Chapter 2277 I Have Friendship with Boss Zheng
After listening to Director Tai's introduction, Zheng Ren had already outlined the surgical procedure in his mind.
After heparinization, the abdominal aorta, left common iliac artery, right internal iliac artery, and right femoral artery were blocked. The right common iliac artery and right external iliac artery were cut open, and the IABP catheter was taken out. After taking it out, it can be seen that the catheter balloon is twisted and internal thrombus is formed.
The intima tear of the right common iliac artery was detected. The tear was from the opening of the right common iliac artery to the opening of the right internal iliac artery. The intima sleeve of the right internal iliac artery was torn off and repaired with a 7/0 slip line.
It was probably such an operation process, Zheng Ren knew it well. But now the problem is not here, but in the operation just now.
"You didn't use much strength when you took the pipe." Zheng Ren asked worriedly.
The most fearful thing at this time is that Director Tai took out the pipeline after DSA angiography and pulled it hard, causing the arterial intima to tear.
If so, it will be troublesome.
"No, no." Director Tai said again and again, "I watch your surgery live broadcast every day, and know that you can't use brute force to solve the problem."
Zheng Ren nodded. It is still useful to open the surgery live broadcast room by himself.
"I tried it twice, and found that it was very stuck, so I didn't dare to move it." Director Tai seemed to have made a mistake, and his voice became smaller and smaller.
"..." Looking at Director Tai's back, Zheng Ren already had a bad feeling.
I hope I'm wrong, so why not.
Even if the IAPB catheter is incarcerated in the iliac artery, the intima of the vessel is torn when it is taken out, so it has to be sutured surgically. I just drew my sword to help, there is no reason to make irresponsible remarks here.
IABP is one of the most widely used cardiac assist devices in clinical practice. The common complications of IABP mainly include lower extremity ischemia, arterial injury, local infection and bleeding, and balloon puncture.
When the IABP is offline, the balloon counterpulsation catheter cannot be withdrawn smoothly, and iatrogenic foreign bodies in large vessels are relatively rare, just like when I first went to the Affiliated Hospital of Medical University in the provincial capital, I encountered a neurosurgery operation with a guide wire. The same goes for pushing in.
These are relatively rare things.
In interventional therapy, most of the common iatrogenic foreign bodies in blood vessels, such as stents, guide wires, spring plugs, etc., can be removed from the body with a micro-coil extractor in the blood vessel, and few need to be removed by surgery.
Of course, the premise is that Director Tai doesn't move around.
I'm afraid that he has no experience in the process of trying, and the more he makes mistakes, the more he helps.
Unconsciously, Zheng Ren had put the big hat of lack of clinical experience on the heads of prefectural and municipal hospital directors, without any psychological barriers.
Iatrogenic foreign bodies are embedded in large blood vessels, and if they are not treated in time, they can cause secondary thrombosis, infection, and even ischemic necrosis of organs and limbs in the blood vessels. When the patient's general condition permits, it should be removed as soon as possible.
"How long has it been incarcerated?" Zheng Ren then asked a crucial question.
"Less than 2 hours."
It's okay, it's okay, it's really a coincidence, Zheng Ren thought to himself. Within 3 hours, the possibility and risk of thrombosis will be greatly reduced.
However, Director Tai stated that he did not repeatedly pull and tried to take out the IABP pipeline violently, so the possibility of local vascular intima tearing is not high.
Try it, it should be ok, I hope it's ok.
Along the way, Zheng Ren briefly asked about the interventional machines and related consumables of the People's Hospital.
The surgery should be possible, so Zheng Ren followed him to the interventional operating room, changed his clothes and went in. He took advantage of the time to change clothes to go to the system operating room to perform an operation, and then came out.
Can be removed, broken IABP tube stuck in a branch of the external iliac artery. It's just that the force to be taken out needs to be twisted, with cleverness, not brute force.
What pleased Zheng Ren the most was that Director Tai really didn't pull too hard, and the intima of the blood vessel was completely fine!
This person is not bad, Zheng Ren has a little fondness for Director Tai in his heart, and the mosaic on his face is also lighter.
The surgery that cannot be done is not done mechanically, and we know how to measure it.
"Boss Zheng, I'm really sorry, but I asked you to save the stage when you came out to play this weekend." Director Tai said apologetically in a low voice.
"It's okay." Zheng Ren smiled and watched the operation process at 4x speed, and then put on a lead suit to brush his hands.
Lin Yuan followed him silently, also put on lead clothes, and prepared to go on stage together.
"Do you think it is possible to take it out successfully?" Director Tai asked vaguely.
"Try it." Zheng Ren still had the tone of a conversation with the patient and the patient's family. It's vague, never saying whether it can be done, but if you ask urgently, it will say a lot of complications.
After being a doctor for a long time, there will always be some such habits, and no one can escape.
Standing in front of the operating table, Zheng Ren got used to the machine first, then gestured to Director Tai outside the leaded glass, and the airtight lead door was slowly closed.
"Director, you are really good, how did you convince Boss Zheng to come up?" Mr. Zhai asked on the sidelines.
"Boss Zheng and I have friendship." Director Tai said coldly.
You can't say too much bragging, the so-called too much is wrong, that's it. In addition, Director Tai was very worried, fearing that Boss Zheng would not be able to do it, he glanced at the screen, and then at Boss Zheng who was doing the surgery inside through the leaded glass.
"Director, the vascular department is here." Two doctors walked in wearing isolation suits, and President Zhai whispered.
Director Tai was engrossed in looking at the screen, his heart was already hanging in the air, and he didn't hear Mr. Zhai's long-winded words.
The director of the vascular department hurried from home, but saw doctors from the circulatory department and interventional department standing outside.
Is this giving up the operation and waiting for him to come? He has no pride or pride in his heart. Naturally, the less things like this, the better. It is not a good thing for him.
It's hard to say whether the operation can be done. I gave up so early and didn't try much.
"Director Tai, can't you do that? Do you want to try again?" The director of the vascular department said as he walked in.
Seeing that Director Tai was looking at the screen without speaking, he thought to himself that Director Tai was dumbfounded. When encountering a medical accident, many people would be confused, but they did not expect Director Tai, who has always been domineering, to do the same.
It will not be inevitable.
But he took a look and was stunned. The airtight lead door of the operating room is closed, and there are doctors operating inside.
It looks like a man and a woman.
Since when did our hospital have a female interventional doctor? Could it be that someone from the circulatory department came on stage to try it?
Then he looked at the screen again.
The blood vessels are empty, and imaging is underway. Isn't it all right? The director of the vascular department was a little puzzled.
Today is April Fool's Day, are they looking for their own fun? It's not that bad, you can make any jokes in the hospital, but no one has ever used emergency rescue to make jokes.
Immediately, the image on the screen stopped, and the airtight lead door slowly opened.