Chapter 1789 Don't Give up if There Is a Glimmer of Hope (Leader LUCKY Bread Tree Plus 5)

Back in the ward, Su Yun stood beside the patient, staring at the ECG monitoring.

"How about it?"

"Not optimistic." Su Yun said, "IABP cannot give the heart enough rest."

Zhao Yunlong put the signed form in the medical record folder, and Su Yun caught a glimpse, and then heaved a sigh of relief.

"Director Lin will be here soon, boss, what are you going to do?" Su Yun asked.

"I think about it." Zheng Ren did not directly answer Su Yun's question, 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 bilateral internal carotid arteries, anterior cerebral arteries, and the origin of middle cerebral arteries, and secondary to abnormal vascular network at the base of the skull. disease.

Because this abnormal vascular network at the base of the skull resembles "smog" on cerebral angiography images, it is called "moyamoya disease".

MRI clearly showed 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 was honeycomb or honeycomb due to flow void effect. Reticular hypointense vascular imaging.

The more obvious moyamoya disease, Zheng Ren looked at the proliferating blood vessels that looked like the smoke spit out after smoking, and felt a little worried.

Forget it, no matter what the patient's family chooses, let's try it in the system operating room.

Although there is little hope that the patient can be rescued, Zheng Ren does not want to give up as long as there is a glimmer of hope.

If the patient can be rescued in the operating room of the system, Zheng Ren also wants to give it a try at a huge risk.

The big pig's hoof is simply too hateful. With such a serious illness, don't you issue a mission?

Zheng Ren habitually placed his left hand under his right armpit, resting his cheek with his right hand, and looked at the patient's MRI image.

After he made a judgment, he directly entered the system space.

Zheng Ren hesitated a bit when he clicked to buy surgery training time.

If the patient's family members do not agree with the operation, the surgical training time purchased by themselves will be wasted. The key is that this is not a general surgery, but a neurosurgery that I have never done before!

At least "waste" a master-level skill book.

I did a quest a while ago, and the accumulated rewards included three master-level skill books. At that time, Zheng Ren thought that he would use it for a long time, but he did not expect to use the last book so soon.

I am about to go to Europe and face the ancient and mysterious vampire family...

But what if the patient's family agrees, but they cannot solve this problem with surgery?

After hesitating for less than a second, Zheng Ren made a judgment.

Click to buy surgery training time, and click to use the last master-level skill book.

Neurosurgery is the most precise of all surgical operations.

When Zheng Ren was in school, he heard from his teacher that when the conditions were not good in the past, drainage strips were indwelled after drilling and drainage. When the drainage strip is not smooth, it is generally used to apply negative pressure to discharge the redundant drainage.

But just such a process of applying negative pressure may cause a few milliliters of brain tissue to be sucked out.

As a result, due to the loss of these brain tissues, patients can not speak, hemiplegia, and walking weakness after surgery.

Therefore, Zheng Ren has always avoided contact with neurosurgery. For him, this is a difficult operation.

But today there is no way, no matter what, I have to try.

After all, it is a master-level skill, so there should be no problem, Zheng Ren thought to himself.

In 1967, Yasargil first successfully anastomosed the superficial temporal artery to the middle cerebral artery for the treatment of cerebral ischemic disease, and since then, such operations have been carried out in many countries.

Zheng Ren didn't believe that his surgical techniques were not as good as those of the 1960s and 1970s.

After entering the operating room of the system, Zheng Ren saw the experimental body lying on the operating table.

He was not in a hurry to operate, but first observed the body position of the subject. After all, it is an unfamiliar neurosurgery, no matter how cautious it is, 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, and uses the radial artery puncture to connect the invasive arterial pressure monitoring, which is convenient to observe the dynamic changes of intraoperative blood pressure in time, and provides the control and regulation of blood pressure. reliable basis.

Being able to monitor arterial pressure anytime and anywhere, it seems that the big pig's hoof is also very cautious, Zheng Ren makes a judgment.

The subject's head was turned to the unaffected side, and a microscope was placed in the surgical area.

Zheng Ren glanced at it, it was Zeiss! He was a little excited.

According to Su Yun's description, Zeiss' microscope can make himself as far as possible to avoid the trouble of vestibular underdevelopment.

Otherwise, every time a microsurgery is done, it will be as uncomfortable as a roller coaster after the operation.

Zheng Ren hates roller coasters!

It should be ok, let's start the operation. Thinking of this, Zheng Ren noticed that the experimental body had already prepared the skin.

The skin preparation in neurosurgery is to shave the head. An experienced nurse will shave the head quickly and steadily. The inexperienced will either leave some hair or cut the scalp.

Zheng Ren glanced at it, Big Pig's Hoof is an experienced nurse, and his skin preparation is almost perfect.

Routine brain surgery was sterilized, covered with sterile dressings, subcutaneously injected with local anesthetic around the incision margin, and the scalp and subcutaneous tissue were incised through the pterional approach with bipolar hemostasis.

The blood supply of the scalp is simply too rich. Although Zheng Ren has master-level surgical skills, he was helped by the system and is not proficient. At this step, a considerable amount of time was wasted.

Then Zheng Ren began to dissociate the superficial temporal artery, and monopolarly incised the reverse top of the temporalis muscle and covered it with saline gauze.

The cranial bone flap was removed with an AO power system and a milling cutter, the dura was cut, and the middle cerebral artery and its branches were dissociated under a microscope.

The microscope is good, 40 times, Zheng Ren is very careful in every step.

But after all, it was the first time to do it, and he failed 12 times at this step.

The operation failed and the subject died...

The operation failed, and the subject was paralyzed...

Such hints made Zheng Ren almost numb.

But after all, he has experience in microsurgery, neurosurgery has a narrow scope of operation, and he quickly mastered the characteristics of making movements as gentle as possible under the microscope.

In the 13th surgical training, Zheng Ren finally completed the dissociation step perfectly.

An appropriate recipient was selected, the stump of the superficial temporal artery was anastomosed with the middle cerebral artery, and 10/0ploene suture was used to suture under the microscope. During the suture process, a soft needle with heparin saline was used to repeatedly flush the surgical field and lumen to prevent thrombosis.

After the anastomosis, the surgical field was thoroughly washed, the dura mater was turned over, the surgical objects were counted, and the inner layer of the temporalis muscle was applied to the surface of the meninges and fixed with the dura mater at the bone edge.

The bone flap was placed back, the scalp was sutured with 3/0 absorbable suture, and the iodine gauze head was covered.

Completion of surgery, 50%!