Chapter 1790： Have a hope, don’t give up
Back to the ward, Su Yun stood next to the patient, eyes watching the ECG monitoring.
"how about it?"
“Not optimistic.” Su Yundao, “IABP has no way to get enough rest in the heart.”
Zhao Yunlong put the signature slip into the medical record folder, Su Yun saw it, and this took a deep breath.
"Director Lin will arrive soon, boss, what are you going to do?" Su Yun asked.
"I think about it." Zheng Ren did not directly answer Su Yun's question, but inserted the patient's nuclear magnetic film into the reader.
Moyamoya disease is a cerebrovascular disease characterized by a chronic stenosis or occlusion of the bilateral internal carotid artery end and anterior cerebral artery, middle cerebral artery, and secondary vascular network of the skull base. disease.
Since this abnormal skull network of the skull base resembles "smoke" on the cerebral angiography image, it is called "motomopathy".
MRI clearly shows the pathological changes of the blood vessels in the patient's brain: old cerebral infarction, localized brain atrophy is most obvious in the frontal lobe and temporal lobe, and the abnormal vascular network at the base of the skull is honeycombed due to the airflow effect. Mesh low signal vascular image.
More obvious moyamoya disease, Zheng Ren looked at the group like the smog-like hyperplasia of blood spit, some guilty.
Forget it, no matter how the patient's family chooses, try the system operating room.
Although the hope of saving the patient is not great, as long as there is a glimmer of hope, Zheng Ren does not want to give up.
If the patient can be rescued in the operating room of the system, risking a big risk, Zheng Ren also wants to give it a try.
The big pig's hoof is simply too odious. Is it a serious illness that does not issue a task?
Zheng Ren's habitual left hand was placed under the right armpit, and his right hand was squatting, looking at the patient's MRI image.
After he made his judgment, he entered the system space directly.
Zheng Ren was hesitant when he clicked on the time of the surgery.
If the patient's family says that they don't agree to the surgery, the time for the surgery they bought will be wasted. The key is not a general surgery, but a neurosurgery that you have never done before!
At least "wasted" a master-level skill book.
A task was done a while ago, and the accumulated rewards have three master-level skill books. At that time, Zheng Ren thought that he would use it for a long time, but did not expect to use the last one so soon.
I am going to Europe soon, facing the ancient, mysterious vampire family...
But what if the patient's family agrees and can't use surgery to solve the problem?
Only hesitated for less than 1 second, Zheng Ren made a judgment.
Click to buy the surgery training time, and click on the last master level skill book.
Neurosurgery is the most sophisticated of all surgical procedures.
When Zheng Ren went to school, he heard from the teacher that when the conditions were not good, the drainage strips were left after drilling and drainage. When the drainage strip is not smooth, it is generally customary to apply a negative pressure to discharge the redundant drainage.
But this is a process of applying negative pressure, which may cause a few milliliters of brain tissue to be sucked out.
As a result, the patient cannot be able to speak, hemiplegia, or walkless after surgery because of the lack of these brain tissues.
Therefore, Zheng Ren has been avoiding surgery in neurosurgery. For him, this is a very difficult procedure.
But today there is no way, how to try it.
After all, it is a master level skill, it should be no problem, Zheng Ren thought.
In 1967, Yasargil first successfully anastomosed the superficial temporal artery in the middle cerebral artery to treat cerebral ischemic diseases. Since then, many countries have performed such operations.
Zheng Ren does not believe that his surgical technique is not comparable to the level of surgery in the 1960s and 1970s.
After entering the operating room of the system, Zheng Ren saw the experimental body lying on the operating table.
He did not have an urgent operation, but first observed the position of the experimental body. After all, it is a strange neurosurgery, and how to be cautious is necessary.
The system adopts a general anesthesia method of tracheal intubation in the supine position of the patient and intravenous administration of the drug, and the use of radial artery puncture to connect the invasive arterial pressure monitoring, so as to facilitate timely observation of the dynamic changes of blood pressure during the operation, and provide for controlling and regulating blood pressure. A reliable basis.
It is possible to monitor arterial pressure anytime and anywhere, and it seems that the big pig's hooves are also very cautious, and Zheng Ren makes a judgment.
The head of the experiment body is biased to the healthy side, and a microscope is placed in the operation area.
Zheng Ren glanced at it, it was Zeiss! He has some little excitement.
According to Su Yun's description, Zeiss's microscope allows itself to avoid the problems of vestibular neuritis.
