Vol 3 Chapter 2686: Hey, wear a lead
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Live Surgical Broadcast
- 真熊初墨
- 1237 characters
- 2021-03-01 09:07:17
In the operating room, the patient is in a prone position. The incision of the appendix is definitely affected, but the problem is not serious.
It's just that the patient didn't understand what happened and kept asking.
On the DSA machine, Zheng Ren did a simple CT first. The technical level here is average, but DSA machines are newly purchased and also have CT function.
Vertebral CT showed that a slightly high-density shadow of tube strips was seen on the right side of the spinal canal at the 7th to 12th levels of the chest. The abnormal density shadow appeared outside the body at the 12th level of the chest, and the soft tissue at the posterior edge of the 12th spinous process of the chest swelled.
"Boss, do you think that the catheter that fell into it is only about 6cm? This is at least 10cm!" Su Yun said scornfully looking at the image.
"No, look at at least 13cm." Zheng Ren pointed at the CT image.
Su Yun no longer said anything, but instead took the operator straight away. He was sitting in front of the operating platform.
"Don't get on the job after drinking." Zheng Ren said.
"I didn't want to move it. You can do it alone, just treat it as nobody outside. I'm just curious, how are you going to take out the broken catheter?" Su Yun smiled, and no one said.
"Just think of it as a thicker blood vessel." Zheng Ren smiled and took Gao Shaojie to brush his hands and come to power.
"Boss Zheng, what's the operation?" Gao Shaojie asked as he brushed his hands.
"First do an epidural, then puncture at the original puncture point, lower the catcher, and grab the broken catheter." Zheng Rendao.
Gao Shaojie didn't want to understand too much. Although the whole process is probably the same, he has never heard of a similar operation himself.
cheer up! Gao Shaojie encouraged himself, he must take a closer look.
He quickened his movements and brushed his hands to place the sterile sheet.
Because of the radiography, Gao Shaojie left two different surgical areas. One is at the tail of the palate, and the other is at the position of continuous epidural puncture.
Xiang Heping looked in silence, he couldn't understand everything here. How do you feel the traumatic area is bigger than the surgical operation in the two surgical areas!
"Lao Gao, have you done epidural imaging?" Zheng Ren asked.
"No, Boss Zheng." Gao Shaojie answered honestly.
"Then I'll come." Zheng Ren, wearing aseptic clothes and gloves, stood on the operating table.
He glanced at the various instruments before staring at Xiang Heping. After 1.25 seconds, Zheng Ren's eyes became grim.
Boss Zheng's eyes turned to Xiang Heping, and until now no one has talked about money with himself. Coupled with the persuasion of Director Zhang, he also saw extremely professional judgment and operation, and the technicians were taken away.
They said they were liars, and now Xiang Heping didn't believe it.
What is Boss Zheng doing when he looks at him like this? Is it going to be swearing? It becomes a person to go to the operating table, and this professor is not without.
In an instant, Xiang Heping's psychological drama was countless, and he even outlined many pictures of himself being bullied by the operating room.
"Director Xiang, are you going to see the operation during the operation?" Zheng Ren asked.
Xiang He nodded blankly.
My father, can't I see the surgery? It shouldn't be.
"Go and wear a lead." Zheng Ren sighed. The technical level of the township hospital is almost understandable, how to even go into the interventional operating room and wear lead clothes is unknown.
At this level ... it's hard to say.
Also in the operating room, the director of orthopedics Zhang, who was preparing to watch the entire operation, almost tucked his head into the crotch.
Really shameful, in the mind of Boss Zheng, the Langshan County Hospital had to be unworkable to what extent.
This old item is really ashamed to the extreme.
After Zheng Ren said that, Xiang Heping hurriedly wore the lead clothes and ignored him, but began to puncture.
After local anesthesia, the 16-epidural puncture needle was used to penetrate the caudal ligament at a 45 ° to the trunk, and then Zheng Ren's hand changed the angle to 25 ° and slowly penetrated into the sacral canal.
"Lao Gao, pay attention here," Zheng Ren said, "because the subarachnoid space terminates in the second sacral spine plane, the puncture needle should not exceed the second sacral spine plane to ensure that it will not penetrate into the subarachnoid space."
Gao Shaojie nodded and took down this point.
Zheng Ren then pulled the needle core to observe whether there was cerebrospinal fluid overflow, inserted the epidural anesthesia catheter into the epidural space between the lumbosacral spinal cord, and then withdrew the puncture needle.
"Anesthetic." Zheng Ren said.
After injecting the anesthetic, Zheng Ren observed for 5-10 minutes and determined that the patient had no spinal anesthesia and ruled out dural puncture injuries before proceeding to the next step.
The air-tight lead door closed slowly, and Zheng Ren began to make an angiogram.
Because epidural anesthesia catheters are hardly developed under X-rays, it is still quite difficult to find a catheter with a thickness of a few centimeters, even with contrast agents.
"Lao Gao, combined with the recent CT image, you can find that there is an abnormal image at the position of the chest 7-12." Zheng Ren explained to Gao Shaojie softly, "Looking at the position of the catheter is not close to the wall, you should not need to blow gas into it."
"Well, boss Zheng, I can probably find a place," Gao Shaojie said.
"I won't let you do it this time." Zheng Ren walked to the thoracolumbar surgery area and began puncture.
Gao Shaojie knew that this should be the first time that Boss Zheng encountered a similar patient. He has enough knowledge of Boss Zheng. In any case, the young boss is here, and his clinical practice is still short board.
Although with deep enough theoretical knowledge combined with virtual operation, there are often general thoughts of Fei Xian, such as the operation in front of me.
But the first operation must require him to catch the knife himself to avoid all accidents.
With the guidance of boss Zheng, Gao Shaojie probably knew the procedure. Whether or not you can do it depends on the technique.
Gao Shaojie still has a certain degree of confidence in this. At least, after Boss Zheng did it once, he should accumulate more experience.
The guidewire enters ~ EbookFREE.me ~ and the catcher also enters the epidural space. Gao Shaojie was intent, holding the end of the guide wire in his hand and staring at the screen opposite.
Should adjust the direction, and then open the catcher, Gao Shaojie judged. This step is the most difficult. If you change yourself, it may take more than ten times to successfully catch the broken catheter.
The 3mm diameter catheter is easy to grasp, but it is difficult to make.
The catcher just went in and the intercom sounded.
"Director Xiang, someone is looking for it." The nurse's voice came from the intercom.
Gao Shaojie was a little bit upset. He was just full of energy and his status was almost exploding. He firmly believed that Boss Zheng had succeeded in a one-time capture and he could definitely see more details.
What is bothering with surgery is being disturbed, even the elegant Gao Shaojie is full of aversion.
He took a dissatisfied glance at Xiang Heping, the "patient's family member", and said nothing.