Chapter 1790 Differences in Treatment (Monthly Ticket 13000 Plus Update × 26)

The operation for moyamoya disease was successfully completed, but Zheng Ren noticed that the ECG monitoring of the subject began to fluctuate violently at the moment when he was about to leave, and the heart rate instantly reached 120...130...150...180...

Before Zheng Ren could do anything, the heart rate of the experimental subject fell like a cliff and returned to zero.

There is no chest opening, intra-chest cardiac compression is performed under direct vision, and the system prompts the death of the subject.

Uh……

Zheng Ren looked at the experimental subject speechlessly, not disappointed, but a little excited.

Although the experimental subject died, the system space told him in this way that he should go to the extracorporeal membrane lung first, and then push the extracorporeal membrane lung machine to the operating room for surgery. Alternatively, the patient can be pushed to the operating room for extracorporeal membrane lung.

It's cumbersome, but it's the only way to go.

This also explains why the system achieves a 50% completion rate for moyamoya bypass surgery.

Just find the reason! Improvements can be made in subsequent surgery.

Zheng Ren started the next operation immediately.

First, begin to give the experimental body the infra-extra-membrane lung.

Extracorporeal membrane lung has two bypass modes to adapt to different conditions.

V-V bypass, the venous blood is drawn out through the vein, oxygenated by the oxygenator, and then pumped into another vein after removing carbon dioxide.

This method is suitable for patients with pulmonary failure. The V-V bypass method is a lung replacement method and is often used in patients with acceptable cardiac function and pulmonary failure.

Respiratory department is more commonly used and can be used for extracorporeal support for some patients with acute respiratory distress syndrome, acute respiratory failure caused by acute lung injury and other respiratory failures, mainly using the membrane lung system of ECMO to provide sufficient oxygenation for patients, Buy time for respiratory function to recover.

V-A bypass, the venous blood is drawn out through the vein, oxygenated by the oxygenator, and then pumped into the artery after removing carbon dioxide.

This method is a combined cardiopulmonary replacement method, which is commonly used in heart failure and cardiopulmonary failure.

If the patient may suffer from cardiac insufficiency for a long time, or the heart stops beating, the AA-v pathway can be used, that is, two cannulas are drawn from the left and right atrium respectively, through the oxygenator, and then pumped into the artery after removing carbon dioxide. .

This method can not only ensure adequate blood flow auxiliary support, but also prevent cardiopulmonary thrombosis and prevent the occurrence of pulmonary edema.

In awake patients, muscle relaxants such as pancuronium bromide or chlorosuccinylcholine, intravenous morphine, and topical lidocaine should be administered before intubation.

However, in the operating room of the system, the subject itself was under general anesthesia, and Zheng Ren saved this step.

After giving heparin 100u/kg, the neck arteriovenous cannulation was performed.

The intubation tube Zheng Ren chose was not very thick, as long as it could provide a flow rate of 2-3L/min. Cut open and look directly into the cannula. The intubation is not deep and should be inclined at a certain angle to avoid collapse and blood spurting due to excessive vertical intubation pressure.

After the insertion, it should be confirmed under the X-ray. After the intubation is sutured, the pipeline is fixed.

After connecting the machine, Zheng Ren started to perform the operation for moyamoya disease again.

The surgery went well and this is the 14th training session.

Zeiss' microscope is still very good. Zheng Ren did not suffer from dizziness and other symptoms like the last surgical training for sutured intestines.

The surgery is 98% complete!

Zheng Ren finally let out a sigh of relief, it should be done!

But he didn't go back right away, he had already spent so much time in surgery training, why not make the surgery perfect?

Eight more surgical trainings were performed, and the completion rate increased by 1% to 99%. The operation time was shortened by about 30%, and Zheng Ren was satisfied with the result.

The next step is to persuade the patient's family to proceed with the operation.

If the patient's family members are financially difficult, they can choose to perform live surgery.

Zheng Ren calculated everything, left the system space calmly, and returned to the EICU ward.

"Boss Zheng, please have a consultation with the whole hospital." Zhao Yunlong suggested on the side, "The neurosurgery has a look. If you feel there is a problem, ask them to order a treatment plan."

"Okay." Zheng Ren nodded.

It is also a normal procedure to organize a hospital-wide consultation. This is not a hospital opened by his own family, and Zheng Ren can't do whatever he wants like in the operating room of the system.

In fact, it can’t be said that he can do whatever he wants and can reason outside. But the big pig's hoof never reasoned with Zheng Ren, and the assignment of tasks is also random, not based on the severity of the disease.

Perhaps in the system's judgment, the patient in front of him belongs to the type that is extremely difficult to treat, and there may be no need to issue a task at all.

"Little Zhao." Just as he was talking, Professor Zhang walked in.

"Professor Zhang." Zhao Yunlong replied respectfully.

"The patient's family refused to rob..." Professor Zhang glanced at the patient and was startled when he saw that the IABP had already entered.

Is it so fast?

When did Zhao Yunlong do things so quickly? Well, it's pretty quick at ordinary times, but this IABP is too fast.

Professor Zhang immediately glanced at the ward, and when he saw Zheng Ren, he immediately understood what was going on.

"Refuse to rescue?" Zheng Ren frowned.

"Yeah." Professor Zhang nodded and said, "I communicated with the patient's family. I didn't have much hope, and the cost was too high. The family couldn't afford it, so I decided to give up."

He had a good impression of Zheng Ren.

Although the last operation on fishbone sticking and mediastinal abscess was a bit of a shame for Professor Zhang, medical treatment is like this.

Anyone with a clue should admit it.

Professor Zhang has no objection to this.

Young people are young people, and they are really full of enthusiasm when they are rescued. Professor Zhang looked at Zheng Ren, Su Yun and Zhao Yunlong and thought to himself.

Wasn't it the same when you were young? Now it has changed. For me, this is just a job.

Don't compete with yourself because of a patient who can't be rescued.

Everyone in the ward fell silent in unison.

Professor Zhang felt that the atmosphere was not right. He said that the patient's family agreed to give up the rescue. Shouldn't everyone breathe a sigh of relief?

Why is the atmosphere so depressing?

"Professor Zhang, that's right." Zheng Ren said: "The patient's situation is rather special, but I think it can still be rescued."

"Alright?" Professor Zhang said in surprise.

IABP is on, but the patient's heart rate is not stable, seeing that the load on the heart is still too large, it is difficult to maintain.

Based on experience, the patient will soon develop heart failure.

With the technical power of 912, he can do it with a sigh of relief and continuous rescue.

But does it make sense to do so?

Professor Zhang was a little angry.

Young people, in order to show off their skills and sacrifice the lives of patients, is there such a thing!

He stared at Zheng Ren and said coldly, "Boss Zheng, tell me what the patient's condition is."