Otherwise, every time you do a microsurgery, it will be as uncomfortable as a roller coaster.
Zheng Ren hates roller coaster!
It should be ok, start surgery. Thinking of this, Zheng Ren noticed that the experimental body had already prepared the skin.
The preparation of neurosurgery is a shaved head. An experienced nurse, who is quick and steady, has no experience, or will leave some hair or cut the scalp.
Zheng Ren took a look. The big pig's hoof is an experienced nurse, and the skin is almost perfect.
Routine brain surgery disinfection, covered with sterile dressing, subcutaneous injection of local anesthetic around the margin, pterional approach to cut the epidermis and subcutaneous tissue and bipolar hemostasis.
The blood supply of the scalp is simply too rich. Although Zheng Ren is a master-level surgical skill, he is encouraged by the system seedlings and is not skilled. In this step, wasted a considerable amount of time.
Then Zheng Ren began to free the superficial temporal artery, unipolarly cut the diaphragm to reverse the top and covered with saline gauze to protect.
The AO power system and milling cutter were used to remove the skull bone flap, the dura mater was cut, and the middle cerebral artery and its branches were removed under the microscope.
The microscope is good, 40 times, and Zheng Ren is very cautious at every step.
But after all, it was the first time that he failed 12 times in this step.
Surgery failure experimental body death...
The operation failed, the experimental body...
This kind of prompt Zheng Ren looked almost numb.
However, after all, there is experience in microsurgery, the scope of surgery in neurosurgery is narrow, and the movement under the microscope is as soft as possible.
In the 13th surgery training, Zheng Ren finally finished the free step perfectly.
The appropriate recipient was selected, and the distal end of the superficial temporal artery was anastomosed with the middle cerebral artery. The suture was sutured with a 10/0ploene line. During the suturing process, the soft needle was used to repeatedly flush the field and lumen to prevent thrombosis.
After the anastomosis is completed, the surgical field is thoroughly washed, the dura mater is turned over, the surgical contents are counted, and the inner layer of the diaphragm is applied to the surface of the meninges and fixed with the dura mater at the edge of the bone.
The bone flap was placed back, and the 3/0 absorbable thread sutured the scalp to cover the iodine yarn toe cap.
Surgery completion, 50%!
"how about it?"
“Not optimistic.” Su Yundao, “IABP has no way to get enough rest in the heart.”
Zhao Yunlong put the signature slip into the medical record folder, Su Yun saw it, and this took a deep breath.
"Director Lin will arrive soon, boss, what are you going to do?" Su Yun asked.
"I think about it." Zheng Ren did not directly answer Su Yun's question, but inserted the patient's nuclear magnetic film into the reader.
Moyamoya disease is a cerebrovascular disease characterized by a chronic stenosis or occlusion of the bilateral internal carotid artery end and anterior cerebral artery, middle cerebral artery, and secondary vascular network of the skull base. disease.
Since this abnormal skull network of the skull base resembles "smoke" on the cerebral angiography image, it is called "motomopathy".
MRI clearly shows the pathological changes of the blood vessels in the patient's brain: old cerebral infarction, localized brain atrophy is most obvious in the frontal lobe and temporal lobe, and the abnormal vascular network at the base of the skull is honeycombed due to the airflow effect. Mesh low signal vascular image.
More obvious moyamoya disease, Zheng Ren looked at the group like the smog-like hyperplasia of blood spit, some guilty.
Forget it, no matter how the patient's family chooses, try the system operating room.
Although the hope of saving the patient is not great, as long as there is a glimmer of hope, Zheng Ren does not want to give up.
If the patient can be rescued in the operating room of the system, risking a big risk, Zheng Ren also wants to give it a try.
The big pig's hoof is simply too odious. Is it a serious illness that does not issue a task?
Zheng Ren's habitual left hand was placed under the right armpit, and his right hand was squatting, looking at the patient's MRI image.
After he made his judgment, he entered the system space directly.
Zheng Ren was hesitant when he clicked on the time of the surgery.
If the patient's family says that they don't agree to the surgery, the time for the surgery they bought will be wasted. The key is not a general surgery, but a neurosurgery that you have never done before!
At least "wasted" a master-level skill book.
A task was done a while ago, and the accumulated rewards have three master-level skill books. At that time, Zheng Ren thought that he would use it for a long time, but did not expect to use the last one so soon.
