735 Swimming (Fanwai 33) Collection 4680—97.7.19W6 Under the guidance of Chen Wenqiang, Li Min completed Director Shi's plan step by step and without any suspense.After Chen Wenqiang examined the aortic anastomosis and there was no possibility of leakage, Director Shi ordered the aortic circulation to be opened offstage.Chen Wenqiang reluctantly returned the position of the surgeon to Director Shi.Then Li Min leaned on the support of the nurse's arms, laboriously moved her stiff legs, and slowly moved down from her special high stool.She laughed at herself: "I'm so nervous that I can't bend my legs." ”Director Liu hooked Li Min's exclusive stepping stool and kicked it aside.He stood in the position of Ichisuke and said to Li Min with a smile: "It's good that your hands are not affected." ”As soon as Director Liu's words fell, Li Min subconsciously stretched the ten knuckles of her hands, and after stretching and contracting a few times, she smiled and said, "It's okay, it's okay."
The fingers didn't stiffen. ”Director Liu laughed: "Xiao Li, your teacher is watching from the stage, you don't have to be so nervous." ”Director Shi was watching Chen Wenqiang check the anastomosis, and before he came to power, he decided to open the aorta as planned.Although it was a little abrupt, it was expected by everyone who knew the surgical plan before the operation.Because they all believed that the blood vessels that Li Min had anastomosed would not leak needles and bleed.But when Director Shi gave the order, Director Zhou moved with the jute, and everyone's eyes shifted to the same place.Now not only the doctors who are on the stage and watching the stage, but also the anesthesiologists and the nurses who patrol the stage, including the two instrument nurses on the stage, are also paying attention to the open loop of the heart.With a blood-perfused transplanted heart, it doesn't take long to have a normal color and temperature.Although Chen Wenqiang's face did not change color, he suddenly shouted to Pan Zhi, who wanted to come to the stage to pull the hook, to give way.Pan Zhi was inexplicable, but he didn't hesitate to give up the position of the third assistant to Dean Chen.Chen Wenqiang stood next to Director Shi, and everyone in the operating room saw that his shoulders were tightened and his neck was stiff, that is, he was wearing glasses and a large mask, which hid his facial expression.But his intention to see Director Shi re-checking the anastomosis for bleeding was too obvious.But who dares to say about him now?
* At this time, the head nurse came in, she greeted Chen Wenqiang, and then looked at Li Min's stiff appearance and said, "Grandma, you hurry up and take a few more steps and move."
I'm not very old, and I'm going to school with old arms and legs.Let me tell you, Director Liang, they have started, let you and Dean Chen hurry up. ”Director Shi raised his head and asked, "When did Lao Liang open the stage?"
”The head nurse smiled a little embarrassed and said, "Xie Xun just picked up the leather knife. ”Director Anesthesia Zhou smiled: "Head nurse, even if you think about Lao Liang in your heart, you don't need to help him so much." ”"yes."
Director Liu cooperated with Director Shi to anastomose the right atrium, and chimed in: "Head nurse, don't worry about Lao Liang all the time." ”"I don't care about him, I don't care about you old men?"
The head nurse is not afraid of such pediatric bickering at all.She urged Chen Wenqiang and said, "Dean Chen, you hurry." ”Chen Wenqiang saw that Director Shi did not find that there were no blood oozing spots in the left atrium, left ventricle and aorta, and that Director Shi was also satisfied with the work done by himself and Li Mincai, and he himself couldn't find anything wrong that needed to be replaced, so he took off his gloves unhurriedly and returned the position to Pan Zhi with a smile.Then he said to the head nurse of the operating room, "What are you anxious about!"
Their liver is harder to get off than their heart.I used to sell nerds now. ”The head nurse grabbed Chen Wenqiang's shoulder and pushed him out while untying the back of the gown.While pushing back, he said: "Lao Liang asked you for supper, you hurry up and eat something, and then go to the duty room to sleep in a daze, wake up, rest and fatigue, and then go on stage, what's wrong!"
You're in a hurry.I'll dry all the rice porridge for you. ”Director Zhou played haha in the back: "Let's all say that the head nurse is worried about Lao Liang, but it turns out that the head nurse is really worried about Lao Chen."
