Chapter 1709: : Successful operation? The operation failed! (on)


   is under the spotlight.
   The operation has started.
   This may be the world’s first combined heart-lung transplant for the treatment of congenital heart disease combined with pulmonary hypertension.
   is naturally attracting more and more people's attention.
   Both the difficulty of the operation and the starting point of the operation are very controversial.
   So, after Chen Cang said that the operation was going to be broadcast live, almost instantly, he boarded the hot search on Weibo.
  Whether it is professionals or ordinary people, they all want to wait and see this operation with different attitudes.
   Actually!
   For Chen Cang, the significance of this live operation is not how powerful the operation is!
   Instead, he hopes that everyone will see the cruelty and authenticity of the operation.
  Medical has never been as beautiful as everyone imagined!
   Behind every miracle of surgery, I don’t know how much effort and danger is hidden, but even so, reality has never been merciless!
   That's right!
   Scalpel is affectionate.
   But disease is ruthless.
   Heart-lung transplantation operation itself is a very difficult operation, not to mention that the patient is a patient with congenital heart disease and pulmonary hypertension against the doctor's order.
   Many experts from the American Association of Thoracic Surgery AATS sighed after learning that Chen Cang had performed this operation!
  In today's humanitarian world, everyone is considering the human rights of patients, but how many people are considering the human rights of doctors?
  Patients have the right to choose.
   But, if you are a doctor, do you have the right to choose when you encounter such a situation?
   It's like a pool freezing. The staff around were worried that something might happen. They fenced off the railing to prevent people from skating. As a result, some people didn't believe in evil and thought they were the sons of destiny and used to skate!
   fell into the river accidentally, and when his life was hanging by a thread, the staff here saw it. You said it could not be saved?
  Save?
   They don’t have enough protective measures either!
   can't help?
   Next, I will face too many discussions and questions.
  Don't underestimate the mentality of some people who eat melons that they are not afraid of big things. Because of this, how many medical staff can't bear the pressure of public opinion and choose to commit suicide!
   They saved it, but the other party was crippled and sick after he was rescued. This blamed you for not being saved in time, instead of considering how much pressure you were under!
   You are dead, and he is also dead. Blame your hospital's imperfect doctor system and limited doctors!
   The one who saved people died, and the one who was saved lives. At most one trophy, who is rare? Is it rare to save people, or is his family rare?
  You don’t save people? Ah! You are completely finished, without professionalism, without being a benevolent doctor, you are rubbish! All kinds of unbearable comments enter the ears, who can resist?
   Everyone is human, don’t think they should be because of different occupations.
   In this world, there is nothing that should or should not, and there is nothing right or wrong!
   Putting everything aside to look at the problem, people are selfish after all!
  ……
   AATS Association President Sabrina stood up this time and supported Chen Cang!
   Even Mr. Zhong from the Chinese Medical Doctor Association came to Amyang in person after learning about this incident!
   is this operation!
   The old man Zhong came in a big storm. He has seen more of these things in these years. His purpose is not to succeed in the operation. To be honest, he can't help much in the operation. His purpose is to Chen Cang!
   is also for this event.
   Although Mr. Zhong cannot represent absolute strength, he is an authority in the medical field!
  He is here to protect Chen Cang.
  ……
  ……
  Being a doctor, the biggest consideration is not technology, but people's mind!
   Often, when you stand from the standpoint of different people, you really have different thinking and decisions.
   On the patient's side, Guo Xue, she may really want a child, and she is even willing to give up her life to let this child come out.
   If his child learns about this, he might thank his mother for giving him a chance of life.
   Even if this case is broken down and opened in any novel, this child can be a model of the protagonist.
   isn't it?
   Even, this incident is from the perspective of most people, and the scene that Professor Chen is most willing to see is that Professor Chen turned the tide, the operation went smoothly, and the mother and child were safe, creating a good story!
   Even many doctors think so!
   Just like Meng Xi, she is an unmarriage activist. When encountering this kind of thing, as a woman, she is most likely to want to help her.
   What she saw was the greatness of a mother, so she hoped that Chen Cang could save it, because Meng Xi knew that the operation was risky, and if it failed, it failed, but it is one thing to do it or not.
