Seven Hundred and Forty-Five Beans Are Big, Still Scaring You to Pee Blood

In the medical industry, when viewed by laymen, it is easy for laymen to have a feeling of low-key luxury and connotation. For example, during the director's ward rounds, the director stood in the middle of the crowd, making slight body movements.

Then he kindly explained the key points of the patient's treatment to the young doctors around him, and occasionally popped out a foreign word that he had hardly heard before, especially the middle-aged male director, whose thick and deep voice really had a charming feeling.

But for the young doctor standing around the director, Nima said it lightly! For doctors, this thing is definitely not a low-key luxury with connotations, but a real existence that can be easily grasped at first glance, and can be discarded after getting started.

For example, Cardiac Surgery is the most obvious one. In the Department of Cardiology, the working principle of the heart is drawn out by individuals. They can explain each one more clearly, from electrophysiology to the threshold of cells, from the entry and exit of sodium ions to you. Talk about the state of heart contraction.

But let’s get started, the hospital can’t pull out three people who can pat their chests and say, I do heart puncture the most neat and simple, and heart puncture among the five major punctures is clearly required by the Ministry of Health’s teaching syllabus. Mastered.

Ke Nima went to see which medical school in Manhuaguo dared to let the interns do this job, and the result was that every time this class came, the students were so excited that they seemed to finally see There has been a long-standing legend of the evil sword manual in the Jianghu.

As a result, during class, the teacher said lightly, I will not explain in detail this chapter for self-study. Zhen Nima is very similar to the biology class in junior high school, when the physiological structure of men and women is about to be taught, the beautiful teacher even tells the students to go home after class to see for themselves.

Damn, why do I need your teacher? Did I pay the tuition fee to study by myself?

In fact, this thing is really difficult. If you have abdominal puncture, even if the worst result is an injection in someone's bladder, at most it will make him urinate blood for a few days, and make the old man with enlarged prostate suddenly feel like It can also be the illusion of a period.

But the heart is not good, one is not strong enough, and one needle is inserted too deep to puncture the muscle layer of the heart. This is not a joke that can be solved with a few pieces of toilet paper, it can kill people.

In the operating room of the Children's Research Institute, Zhang Fan and old man Jiang have separated the child's circulatory system. How can I say this thing? It's like putting a front-load washing machine next to the operating table, and Nima is a double-tub.

The blood entered the extracorporeal circulation machine, and the child looked like an alien, covered in electric wires.

Especially infants and toddlers, who are covered with wires and pipes, and then there is a big blood hole on their chest. Really, the more you look at it, the more you feel heartbroken.

At this time, Zhang Fan and old man Jiang, where there is no time to worry, they have now reached the most critical moment.

"The temperature must be lowered and brain perfusion should be performed, otherwise the brain will be damaged. The child is too young, and we can't even judge whether it is damaged or not. Let Zhang Fan cool down!" Old man Jiang looked at the bean on Zhang Fan's forehead. The big sweat bead said a word.

To be honest, Zhang Fan, who has not turned on the secondary extracardiac system, can do very well in surgery, but Zhang Fan can only say that he has a pair of golden hands, and lacks a brain that is fatal to heart disease. .

His extracardiac operations and knowledge are not enough.

Cooling, cooling on the operating table, to be honest, this thing is a double-edged sword.

Human brain tissue is extremely sensitive to ischemia and hypoxia. At room temperature, the brain can withstand ischemia for five minutes, which is also the treatment window for cardiopulmonary resuscitation. If it exceeds five minutes, brain damage will definitely occur.

Therefore, when rescuing people who are not in the medical industry, once you find that the heart of the person who needs to be rescued is not beating, you should not try to take advantage of it and open someone's mouth to blow air to them. You must first find a way to make the heart beat.

Whether it is passive or active, as long as you can make the heart beat, it is successful. First of all, you extend the resuscitation treatment window for rescue.

In brain tissue, 40% of oxygen consumption is used to maintain the integrity of cells and 60% is used to conduct nerve impulses. This is why when the concentration of carbon dioxide is too high, people will have some hallucinations.

Because at this time, the brain is actually the same as that of a worker who is not fully paid. It looks like he is at work, but he is actually fishing for fish.

But the current surgery requires the whole body to stop and circulate for ten minutes, ten minutes, let alone other organs, the brain is not willing.

What to do, lower the temperature, every time the body drops by 10, the oxygen metabolism of the brain will decrease linearly, just like the intersection of the two functions. When the body temperature reaches 13, the safe period of supply cut-off can reach 29 minutes.

Of course, the body temperature continues to drop, and the safe oxygen-consuming metabolism will continue to decrease, but the side effects will become more and more serious. First of all, the brain is happy, but the heart will not. At this temperature, the heart may not be able to sleep at any time Or blood vessels can become clogged.

This is why many elderly people suffer from cardiovascular disease when winter comes.

This kind of cooling is very troublesome, and there must be corresponding instruments, such as special water baths. Cooling down the patient is not like buying a piece of meat and throwing it in the refrigerator. This needs to be in a constant water bath.

And it still needs to be done after extracorporeal circulation starts. This cooling time is very slow, and sufficient cooling should be maintained for at least 30 minutes. The current experimental data clearly proves that at least 75 minutes are required for sufficient and uniform cooling.

When cooling down, the other side also needs to open an opening in the large blood vessel, so as to infuse warm blood retrogradely and antegradely.

