"Mr. Sun, for similar surgeries, the interventional function is to open blood vessels. Are there any other uses?" Xie Ning asked.
"Uncle Ning, it's amazing to be able to open blood vessels. Especially for this kind of critical and severe traumatic blood clots, wherever the limb is opened... the upper 5-10cm of the limb can be saved." Mr. Sun explained: "But Interventional thrombectomy surgery is difficult to perform, and it is particularly difficult to remove thrombus for a blood clot that lasts for more than 6 hours. I don’t understand the specifics if I don’t do interventional surgery.”
Xie Ning nodded without saying anything. He looked thoughtfully at Zheng Ren inside as he began the operation.
Soon, the screen in the operating room lit up.
The guide wire was extended down the femoral artery, but not very far, and the catheter was positioned. The moment the screen lights up, imaging has already started.
The contrast agent didn't go far before it was blocked. Below 1/3 of the injured person's thigh, the blood vessels were severely occluded and completely blank. This means that blood clots continue to form and have spread from below the knee joint to 1/3 of the thigh.
Ischemia, exudation, and edema have caused the condition of the injured limb to continue to deteriorate.
In the past two days, there have been too many similar injuries, and Mr. Sun has become numb.
If there was even a trace of emotion, the doctor would probably have an emotional breakdown, and more people would not be able to receive treatment.
Now, all doctors only focus on the condition, without thinking about other conditions of the injured.
Being able to come down from the front alive is already a blessing among misfortunes.
On the screen, after the angiography was completed, the surgeon did not stop stepping on the thread, but pulled out the ordinary catheter, and then inserted the thrombectomy catheter.
It's time for the operation, and Mr. Sun knows it.
The emboli have been formed for at least 6 hours, or even 36-72 hours. They are not considered fresh thrombi and are extremely difficult to remove.
But the surgeon insisted on doing it, and he should be able to remove a section of the embolus. Mr. Sun had this confidence.
Under the current situation, people who are not good enough will never dare to waste time trying again and again. The mountains of wounded outside were a huge pressure in itself.
In this case, it is not the time to show off. Do what you can do, that's the key.
"Huh? Uncle Ning? You're not busy there, so why are you free to come here?" Su Yun's voice came from the door of the operation room.
"Su Yun, let me take a look at the situation here and be aware of it. Is everything okay on your side?" Xie Ning smiled and said, "Did you do the surgery quickly?"
"It's because the boss does the surgery quickly. It has nothing to do with me." Su Yun said: "Mu Tao can do one in forty minutes, which is as slow as an oxen pulling a cart."
Su Yun talked about Mu Tao without any pressure, as if he had nothing to do with him.
Um... Mr. Sun was stunned.
Forty minutes of interventional surgery for a severe pelvic fracture? It's already flying quickly, okay
Why did you become so slow as to pull a cart with oxen
He glanced sideways at the person who walked in. He was a handsome young man.
What a loud tone. Do young people today talk like this? You don’t have any serious words to say during emergency treatment
Perhaps, this is the style of their operating room? possible. The atmosphere of chatting in the operating room of each hospital is different. In short, the simpler and more relaxed the better. But where is this doctor? Why is he so unscrupulous
"Pretty good." Xie Ning smiled.
"Director Jiang, what is the boss doing?" Su Yun asked.
"Thrombectomy surgery." Director Jiang replied.
"Oh, has he slept for a while?" Su Yun asked.
"I just slept for about ten minutes."
"Just do it, sooner or later you'll be exhausted from this shit." Su Yun cursed.
The few people standing in front of the operating table felt gloomy. They had been busy with the operation for at least 36 hours, and had to carry the seriously injured over the mountains and ridges before. Su Yun was telling the truth.
But, so what
There were more than a dozen seriously injured people lying outside waiting for amputation. If the thrombectomy is successful, it means that as much of the limb as possible will be preserved.
Mr. Sun was stunned for a moment and felt a little sad. When I looked back at the screen, I was shocked to find that the thrombectomy catheter was no longer in the femoral artery.
Was it an operational error? Definitely is.
When you're so sleepy, mistakes are inevitable, but it's not a big deal.
