Reasoning diagnosis: Big brother, your wife has been prescribed medicine!

Chapter 104 Precise, yet elegant! (Please subscribe!)
After Lin Yi answered, everyone present couldn't help being stunned.

Although they are not professional doctors in the interventional department, their understanding of this aspect is not so thorough.

But they knew that the question Xie Yaqiang asked would never be simple.

But Lin Yi answered without thinking.

But then, they figured it out again.

It's one thing to know the answer, but quite another to be right!
And Yu Guang who was on the side knew very well the correctness of Lin Yi's answer!
His expression suddenly changed.

I have to think a little bit about the question I raised, but this kid actually said the best method directly?
At this time, everyone's eyes were fixed on Xie Yaqiang projected on the screen.

After listening to Lin Yi's answer, Xie Yaqiang pondered for a moment, thinking about Lin Yi's answer.

Hmm...he was right.

And the answer is very detailed, even the specifications of the tubes are mentioned!

This method also coincides with my own ideas.

Immediately afterwards, Xie Yaqiang nodded slightly, affirming:

"Well, there's nothing wrong with that answer."

After he finished speaking, everyone couldn't help being surprised.

It seems that this kid is really not pretending?
What he said just now was so detailed, it turned out to be accurate.

This... is really amazing!

Sun Liantao couldn't help but change the way he looked at Lin Yi.

"Okay, next question."

Now that the answer is correct, Xie Yaqiang no longer wastes time and continues to ask,
"Just now, Yu has already sent me the test results of the patient."

"The next question I'm going to ask is more difficult, related to his test results."

"Well, Director Xie, you can ask."

Lin Yi nodded and said to him.

"I want you to tell me about the specific thrombolysis process and drug dosage based on the patient's test results."

After listening to his question, everyone present could not help but click their tongues secretly.

Director Xie's question is really tricky!
Although they are not doctors in the interventional department, they also know that intracranial thrombolysis through interventional means is a highly precise operation.

There are technical barriers to this operation!

If you do not master this technique, it is impossible to tell the operation process and medication.

Many people may not understand interventional therapy.

Interventional therapy is a minimally invasive treatment using modern high-tech means.

That is, under the guidance of medical imaging equipment, special catheters, guide wires and other precision instruments are introduced into the human body to diagnose and locally treat diseases in the body.

This kind of surgery in the blood vessel, not only need to pay attention to the operation!

But also be good at using drugs.

Therefore, the interventional department is different from departments other than surgery, internal medicine, and imaging!
At the same time, it is also a comprehensive discipline that integrates surgery, internal medicine, and imaging!
After asking, Xie Yaqiang stared at Lin Yi closely with a pair of sharp eyes, as if trying to see through him.

Is it a bluff, you can see it through this question!
After Yu Guang heard this question, he immediately calculated on the notebook with a pen.

But as soon as he wrote a few words on the paper, Lin Yi said calmly:

"After the operation begins, 5 U of urokinase can be dissolved in 250ml of normal saline, injected manually or infused with an automatic pressurized infusion pump, and the drip is completed within one hour."

"If one dose is not enough, you can continue to add more!"

"According to the Labange report, it can be used continuously within 3 to 6 hours at a maximum of 7.5 to 22.5 U!"

"But judging from the current situation of the old man, this dose is obviously not enough!"

"Because he currently has high blood pressure and low platelets!"

"So I think that 10 units of the vasodilator papaverine and vasospasmodic drugs such as the calcium ion antagonist nimodipine should be used during the operation..."

Lin Yi continued to speak in an orderly manner.

In a few minutes, he will explain the intervention process and how to use the medicine in one breath.

The scene was silent!Deathly silence!

Everyone looked at Lin Yi dumbfounded!

They never expected that this young doctor in the emergency department would know so well about interventional surgery!

If it is not understood very thoroughly, it is impossible to describe it directly and in detail in such a short period of time!

After hearing Lin Yi's answer, Xie Yaqiang was also shocked and speechless!
His answer was impeccable!
There is such a talent in the emergency department? !

Put this question in your own interventional department and let them answer it, and no one can answer it faster and more perfectly than him!

"Xiao Xie, is his answer correct?"

Seeing that everyone was silent, Sun Liantao looked at Xie Yaqiang on the screen and asked.

Xie Yaqiang nodded vigorously and said:
"Yes, very correct!"

"Director Xie, there is another question, so hurry up and ask, don't waste time, there is not much time left."

