Back in the ward, Su Yun stood beside the patient, staring at the ECG monitor.
"How about it?"
"Not optimistic." Su Yun said, "iabp cannot give the heart enough rest."
Zhao Yunlong put the signature form into the medical record folder. Su Yun took a look and let out a sigh of relief.
"Director Lin will be here soon. Boss, what are you going to do?" Su Yun asked.
"I thought about it." Zheng Ren did not answer Su Yun's question directly, but inserted the patient's MRI film into the reader.
Moyamoya disease is a cerebrovascular disease of unknown etiology, characterized by chronic progressive stenosis or occlusion of the ends of the bilateral internal carotid arteries and the beginnings of the anterior cerebral artery and the middle cerebral artery, followed by the formation of an abnormal vascular network at the base of the skull. disease.
Because this abnormal vascular network at the skull base looks like "smoke" on cerebral angiography images, it is called "moyamoya disease".
MRI clearly shows the pathological morphological changes of the patient's brain blood vessels: old cerebral infarction, localized brain atrophy, most obvious at the base of the frontal lobe and temporal lobe, abnormal vascular network at the base of the skull that appears honeycomb-shaped or Reticular low-intensity vascular imaging.
The more obvious moyamoya disease, Zheng Ren looked at the group of proliferating blood vessels that looked like the smoke exhaled after smoking, and felt a little worried.
Forget it, no matter what the patient's family chooses, let's go to the system operating room and give it a try.
Although there was not much hope of saving the patient, Zheng Ren did not want to give up as long as there was a glimmer of hope.
If the patient can be rescued in the system operating room, Zheng Ren would like to give it a try at a huge risk.
The big pig's hooves are so disgusting. Why don't you issue a mission for such a serious disease
Zheng Ren habitually placed his left hand under his right armpit and held his chin with his right hand while looking at the patient's MRI images.
After making his judgment, he directly entered the system space.
When he clicked to purchase surgical training time, Zheng Ren hesitated slightly.
If the patient's family members disagree with the surgery, the surgical training time they purchased will be wasted. The key point is that this is not a general surgery, but a neurosurgery that I have never done before!
At least one master-level skill book will be "wasted".
I did a mission a while ago, and the accumulated rewards include three master-level skill books. At that time, Zheng Ren thought he would use it for a long time, but he didn't expect to use the last one so soon.
He is about to go to Europe and face the ancient and mysterious vampire family...
But what if the patient's family agrees but he cannot solve the problem with surgery
After hesitating for less than a second, Zheng Ren made a judgment.
Click to purchase surgical training time, and click to use the last master-level skill book.
Neurosurgery is the most sophisticated of all surgeries.
When Zheng Ren was in school, he heard his teacher say that when conditions were not good in the past, drainage strips were left behind after drilling holes for drainage. When the drainage strip is not smooth, it is generally customary to apply negative pressure to drain the redundant drainage.
But just such a process of applying negative pressure may cause several milliliters of brain tissue to be sucked out.
As a result, patients suffer from symptoms such as inability to speak, hemiplegia, and weakness in walking after surgery due to the loss of these brain tissues.
Therefore, Zheng Ren has always avoided neurosurgery. For him, this is a very difficult surgery.
But there is nothing I can do today, I have to try it no matter what.
After all, it is a master-level skill, so it should be no problem, Zheng Ren thought.
In 1967, Yasargil was the first to successfully anastomose the superficial temporal artery to the middle cerebral artery to treat cerebral ischemic disease. Since then, this type of surgery has been carried out in many countries.
Zheng Ren didn't believe that his surgical skills were not as good as those of the 1960s and 1970s.
After entering the system operating room, Zheng Ren saw the experimental subject lying on the operating table.
He did not rush into surgery, but first observed the position of the experimental subject. After all, it is an unfamiliar neurosurgery, so no matter how cautious you are, it is necessary.
The system adopts the general anesthesia method of tracheal intubation with the patient in the supine position and intravenous medication at the same time. It also uses radial artery puncture and is connected to invasive arterial pressure monitoring to facilitate timely observation of dynamic changes in blood pressure during the operation and provide information for controlling and regulating blood pressure. reliable basis.
It can monitor arterial pressure anytime and anywhere. It seems that Big Pig Hoof is also very cautious. Zheng Ren made a judgment.
The subject's head was tilted to the healthy side, and a microscope was placed in the surgical area.
Zheng Ren glanced at it and saw that it belonged to Zeiss! He was a little excited.
According to Su Yun's description, Zeiss's microscope can help him avoid the problem of underdeveloped vestibular nerves.
Otherwise, every time after a microsurgery, the postoperative experience will be as uncomfortable as riding a roller coaster.
Zheng Ren hates roller coasters!
It should be fine, let's start the surgery. Thinking of this, Zheng Ren noticed that the experimental subject had already prepared the skin.
Skin preparation for neurosurgery involves shaving the head. An experienced nurse can shave the head quickly and steadily. An inexperienced nurse will either leave some hair behind or cut the scalp.
Zheng Ren took a look and saw that Big Pig Hotter was an experienced nurse and his skin preparation was almost perfect.
Routine brain surgery disinfection, covering with sterile dressing, subcutaneous injection of local anesthetic around the incision edge, incision of the scalp and subcutaneous tissue through pterional approach and bipolar hemostasis.
The blood supply to the scalp is simply too rich. Although Zheng Ren has master-level surgical skills, he was encouraged by the system and is not proficient. A considerable amount of time was wasted on this step.
Zheng Ren then began to free the superficial temporal artery, unipolarly incised the reverse top of the temporalis muscle and covered it with saline gauze for protection.
Use an AO power system and a milling cutter to remove the cranial bone flap, cut the dura mater, and dissociate the middle cerebral artery and its branches under a microscope.
The microscope is good, 40x, and Zheng Ren is very cautious in every move he makes.
But after all, it was his first time doing it, and he failed at this step 12 times.
The operation failed and the experimental subject died...
The operation failed and the experimental subject became paralyzed...
Zheng Ren was almost numb when he saw such reminders.
But after all, he has experience in microsurgery. The scope of neurosurgery is narrow, and he quickly mastered the characteristics of being as gentle as possible under the microscope.
In the 13th surgical training, Zheng Ren finally completed the dissociation step perfectly.
Select a suitable recipient, perform an end-to-side anastomosis of the severed end of the superficial temporal artery and the middle cerebral artery, and suture it under a microscope using /0ploene. During the suturing process, a soft needle with heparinized saline is used to repeatedly flush the surgical field and lumen to prevent thrombosis.
After the anastomosis is completed, the surgical field is thoroughly flushed, the dura mater is turned over, the surgical supplies are counted, and the inner layer of the temporalis muscle is applied to the meningeal surface and fixed with the dura mater at the bone edge.
The bone flap is replaced, the scalp is sutured with 3 absorbable sutures, and the head is covered with iodine gauze.
Surgery completion rate, 50%!