Vol 2 Chapter 1408: The beans are big, you still have blood in your urine

   Chapter 1408 The beans are big, but you still have blood in your urine
  The medical industry, when viewed by laymen, it is easy for laymen to have a sense of low-key luxury and connotation. For example, when the director rounds the ward, the director stands in the middle of the crowd, slightly with some physical movements.
   Then amiably told the young doctors around the patient's treatment points, and occasionally popped up a foreign word that he had hardly heard, especially the middle-aged male director. The deep and deep voice really had a charming feeling.
  But for the young doctors standing around the director, Nima said it is light! For doctors, this thing is definitely not low-key luxury and connotation, but the real thing is that it will be easy to see, and it will be discarded when it is used.
For example, the cardiology surgery is the most obvious one. The working principle of the heart. In the cardiology department, it is a person who pulls it out. It can be said one by one more neatly. From the electrophysiology to the threshold of the cell, it is given to you from the entry and exit of sodium ions. Speaking of the state of heart contraction.
You can get started, the whole hospital can’t pull out the three who can pat their chests and say, I do heart puncture the most agile! The simplest, heart puncture in the five major punctures, which is clearly required by the Ministry of Health's syllabus for interns Must be mastered.
But Nima went to see, which medical school in Manchuria dared to let the interns do the job, and the result was that every time this lesson came, the students were so excited that they could finally see it. There has been a long-standing legend of evil spirits in the arena.
  As a result, during the class, the teacher said lightly, I will not explain in detail in this chapter for self-study. Zhen Nima looked like a junior high school biology class, and it was going to be on the physiology of men and women. The beautiful teacher said that she would let the students go home after class to see for themselves.
  Nima, what do I want your teacher to do? Did Lao Tzu learn by himself when he paid the tuition?
In fact, this thing is really difficult. If you have a puncture in the abdomen, even if the worst result is a needle in the bladder, it will make people urinate for a few days, and the old man with enlarged prostate suddenly feels like himself. It can also be an illusion of period.
  But the heart is not good. One is not strong enough, and one needle is inserted too deeply to pierce the muscular layer of the heart. This Nima is not a joke that can be solved with a few pieces of toilet paper. This can be fatal.
In the operating room of the Children's Research Institute, Zhang Fan and Old Man Jiang have separated the child's circulatory system. How do you say this is like a drum washing machine on the side of the operating table, and Nima has a double barrel.
  The blood enters the extracorporeal circulation machine, and the child is like an alien, full of wires.
  Especially infants and young children, with wires and pipes all over the body, and then there is a big blood hole in the chest. Really, the more you look at it, the more people feel heart-stuck.
  At this time, Zhang Fan and Old Man Jiang, where there is no time to worry, they have now reached the most critical moment.
"You have to lower the temperature and perform cerebral perfusion, otherwise the brain will be damaged. The child is too young. We can't judge whether it is damaged or not. Let's cool down Zhang Fan!" Old man Jiang looked at the beans on Zhang Fan's forehead. The big sweat bead said a word.
To be honest, Zhang Fan, who has not opened the secondary extracardiac system, can do 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. .
  The amount of extra-heart surgery and knowledge is not enough.
  Cooling, cooling on the operating table, to be honest, this thing is a double-edged sword.
  The human brain tissue is extremely sensitive to ischemia and hypoxia. At room temperature, the time for the brain to resist ischemia is five minutes. This is the treatment window for cardiopulmonary resuscitation. If it exceeds five minutes, brain damage will definitely occur.
  So when you are rescued, people in the non-medical industry, if you find that the heart of the person who needs to be rescued is not beating, you should not think about taking advantage of breaking other people’s mouths and blowing air. You must first find a way to make the heart beat.
  Whether it is passive or active, as long as you can make your heart beat, this is successful. First of all, you extend the resuscitation treatment window for rescue.
  In brain tissue, 40% of oxygen consumption is used to maintain cell integrity, and 60% is used to conduct nerve impulses. This is why people will have some hallucinations when the concentration of carbon dioxide is too high.
  Because at this time, the brain is actually the same as a worker who is paid incompletely. Looking at work, Nima is actually fishing.
  The current operation requires the whole body to stop and circulate for ten minutes, ten minutes. If you don’t talk about other organs, the brain is unwilling.
  What to do? Lower the temperature. For every 10°C decrease in the body, the oxygen metabolism of the brain decreases linearly, just like the intersection of two functions. When the body temperature reaches 13°C, the safe period of cut-off can reach 29 minutes.
Of course, the body temperature will continue to drop and the safe oxygen consumption 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 is unwilling. At this temperature, the heart may not be able to sleep at any time. Or the blood vessels will be blocked.
  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 equipment, such as a special water bath. To cool the patient, it’s not that Nima bought a piece of meat like you, throw it in the refrigerator and it’s done. This needs to be in a constant water bath.
  Moreover, it must be performed after the start of extracorporeal circulation. This cooling time is very slow, and sufficient cooling is maintained for at least 30 minutes. The current experimental data clearly confirms that it takes at least 75 minutes for a sufficient and uniform cooling.
