Start From Emergency Doctor

Chapter 197

Zhou Yuan glanced at the end of the corridor subconsciously, turned the operating bed, and pushed his back to the end of the corridor to the operating room.

Qian Wei’s wife heard the movement, waited for another two seconds, and slowly raised the phone camera that was in the video state…

It wasn’t until a minute later that Qian Wei’s wife walked out, entered Qian Wei’s ward, silently folded the quilt, and sorted the contents of the bed.

At this time, Qian Wei’s wife could not help Qian Wei with anything, and even the most basic companionship could become a risk factor for Qian Wei’s death. She could only hide behind her back and give silently.

After cleaning the bed, Qian Wei’s wife sat on the bed, turned on the video on the phone, wiped her tears, and browsed from the acquaintance seven years ago to today, Qian Wei was pushed into the operating room by several doctors…

…

Operating room.

The light of the shadowless lamp was so dazzling that Qian Wei couldn’t open his eyes.

“Do you know that the former president of Country M also had heart bypass surgery?” Zhou Yuan glanced at Qian Wei and found that he was a little nervous, so he found a topic and started a conversation.

“He did it too?” Qian Wei looked at Zhou Yuan in surprise.

Zhou Yuan nodded, “Yes, people from country M, as you know, like junk food like fried chicken and hamburgers, so many of them have high blood pressure and high blood lipids. These are the causes of acute myocardial infarction One, the heart is naturally prone to problems.”

“Does the heart bypass technology in country M have our country?” Qian Wei asked.

Zhou Yuan frowned and said, “In fact, it’s not better than us. They have the inherent advantages of science and technology, and some equipment may be better than our country. However, if they have fewer people, they will contact fewer patients. The doctors have accumulated experience. not enough.”

“On the contrary, it is our country. Many doctors may perform four or five operations in a day. In terms of surgical techniques, I am confident that our country’s doctors are better.”

Qian Wei smiled: “It’s great.”

“The equipment test is complete and the equipment is ready~ˇ.” The nurse said.

Zhou Yuan nodded and said to Qian Wei: “Lie down in a comfortable position for you, and we will anaesthetize you immediately. When you wake up, your heart problem will be resolved.”

Qian Wei relaxed a lot, nodded, and lay down on his back.

“General anesthesia, tracheal intubation to maintain breathing.” Zhou Yuan said.

Both the anesthesiologist and He Jianyi came up, one in charge of anesthesia and the other in charge of intubation.

“Do you perform internal thoracic artery bypass or radial artery bypass?” asked the director of cardiac surgery.

After choosing an arterial bypass, which artery needs to be selected next.

“Radial artery bypass surgery.” Zhou Yuan said.

The long-term patency rate after internal thoracic artery bypass surgery is better, and the 10-year patency rate is 90%. The internal thoracic artery can adjust the blood flow according to the physiological needs of myocardial blood supply, and the chance of atherosclerosis is very small, but the internal thoracic artery is limited in length and is not suitable for Qian Wei.(Read more @ wuxiax.com)

Although the patency rate of radial artery bypass is not as good as that of internal thoracic artery bypass, there is no need to worry too much about the length.

Generally, doctors choose to perform internal thoracic artery bypass surgery because of the patency rate.

However, with Zhou Yuan’s technology, the shortcoming of insufficient radial artery patency can be overcome, and bypass arterial bypass surgery is obviously more suitable.

“The anesthesia is complete.” The anesthetist’s voice rang.

Zhou Yuan immediately raised his head and glanced at the time, “The operation has begun.”

“disinfect.”

Zhou Yuan and He Jian set out to disinfect the skin of the front chest and upper limbs.

The anterior chest is used to open the heart, and the upper limbs are used to take the radial artery as a vascular bridge.

The great saphenous vein, radial artery, internal thoracic artery, etc. can be transplanted to other parts of the body as a vascular bridge because the tissues, organs, etc. they connect to have compensatory blood vessels.

For example, the radial artery. The deep palmar arch and the superficial palmar arch in the palm can replace the radial artery and supply blood to the radial side of the hand compensatoryly, thus ensuring that the blood supply will not be affected in the absence of the radial artery.

Although it will definitely have a certain impact on the patient’s body, such as not being able to perform strenuous exercise, not being too heavy on the palm, etc., it is nothing compared to life-saving.

“Starting to extract the radial artery bridge.” Zhou Yuan said.

The cardiologist on the side handed a scalpel and stared closely at Zhou Yuan’s movements.

Zhou Yuan picked up the scalpel and slashed gorgeously, exposing the radial artery.

The radial artery is actually the arterial blood vessel at the wrist, where the pulse is clinically touched.

After Qian Wei recovers and is discharged from the hospital, he will go to the Chinese medicine doctor again. If he has no pulse, will the old Chinese medicine doctor be scared to death?

Zhou Yuan almost laughed.

“Zhou Yuan, your vascular clamp…” He Jian looked at Zhou Yuan in horror.

No one smiles while operating the knife, it’s so horrified…

The cardiac surgeon leaned forward, “Old He, Zhou Yuan, how long has it been since I touched a scalpel?”

He Jianyi was silent for a moment and said: “It’s true that I haven’t used the knife for several days…”

Zhou Yuan concentrated on the operation and ignored He Jianyi and the director of cardiac surgery.

After swiftly blocking the blood flow in the radial artery, Zhou Yuan began to measure the pulsation of the distal palm.

Theoretically, after the radial artery is missing, the body can provide compensatory blood supply through the deep palmar arch and the superficial palmar arch, but it is also necessary to prevent accidents in the deep palmar arch and superficial palmar arch and the special circumstances of the loss of the compensatory blood supply.

“¨ˇThe distal pulsation is good, the blood oxygen saturation of the thumb artery does not decrease significantly, and the compensatory blood supply is good.”

This data shows that the radial artery can be excised.

Although Qian Wei’s coronary artery stenosis has reached 80%, there is no stenosis of multiple blood vessels, so only one hand is required, that is, a unilateral radial artery extraction.

Unilateral radial artery resection generally uses non-profitable hands. Qian Wei is right-handed and uses more right hands. Therefore, Zhou Yuan chose the left hand, which uses relatively less.

“The upper limb is in the right-angled abduction and supination position.” Zhou Yuan said.

He Jianyi gave Qian Wei a pose (good promise) system.

After disinfecting the drape, Zhou Yuan picked up the scalpel again and started dissection along the direction of the radial artery two centimeters below the elbow.

During the dissection, Zhou Yuan’s knife was tilted to the inner side of his arm to prevent damage to the outer blood vessels.

After the incision, Zhou Yuan made another skin incision at the distal end, reaching two centimeters on the wrist.

After the skin incision, Zhou Yuan began to separate the subcutaneous fat.

The blood vessels are protected by fatty tissue, superficial fascia, deep fascia, etc., which must be separated from the outside to the inside to reveal the blood vessels.

After subcutaneous fat separation, the brachioradialis muscle is exposed in the surgical field.

Brachioradialis is a muscle on the forearm, and its proximal two-thirds area covers the superficial layer of the artery.

Next to the brachioradialis, it is connected to the wrist flexor radialis muscle.

Zhou Yuan dropped the knife again and cut open the abdominal muscles of the two muscles, exposing the deep fascia between the abdominal muscles. .