godfather of surgery

Chapter 584
When Yang Ping rushed to the interventional operating room, Qin Xiaowei sat on the bench at the door, buried his head, and put his hands in his hair.

Hearing the sound of footsteps, Qin Xiaowei raised his head and saw Yang Ping, as if seeing hope, he got up immediately: "Professor Yang, Ah Jun is inside for rescue."

Yang Ping pressed his shoulder: "Don't worry, I'll go in and have a look."

"Ah Jun had a pulmonary embolism before, but the symptoms were very mild. At that time, the doctor said that he was lucky. If he was unlucky and had a fatal pulmonary embolism, the hope of successful rescue was very small."

Qin Xiaowei was anxious and exhausted, his face was covered with grease and gleaming.

What he said was correct. The probability of successful rescue of fatal pulmonary embolism is very low. The average time from onset to death is two hours, and it will disappear in a few minutes.

The emboli of pulmonary embolism come from veins, usually from the veins of the lower extremities. The greatest harm of emboli is to block the blood vessels. If the peripheral parts are blocked, it will quietly cause venous return obstruction. Once the emboli fall off, they will flow back to the heart along with the venous blood. Then it flows from the heart to the pulmonary artery, and the artery becomes thinner and thinner. At some point, an embolus cannot pass through, blocking the pulmonary artery or its branch vessels.

The blood vessels are blocked, and a chain reaction occurs.

In this way, the pulmonary artery is sequentially blocked, the pulmonary artery pressure suddenly increases, and the cardiac output drops sharply.

Cardiac output drops sharply, causing circulatory failure, especially acute right heart failure, leading to shock and insufficient blood supply to important organs, such as cerebrovascular and coronary artery insufficiency, which in turn causes syncope and even death.

A large number of small emboli stimulate blood vessels to cause vagus nerve excitement, stimulate platelets to release serotonin, thromboxane a2, etc., nerve reflexes cause coronary artery, pulmonary artery, and bronchial artery spasm, pulmonary hypertension, right heart failure, and stubborn hypoxemia.

After comforting Qin Xiaowei, Yang Ping entered the interventional operating room with Song Zimo, while Xu Zhiliang, Gao Qiao, Robert and others stayed outside.

The interventional doctor moved quickly, and the angiogram of the pulmonary artery had already appeared on the screen.

Director Ji is the chief surgeon. Director Ji and Director Guan are the two trump cards of the interventional department. Director Guan is the director of the department and has deep knowledge in cardiovascular intervention. Director Ji has comprehensive skills and is very skilled in almost all interventional surgeries.

"It developed very rapidly. The main pulmonary artery was embolized. I smashed it first, and then melted it with a thrombus ablation device. The rest was treated with local drug thrombolysis."

"Look, after I got through here, it thickened like snow, and I'll pound it for a while."

"It's not good!"

Director Ji has worked with Yang Ping before, so he is very familiar with Yang Ping.

"The diameter of the pulmonary artery is normal, and there should be no spasm, indicating that the vagus nerve is not excited, and there is hope."

In fact, Yang Ping has also received a lot of interventional surgery training in the operating room of the system, but he doesn't use it much at ordinary times.

"That's right, your doctor discovered it early, quickly, and sent it in time, otherwise there would be no chance of being on the operating table."

Director Ji is very satisfied with Li Guodong's performance.

Li Guodong stood beside him: "These are the basic requirements that Professor Yang places on us."

At this time, he was still flattering, but it is true that Li Guodong did a good job this time, if it was a few minutes later, it would be a different ending.

Rescue is really a race against time. If you seize the time, you can save your life. If you miss the opportunity, you will be powerless.

Director Ji performed surgery while talking, smashed the large thrombus, and then melted the remaining thrombus with a thrombolytic device. For the last remaining thrombus, he injected alteplase into the thrombus with a catheter, and the operation effect was very good.

After the thrombus is eliminated in time, the blood coagulation function does not completely collapse, just like the snow stops, and the blood vessel wall does not accumulate snow anymore, so it can naturally remain unobstructed.

Director Ji observed for a few minutes and felt that there was no problem, so he asked the doctors in the audience:

"How about blood oxygen?"

Director Ji asked the doctors in the audience.

"80.00%."

The anesthetist in the audience replied.

How can this work? This is still ventilator ventilation, and the oxygen infused is high flow.

The high-flow oxygen ventilation time should not be too long, otherwise it will cause oxygen toxicity.

"Get on ECMO, hurry up!"

The blood oxygen has been unable to get up, so ECMO (Extracorporeal Membrane Oxygenation) can only be used. Otherwise, it will be hypoxic for a long time, and the brain and other important organs will be hypoxic and damaged.

ECMO is only available in the ICU. Director Ji is more experienced. As soon as he saw Li Jun's CT picture, he knew it was very dangerous. He contacted the ICU in advance and sent an ECMO to stand by in the operating room.

Without ECMO, this guy basically has no chance.

After connecting to ECMO, Li Jun's blood oxygen began to rise, and it rose to [-]%.

The extracorporeal membrane oxygenation device replaced Li Jun's lungs for artificial pulmonary circulation.