   Meng Xi never thought that there was so much complicated information behind this incident.
   But, think about it.
   Meng Xi said it.
   How many people did not say these words at the time.
   Chen Cang's savvy has increased a lot. He sees the problem more thoroughly, but it doesn't mean that everyone can think so far.
   This station seems to justify the name of love, but it is actually a kidnapping operation with love.
   Many things, not everyone can see through, Meng Xi is just a PhD in his early thirties, after all, his perspective on issues is not as mature as Chen Cang!
   Hmm... If you lose physically, it doesn't mean you are familiar with yourself.
   Chen Cang's IQ, thinking ability, comprehension, and reaction are very fast, so he can think of these things in a very short time!
   Chen Cang does not blame Meng Xi, this is in line with what Ms. Meng did.
   However, the arrival of Mr. Zhong surprised Chen Cang a bit.
   "Mr. Zhong, why are you here?" Chen Cang couldn't help asking.
   Mr. Zhong smiled slightly: "This operation not only requires superb technology, but also needs to deal with many things, I will help solve the trouble."
   Chen Cang is naturally grateful for Mr. Zhong's active help.
   That's it, with the participation of Mr. Zhong.
  Chen Cang combined obstetrics, hematology, anesthesiology, infection, cardiology, respiratory...nearly ten departments had the last preoperative discussion!
   The arrival of Mr. Zhong gave the operation more security.
   Now Guo Xue has begun to show a trend of severe cardiopulmonary failure.
   If this continues, it is bound to affect the fetus.
   Just when Chen Cang and others were thinking about how to perform transplantation without affecting the fetus.
   Mr. Zhong suddenly suggested: "First, perform a caesarean section, and then perform a combined heart-lung transplant!"
   I have to say, is still hot.
   Everyone immediately started a new discussion on this plan.
   Zhang Jinfeng is a gynecologist, and he promptly stated that this operation can only be performed by cesarean section: "Now that the fetus has developed for 28 weeks, it can be cesarean, and then put it in an incubator for treatment.
   Zhang Jinfeng said suddenly: "It's been seven months. I really don't know how this girl persisted. Anyway, everyone should do their best to save this child."
   Everyone nodded. In fact, saving the child may already be the greatest possibility.
  Because most people persist for less than seven months!
   Congenital heart disease combined with pulmonary hypertension, wanting to persist in a seven-month pregnancy, this kind of pain is really not something ordinary people can persist.
   At this time, Chen Cang asked curiously: "Director Zhang, is it true that pregnancy can't be said to be 70% to 80%?"
   Zhang Jinfeng shook his head: "How do you say this sentence, it's a bit one-sided."
   "If the health of the mother and the fetus is normal, this sentence is completely wrong. After all, as time goes by, the embryo gradually matures. Naturally, eight months is better than seven months."
   "At 7 months of pregnancy, the lungs of the fetus have basic respiratory functions. This is also the basic condition for the survival of newborns, so it can be achieved in July."
   At this point, Zhang Jinfeng smiled instead: "Of course, in fact, it is not an absolute mistake that seven percent of the failures are impossible. I think the ancients may have studied a pathological state."
"If the mother has a disease during pregnancy and has to give birth prematurely, such as Guo Xue, if her physical condition continues, it will only bring a lot of adverse effects to the child. At this time, if you are satisfied for about seven months, you can I was born premature, and it’s not a good thing to continue to procrastinate."
"Of course, there is also the reason that the fetus cannot survive in the uterus due to its own reasons, and it was born prematurely in August, but this is caused by the fetus's own reasons. The mortality rate is very high, so the folks have such a saying. It's not very good."
   After some explanation, everyone was relieved.
   (You can remember this. After all, many elderly people now have this kind of perception, so don't believe it blindly.)
   The surgical plan was further revised and formulated.
   decided to give Guo Xue a caesarean section tonight.
   At the same time, Chen Cang underwent donor cardiopulmonary surgery.
   Use artificial heart-lung machine to support the patient during anesthesia.
After   , a combined heart-lung transplant will be performed.
   In just a few steps, it seems simple, but in fact it is very risky!
