Chapter 2197： Chilli in the lungs

Using freezing technology..." Su Yun asked a beginning and stopped.

"I have considered it, but the patient now has hemoptysis. If it is frozen, it is more likely to have problems with poor scales." Fang Lin frowned.

"I think I can give it a try. This position should be more suitable for freezing technology." Zheng Ren looked at the film and said softly.

Fang Lin carefully pondered the difficulty of doing bronchoscope + freezing technology, and some were difficult.

Zheng Ren looked at the film and entered the system space, ready to do a bronchoscope.

The principle of cryotherapy is to treat the lesion according to the Joule-Thomson effect and achieve the goal that the doctor needs.

The high-pressure gas in the cryoprobe is ejected through the nozzle and rapidly expands in the low-pressure region. When the probe contacts the tissue, heat exchange with the tissue causes the tissue heat to be removed to freeze the tissue.

Tissue damage caused by freezing can occur at the cellular and tissue levels without causing more damage.

The difficulty of the patient's condition is that the bronchial foreign body, or the adhesion of the stone to the surrounding tissue, has caused bronchial wall rupture and bleeding.

It can cause hemoptysis of 350ml, which means that the blood vessels that are bleeding are relatively large, at least the blood vessels like the branch of the bronchial artery.

The adhesion is serious, not a clear foreign body with a clear boundary. It is difficult to tell the truth about the complete removal of bronchial foreign bodies.

Fang Lin’s concern is that direct removal of foreign bodies and retention of lung tissue will result in more severe hemoptysis and never endanger the patient’s life.

Can only try it.

Zheng Ren started the surgery training with a try-and-test attitude. It is really impossible to remove the lungs according to Fang Lin's opinion.

Intramuscular injection of 10 mg of medlar was performed 30 min before surgery. Zheng Ren still felt uneasy, added 50mg of a cold, atropine O.5mg intramuscular injection, and given 2% lidocaine 10ml atomized inhalation.

After the drug started, Zheng Ren operated a fiberoptic bronchoscope into the right lung and entered the problematic right lower lung.

Soon, Zheng Ren saw foreign bodies.

Mucosal edema, granulation hyperplasia, visible distal foreign body, granulation tissue wrapped, the lens hit the foreign body after bleeding, and accompanied by a large number of purulent secretions spilled.

What kind of ghost is this? Looked at the problem. Long look... seems familiar.

Zheng Ren carefully looked at the foreign objects wrapped in the fiberoptic bronchoscope, and suddenly thought of several case reports published in China.

Yes... chili.

It is unbelievable to eat chili peppers in the lungs, but it has been reported intermittently over the years.

However, knowing what foreign objects are, there is no egg at all.

Combined with the medical history and repeated episodes of the patient, the foreign body should have been for several years, and the granulation is obvious, resulting in a small orifice, and it is difficult to completely remove the foreign body inside. Adding foreign matter and adhesion around, the mirror bleeds after touching, and it is quite difficult to completely remove it.

Zheng Ren did not hesitate to remove the secretions and necrotic material on the surface of the lesion so that the cryoprobe could fully contact the lesion.

Subsequently, the sterile cryoprobe is inserted through the biopsy hole, and the metal end of the cryoprobe is placed in the center of the lesion. The probe is more than 5 mm away from the distal end of the bronchoscope. The probe can be perpendicular or tangential to the tissue, or directly affect the inside of the lesion. Produces maximum freezing effect.

Press the pedal to start the probe. After about 15-20s, a puck is formed on the top of the probe. The visible tissue is white and frozen. When the switch is released, it will naturally melt.

1-3 freeze-ablation cycles, each cycle lasting 3-4 minutes in the same or adjacent area, larger lesions can be more frozen until the visible portion is completely frozen.

After several failures, Zheng Ren summed up the experience.

The freezing time is about 18 seconds, and it takes 4 freeze-absence cycles, each of which lasts 3 minutes and 20 seconds.

Finally, in the case of a small amount of bleeding, the entire foreign body was clamped by Zheng Ren with a foreign object.

The peppers are already corrupt and exude a weird taste that is unacceptable.

Because of the severe bronchial wall corrosion, Zheng Ren had a bronchial stent, which completed the operation.

Looking at the 99% of the completion of the surgery, Zheng Ren took a deep breath.

He was curious, what happened to the pepper in the trachea.

Holding a hemostatic forceps, Zheng Ren began to open the mechanized layer wrapped in the pepper. As soon as it is opened, the smell of rotten peppers rushes into the olfactory epithelium consisting of supporting cells, olfactory cells and basal cells in the nasal cavity of Zheng Ren.

Through the olfactory nervous system and the nasal trigeminal nervous system, enter the olfactory bulb of the telencephalon.

After a moment, Zheng Ren almost fainted in the system operating room.

This smell... No wonder the right grass does not eat, smell this taste every day, can eat and enter things to blame.

And not only taste, but also toxic gases. If the physical quality is not enhanced in the system space, I am afraid that Zheng Ren will faint in the operating room.

At that time, even if people can survive, countless surgical training time is "wasted", fearing that Zheng Renlian's heart will die.

Zheng Ren came out of the system operating room and ended the surgery. If you faint in the operating room of the system, so many times of surgery training time is exhausted, Zheng Ren has grief.

"Boss, how about freezing technology? I think I can give it a try. The difficulty is big, but I am going to cut the lungs anyway, why..."

"You can give it a try. In the hybrid operating room, first use the fiberoptic bronchoscope to take foreign bodies in the freezing technique If it is successful, you have to have a bronchial shelf to block the bleeding point."

Su Yun listened to his boss and said that he has a bottom.

"Fang Lin, who is your second-line professor today?" he asked.

The hospital is always responsible for the emergency department. The surgery that is dangerous and may not be taken is of course to find the second line.

"I wish the teacher a second line, but he has more operations today and has not finished yet." Fang Lindao.

"Go to communicate with the patient's family, and then look for the second line to see the situation." Su Yundao.

Fang Lin did not hesitate, since Zheng boss said that he can, take him to see it. As for the second-line teacher, I want to try it, he will not stop himself.

Eight laparoscopic operations a day, it is said that in the afternoon to do three endoscopic esophageal cancer radical surgery, he has time to deal with a bronchial foreign body.

"Zheng boss, Yun Geer, two wait for me." Fang Lin hung a big red stethoscope, swaying, and the style is unusual.

"Well, we are waiting for you back to the ward." Zheng Rendao, "When you are ready to call Su Yun, we will go up."

After that, Zheng Ren thought about it, and Su Yun said: "What class is Laohe? Let's come to Taiwan. If there is a major bleeding, you need an emergency intubation."

Fang Lin began to have a headache when he thought of major bleeding and emergency intubation.

This kind of surgery, once it is urgent to do it, the risk is suddenly rising.

Just looking at Zheng Boss's quite confident look, Fang Lin was entangled for 3.2 seconds, and finally decided to carefully explain to the patient's family members, must make the risks in the surgery clear, let the family choose.

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