"Send to the ICU!"

Director Ji handed over the finishing work to his doctor and took off his gloves and surgical gown.

"Let's go and explain to his family."

Director Ji invited Yang Ping to communicate with the family members.

When the two came out of the interventional operating room, Qin Xiaowei got up immediately and asked anxiously, "Professor Yang, how are you?"

Yang Ping said calmly: "We have been rescued temporarily, but it may be due to pulmonary infarction and intractable hypoxemia. A special machine is needed to replace the function of the lungs, so that it is possible to survive the dangerous period."

Qin Xiaowei heard that there is still hope, so he didn't hesitate: "Professor Yang, I agree, I will sign!"

Before the operation, Li Jun wrote a power of attorney to Qin Xiaowei, entrusting Qin Xiaowei with full authority to be responsible for signing the medical decisions during his hospitalization in Sanbo Hospital.

"This fee is very expensive. If you don't have medical insurance, it costs [-] yuan to start up, and at least [-] yuan a day for the follow-up treatment. In addition to other treatment fees in the ICU, the follow-up treatment fee is more than [-] yuan a day. How long will it last? I don't know now. Will it be possible in the end? I'm not sure about saving my life."

Yang Ping had to explain to Tan Xiaowei.

"That is to say, the cost is high, and it is very likely that there will be no people and money at that time. Are you willing to do this?"

Director Ji added straightforwardly.

For many things, feelings are on the one hand, but reality is on the other hand. The doctor must tell the family members of the current situation and choose to let the family members do it themselves.

Sometimes when encountering this kind of situation, huge financial resources are invested, but in the end the person still cannot be kept. Some families have to weigh the pros and cons, whether to continue or give up.

If you give up, you will have a hard time psychologically; but if you continue to persist, the whole family will get involved, and the rest of your life will be the day to pay off the debt.

"Hope is very slim!"

Director Ji's tone was heavy.

"I understand, help Ah Jun get on this machine, no matter what, try to save it as much as possible, I will raise money, please!" Qin Xiaowei didn't hesitate at all.

He fell to his knees with a plop.

"Save him, definitely save him, no matter how much it is, I have a way to raise money, Professor Yang!" Tan Xiaowei's voice was hoarse, his face was covered with sweat.

Unexpectedly, Ah Jun was so serious. The previous doctors did not scare him, and the fatal pulmonary embolism was almost impossible to save.

Now Ah Jun still has a glimmer of hope, he will not give up.

"Don't be like this, get up and talk." Yang Ping helped him up.

With trembling hands, Qin Xiaowei opened his pocket and took out a thick stack of money: "I'll pay the money now."

Then he took out the folded document and opened it again: "Look, this is the contract. As long as I sign it, I will have a 100 million advance payment. Look, you can call this company and ask, it's true."

Yang Ping grabbed his hand: "Xiao Wei, don't get excited, we have installed the machine on Ah Jun, we will do our best."

Qin Xiaowei nodded: "Thank you, please, I must save Ah Jun."

Li Jun was pushed out from the operating room and was already in a coma. Qin Xiaowei rushed up and grabbed Li Jun's hand, with tears still on his face, sobbing and saying: "Ah Jun, don't be afraid, I'm here, don't be afraid, you must nothing--"

Li Jun seemed to understand Tan Xiaowei's words, and tears welled up from the corners of his eyes.

The cart pushed Li Jun all the way to the ICU, but Qin Xiaowei was blocked outside. He sat on a chair in the family waiting area, very tired, but he forced himself to cheer up.

He searched for various ways to raise money in his mind, and he just had a little money on hand, thinking that he could pay for the kidney replacement.

But people are not as good as heaven, and now the tens of thousands of dollars are a drop in the bucket.

Looking for a friend to borrow money?

But he quickly dispelled this idea. The relationship is relatively good, and he understands the economic situation. This problem can be solved without a few thousand or tens of thousands of dollars.

Others, it's useless to ask, even if they are humble about borrowing money, they won't borrow it.

Qin Xiaowei held a contract in his hand, and he held it tightly. He carefully opened it, read it again, and put it in his pocket.

At this moment, a doctor from the ICU came out and called Li Jun's family members.

In the meeting room, several informed consent forms were in front of him. The doctor introduced Li Jun's condition in detail. Tan Xiaowei was not in the mood to listen, so he just signed it.

"Is there anything else you don't understand?" asked the doctor.

Qin Xiaowei was a little dazed: "How is Ah Jun? Can I go in and see him?"

The doctor shook his head: "With the support of the extracorporeal membrane oxygenation device, the current vital signs are stable, and I can't visit now. If I can visit, I will notify you."

After speaking, the doctor got up to leave.

Qin Xiaowei thought of something again: "Doctor!"

The doctor stopped and turned around: "What's the matter?"

"If he can hear it, tell Ah Jun for me, I'll be outside, so don't be afraid, I can help."

Qin Xiaowei asked.

The doctor nodded: "If he wakes up, I will definitely tell him the exact words. Keep your mobile phone unblocked. Don't leave the hospital too far. If there is any change in his condition, we will notify you at any time."