  When the temperature is lowered, the other side has to make an opening in the large blood vessel, and enter the blood with temperature in the retrograde antegrade.
What does    mean, in fact, to put it bluntly, while bleeding and cooling, a little warm blood must be input to ensure that the neurons and internal organs in the body will not be frozen out.
  This kind of operation is particularly troublesome. It needs to lower the temperature while ensuring the body temperature and body temperature in a small amount. When the temperature is high, the brain becomes active and excited. When the temperature drops, other internal organs and neurons will die again.
  Really, let’s be honest, nothing else, just cooling and heating is enough for a doctor to study for a lifetime.
  This kind of surgery, not to mention the tea, has not done a few in the entire Northwest.
   "What should I do now?" Zhang Fan asked Old Man Jiang directly without talking nonsense.
  Old man Jiang was slightly taken aback, and cursed in his head: Bangma! But I still began to say: "Is there a constant temperature water bath?"
  "Yes!" The director of the Institute of Children's Research nodded and replied, and then directly asked the doctors under his staff to push out the water bath. This thing is a bit similar to the electric incubator for incubating chicks.
   "Is there a bedside detector?" Old man Jiang swallowed and foamed!
   "Should there be EEG and somatosensory evoked point detection?"
  "Yes, the European standard or the American standard is needed. We have three sets!"
  "It is better to have a jugular venous blood oxygen test balloon catheter temperature tester."
   "Yes, it's a toddler version!"
  The more old man Jiang said, the more Nima was surprised. Finally, he wiped his sweat and asked tentatively: "Is there a non-invasive transcranial blood oxygen saturation detector?"
  The blood oxygen saturation test usually requires puncture of the artery. Generally, the doctor or nurse will take off your pants and insert a thick needle tube at the base of your thigh. Under normal circumstances, nurses do not know how to perform this operation, and they are often assisted by doctors operating nurses.
  Non-invasive detection means that infrared rays are emitted 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.
  As a result, the director of the Children’s Research Institute nodded shyly, "Yes, but..."
  Unexpectedly, Nima Tea 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 the things were too advanced and let this group of goods break.
  Unexpectedly, the director of the Institute of Children’s Research shook his head and said,
It’s not broken, it’s not broken, but the doctors here are not very good at it!

   "Hurry up, come out!" These words almost sent Old Man Jiang away. Nima has wanted this instrument for a long time!
  When all the equipment is set up, the child is like a little fish with a broken belly in the water basin.
  It’s just the green onion, and garlic sprouts, otherwise it really seems to be pickled.
   "DHCA temperature management begins!" Old Jiang began to roll the names one by one.
  "Yes, the DHCA temperature management has begun!" At the same time, Yang Yong from the Institute of Children's Research repeated the old man's words, and then turned on the instrument's switch.
  "PH management begins!"
   "Yes, PH management begins!"
"Increase the amount 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 hormones! Get into the pot!"
   "Boy, it's up to you now. Twenty minutes, this hole depends on whether you can plug it." After finishing the arrangement, Old Jiang took a deep look at Zhang Fan.
   "Okay, let's start!"
  At this time, it is obvious that the blood oxygen data of the EEG is as stable as the patient of the prostate, and the stability can no longer be stable.
  Under the microscope, Zhang Fan began to operate. When everything is stable, to be honest, this hole, a hole as big as a yellow bean, is under Zhang Fan's hands, and Nima is a younger brother.
  Only the Nima soybean is big. I look down on Zhang Fan too much. If you have the ability, you can come out with a broad bean.
  Zhang Fan didn’t need assistance. One hand held the needle holder with absorbable purple sutures hanging on the needle holder, and the other hand held ophthalmic forceps, directly pulling the edge of the heart's hole, without any estimation.
  It’s so easy to sew directly, it’s so easy, I’m in vain.
Up and down, left and right, a cross nodule was stitched out by Zhang Fan, and it was beautiful like a small chrysanthemum growing on the heart of a child. It really opened and closed as the muscles moved. So beautiful.
   "Re-warming, perfusion!"
  The blood is slowly sent into the body from the body circulator, and the temperature of the water in the child's bathtub slowly begins to change from cool to white.
  And the child who was originally blue like a Smurf slowly changed from the cheeks to pink, then the neck, the whole body, and finally the limbs and lips.
  Slowly, the little doll that looked like a little devil originally looked like a little devil. At this time, it became pink, and Nima was Peppa who was asleep.
   "Heart rate, blood pressure, blood oxygen, and breathing are all normal, Zhang Yuan's child has recovered. The child's EEG is also normal. Zhang Yuan has succeeded!"
  The director of the Institute of Children's Research, Le'er, didn't know what to say.
  It's really a surprise that something that was originally hopeless has succeeded perfectly.
  Old man Jiang touched the instrument next to him at this time, and muttered in his heart, "It's really a good thing, it's a good thing!"
  Zhang Fan looked at the child’s instrument, and he was also excited. Really, when the child couldn’t operate after cardiopulmonary bypass, his eyes were dark in front of him, really.
  He looked at the data and took a moment to 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.
  (End of this chapter)