   With the help of the staff, after Chen Cang returned to Amyang, he was the first highly difficult, even the world’s first combined heart-lung transplant for patients with pulmonary hypertension and pregnancy risk!
   This time, the Health Commission did not participate.
   But the arrival of Mr. Zhong Lao shows the attitude of the doctor this time. After all, he is the president of the Chinese Medical Doctor Association.
   That night, the operation started!
  The patient who provided a heart-lung transplant is a brain-dead patient after a car accident!
   I have to say that Guo Xue's family also spent a lot of money to support her.
   I can’t wait for you because of the organ transplant!
   After all, organs are not the same as pork. It does not mean that it can be used frozen.
   To put it plainly, every organ in the human body is a life, the life of cells, nerves, and tissues.
   But in the past ten years, due to advances in medical technology, when a person suffers from brain death, doctors can use ventilator and drugs to maintain his breathing, heartbeat, blood pressure and other physiological functions for more than two weeks.
   But once these auxiliary facilities are removed, patients cannot breathe on their own, and their heartbeat will also stop.
   In this case, if there are no other special diseases, the organs and tissues in other parts of the body are still healthy except for the death of brain cells.
   Operating room!
   The soldiers are divided into two groups.
  While complicated cesarean section operation, he is closely preparing for organ transplantation!
   Combined heart-lung transplantation requires the removal of the donor heart and lung as a whole.
   This means that the operation will be very difficult, because a lot of blood vessels, nerves and other tissues are involved, so there should be no slight damage during the operation.
   At this time, Dingxiang.com and Chen Cang have already had many cooperation experiences, but even so, the live operation of the operation was beyond their expectations!
  Because this time, whether it is overseas or domestic, the number of people watching this operation has soared, which is several times higher than usual!
  Special patient!
  Special surgery!
   Everyone joked, this may be the hottest time in the live broadcast industry!
  The medical staff who watched the operation saw such a difficult operation.
   And the audience first came to join in the fun, and secondly, they wanted to see the real surgery.
  Dingxiang.com has prepared two domestic academicians of cardiac surgery as guests to explain surgery to most audiences.
   After all, the professionalism is too high to prevent everyone from not understanding!
   This time, Chen Cang performed the operation in full view. In fact, it also put an end to the possibility of the patients and their families making trouble after the operation and the media reporters improper publicity!
   At the same time, one of the two guests from the Dingxiang community is Wang Tong, the director of Xiehe Cardiology Surgery, and the other is a lung transplant master, Academician Chen Jing, the first lung transplant in China.
   The host began to interview: "Two experts, what do you two think about today's surgery?"
As soon as she said this, Chen Jing couldn't help but say: "Actually, let me just say that Professor Chen can stand in front of so many people across the country and even experts from all over the world to start this operation. Everyone should rest assured. !"
   "Because of Professor Chen, I have gone all out!"
   Wang Tong nodded: "I haven't seen Professor Chen's heart transplantation several times, but I think he is willing to perform surgery on Guo Xue, which can explain everything, because at the time Guo Xue found me, I refused!"
   Chen Jingxin said bluntly: "Actually, is the result of this operation important? To be honest, it doesn't matter to me!"
"I don't approve of an operation that I know is about to lose, but still to start, but sometimes medical ethics, humanities, ethics, medical ethics, social ethics, etc., have contributed to such an operation! "
   "This is a kidnapping in the name of love, so, as Professor Chen said, such an operation will only be performed once in his life, regardless of success or failure!"
   After listening to Chen Jing's words, everyone watching the live broadcast began to reflect silently.
   Maybe sometimes, it is really necessary to strengthen communication and contact between doctors and patients.
   And such a live broadcast of surgery that looks like ordinary people may be really meaningful.
   Let people really experience such a live operation!
   The purpose of live broadcast is definitely not just to please everyone, but to the unpredictable future.
   It is necessary for patients to understand the unpredictability and risk of medical treatment, and the uncertainty of medical treatment!
   Actually, what Chen Cang did today was for this.
Speaking of this, Chen Jing couldn't help but sighed: "Actually, if I hadn't seen it with my own eyes, I would never believe that Professor Chen is less than 30 years old, he can see, and the methods he can think of, even his The courage far surpasses our generation!"