Lin Yi was expressionless, and urged Xie Yaqiang.

"Do not."

Xie Yaqiang shook his head directly and said:
"I don't think it's necessary to ask the last question."

"President Sun, I think it's better to let Dr. Lin arrange an interventional operation as soon as possible."

This... is this a direct pass?
Seeing that Xie Yaqiang didn't even ask the third question, everyone present was even more surprised.

It seems that Lin Yi's performance made Xie Yaqiang very satisfied, otherwise he wouldn't be like this!
"it is good!"

After reacting for two seconds, Sun Liantao immediately nodded in agreement.

With Xie Yaqiang's approval, it shouldn't be a big problem for him to do the surgery!

At this moment, Sun Liantao breathed a sigh of relief!

"Lin Yi!"

Immediately afterwards, Sun Liantao looked at Lin Yi and shouted.

"exist!"

"Arrange interventional surgery immediately! Others cooperate unconditionally!"

Sun Liantao stared at him as he announced the task.

Lin Yi agreed, and immediately got up and walked out of the conference room.

Yu Guang followed closely behind and followed out.

"Doctor Lin, let's go, I'll take you to the operating room of our interventional department!"

He walked up to Lin Yi and said to him with a serious expression.

After the test of Lin Yi just now, he admires Lin Yi very much!
In the beginning, he neglected Lin Yi because he felt that he was a brat who could only move his mouth and didn't know the heights of the sky and the earth.

But now he knows that Lin Yi is really powerful!

"Doctor Lin, what equipment do you need, I will let them prepare it in advance."

Afterwards, Yu Guang looked at Lin Yi again and asked.

Lin Yi thought for a while, then said directly in one breath:

“16G或18G穿刺针1根、直径0.89mm、长40cm导丝1根、6F导管鞘1个、加压输液袋1套；51ml注射器3副、尿激酶5万U/支×10……..”

"Wait a minute, Doctor Lin, speak slowly."

While Yu Guang was listening, his brain was memorizing quickly.

Hearing Lin Yi speak these equipment so proficiently, he secretly admired them.

In the operating room, the nurse had already placed Mr. He on the angiography table, prepared the instruments in advance, and waited for Lin Yi and the others to arrive.

After Lin Yi walked in, he prepared a bit, and then said:

"Detect vital signs and prepare for surgery!"

Then, the surgery begins immediately!
Immediately after anesthesia, Lin Yibian inserted a 6F catheter sheath into the patient's right femoral artery!
Insert the 6F guide tube through the 6F catheter sheath, and choose to insert the left and right internal carotid artery or vertebral artery under TV monitoring for selective cerebral angiography!

The catheter was in Lin Yi's hands, extremely dexterous!
After some operations, the guide tube was directly inserted into the internal carotid artery on the lesion side.

Soon, the operation will reach the most critical moment!
That is to send the guide wire into the malformed blood vessel!

Because the patient's posterior cerebral artery already had a vascular malformation.

So this is the hardest part of the operation!

At this time, Lin Yi directly connected the end of the 6F guide tube to the Y-shaped joint with valve.

Its side arm is connected with the infusion tube of the pressurized infusion bag, and the air bubbles in the tube are drained.

Afterwards, Lin Yi immediately said to Yu Guang who was next to him: "Director Yu, adjust the speed of pressurized infusion, slowly instill normal saline, and heparinize the patient's whole body!"

"faster!"

After Yu Guang heard it, he nodded immediately!
Hastily started to prepare.

Lin Yi did not sit idle, but directly inserted the Y-shaped valve with the valve arm into the Magic-3F/1.8F!

At this moment, everyone in the operating room couldn't help but lift their hearts.

Because they have seen, the guide wire is entering the thrombus area!
Seeing the scene in front of them, everyone present was completely stunned!
This... How did this happen?
Yu Guang never expected that he would cooperate with Lin Yi to complete such a difficult operation!
but……

What did you do?Why is there no impression at all!

Follow Lin Yi in a daze and it's done!

At this time, the guide wire in Lin Yi's hand had been sent to the site close to the thrombus under the TV surveillance.

Up to now, 80.00% of the thrombolytic surgery has been completed!

But the smooth operation just now.

Everyone present did not notice.

I didn't realize the depth of that operation at all.

This is where the difficulty of surgery lies.

Lin Yi's operation just now requires at least a thousand times of practice before he can do it!
At this time, Lin Yi had already started to dissolve 5 U of urokinase in 250ml of normal saline.

