The thymus itself is very close to the heart. After a tumor developed in this patient's thymus, it directly occupied part of the pericardium.
The injured artery is now directly ligated and blocked.
It is equivalent to cutting off the blood supply along the way.
The entire blood supply system of the human body is very delicate, especially the blood vessels in the chest cavity.
Whether it is veins or arteries, they all form a systemic blood circulation system with the heart as the core.
The blood supplied by the chest cavity goes up to the brain and down to the soles of the feet. It also supplies blood to the limbs, bones, and organs of the body.
The patient's blood oxygen level continued to drop, but it is not clear whether this was related to the rupture of this blood vessel.
But if the thymoma is not completely separated, there is no way to anastomose this blood vessel now!
Director Hu Kan encountered unprecedented challenges.
"I'll try increasing the oxygen concentration first. But I feel like the effect won't be that great."
Dr. Feng tried to increase the concentration of oxygen inhaled by the patient.
In hospitals, we often see patients who need oxygen. For example, pregnant women, patients with impaired or failed lung function, chronic obstructive pulmonary disease, etc. may all need oxygen.
Patients generally inhale low-concentration oxygen. Occasionally, in special circumstances, the oxygen concentration will be slightly increased.
However, the oxygen concentration cannot be adjusted too high.
Otherwise, it will backfire.
For example, the common ones include carbon dioxide retention, lung function suppression, oxygen poisoning, etc.
Doctor Feng appeared to be very cautious when operating.
The patient's blood oxygen level already has problems. If the oxygen concentration is too high, the patient's lung function will be suppressed, which will immediately make the situation worse.
Zhou Can was watching silently from the side, his heartbeat slightly quickening.
Because he knew that he had been in the cardiothoracic surgery department for almost two months, but he had not been able to get much hands-on training opportunities. Now, the opportunity came.
It is true that cardiothoracic surgery is full of experts. These chief and deputy chief physicians are all experts among experts.
Even the attending physicians were extremely capable, and their surgical skills surpassed those of doctors of the same level in other surgical departments.
But they have one major weakness.
That's slow.
Success and failure are all due to Xiao He.
It's slow. If it were in other operations, it wouldn't be a big deal.
The accidental rupture of an artery at this moment had already laid the seeds of disaster. Add to that the slow speed of the operation, and it was basically like adding insult to injury.
Oxygen therapy is not a panacea for low blood oxygen levels.
In many cases, low blood oxygen levels cannot be resolved by oxygen inhalation.
As Zhou Can expected, even after the oxygen concentration was increased, the patient's blood oxygen saturation continued to decline.
It has fallen below 90.
"Oxygen doesn't work!"
Dr. Feng issued a warning.
Director Hu Kan, who was speeding up the operation, suddenly changed his expression. What he feared came true.
Today's matter seems to be troublesome.
"Director Le, how long will it take to anastomose that ruptured blood vessel?"
"It will probably take more than three hours."
Director Le is considered a doctor in the surgical team with mature skills and nimble hands and feet.
The time it takes to anastomose larger arteries usually ranges from half an hour to three or four hours.
For operations that are more difficult, it may take up to eight hours.
In general, the operation of arterial anastomosis and placement of an inferior vena cava filter can usually be completed within half an hour. If the artery or blood vessel occlusion is very difficult, appropriate drugs must be used to assist the operation, which will greatly extend the operation time.
Moreover, even a top surgeon like Director Hu Kan would not dare to say that he can sew it right in one go.
If you fail, you have to sew it again.
There are also many risks during surgery, and the variables are very large.
"Doctor Feng, I think we should make preparations for both scenarios! Immediately prepare to establish extracorporeal circulation in case of any accidents."
"good!"
Dr. Feng agreed immediately.
"Let me help you with that!"
Zhou Can received a lot of guidance from Dr. Feng today, and his relationship with Dr. Feng was also quietly changing.
Obviously they became much closer.
The biggest difference between humans and animals is probably that humans have complex emotions.
Although animals also have emotions, such as their care and protection for their partners and their young, these are all manifestations of emotion.
Human emotions are much more complex.
Zhou Can used to help Doctor Feng, but he never said thank you and his attitude was always indifferent and cold.
