Chapter 596: : Very in place!

Teacher Meng's words directly made these "Chen Cang support groups" dumbfounded!
Director Tao closed his eyes and kept silent, and Xia Gaofeng had a look. I don't know. Ask him.
And Cui Yuanwu looked at Meng Xi: "Director Meng, don't lie to us. Director Tao gave us all the explanations. Xiao Chen was preserving her strength and broke out at a critical moment, right?"
Having said that, Cui Yuanwu lowered his voice and said with a smile: "It's okay, we have a tight mouth!"
Seeing this, Meng Xi rolled her eyes!
How can this group of people be blindly confident about Chen Cang!
Just after Meng Xi turned around, she saw that Cui Yuanwu and teacher Yang Jianshu had already opened.
Meng Xi could not help but sigh.
...
...
Chen Cang just came in, and the two examiners suddenly froze, because they saw Chen Cang yesterday!
Chen Cang just had the ascending aortic injury repair yesterday to have the two examiners discuss that he was unable to fall asleep late in the evening. I did not expect to meet Chen Cang again today!
The two examiners were surprised and happy!
Even ... there is still a little expectation in my heart.
However, under surveillance cameras, neither of them can be too obvious.
The examiner Sun looked at Chen Cang happily, but he was a little happy, but still said faintly: "Examinees please note that at this time, another operation is being performed in the operating room of the emergency center. Instrument to start your operation! "
After Chen Cang heard it, he nodded.
"Are candidates ready?"
Chen Cang: "Ready!"
"Start now!"
As soon as the voice fell, the sound of the ECG monitor started to sound, and the descending aorta was constantly bleeding!
After seeing the wound, Chen Cang was dumbfounded!
This ... This wound is completely different from what I encountered yesterday ...
The difficulty of the surgery has increased significantly.
Although it is also the descending aortic repair, the repair methods required are different because of different injury sites and different wound sizes.
Today's surgery is obviously no longer as simple as vascular repair and suture, and the difficulty has increased significantly!
Chen Cang stared at the bleeding point of the wound. He didn't rush to stop bleeding, nor did he use hemostatic forceps directly!
Keep thinking about all these surgical methods in my mind!
The wound has a large fissure and many injuries, and the direct block blood flow suture method is only suitable for small wounds in emergency situations. It can be repaired directly, but the time is strictly controlled!
And similarly, clamping the aorta to suture the cleft is also required, and the time for the aorta to receive occlusion is very limited!
Chen Cang's stitching speed is fast, but it can't be an optimal choice.
Sometimes, the method you choose must have a fault tolerance rate, which is the best choice for surgery!
This is not to say that this adventurous rapid suture is not good, it can only be said that this is the only option when no other surgical method is available.
You need to know that doctors are humans and they have a chance of making mistakes. They are not machines, and humans are very random.
After a few seconds of consideration, Chen Cang made a choice instantly!
At this moment, in this state, choosing the centrifugal pump for partial flow is the best choice!
There is no need for heparinization, just the flow from the left atrium or the left upper pulmonary vein to the tearing distal aorta according to the patient's condition.
Unfortunately, there was no centrifugal pump on site for Chen Cang to use!
This will test a doctor's ability to adapt!
Chen Cang thought for a while, turned around without hesitation, and said to the nurse:
"Hemostatic forceps!"
The nurse immediately passed over.
Sun was glad to see Chen Cang's operation, and frowned slightly. What should Chen Cang do?
Deputy Examiner Hou Liang is also contemplative. Is it necessary to challenge his own limit, give play to his advantages of fast suture, and directly choose fast suture when the blood vessel is closed with a hemostat?
In this way, even if they are successful, they will not necessarily give the highest score, because in terms of surgical choice, Chen Cang did not use the optimization principle.
After Chen Cang stopped bleeding, he said to the nurse, "Diverter heparin treatment!"
As the words came out, the two examiners were relieved and nodded with relief.
He did not take risks!
Use the Gott shunt method!
After the operation, Chen Cang cut the pericardium directly in front of the left phrenic nerve, and exposed the ascending aorta from the pericardium!
Carefully separate the ascending aorta and descending arch, freeing and blocking the distal, proximal thoracic aorta, and proximal left subclavian artery.
Although the simulated person and human are not very similar, but ... Chen Cang still pretended to be nervous, and carefully avoided ...
Well, although it is a simulated person, it must also look like a real person.
Chen Cang feels that he is now Chen Yingdi!
Chen Cang inserted the proximal lumen of the plastic tube into the ascending aorta, inserted the distal end into the distal descending aorta, and then sutured two layers of poached lines with a 3-0 noninvasive thread, carefully tighten!
After removing air from the pipe, open the intubation and flow!
In this way, the wound site is just separated, and the surgery can naturally have enough time to repair the descending aorta!
but!
The Gott shunt method has a fatal disadvantage!
That is the inability to control the transfer flow.
What does that mean?
Once the flow is opened, there is enough blood flow in the pipe, which is not only not conducive to the operation, but even coagulation!
Even if the blood flow is too fast, there will be some effects.
Chen Cang's previous operation was very precise, just like the textbook Gott shunt surgery.
However, the examiner Sun Xing and Hou Liang looked at Chen Cang with interest, because it was more than a difficult operation waiting for Chen Cang!
There was even an accident!
That's right!
Do you think the Sims will not cause accidents?
These are all program settings ...
After all, human surgery is also unexpected, and such high-priced human accidents can be simulated.
really!
As soon as Chen Cang was preparing for suture, the operation immediately encountered an accident. The patient had a problem with the flow rate because the blood pressure was already low!
Even ... caused reflux!
Sun looked at Chen Cang happily with interest, EbookFREE.me, and wanted to see how he handled it.
but……
I saw Chen Cang was unmoved, and gently adjusted the shunt tube at an angle, and suddenly a one-way valve appeared!
At this moment, the two examiners were dumbfounded!
When will this kid put a unidirectional valve in the shunt!
Could he have guessed it?
Sun was keenly aware that Chen Cang was not guessing, but designed it according to the patient's blood pressure.
This is the basic professional quality that a powerful surgeon should have.
This is a high degree of grasp and control of the operation!
Be prepared for any accident.
However, at this moment, Chen Cang said to the nurse, "Give me two silk threads!"
Sun Xingxia and Hou Liang looked at each other, what did they do with the silk thread?