   Wang Tong nodded in approval: "Yes, I am looking forward to Teacher Chen's taking China Medical Care to a better step."
   "The operation has started, let's cut back the picture!"
  ……
   After the live broadcast started, Chen Cang said nothing.
   Although he has the [Heart-lung transplantation] perfect level.
   But there is no bottom in my heart.
   Because of the patient's condition, 90% of the possibility is that an accident will happen after the operation!
   Because of this physical condition, if you don’t have a heart-lung transplant, you will die!
  If a heart-lung transplantation is performed, there is a high probability of postoperative complications and rejection. After all, this is a different body tissue.
   Of course, there is another situation that Chen Cang fears most: postoperative infection!
   Looking at the brain-dead patient, Chen Cang couldn't help but talk!
  If the operation fails, it's a thing, it will ruin a good heart and lungs!
   This set of heart and lungs might save two people again!
  While speaking, the operation has officially started!
   Chen Cang looked at Meng Xi: "Give me the scalpel!"
   Meng Xi nodded honestly.
   After this happened, Meng Xi changed a lot.
   Medical care should not only consider patients, but also many things!
   Chen Cang took the scalpel, took a deep breath, and made an incision along the middle of his chest.
   is accompanied by cutting the skin, fat layer, fascia layer by layer...
   is like the same song: Have fun layer by layer!
   After opening their chests, Tao Mi and Meng Xi quickly opened them with equipment!
   Within the field of vision, the pericardium was revealed.
   Chen Cang began to use a scalpel to make extensive incisions to the pulmonary veins on both sides.
   Then carefully free the ascending aorta, innominate artery, and superior vena cava.
   His hands are extremely light, and seem to be spiritual.
  Looking at Chen Cang wearing bands, ligating odd veins and free trachea...
   These subtle and delicate operations are an eye-opener for ordinary people who see surgery for the first time!
This guy!
   Even those craftsmen don’t have such dexterous hands?
   Looking at the live blood vessels, trachea, and nerves densely distributed in the chest cavity, Chen Cang's hands can subtly resolve these complicated situations, and then dexterously separate.
   Seeing this scene, most of the ordinary people were amazed.
   Surgery is really dangerous!
   In addition to superb technology, there are comprehensive considerations.
   Chen Cang started to do it while giving various medical orders.
   "Intravenous heparin!"
   "Prostaglandin E120ng/(kg·min)!"
  ……
   At the beginning, the atmosphere was relatively mild, but gradually, it was accompanied by Chen Cang's orders one by one.
   In the entire operating room, a tense atmosphere like a battlefield began to fill!
  Strict!
   But there is also tension.
   I saw Chen Cang quickly complete the high ligation!
   is followed by cutting the superior vena cava, close to the diaphragm, clamp the inferior vena cava with vascular forceps, and cut it off on the upper side of the forceps.
   The whole set of actions was hearty, and it scared the people watching the live broadcast!
  While Wang Tong and Chen Jing were explaining, they couldn’t help saying:
This may be the smoothest cardiopulmonary surgery I have ever seen!

   After less than half an hour, Chen Cang has skillfully incised the left atrial appendage, drained the lung perfusion, and then cut the ascending aorta at the plane of the innominate artery!
   Then separate the heart and lungs from the bottom up to the posterior mediastinum, ligate and cut the lower lung ligaments, and remove the heart and lungs from the chest cavity.
   When I saw this coming out, I still had a beating heart, and the whole live broadcast room was boiling.
   Here, Meng Xi has brought the container, and Chen Cang carefully soaks the separated heart and lung tissues in 4℃ normal saline!
   At the same time, the patient is undergoing a caesarean section!
  Chen Cang also began to skillfully change and clean the surgical gown, and then the patient's new surgical gown came to the operating room where Guo Xue was.
   Chen Cang must guarantee all the conditions that can be guaranteed to prevent complications and infections.
   And here, Zhang Jinfeng has led the team to start further caesarean section work!
   This step is not difficult!
   However, the patient's condition is unstable.
   Just after cutting open the abdominal wall, I heard the sound of Didi!
   is very piercing.
   Everyone who watched the operation was shocked!
