ren entered, he took a look at the film and started the operation directly. The catheter entered, and an angiography, Zheng Ren was stupid after seeing the image.

The stent in the thoracic aorta of the experimental body, with the proximal end in the thoracic aorta and the distal end in the torn false lumen. The true cavity of the thoracic aorta has almost no blood flow, and although the false cavity is not as exaggerated as it is expected, it also directly tears to the position of the common iliac artery.

This... is too heavy.

The severity of the illness, beyond the prediction of Zheng Ren, is already imminent, and patients may die at any time because of rupture of blood vessels.

The outer layer of the thoracic aorta is relatively tough, and the patient is still lucky, so there is no bleeding. The high pressure of the aorta continues to tear the blood vessels and fills the common iliac artery.

The blood vessels here, whether thick or thick, cannot be torn at any time compared to the thoracic aorta.

As long as the blood vessels are broken, the patient will die.

In my heart, Zheng Rengang wanted to operate, and he was directly paralyzed.

How to operate?

This is a very unfamiliar surgery, even if Zheng Ren, who is at the top of the peak, is beginning to be confused.

Surgery, it is not to say that it is done.

Femoral artery puncture, under normal circumstances is a built-in guide wire, catheter.

The current situation of the patient is to remove the stent, and the aorta and the false lumen cannot be operated simultaneously.

A guide wire and a catheter must not be operated at the same time in two places.

Zheng Renjing thought for a while and decided to adopt a mode of operation that he had not done before - bilateral femoral artery catheterization.

It’s just that there’s only one person in the operating room...

Sighing, Zheng Ren condensed God to deal with the current situation. Even if there is only one person, what can it be?

I am a step-by-step man, Zheng Ren cheers on himselfThe experimental body exposes the bilateral femoral artery under general anesthesia and puts into the sheath tube. Zheng Ren also does not care about aseptic operation, and is in a small operation. On the stage, surgery begins.

After all, if you really have surgery, the other side can be handed over to Professor Rudolf Wagner. Zheng Ren gave a strong recognition of the level of the professor.

Bilateral femoral artery puncture, the right catheter was placed into the true cavity, and the left catheter was placed directly into the false lumen. After the hard guide wire was placed, a 5F, 95cm long wind guide sheath was placed at the level of the abdominal cavity for angiography. The results showed that the celiac trunk, superior mesenteric artery and right renal artery were the true blood supply, and the left renal artery and the lumbar artery were The false cavity supplies blood.

The left sheath is placed at the distal end of the original stent in the false lumen and placed in a multi-ring snare. On the right side, the 10F sheath was exchanged through a hard guide wire and placed in a true cavity so that it was located 2 cm away from the end of the original stent.

After several failed operations, Zheng Ren summed up his experience and began to have some thoughts on the operation.

A 5F catheter was placed through the end of the 10F sheath and placed close to the snare in the dummy lumen. Follow the 0.014 inch guidewire and, with the cooperation of the catheter, pass through the inner membrane between the true and false lumens into the snare. The guide wire and catheter are then placed into the original stent.

After exchanging the hard guide wire, the balloon was expanded to a diameter of 25 mm, and then a 36 mm wide, 77 mm long TX2 stent was placed, half of which was in the original stent and the other half was located in the true aorta of the abdominal aorta above the abdominal cavity.

Contrast showed increased visceral artery and renal artery perfusion.

At the end of the operation, the degree of completion was 88%.

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