But... the image looks a little different.
He looked carefully and found that the femoral artery in the thigh seemed to be partially open, and the residual contrast agent was spreading in the nearby capillary branches at a speed visible to the naked eye.
This means that the blood supply has been lost not long ago, and the capillaries have not been completely blocked. Once the femoral artery is open and blood flows down, the arterial pressure reopens the capillary network.
Just when you were talking, you took out a piece of embolus
This speed... is too fast.
However, Mr. Sun was not surprised. The operation had just begun, and the femoral artery was full of thrombus. Only one section was removed, which would not be particularly helpful to the overall condition or subsequent operations.
The details remain to be seen.
"Orthopedics?" Su Yun walked over, looked sideways at Mr. Sun, and asked.
Uh... The tone of this speech is very unfriendly. Mr. Sun was surprised. He didn't seem to have offended this person. Why did he talk to him in such a tone
He was a little dazed, but he couldn't care less about this trivial matter. Everyone was very angry, and Mr. Sun knew it. He nodded and said, "Well, I am the chief resident of the Orthopedics Department of the Provincial Hospital."
"General resident, is your director here?" Su Yun asked in a lazy voice.
"The director stayed at home. I was immediately pulled over for emergency treatment when something happened." Mr. Sun became increasingly bored with this sissy and responded casually.
"You may not be able to handle that surgery..." Su Yun said in a long tone, then seemed to be deep in thought.
"I've done it before, and I can definitely do it." No matter how good-tempered Mr. Sun was, he couldn't hold it in anymore, he said coldly.
"Haha." Su Yun chuckled, "Looking at the angiography, the pressure injury should be 5-6cm below the knee joint. The distance is extremely short. Are you sure you can save the knee joint?"
"Uh..." Mr. Sun hesitated. In his opinion, the knee joint could not be saved. The efforts of the surgeon during the operation are to open up the blood vessels as much as possible, so that the postoperative compartment syndrome will be less severe, the healing will be faster, and only a section of the thigh will be cut off.
"And I think the boss means that you can't use a tourniquet when amputation is necessary." Su Yun squinted at the screen and murmured.
Even he himself didn't quite believe what he said. But Zheng Ren worked hard to remove the thrombus and open the artery. Normally, he would wait at least 12 hours for all capillaries to open before performing the operation.
This is a special thing in special times.
Normally, it is rare to encounter patients who are squeezed by heavy objects for more than an hour. Now, an hour is considered a fresh crush injury. Most people are squeezed by heavy objects for about 1-2 days, resulting in serious trauma and necrosis.
At this time, capillaries open and necrotic tissue will be absorbed into the blood, causing serious complications such as bacteremia and acute renal failure.
Therefore, you must not wait 12 hours before performing amputation surgery. Instead, you must seize the time. It is best to start amputation immediately after opening the blood vessels to remove necrotic body tissue and minimize the possibility of complications.
Mr. Sun was stunned. Amputation does not require a tourniquet? What to do about bleeding? That's the femoral artery, the kind that bleeds like a river after being cut open.
"So, it's in vain for you to see someone with higher skills." Su Yun hugged his arms and looked at the operations on the screen, admiring: "Speaking of the boss's surgery, he is becoming more and more skilled. Wow, it’s really amazing.”
The tone of praising Zheng Ren was completely different from the tone of speaking to Mr. Sun, as if he was a different person.
Sun Zhenxing was stunned. This person really turned against him faster than turning over a book. Was the surgery well done? Not necessarily. Although he didn't understand interventional surgery, he couldn't help but curse a few words.
He was a little angry. Even his director had never spoken to him in such a choked manner. Who is this person? Why is it so annoying
But I hate it, so I can't quarrel with people in the operation room. Sun Zhenxing let out a sigh of relief and tried his best to maintain his grace.
After a few breaths, Sun Zhenxing's mood stabilized.
He was watching the operation intently, and suddenly he saw... the thrombectomy catheter was removing a large section of thrombus from the anterior tibial artery and was pulling it out.
Is it past the knee joint
How did he remove the blood clot that had been embolized for more than 48 hours...