169 What to do if you encounter a ruptured heart
When he came to the stage, Zhou Congwen was the translucent Sansuke, standing next to Wang Chengfa.
The coronary artery bypass surgery in 2002 helped to get the saphenous vein when you have the opportunity to take the saphenous vein.
But Zhou Congwen's location is still invisible.
He used to be a little transparent, but now he is a little transparent that is deliberately ignored. Anyway, he can't see the magic field. He can just pull the hook anyway, so he can just pull the hook any time he wants to save worry.
Zhou Congwen was not curious about Zhang You's skills. In 2002, no matter how strong Zhang You was, he could still go against the will of heaven?
"Doctor Liu Di, right?" Zhang You was chatting with Liu Di opposite him while disinfecting.
Since Wang Chengfa has done more than he wants, Zhang You didn't mind satisfying some of the requests he made.
"Yes, yes, Teacher Zhang." Liu Di was well-behaved, not calling Director Zhang, but called Teacher Zhang, and by the way he made a hammer of the postgraduate supervisor.
"Where is the first dangerous point of the operation?" Zhang You asked, reaching out for a knife.
"When you saw the sternum, you may damage the heart." Liu Di did his homework very well, and he blurted out the answer without thinking.
Zhang You cut off the skin with a knife and then stopped the bleeding. Because he knew there was no electric fever in the Third Hospital in advance, he was not surprised and ligated a little bit.
"Do you know what could be the sternum sawing of the heart?"
Liu Di was slightly stunned. This... the book was not very detailed. But after Zhang You and Teacher Zhang asked, he had to answer no.
"The distance between the myocardium or aorta and the sternum is small... narrow... short..." Liu Di thought of several adjectives, but everyone knew what he meant, so Zhang You didn't deliberately make things difficult for him.
The hemostasis clamp on the right hand clamped the bleeding blood vessels. Wang Chengfa then wrapped the clamp with a wire around the clamp. As soon as the ligation was tied, the hemostasis clamp in Zhang You left.
The two of them cooperated perfectly in the most basic work, and Zhang You still has time to take Liu Di.
"What else?"
"I can't remember it." Liu Di said frankly.
"When the sternum is slump deformed, it may damage the heart." Zhang You said with a smile.
“Oh oh oh.”
"The sternum saw blade is loose and cuts the heart."
"The sternum sawing wire cuts the heart."
“…”
"The first surgery caused the adhesion between the heart and the sternum and the pericardial not sutured, which may cause the heart to be injured during the resurgence."
Zhang You talked about more than a dozen possible situations in one breath.
"Liu Di, learn a little, this is clinical experience!" Wang Chengfa curled his lips, moved the mask slightly, and said in a muffled voice.
"We had heart surgery when we had heart surgery. My teacher completed the first heart transplant in the country, which was a huge risk." Zhang You said while stopping the bleeding.
The first case of heart transplant, Zhou Congwen smiled. It happened more than ten years ago.
There are no difficulties in surgery except for brain transplants that have not been studied and understood. The difficulties are after the operation, various rejection reactions have already been unexpected, etc.
The Medical University has done a heart transplant more than ten years ago and has never been carried out again. Unlike Wuxi, a broken infectious disease hospital was fucked into a national lung transplant base.
So much so that the joke about head transplant at the Medical University more than ten years later is really embarrassing.
But although there are only a handful of successful cases, they are bragging enough. This was the case in the last life. As long as Zhang You had a heart surgery, he would definitely say that he had a heart transplant back then.
Others don’t know that Zhou Congwen knew this clearly. When Zhang You was the first heart transplant in the country, he was not the operator, but his own place for three helpers.
"I have met a patient with a heart ruptured when the chest is opened. The first time I am a little confused, and then it will be cured." Zhang You began to separate bluntly.
"I'll ask you, what should I do after my heart ruptures?" Zhang You asked.
Liu Di was stunned for a moment.
This kind of question is definitely beyond the rules and cannot be answered by a doctor who has not yet been given the attendance.
"Actually, people should say that they are really sarcastic. After being a doctor for a long time, they gradually became loyal." Zhang Youyouyou said, "Some patients were hit by a car and almost didn't make parts, but they could survive. Some patients walked onto the operating table and had a caesarean section or appendicitis, but died."
"Teacher Zhang, how do you solve the problem of heart rupture?" Liu Di asked.
"Once we went on stage to do coronary artery bridges, and halfway through the sternum saw saw, it was very strong. We had surgery like driving, so we can't be hard. You must remember this."
Liu Di nodded repeatedly.
"There is a lot of resistance, and a lot of blood began to flow out of the incision. Everyone else on the operating table was stunned. I immediately asked the operator to withdraw from the sternum saw and found that the saw blade had fallen."
"..." Liu Di thought of that situation and began to get nervous inexplicably.
"At that time, I put my right finger into the mediastinum because I couldn't see it, so I could only feel it. I found that the anterior wall of my heart was ruptured, so I immediately blocked the ruptured mouth with my fingers."
"This is the most suitable treatment method. Then I cut the sternum and found a 2.5m-long rupture on the anterior wall of the right ventricle. Immediately use 4-0 polypropylene thread to suture the crack continuously."
"Actually, as long as you know the principle, it's nothing difficult. I heard from Director Wang that you will collect 3-5 patients with heart stabbing in a year."
"It is the same as the heart knife stab wound. As long as you encounter a critical situation, don't panic."
While showing off, Zhang You's sternum had been separated.
"Sternum saw!" Zhang You said in a deep voice.
The instrument nurse handed Zhang You the sternum saw, and Zhou Congwen helped pass it. Zhang You glanced at the honest Zhou Congwen and smiled at the corner of his eyes.
Pulling the switch, the sternum saw makes a buzzing sound.
"First install it, and after the inspection is completed, put the sternum saw in. Remember to hold the saw upwards with force to avoid most of the damage."
Zhang You did it while saying that, and the entire sternum was lifted by the sternum saw by at least 0.5m.
The incisions that were lowered by the xiphoid process did not seem to be big enough, and the pulling was deformed, which looked a little pitiful. Zhou Congwen sighed, it would be better to have an interventional surgery, puncture, stent, and end.
Wang Chengfa asked for a sterile gauze that covered the sternum with vain.
Buzz ~
The sound of the sternum saw sounded, and blood foam and bone debris splashed everywhere. But Wang Chengfa was prepared for it and did not spray it everywhere.
Whether the surgery is done cleanly actually shows the operator's experience.
In this part of breast opening, both Zhang You and Wang Chengfa are experienced.
When the sternum sawed at 1/3 of the lower part of the sternum, it suddenly stuttered. Zhang You's eyebrows jumped slightly, stopped temporarily, and looked at the ECG monitoring.
It's okay, a false alarm.
But with the buzzing sound again, there was also electrocardiogram monitoring.
The alarm sounded loudly.
Chapter completed!