medical road high rise

Chapter 313 Blood Vessels of the Elderly

A Will Eternal Chapter 314

"Immediately change to a breathing ball to assist ventilation." Qin Feng said.

The anesthesiologist reacted immediately.

Breathing ball assisted breathing is to manually press a device similar to a sphere to send gas into the patient's body, which is also called pinching a balloon in the doctor's mouth.

The anesthesiologist connected the respirator and oxygen mask to the compression balloon, and the compression frequency was 18 times/min.

"The patient's breathing has stabilized." Li Xuewen said.

Qin Feng also breathed a sigh of relief, staring at the monitor and watching the data recovery, he was completely relieved.

After the patient's breathing is stable, the heart rate rises and stabilizes, at least there will be no cardiac arrest.

The equipment nurse stepped forward and took advantage of the gap to wipe Qin Feng's sweat.

Although Qin Feng looked calm on the outside, he was still very nervous inside.

Surgery continues.

The next thing Qin Feng will do is carotid endarterectomy. This surgery is not a popular surgery, but it is actually a bit unpopular.

It is mainly used to treat stroke caused by plaque shedding, but there are relatively few doctors in China who can do it, and there are relatively few cases.

It is also a miracle that this patient can persist until now.

Because patients in our country have a fluke mentality, they will not go to the hospital for treatment unless they have a last resort.

However, once a stroke caused by plaque shedding occurs, most patients will die due to ineffective rescue, which leads to even rarer cases.

With few cases, the hospital will naturally not arrange similar operations on a large scale, and doctors will not be able to obtain too much profit through this operation.

Stroke medical centers in most hospitals mainly focus on interventional surgery and surgical thrombectomy, and very few use carotid endarterectomy.

Although the benefits are great, the risks are also great.

Qin Feng cut open the surface of the patient's skin, revealing the blood vessels inside. The situation inside was not optimistic.

The porridge-like blood clogged the blood vessels, with dense plaques in the spaces inside. The blood vessel walls seemed to be in danger of collapse. They looked extremely fragile, like crumbling glass. The surface of the blood vessel walls was also unevenly layered and looked dull. Unlike young people, the blood vessel walls are smooth and easy to cut and sew.

Qin Feng checked the surrounding blood vessels again and found a serious problem, that is, the patient did not have enough collateral blood vessels for blood compensation.

This means that Qin Feng wants to surgically clear the thrombus in the main blood vessel, but he cannot temporarily connect the blood circulation with the collateral circulation to ensure the normal operation of the body's blood transfusion function.

Li Xuewen and the hospital chief of the emergency department naturally knew how difficult this operation was.

Clean up the clogged carotid artery and do carotid endarterectomy.

It sounds simple, just two steps, but in fact, it is not even easy to choose the position of the knife.

If you cut randomly, it is easy to cause secondary damage to the blood vessel, causing irreversible damage. Cutting other places also requires extremely high suture after surgery, which is also a test for the suture technique of the surgeon.

This operation is more of a test of a doctor's skill.

The importance of the neck to the human body is self-evident. The connection and control of the head and limbs are all carried out by the blood vessels and nerves in the neck.

Once damaged or cannot be sutured, the patient cannot get off the operating table.

Qin Feng took a deep breath and turned his gaze to the blood vessels under the microscope.

Li Xuewen and others did not bother Qin Feng. It is the best choice for Qin Feng to think quietly at this time.

Qin Feng paused for a moment, then started to move.

Firstly, the arterial root and the vein root are respectively clamped with non-invasive vascular forceps to protect both.

Because Qin Feng underwent a thoracotomy, after entering the surgical site, there are unknown arteries and veins nearby, also known as unnamed arteries and veins.

They belong to the vessels formed by the confluence of the ipsilateral internal jugular and subclavian veins behind the sternoclavicular joint. This part of the confluence is also called the venous and arterial angles.

Although unknown, they cannot be damaged, otherwise it will cause different degrees of brain damage.

After the protection was done, Qin Feng began to use the intima stripper to strip the intima of the diseased blood vessel.

"Blunt curved tissue scissors."

"Catcher."

……

Qin Feng kept changing the surgical instruments, cleaned the blood vessels, and fished out some small thrombus from the blood.

Although these small thrombi are not important, they will also affect the smoothness of blood flow, such as blocking the capillary network, and may even enter the cerebral blood vessels, blocking the small cerebral blood vessels and causing cerebral infarction.

Mild cases can lead to transient cerebral ischemia, severe cases can lead to multiple lacunar infarctions, and even cerebral hemorrhage.

This is also an important reason why other hospitals dare not perform surgery on patients. Due to the long delay, there are too many small blood clots in the patient's body, which are densely packed.

Although these small thrombi are fine in large blood vessels such as the carotid artery and aorta, once they enter the capillary network and cerebral blood vessels, they can cause symptoms such as fainting and falling to the ground.

Qin Feng's cleaning speed was not fast, but he was very careful and did not miss any blood vessel.

Do not continue to the next blood vessel until the plaque and thrombus are drained and the blood vessel is seen to be unblocked.

After a full hour, Qin Feng cleaned up all the blood clots and plaques, checked again, and after there were no omissions, Qin Feng started to suture.

It's just that sewing is also a big test.

The patient is an elderly person and the blood vessels are too fragile. The suture force should not be too heavy and the number of needle insertions should not be too many. Otherwise, the blood vessels will penetrate or even bleed.

Qin Feng observed it, and decided to insert the needle three to five times. If it is less than three times, the blood vessel may not be sutured well, or even the suture is firm. If it moves, it may loosen and cause the wound to open.

If it is more than five needles, the patient's blood vessels will not be able to bear it, and blood vessel leakage is prone to occur, and there will be hemorrhage in the chest cavity, and surgery will be required at that time.

At this age of the patient, the second operation in a short period of time, whether the patient can step down is a problem.

Qin Feng took the needle-holding forceps, pierced the threaded suture into the blood vessel through the short needle, and quickly tied the knot with the tweezers in his left hand, pulling the incision of the blood vessel together.

"Release the hemostat."

Li Xuewen loosened the vascular clamp that clamped the blood vessel, and the blocked blood quickly circulated throughout the body along the unobstructed blood vessel.

Qin Feng stared at the sutured blood vessel, and there was no leakage, and the blood vessel's ability to withstand it was relatively good. The only bad news was that the elasticity of the blood vessel was not enough.
It's just that Qin Feng can't solve this problem, unless the blood vessels in the patient's whole body are replaced.

The physical gap between the elderly and the young lies here. Under the blood circulation, the blood vessels of young people can agitate with the rhythm of the heart pumping blood, but most of the blood vessels of the elderly are as calm as water.

(End of this chapter)