I am going to Europe soon, facing the ancient, mysterious vampire family...
But what if the patient's family agrees and can't use surgery to solve the problem?
Only hesitated for less than 1 second, Zheng Ren made a judgment.
Click to buy the surgery training time, and click on the last master level skill book.
Neurosurgery is the most sophisticated of all surgical procedures.
When Zheng Ren went to school, he heard from the teacher that when the conditions were not good, the drainage strips were left after drilling and drainage. When the drainage strip is not smooth, it is generally customary to apply a negative pressure to discharge the redundant drainage.
But this is a process of applying negative pressure, which may cause a few milliliters of brain tissue to be sucked out.
As a result, the patient cannot be able to speak, hemiplegia, or walkless after surgery because of the lack of these brain tissues.
Therefore, Zheng Ren has been avoiding surgery in neurosurgery. For him, this is a very difficult procedure.
But today there is no way, how to try it.
After all, it is a master level skill, it should be no problem, Zheng Ren thought.
In 1967, Yasargil first successfully anastomosed the superficial temporal artery in the middle cerebral artery to treat cerebral ischemic diseases. Since then, many countries have performed such operations.
Zheng Ren does not believe that his surgical technique is not comparable to the level of surgery in the 1960s and 1970s.
After entering the operating room of the system, Zheng Ren saw the experimental body lying on the operating table.
He did not have an urgent operation, but first observed the position of the experimental body. After all, it is a strange neurosurgery, and how to be cautious is necessary.
The system adopts a general anesthesia method of tracheal intubation in the supine position of the patient and intravenous administration of the drug, and the use of radial artery puncture to connect the invasive arterial pressure monitoring, so as to facilitate timely observation of the dynamic changes of blood pressure during the operation, and provide for controlling and regulating blood pressure. A reliable basis.
It is possible to monitor arterial pressure anytime and anywhere, and it seems that the big pig's hooves are also very cautious, and Zheng Ren makes a judgment.
The head of the experiment body is biased to the healthy side, and a microscope is placed in the operation area.
Zheng Ren glanced at it, it was Zeiss! He has some little excitement.
According to Su Yun's description, Zeiss's microscope allows itself to avoid the problems of vestibular neuritis.
Otherwise, every time you do a microsurgery, it will be as uncomfortable as a roller coaster.
Zheng Ren hates roller coaster!
It should be ok, start surgery. Thinking of this, Zheng Ren noticed that the experimental body had already prepared the skin.
The preparation of neurosurgery is a shaved head. An experienced nurse, who is quick and steady, has no experience, or will leave some hair or cut the scalp.
Zheng Ren took a look. The big pig's hoof is an experienced nurse, and the skin is almost perfect.
Routine brain surgery disinfection, covered with sterile dressing, subcutaneous injection of local anesthetic around the margin, pterional approach to cut the epidermis and subcutaneous tissue and bipolar hemostasis.
The blood supply of the scalp is simply too rich. Although Zheng Ren is a master-level surgical skill, he is encouraged by the system seedlings and is not skilled. In this step, wasted a considerable amount of time.
Then Zheng Ren began to free the superficial temporal artery, unipolarly cut the diaphragm to reverse the top and covered with saline gauze to protect.
The AO power system and milling cutter were used to remove the skull bone flap, the dura mater was cut, and the middle cerebral artery and its branches were removed under the microscope.
The microscope is good, 40 times, and Zheng Ren is very cautious at every step.
But after all, it was the first time that he failed 12 times in this step.
Surgery failure experimental body death...
The operation failed, the experimental body...
This kind of prompt Zheng Ren looked almost numb.
However, after all, there is experience in microsurgery, the scope of surgery in neurosurgery is narrow, and the movement under the microscope is as soft as possible.
In the 13th surgery training, Zheng Ren finally finished the free step perfectly.
The appropriate recipient was selected, and the distal end of the superficial temporal artery was anastomosed with the middle cerebral artery. The suture was sutured with a 10/0ploene line. During the suturing process, the soft needle was used to repeatedly flush the field and lumen to prevent thrombosis.
After the anastomosis is completed, the surgical field is thoroughly washed, the dura mater is turned over, the surgical contents are counted, and the inner layer of the diaphragm is applied to the surface of the meninges and fixed with the dura mater at the edge of the bone.
The bone flap was placed back, and the 3/0 absorbable thread sutured the scalp to cover the iodine yarn toe cap.
Surgery completion, 50%!
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