   "Blood pressure is too low!"
   Zhang Jinfeng calmly and resolutely: "Add blood volume!"
   Zhang Yan nodded quickly and started to deal with it, making up as soon as possible.
   However, the good times did not last long, less than ten minutes, accidents continued!
   "The blood pressure keeps dropping!"
   At this time, Zhang Jinfeng is also frowning.
   What is the situation of sudden low blood pressure now?
  Who would have expected that hypotension will suddenly be induced at this time.
   The patient itself has pulmonary hypertension, but now suddenly it is accompanied by hypotension.
   Just when everyone was a little uneasy, Chen Cang just walked in!
"what's the situation?"
   Zhang Jinfeng said quickly: "The patient has unexplained hypotension!"
   Chen Cang frowned suddenly: "Is there bleeding?"
   The ultrasound doctor hurriedly proceeded to check: "No abnormal uterine bleeding was found!"
   Chen Cang put on the surgical gown and hurriedly walked forward.
   At this moment!
   Wang Tong and Chen Jing who were commenting in the live broadcast also suddenly became nervous.
   There are many people watching live surgery!
   Everyone is babbling, no one can explain it clearly.
   How can hypotension happen well?
   is incredible.
   "Blood pressure 60/30mmHg!"
   "It's still declining!"
   An alarm sound, like a reminder, made everyone’s heart throb!
   This is the first time everyone has been in close contact with the operating room!
   This is also the first time they have seen the danger of surgery.
  At this moment, they seem to realize: Maybe no one can guarantee the success of the operation!
   is really a risk that always occurs where you can’t see it!
   happened in a way you never thought of!
   Zhang Jinfeng thought of abnormal fetal position, thought of abnormal umbilical cord, and even thought of hemorrhage during surgery, but he never thought that such a thing happened in the beginning!
   Wang Tong and Chen Jing began to discuss the cause of hypotension!
   But I can't figure it out.
   The people watching the operation were sweating unconsciously!
   Now suddenly like this, will he die at the same time?
   Thinking of this, everyone started to be scared!
   Various "protection" words began to appear on the barrage.
indeed!
   This is the real live broadcast, and no one can expect what will happen in the next minute.
   It is even possible that the patient died suddenly!
   This is not playing a game. If you die, you die. Anyway, you can continue to play!
   This is a living life!
   It's gone if you die!
   So everyone can not be afraid?
   even looking at the scalpel, but there is a feeling on himself!
   At this moment, Chen Cang looked at the patient's various situations and analyzed carefully, and the four-dimensional model diagram in his mind began to activate.
  Diagnosis has reached an unprecedented level of tension!
  What causes hypotension!
   This is not a guess, but a diagnosis and treatment must be made within a few minutes.
  At this time, the four-dimensional model diagram began to simulate the various indicators of the patient.
   bleeding?
No!
  Insufficient perfusion?
   also not!
  ……
   Various inferences flashed through Chen Cang's mind.
at last!
   His eyes lit up!
   He found it.
   The reason is found!
  Chen Cang looked at the anesthesiologist and asked, "Is it epidural?"
   The anesthesiologist nodded quickly: "That's right!"
   Chen Cang thought of this, and quickly said: "Use 20mg of ephedrine intravenously and stop the operation until the blood pressure rises!"
   "Oxygen increases flow stimulation!"
   Here, hearing Chen Cang's words, the nurse nodded quickly and started the operation!
   It didn’t take long before the drug injection was finished!
   Everyone started to wait.
   a little uneasy.
Can    really recover?
   At this moment, every minute and every second of time seems very heavy.
   Not only is it in the operating room, but everyone who watches the operation feels frightened and scared!
   1 minute... two minutes... three minutes...
   After three minutes passed, the nurse said in surprise: "Blood pressure has risen!"
   "36/70mmHg!"
   "45/80mmHg!"
  ……
   When everyone heard the sound, they were overjoyed!
   I don’t know how many people who watched the live broadcast all got up to celebrate!
   "Chen Cang is awesome!"
   "I, Cao, this is too awesome!"
   "I just scared me, watching this is more scary than watching a horror movie!"
   "How do I feel that this operation is like a crime-solving film, the disease is like a murderer, you don't know where he will appear from! It's scary!"
