Chapter 1205: : 6 even stranger is back!

Results after the scalpel.
Chen Cang held his breath, touched the blood vessel wall gently with his hand, wanted to feel the arterial blood pressure flowing, and wanted to sense the pressure of the blood vessel wall.
Faintly, Chen Cang could feel some.
But it's too difficult!
Perhaps the difficulty of the entire operation is great.
"Sodium nitroprusside."
"Pranorol!"
...
Before the operation, in order to ensure the condition of the patient, Chen Cang could only administer the drug again.
It's not so much the difficulty of surgery as it is the challenge of the patient itself.
Multiple aortic dissection is not 1 + 1 + 1 = 3, it is equivalent to three dissections.
The tension and elasticity of the blood vessel wall is limited. When the tension bearing capacity of the blood vessel wall fiber reaches a limit, if one of the operations is performed after the block, the pressure of the other blood vessel will increase a lot!
A little carelessness is very likely to cause the rupture of the dissection during the operation to aggravate the condition!
Even let the patient die on the operating table.
Here, the blood transfusion department has completed the blood distribution, according to Chen Cang's request, prepared a portion of blood.
Almost 5,000 milliliters of blood already has 1,000 milliliters ready to warm up.
Everyone is very nervous, this may be the most difficult operation they have experienced.
Looking at the thick and even deformed blood vessel walls section by section, although the bulging dissection is not very obvious, but there is a weird unspeakable.
From the aortic arch, to the thoracic aorta, to the abdominal aorta.
The first problem was encountered before the operation!
That's how to get started! ?
Is it traditional to use iliac artery replacement first? Then complete the abdominal aorta, so as to ensure kidney blood flow, will not induce damage to liver and kidney function?
but!
The most critical ascending aorta and thoracic aorta are the key points.
Now once the abdominal aorta of the iliac artery is clipped off, the systemic blood return is limited, and the change in blood flow directly affects the patient's systemic blood pressure!
In case, what Chen Cang said is in case!
In case the abdominal aorta and the iliac artery are replaced, the thoracic aorta ruptures.
Can anyone help me deal with it?
surgery!
After all, it's not alone!
A qualified and excellent team can make Chen Cang no worries.
But at this time, when Chen Cang does not have his own excellent team, he needs to think more clearly and comprehensively!
Even think of any possibility!
In order to make countermeasures.
Thinking about it, Chen Cang decided to perform ascending aortic replacement first!
In this way, is it difficult?
It will definitely be bigger, but it will not cause a series of ruptured vascular dissections, resulting in massive bleeding, and then it is too late to stop the bleeding and repair and cause death!
Of course, it is also possible to clamp the ascending aorta hard.
but……
If the blood supply to the spinal cord and nervous system is insufficient due to hemostasis, the nervous system ischemic and hypoxic necrosis.
The patient may indeed survive.
But what is the difference between living and dying like this?
Watching Chen Cang touch the blood vessel gently with one hand, while holding the scalpel in the other, his eyes stared at the monitor.
Everyone thought that Chen Cang was waiting for the effect of medicine.
I can't see that Chen Cang is actually anxious.
However, Hou Liang and Zhang Peiyi were anxious and disturbed.
They really have no idea!
I don't know how to deal with patients.
I don't even know how to get started.
Hou Liang is much more professional than Zhang Peiyi, but this is the first time Hou Liang discovered what it means: the more you know, the more afraid you are!
It is precisely because he understands the difficulty of this operation that he is more afraid, and even when the operation is started, there is no confidence!
This is not the case. He has seen it in many patients with extremely high mortality.
He looked up at Chen Cang, but for the first time he saw such a calm look.
Facing such a patient, Chen Cang ... isn't he nervous?
Just at this time!
Chen Cang gave the surgical plan!
"Hypostatic circulation, ascending aortic replacement!"
The anesthesiologist is the director of the anesthesiology department. After hearing Chen Cang's words, he nodded and started his work.
This is his first cooperation with Chen Cang!
He hopes to be smoother.
The young and promising director Liang Tai hurriedly began to deal with it in an orderly manner.
Liang Tai ’s brother with the same teacher is Zhou He, the director of Zhou He in the emergency center.
Even though Liang Tai has achieved the director level in the Provincial People's Hospital, he still respects Zhou He!
He did not listen to Brother Zhou He's statement about Chen Cang's greatness on weekdays.
He remembers one sentence very clearly!
"Professor Chen's surgery, don't ask why! It's all about cooperation!"
He used to feel exaggerated about this sentence before.
But when he saw this operation today, he knew that this is not an exaggeration.
Because he has no knowledge of this operation.
He seemed to know how long it took his brother to get this way?
Seeing it cool down to 30 ° C in nasopharyngeal temperature!
Chen Cang glanced at Hou Liang, Zhang Peiyi, anesthetist Liang Tai, and every nurse!
Although there is only one glance, his eyes are very sharp!
Chen Cang said calmly: "I will block the ascending aorta and perform replacement surgery. The whole operation time, I don't want 20 minutes!"
"In these 20 minutes, I hope everyone will go all out to cooperate with me!"
These plain words stopped in everyone's ears, like a thunder!
20 minutes?
Complete ascending aorta replacement?
This is crazy!
And not only is Chen Cang alone crazy, but each of them needs to accompany Chen Cang crazy!
nervous?
tension!
Is there pressure?
Have!
But watching the doctor Chen Cang is so determined, everyone can't help being driven by this momentum!
"Are you ready?"
"Ready!" Everyone nodded in unison!
As soon as the words fell, Chen Cang directly took the hemostatic forceps, and decisively blocked the ascending aorta 3.0 cm away from the beginning of the unknown artery!
This distance is very important!
No more, no less, just happened to play a key role in the operation!
Chill for 20 minutes!
The circulatory arrest injury will not be obvious ~ EbookFREE.me ~ Even many operations require hypothermic circulatory arrest for 40 minutes.
Chen Cang squeezed the time within 20 minutes, which is the key to ensuring the operation, and is also the need for subsequent surgery!
At this time, Chen Cang quickly said to Hou Liang on the side: "Cardioplegia! Prepare for injection!"
Hou Liang nodded quickly and began to prepare.
After Chen Cang finished speaking, without any pause, he directly picked up the scalpel to cut the artery dissection and passed the left and right coronary arteries!
Surgery time is limited!
Chen Cang cannot waste time on these tasks!
Because the next anastomosis is the top priority of the operation!
At this moment, the director of the imaging department and the director of the blood transfusion department ... everyone stood around and couldn't help being excited when they watched this scene!