Look, this supper and sleep with you have already been arranged. ”Director Liu and Director Shi said in unison: "Yes, yes." ”I don't know that the little young man added in a whisper: "My daughter-in-law has never dried rice porridge for me." ”Everyone gathered around the operating table heard it, and the hahaha laughter let the head nurse who walked to the door know that they didn't say anything nice.But she only turned her head and glared at Director Zhou and the others, and didn't say anything about Director Shi and Director Liu's stinky feet to Director Zhou, she shouted to Li Min: "Grandma, don't wait for me to urge you, the liver transplant has started over there." ”Li Min then dragged Sister Feng, the patrol nurse behind her, who untied her surgical gown, to the door.When the head nurse saw her going on the road like this, she pushed Chen Wenqiang out with satisfaction.Li Min followed them out of the No. 9 operating room.I took off my surgical gown, took off my gloves and went to the designated place, then went to the bathroom, and then came back for supper.After half full, the two went to see a liver transplant presided over by Xie Xun.
*The surgery is really just beginning.Xie Xun took Xiao Chen's ligaments in the free liver, and the assistants were Dr.
Song and Dr.
Zhou, one is high and three is sub-high, and such a staffing can be blind anywhere.This is also the only combination of the most sophisticated general surgery in the provincial hospital (laughs).Director Liang put on a surgical gown, sat on a step stool, put his gloved hands in the pockets in front of his chest and abdomen, and was napping against the wall.Don't look at him napping, if there is anything on the stage, he will definitely jump up and immediately pounce on it to take over.His state is loose and tight, to use an analogy, it is not much different from a tiger taking a nap on all beings.Chen Wenqiang entered the operating room and went straight to the headframe.He dragged a young doctor who had not noticed him coming in, nor did he notice the words of "Dean Chen" greeting him around him.Because he was too anxious, he still dragged the person down and said, "Let me see."
The young doctor's attitude was not very good.He was probably very angry that someone dared to disturb himself so unscrupulously to see the operation, a "you" word came out, and no word came out later.He saw that it was the dean who was dragging him.Hey!
The people in the operating room, who pay attention to the movement of the headframe, can think of what he wants to say.The other doctors in the audience couldn't help but shed tears of sympathy for him.This young doctor is Zhang Youdao, an intern who Xie Xun took twice in the early years, he is the first batch of undergraduates from Jinzhou Medical College to come to the provincial hospital for internship, and he is the seedling of Director Shi who came forward to stay in the Department of Thoracic Surgery.Later, when he was rotating in Puwai, Director Liang was optimistic about him, so Director Shi reluctantly gave him to Director Liang, and finally asked for Miao Yuesheng.Zhang Youdao was embarrassed.He looked at Chen Wenqiang's back and wanted to say something, but he finally squirmed his lips a few times under the mask, and nothing came out in the end.Because Chen Wenqiang has already focused on the operation.Zhang Youdao slipped away quietly, secretly hoping that Dean Chen didn't hear what he just said.But his psychology is strong enough.You see that when he passed by Li Min who came in after passing by, he still remembered to greet Li Min."
Teacher Li is here.""
Hmm."
Li Min nodded at him, and said in his heart that this Zhang Youdao was really focused on watching the operation, and he didn't even hear the anesthesiologist say hello to the dean.It's a good thing he didn't hear it, otherwise it was well known that the dean liked to stand there and watch the jutsu field condescendingly, and if he saw the dean, he wouldn't have the sight to see it before he immediately gave up his position.Liu Xiuyu, deputy director of the anesthesiology department, was sent by Director Zhou to support this one.When she saw Chen Wenqiang, she couldn't help but say that she had seized Zhang Youdao's position, and teased Chen Wenqiang with a smile: "Dean Chen, you are bullying Dr.
Zhang for being young."
You have to be careful, where can Director Liang watch?
”Director Liang saw Chen Wenqiang and Li Min coming in, so he beckoned to the two of them: "Old Chen, Xiao Li, come and sit." ”When Li Min heard this, he immediately gave up his plan to see the progress of the operation and walked over.She moved a footstool and placed it on Director Liang's side, and after sitting down, she stretched out her legs and rotated her ankles back and forth, flexing and extending her ankles to relax her legs.Director Liang asked her about the progress of the heart transplant, and when she learned that the second half would be done with open circulation, she nodded and said, "This will not affect the follow-up part."
Early open circulation is good for myocardium and can reduce the necrosis of myocardial cells.Did you eat something?