   "Who would say no! But this Professor Chen is really awesome, I can catch it!"
   "This is probably a master!"
   "Yes, what is the reason?"
   No matter how excited the outsiders are, everyone is calm in the operating room!
   Then Zhang Jinfeng led everyone to start the next wave of operations!
   It seems that what happened just now is very trivial!
   Isn’t it worth the excitement and celebration?
   For a while, the barrage was flashing:
   "Isn't this worth the excitement?"
   "What are you excited about? Isn't this kind of thing a common operation in emergency and operating rooms?"
   "Before the operation is over, any stage of victory is trivial!"
   "This... is surgery!"
   "It's hard!"
   "Are there any masters? Explain what happened just now?"
   Here, Chen Jing and Wang Tong also saw everyone chatting.
   explained: "As you can see, there are all kinds of things in the operating room. You will never think of what will happen next, and again, every minute is precious and must be handled well."
   "However, Director Wang, did you see why the patient had hypotension just now?"
  Wang Tong frowned slightly, and after thinking for a moment, he said, "It should have been a neurological hypotension just now!"
   "After anesthesia, the patient's sympathetic nerves are extensively blocked, which will cause the surrounding blood vessels to dilate and the blood volume of the venous return to the heart will decrease. Generally speaking, it does not affect.
   "However, you have to consider that the patient is a severe pulmonary hypertension patient. Therefore, after the combination of the two, due to sympathetic nerve block, the additional myocardial contractility is weakened, and the effective circulating blood volume is reduced, resulting in high blood pressure!"
   Wang Tong said with some emotion: "Actually, these are the results I got after hearing Teacher Chen's plan!"
   After finishing speaking, Wang Tong explained: "So, the surgeries that everyone sees are definitely not just hands-on ability, but a comprehensive ability. Medicine requires not only the spirit of craftsmanship, but also the thinking of mastery."
   Hearing Wang Tong’s explanation, everyone was full of emotion!
   "This is too difficult!"
"Yes!"
   "I wish I could meet someone like Professor Chen during the operation!"
   "Surgery is too dangerous, cherish your life!"
   "Yes, lose weight tomorrow, no, I will start tonight!"
  ……
   Looking at the barrage, Wang Tong suddenly felt that although Professor Chen’s live operation was difficult, it might be effective!
   The operation continues!
   Zhang Jinfeng and Zhang Yan can already deal with these things.
   Zhang Jinfeng personally operated the knife and carefully explored the abdominal cavity for fear of an accident.
   Then, she cautiously pushed her bladder away, exposing the lower part of the uterus.
   The next thing to do is to cut the uterus and take out the fetus!
   This is the first time everyone has seen giving birth!
   originally thought it should be very simple and came out, but... when they saw the blood sparkling scene, they were all silent!
   Seeing a knife cut on the uterus, the blood was streaming out, everyone's complexion changed!
   This may be the first time in a lifetime that ordinary viewers have seen a caesarean section so clearly!
   Even many parents call their half-old children around and open the video for them to watch!
   Let them see with their own eyes that your mother was born under such pressure and pain.
   Having a baby is really not so simple, so beautiful, this is an operation!
   There may be heavy bleeding and death.
   When the teenager saw this scene, his heart was really touched!
   That kind of gratitude for the mother comes from the bottom of my heart!
   Watching the fetus taken out of the uterus~EbookFREE.me~Clean the uterine cavity, suture the uterus...
   There is really nothing beautiful at all.
   This may be what surgery should look like.
   One after another, many children who watched the operation couldn't help but say to their mother:
   "Mom, thank you very much!"
   "Mom, I will be filial to you!"
   "Thank you, mother!"
   This greeting made all the people who originally saw the operation stunned!
   Everyone looked up at their children, and there was a feeling that they couldn’t tell!
   is happiness?
   is gratitude?
then what.
   Chen Cang himself did not expect that this time the operation would have such unexpected results.
   At this time, guests Wang Tong and Chen Jing couldn't help but feel happy watching the various voices about their mothers on the barrage.
  Perhaps, this is also a correct guidance!
   Let many children really understand some things they need to know!
  
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