What do you mean, in fact, to put it bluntly, at the same time of bloodletting to cool down, a little bit of warm blood should be injected, so that the blood can ensure that the neurons and internal organs in the body will not be damaged by freezing.

This kind of operation is particularly troublesome. While cooling down, a small amount of temperature and body temperature must be ensured in the body. When the temperature is high, the brain becomes active. When the temperature is low, other internal organs and neurons will die again.

Really, to be honest, not to mention other things, just such a cooling and heating is enough for a doctor to learn for a lifetime.

This kind of operation, not to mention the tea element, has not been performed in the whole Northwest.

"What should we do now?" Zhang Fan didn't talk nonsense, and asked old man Jiang directly.

The old man Jiang was slightly taken aback, and cursed in his head: Bang! But I still started to say: "Is there a constant temperature water bath?"

"Yes!" The director of the Institute of Pediatrics answered with a nod, and then asked his doctor to push out the water bath box. This thing is somewhat similar to an electric incubator for hatching chickens.

"Is there a bedside detector?" Jiang old man swallowed and spit!

"There should be electroencephalogram and somatosensory trigger point detection?"

"Yes, you need European standard or American standard, we have three sets!"

"It is best to have a jugular vein blood oxygen detection balloon catheter temperature detector."

"Yes, the children's version!"

The more old man Jiang talked, the more Nima was surprised. Finally, he wiped his sweat and asked tentatively: "Is there a non-invasive transcranial blood oxygen saturation detector?"

The detection of blood oxygen saturation usually needs to puncture the artery. Generally, doctors and nurses will take off your pants and stick a thick needle tube in at the root of your thigh. Under normal circumstances, nurses do not know how to do this operation, and it is often assisted by doctors and nurses.

The non-invasive detection, in fact, is to emit infrared rays to the outer cortex, just like an electronic thermometer. This thing is effective, but this method is relatively new, so it only appeared in some high-end laboratories first.

In the end, the director of the Children's Research Institute nodded shyly, "Yes, but..."

Unexpectedly, Nima Cha Suer Research Institute also has it. When old man Jiang heard this, he quickly asked, "What's wrong, is it broken?"

The old man thought that the things were too advanced, so they broke the goods.

Unexpectedly, the director of the Children's Research Institute shook his head and said: "It's not broken, it's not broken, but our doctors are not very good at using it!"

"Quickly, push it out!" Old man Jiang was almost sent away by these words. Nima, he has wanted this instrument for a long time!

When all the equipment is set up, the child is like a fish that has been disembowelled and put into the water basin.

The only thing missing is the green onion, ginger and garlic, otherwise it really seems to be marinated to taste.

"Temperature management begins!" Lao Jiang started to roll the roll one by one.

"Yes, temperature management has started!" At the same time, Yang Yong from the Children's Research Institute repeated the old man's words, and then turned on the switch of the instrument.

"Management begins!"

"Yes, management begins!"

"Increase the dosage of halothane and isoflurane!" The three old men outside the operating table changed the amount of anesthesia at the same time. When the child entered the pool and the temperature began to drop, the injection anesthesia gradually changed to inhalation anesthesia. Mainly.

"Double the hormone! Enter the pot!"

"Boy, it's up to you now. In 20 minutes, it depends on whether you can plug this hole." After the old Jiang made arrangements, he took a deep look at Zhang Fan with his eyes.

"Okay, let's start!"

At this time, it is obvious that the blood oxygen data of the EEG are as stable as the ticking of a prostate patient, and the stability cannot be more stable.

Under the microscope, Zhang Fan began to operate. When everything is stable, to be honest, this hole, the hole the size of a soybean, under Zhang Fan's hands, only Nima is his younger brother.

Cai Nima is the size of a soybean, I look down on Zhang Fan too much, if you have the ability, you can come out as big as a broad bean.

Zhang Fan didn't need any assistance, one hand held a needle holder with absorbable purple sutures hanging on it, and the other hand held ophthalmic tweezers, pulling directly at the edge of the hole in the heart without any guesswork.

It's too easy to sew up directly, and it's all in vain, and I'm sweating a lot.

Up, down, left, right, a cross nodule was sutured out by Zhang Fan, and it was as beautiful as a small chrysanthemum growing on the heart of a child. With the movement of the muscles, the small chrysanthemum opened and closed. So pretty.

"Rewarm, perfuse!"

The blood is slowly sent into the body from the body circulator, and the temperature of the water in the child's bathtub gradually changes from cool to warm.

And the child who was originally blue like a Smurf gradually turned pink from the cheeks first, then the neck, the whole body, and finally the limbs and lips.

Slowly, the little doll who looked like a little devil turned pink at this time, Nima is the sleeping Paige.

"The heart rate, blood pressure, blood oxygen, and breathing are all normal, and the child in Zhang Yuan has recovered. The EEG of the child is also normal. Zhang Yuan has succeeded!"

The director of the Children's Institute was so happy that he didn't know what to say.

It's really a surprise that something that I didn't expect at first turned out to be a perfect success.

At this time, old man Jiang touched the instrument beside him, muttering to himself, "It's really a good thing, it's a really good thing!"

Zhang Fan looked at the child's equipment, and he was also excited. Really, when the child couldn't be operated on after extracorporeal circulation, the front of his eyes became dark, really.

He looked at the data and took a look at old man Jiang. He wanted to thank the old man, but when he saw that the old man was so greedy, he smiled slightly.