world famous doctor

Chapter 19 Risky Decision

Zhao Jian discovered that all of Zhou Chen's treatments just now were only adjuvant treatments.

It has no fundamental therapeutic effect on patients with severe complications of cerebral infarction combined with hemorrhagic transformation.

With the cautious attitude of practicing medicine, Zhao Jian finally couldn't help asking in a low voice:
"Doctor Zhou, I personally think that the most effective method right now is craniotomy. Only in this way can we avoid further expansion of the hematoma, mechanical compression, secondary nerve damage and other problems."

Zhou Chen also agreed with Zhao Jian's point of view.

However, with the common craniotomy currently performed in the hospital, the trauma is very large.

Moreover, years of clinical research have shown that early craniotomy for hematoma removal does not bring much benefit, but the risk of sequelae and various infections is very high.

Zhou Chen has not yet systematically mastered various high-level surgical techniques and postoperative sutures, so he cannot agree to surgical treatment hastily.

"Strict medical treatment, praised +20"

By the way, don't I have a famous medical system?
Zhou Chen suddenly thought of a question, can I buy or exchange this surgical skill from the system?
After accumulating so many "likes", it's time to use them, right?
He opened the system mall in the sea of ​​consciousness.

Find the corresponding "CT-guided endoscopic minimally invasive hematoma removal surgery".

It can be seen that it takes 3000 likes to redeem this surgical skill.

My God, so expensive?
This made Zhou Chen a little distressed.

He looks at all the "Likes" he's gotten before.

A total of 5092 likes.

After deducting these 3000 likes, there are only 2092 likes left.

But what's the point of spending a few likes if it can save a life?

It's not like you can earn it back by installing X a few more times.

Take a step back and think.

This is just like an investment. This time, you spend 3000 likes in exchange for this surgical skill. After treating several patients with the same patient repeatedly, won’t you earn it back?
In addition, you can also advance your level in the famous doctor system.

Isn't it beautiful?

Zhou Chen nodded and clicked OK.

Intracranial neuroendoscopic minimally invasive hematoma removal surgery is a surgery performed on the target part of the intracranial surgery through surgical endoscopic instruments through the scalp cortex.

The advantage is that the damage and compression to surrounding brain tissue is greatly reduced.

It also has many advantages such as short time, good visual field, minimally invasiveness, and good prognosis.

The first successful case of this operation dates back to 1985.

It was invented by a foreigner in 1806.

Currently, in order to prevent vasodilation and neurological deterioration.

Zhou Chen decided to first target blood pressure management.

It must be assumed that the patient's systolic blood pressure will be 140mmHg.

Immediately after he ordered, the nurse gave the patient several consecutive intravenous injections of antihypertensive drugs.

"Doctor Zhou, our suggestion is to perform craniotomy immediately! The treatment time has been delayed for so long, and the prognosis of the patient is very likely to be poor!"

It was Director Zhao Jian who spoke. He was always tense and felt under great pressure.

The same is true of all the medical staff present.

As long as the patient is not out of danger for a moment, he dare not relax for a moment.

In response to acute intracranial pressure elevation, Zhou Chen chose hypertonic saline for treatment.

However, there is a shortage of hypertonic saline in the hospital, so we can only choose mannitol.

At the same time, he raised the head of the patient's bed by 30 cm to reduce the external force of venous contraction.

In a short period of time, Zhou Chen gave many accurate treatment measures.

All the doctors and nurses assisted him to complete it in the first time.

"Calmly treat patients, praise +20"

Immediately afterwards, they performed a plain CT scan for the patient.

The X-rays showed that the patient's current morphology and density of hemorrhage have stabilized.

To be sure, Zhou Chen also asked the patient to undergo CT angiography to further identify potential vascular lesions.

Finally, it has been ensured that the patient no longer has intracranial bleeding.

"Control the disease, get praise +30"

Fortunately, the patient's previous bleeding did not include intraventricular hemorrhage or subarachnoid hemorrhage.

This proves that Zhou Chen's series of first aid measures are very effective.

Zhou Chen looked very professional in lowering blood pressure, correcting blood coagulation abnormalities, and preventing complications.

Next, the more important focus is to continue to reduce intracranial pressure and prevent recurrent cerebral hemorrhage and other serious vascular events.

Now that the patient has indications for surgery, the operation can finally be carried out.

There is always a doubt in Zhou Chen's heart.

Why don't hospitals perform endoscopic hematoma evacuation minimally invasive surgery on patients?
Instead, they choose the traditional craniotomy, which is more likely to damage the surrounding brain tissue and is not conducive to the patient's prognosis?
Perhaps, it is because the treatment plan of each hospital is different.

When Zhou Chen asked this question directly, the answer he got was really ridiculous.

It turned out that Director Chen Jiawei, the only one in the hospital who mastered endoscopic hematoma removal and minimally invasive surgery, is not in the hospital now.

I didn't think much of it.

Zhou Chen turned around and quickly put on the plastic gloves.

He gave an order: "Immediately prepare to remove the neuroendoscopic hematoma for the patient."

Hearing this, Dr. Zhao in the emergency room, and the doctors present in neurosurgery, critical care, neurology and other departments all looked in disbelief at the same time.

They looked at each other strangely.

A question that arises in their minds at the same time is:

Who will do such a high-tech operation?

Zhou Chen, a young man in his 20s?
Is this too risky?

I can't believe it.

The main reason they think this way is because objectively, the specific location of the hematoma in this elderly patient is in her important brain function area.

The operation process based on endoscopic surgery is limited by space, and the neuroendoscope is a two-dimensional imaging. The imaging effect is not three-dimensional, prone to visual errors, and the level of precision is not high enough.

Subjectively, this operation has high requirements for the operator, and requires the doctor to have very superb technical means and very rich clinical experience.

Otherwise, once the direction of the precision instruments used in the operation is slightly deviated during the operation, or the endoscope lens is contaminated with blood during the anatomical position, visual errors may occur.

Or if a certain movement of the operator is not in place and shakes, it is easy to cause bleeding again during the process.

At that time, it will be difficult to stop the bleeding at all, and the danger will be even greater.

"Doctor Zhou, are you sure you want to do this?" Zhao Jian frowned.

While speaking, he was deeply worried.

"You can do it?" Zhou Chen replied forcefully.

Zhao Jian was left speechless.

"Have an accent, have courage, get praise +50"

Zhou Chen was concentrating on the preparations before the operation.

All the medical staff in the emergency room looked at Director Zhao Jian with blank expressions.

Director Zhao Jian hesitated for a moment. Anyway, there is no better solution right now, so he can only pin all his hopes on Zhou Chen.

Thinking of this, he nodded to the medical staff.

Then, they started the work of assisting surgery.

They start by drilling a tiny hole in the patient's skull.

This can reduce damage to brain tissue, as well as address infection and other blood loss from exposure of brain tissue to air.

Zhou Chen breathed a sigh of relief and gritted his teeth.

Endoscopic minimally invasive hematoma removal surgery, officially started!
What Zhou Chen held in his left hand was a hard desleeving endoscope as thick as a chopstick.

He slowly passed the endoscope through the cerebral cortex, and gently punctured into the bleeding site of the patient's brain tissue.

He holds surgical instruments thinner than the endoscope in his right hand, and enters the patient's brain through the working channel of the endoscope hole in his left hand.

(End of this chapter)