Yu Guang took the initiative to send the automatic pressurizer over.

Lin Yi shook his head and said:
"I don't use this thing."

Yu Guang was taken aback for a moment, and asked him in disbelief:
"You don't use this? What do you use?"

Without the automatic pressurizer, what to do next?
Can he do it? !
Lin Yi stretched out his left hand, shook it at him and said:

"By hand, it will be more precise!"

After speaking, he started to pressurize the infusion pump with his hands to infuse!

Yu Guang stared at Lin Yi dumbfounded.

I just heard that he used to stop the bleeding with bare hands, and now he is playing with bare hands pressurization? !

This... this is too fierce!
Because this link needs to be very precise, Lin Yi is worried about automatic pressurization, its controllability is too poor.

After all, the old man's body is not comparable to that of ordinary people!

Lin Yi knew very well that the operation could only be successful if the intravascular urokinase was released accurately!

Lin Yi's hand, just press it manually!

One hour drip.

During this entire hour, Lin Yi has been precisely controlling the pressure with his hands.

During the whole process of thrombolysis, Lin Yi continued to check the thrombus dissolution status through 6F guiding catheter angiography, and then went through 6F guiding tube angiography again after thrombolysis to check the thrombolytic effect and vascular recanalization!
After a while, a medical staff stared at the TV and said excitedly:
"It's done, it's finally done!"

"pass?"

"That's right!"

At this moment, everyone's eyes turned to the TV.

I saw the thrombus in the deformed blood vessel in Mr. He's head suddenly open!

Suddenly, everyone became excited.

"Success, it really succeeded!"

"Doctor Lin, you are simply amazing!"

"Just now your bare-handed pressure, I was stunned!"

"awesome!"

indeed!

Manual pressurized administration requires extremely high technical requirements for doctors!
Of course, this is just ordinary drug administration.

For this precise intracranial arterial thrombolysis.

Urokinase is a drug that is extremely easy to cause bleeding, and the requirements are even higher!
Because patients are at risk.

First of all, Mr. He is over 70 years old, and the intracranial arteries have aged, and there is a possibility of atherosclerosis.

And he has grade [-] high blood pressure for many years, which is extremely dangerous!

And when he was doing blood routine, the platelet concentration was normal and low!

what does this mean?
If one is not careful, it is easy to cause intracranial hemorrhage.

At this moment, everyone saw that the embolus in Mr. He's malformed artery was gradually disappearing.

The tension in my heart has also relaxed a lot.

But Lin Yi didn't dare to relax in the slightest at this time.

Because he knows very well that the real battle has just begun!
This operation is called precise intra-arterial thrombolysis.

What is precision?

The meaning of precision is to give a precise amount of thrombolytic drugs to the thrombolytic area, so that the thrombus can be successfully dredged without causing bleeding!

And this is also the reason why Lin Yi had to manually pressurize the medicine himself.

He knows exactly when to give the medicine and at what speed.

The automatic pressurized infusion may be better in terms of stability.

However, the upper limit of manual pressurization is very high!
At this moment, Yu Guang suddenly became nervous and said to Lin Yi: "Doctor Lin, be careful, there is reflux..."

Hearing this, everyone at the scene immediately stared at the blood vessels!
Reflux is a very dangerous situation.

Normally, the blood in the blood vessels flows from the arteries to the veins.

The speed of flow is also very fast!
However, due to Mr. He's vascular malformation, a special situation occurred.

That is, the blood vessels are in the lumen, and it is easy to cause blood backflow due to some other factors.

At this time, the patient was undergoing thrombolysis, because when thrombolytic drugs were administered with normal saline, a third factor appeared in the blood flow.

Therefore, backflow may occur.

The most important situation at this time is that the reflux of the embolus may lead to further obstruction, and even the reflux of the drug may cause bleeding!

This situation is very serious.

It can range from small vessel cerebral infarction to severe cerebral hemorrhage!

Therefore, reflux occurs at this time, and the risk is very high.

All of a sudden, all the medical staff present became nervous!

At this moment, everyone is staring at the TV very nervously!

However, Lin Yi's expression did not change.

His left hand squeezed lightly, then let go, and so on.

In this way, the infusion bag in the hand naturally produces different flow rates.

This kind of flow rate was involved, and everyone suddenly discovered that the backflow disappeared directly!
(End of this chapter)