I asked the cafeteria to deliver a snack.Everything was delivered. ”"Eat.I ate beef patties and millet porridge.It's enough to hold out until dawn. ”Li Min replied with a smile.I had just nervously done a vascular anastomosis for more than two hours, and the extra dinner had already been digested.Therefore, she not only drank half a bowl of porridge just now, but also ate most of the beef pie.These are not the amount of supper for her, but the amount of food that is serious.If it weren't for the fear that eating too much would increase the burden on her stomach to digest food, and that it would lead to a lack of blood supply to her brain during this period, she thought she could eat a whole pie.Chen Wenqiang looked at it for a while, and then came over to sit on Director Liang's side.The operation on the stage to remove the failed liver with most of the cell necrosis was performed by Xie Xun, accompanied by the experienced Song Yimin, these two young and strong people did not need Director Liang to come to the stage to be Xie Xun's assistant.But the same cannot be said.Director Liang, as the director of surgery and the chief physician of general surgery, his research direction is still hepatobiliary, and the first liver transplant operation in this provincial hospital, he wants to be an operator, who can say that he is not qualified?
But he wrote Xie Xun's name in front of him on the operation notice so lightly, gave up the position of the surgeon to Xie Xun, and gave this brilliant page in the history of the development of the provincial hospital to Xie Xun, who can continue to attack at high speed and climb the peak step by step in the general surgery department.This is the crown jewel of liver transplantation, surgery!
Not to mention the entire three northeastern provinces, even in the whole country, there is no one that can carry out liver transplantation on a large scale.If Director Liang can complete the first liver transplant operation in the provincial hospital, then he can logically control this operation project in his hands.It will definitely be a strong stroke in his career as a general surgeon, and it will definitely leave a more brilliant page in the history of the development of the provincial hospital.
*But Chen Wenqiang understands what Director Liang is thinking.Long before he entered the operating room, he saw who the liver transplant surgeon was in the lobby of the operating room.Therefore, after he sat down, he asked very calmly: "Lao Liang, how is it arranged for a while?"
”Director Liang said slowly but without hesitation: "After a while, you take Xiao Li to anastomosis the inferior vena cava and portal vein first."
My plan is to open the blood circulation as soon as these two blood vessels are anastomosed, so that the early perfusion of the liver can be rewarmed early, and the liverless phase can be ended early, which can ensure the safety of patients to the greatest extent.Then the hepatic artery was rebuilt, and it was handed over to Xie Xun and them to complete. ”Chen Wenqiang nodded.He expressed his support for Director Liang's choice to shorten the liverless period and preserve the transplanted liver function, because there are not many hospitals in China that can carry out this project for liver transplantation, so in clinical practice, everyone is in the exploration stage.In addition, in the world, it is also inclined to choose this kind of surgery to open blood circulation in advance and reperfuse the donor liver early.This practice can indeed shorten the hepatic period and the time of donor ischemia.But this is not 100% without drawbacks.Because the donor liver rewarms immediately after the portal vein is opened, and there is no hepatic artery at this time, it takes time to rebuild the hepatic artery, which leads to a longer thermal ischemic process in the biliary system, which depends on the hepatic artery blood supply.This means that this type of donor reperfusion may increase the risk of biliary complications after orthotopic liver transplantation.Therefore, some scholars have proposed a new donor liver reperfusion method: opening the hepatic artery and portal vein blood flow at the same time to prevent the bile duct epithelium from being damaged under continuous ischemia and reduce the probability of biliary complications.Director Liang and Xie Xun discussed this argument when they did the first kidney transplant, and they agreed that this was a loss of watermelon and picking up sesame seeds.Prolonging the liverless phase not only affects the function of the transplanted liver after surgery, but also directly exposes the patient to danger and increases the difficulty of recovery after surgery.This is because biliary complications are not comparable to those that may lead to liver failure-like complications such as hepatic encephalopathy, cerebral edema, hepatorenal syndrome, hepatopulmonary syndrome, and upper gastrointestinal bleeding without prolonged hepatic phase.Chen Wenqiang understands these professional theories, and Li Min also understands them, so there is no need for Director Liang to explain them.Seeing that Director Liang didn't speak anymore, the two of them also followed him to lean against the wall and close their eyes to recuperate.Recharge your energy and save your energy for the anastomosis of the inferior vena cava and portal vein.※※※※※※※※※※※※※※※※※※※※ full eighteen months, thank you for your company, there should be an extra tomorrow to end the full text.And then before the birth of my grandson, I will go with all my strength to fill in the pits, alas!
() The distance is a bit far