"Don't worry! I'm nearby." Tan Xiaowei assured.

After the doctor left, Qin Xiaowei sat in the last row of the family waiting area, took out his mobile phone, and dialed a number.

There is no one in the family waiting area of ​​the ICU, only him.

The other party's tone was gentle: "Xiao Wei, how are you? How did you think about it? Let me tell you, the cliff you chose is not good. The cliff chosen by our boss is exciting. The current Internet users have very high tastes and are not exciting enough. It’s hard to attract attention. You are more familiar with the rock-climbing part of Angel Falls in "The Thief". Our boss came to find it according to that cliff, so it was definitely a hit. With your skills, as long as you are fully prepared, you will definitely not Question? Wealth and wealth come with insurance, there is no free lunch in the world, is it so easy to get a few million, right, brother! Moreover, after this hit, you will be worth more than these few million in the future."

"I've made up my mind and agree to the terms of the agreement." Tan Xiaowei said calmly.

"Then find a time to come to the company. Let me tell you the truth. We are not capable of this. We are backed by a big company. It is inconvenient for a big company to come forward. We are just acting on behalf of him. Come here and sign your name, and you will pay 100 million in advance. Immediately, after the matter is completed, the remaining 500 million yuan will not be less, 600 million yuan, many people will never make money in their lifetime, I also want to do this job, but I can’t do it, people call you by name.”

"Also, brother, we will buy you tens of millions of life insurance. I'm not cursing you. This is an industry rule, so you don't have to worry about it."

The other party is very enthusiastic.

"I've been busy these days—"

"It's okay, where are you, give me a position, I'll come over to ask you to sign, it's okay, Brother Xiao Wei, I also want to thank you, if people didn't fancy you, how could we have the opportunity to cooperate with big companies, I also entrust you Good luck, follow along to make some money."

When the other party heard that Qin Xiaowei agreed, his tone became more enthusiastic.

With the support of the extracorporeal membrane oxygenation device, Li Jun's vital signs are stable, at least his life is temporarily held, but it is not known when he will be able to go offline.

When Yang Ping came out of the ICU, Qin Xiaowei was still sitting in the family waiting area. Yang Ping greeted him and told him: Li Jun's vital signs are stable now, and the ICU doctor will not come to him for the time being, so let him eat something.

In the afternoon, the unfinished game had to be finished.

Rescue, for doctors, is commonplace. In these buildings of Sanbo Hospital, there are people rescued every day.

Even if there is a fierce competition on the basketball court, some department may be doing intensive rescue.
-
The next day, Yang Ping went to the ICU to see Li Jun. Tan Xiaowei got up from the chair in the family waiting area.

"You slept here all night?" Song Zimo asked in surprise.

"Yes, I'm afraid that Ah Jun's condition will change. I'll sleep here, and the doctor can find him soon."

The young man rubbed his bloodshot eyes with a shy expression. He was really afraid that if the doctor couldn't find him, he would give up the rescue.

Yang Ping took everyone into the ICU, and Li Jun's vital signs were stable.

The extracorporeal membrane oxygenation device was placed next to it, making a unique sound. The blood flowed from Li Jun's body, passed through the artificial machine for oxygenation, and then entered Li Jun's body to supply oxygen to various organs.

"It's stable for the time being! I just don't know if I can go offline! Long-term use of anticoagulant drugs has disrupted the blood coagulation function, so thrombosis is prone to occur."

The director of the ICU accompanied Yang Ping.

"Yes, it happened once before. Fortunately, it was mild and there was no major problem."

Yang Ping talked with the director of the ICU.

Song Zimo, Xu Zhiliang, Gao Qiao, and Robert surrounded Li Jun's bed. Song Zimo changed Li Jun's dressing and checked the surgical incision.

Many ICU doctors and nurses came to watch. They were very curious when they heard that several foreigners in the Yangpyeong Department came to study.

In addition to worship, everyone still worships, and at such a young age, they actually let foreigners travel across the ocean to study.

And looking at the expressions of these foreigners, they look like grandchildren.

"This kind of kidney should be replaced as soon as possible, otherwise, even if it passes now, it will be a bomb in the future."

What the director of the ICU meant was that if the kidney is replaced, the dialysis does not need to be so frequent. Naturally, the anticoagulant does not need to be used frequently, and the blood coagulation mechanism can return to normal.

"He has never found a kidney source."

Yang Ping was just talking casually, but Yang Ping didn't say anything about Tan Xiaowei's successful matching with him.

"His cousin is quite affectionate and righteous. He paid another 30 this morning. It seems that he is determined to save him. In this situation, many families will give up after a few days of symbolic support."

I have seen a lot of life and death of ICU directors.

Many parents and brothers gave up in the end. I have never seen my cousin so powerful.

Qin Xiaowei paid 30?Yang Ping was also a little surprised. Could it be that he really signed that contract and got 100 million.

Although Yang Ping didn't know what the contract was, he felt that this young man was indeed affectionate and righteous.

PS: If it is a chapter, it must be a big chapter. This chapter has more than 4000 words!That's the equivalent of two chapters!
(End of this chapter)