Until today, he suddenly taught Zhou Can knowledge .
This can be considered a qualitative breakthrough in the relationship between the two.
Just like falling in love, at the beginning, at most you watch a movie together, go shopping, send messages, and make phone calls. Until the relationship heats up, one day, you suddenly hold hands.
And the woman did not refuse.
This is a substantial breakthrough.
Zhou Can has performed extracorporeal circulation on patients many times and is very familiar with it. His speed is much faster than others.
[Insert experience value +1, +1...]
When he performed the femoral artery catheterization again, he clearly felt that the operation was easier than before.
Quietly checking the attributes, the implantation technique has indeed quietly risen to the middle level of the main treatment. The current experience value is 6001/10000.
While others get rich through hard work, he relies on hard work to quickly earn experience points and upgrade his medical skills.
Although it is somewhat similar to the immortal cultivators taking elixirs , there are some flaws.
However, this upgrade speed of surpassing others by ten or even more than ten years in one year still makes Zhou Can feel extremely happy.
Experience can be accumulated slowly.
You need to improve your skills first before you can get more opportunities to practice.
It may take an ordinary surgeon 20 years to master suture to the level of deputy director. However, Zhou Can only took one year to improve from the internship level to the level of deputy director.
Not just one, but two medical skills, suturing and ligation, have both been upgraded to level five.
This kind of overtaking on a curve and asymmetric competition is naturally very exciting.
The minor defects brought about by the rapid improvement of medical skills are nothing.
Extracorporeal circulation was quickly established.
However, extracorporeal circulation can only be used as a temporary emergency measure and usually lasts about six hours.
If the time is exceeded, the patient will often be transferred to external ECMO.
With extracorporeal circulation, the operation continued.
Zhou Can felt a little regretful, as he thought the opportunity had come.
I didn't expect that Tuya's top department, with many methods and complete equipment, could solve the problem temporarily with an extracorporeal circulation.
"Wipe your sweat!"
Director Hu Kan said to the nurse.
Only then did Zhou Can notice that Director Hu Kan's forehead was covered with fine beads of sweat.
The patient's critical condition just now must have put a lot of pressure on Director Hu. However, as the lead surgeon, he had to stabilize the morale of the troops and force himself to remain calm.
Not long after the nurse wiped his sweat, sweat started to appear on his forehead again.
There seemed to be something wrong with his face, he looked a little pale.
Unfortunately, the mask covers most of the face, making it difficult to see clearly.
"Director Hu seems to be in trouble!"
Zhou Can keenly noticed that Director Hu Kan not only had cold sweat on his forehead and a pale face, but his hand movements also became extremely slow.
"Wipe your sweat!"
Less than five minutes later, he shouted to the nurse again.
The other doctors also noticed something was wrong with Director Hu at this time.
"Director Hu, why don't you sit down and rest for a while, and let me take over and complete the rest of the operation!"
Director Le immediately took the initiative to share the responsibility.
"That's good! The patient has severe adhesions of fibrous connective tissue, so the surgery must be done with caution."
Director Hu Kan staggered as he stepped back.
After all, Zhou Can was a martial artist, so he was quick-eyed and quick-handed. He rushed forward and supported the man.
"Director Hu, be careful!"
These directors are the backbone of Tuya Hospital. If they fall down when getting off the operating table, the consequences will be serious.
After all, they are not young anymore.
"Xiao Zhou, help me sit over there and take a rest!"
Director Hu Kan likes Zhou Can very much.
Zhou Can supported the surgical master and found that Director Hu Kan was much thinner than he had imagined. And his body was shaking.
This is by no means normal.
"Do you need to go outside the operating room to drink some water and eat something to replenish your energy?"
Zhou Can thought that Director Hu was showing signs of exhaustion.
"It's okay! I'll just sit over there and take a break. This operation is extremely difficult. Although Director Le has been learning from me for many years, he still lacks some skills in many aspects. I am a little worried."
Zhou Can had already known that Director Le was Director Hu Kan's apprentice.
To be precise, many people in the cardiothoracic surgery department are disciples of Director Hu Kan.
He is never stingy in giving advice to other doctors.
Zhou Can also stayed in the Department of Neurosurgery for a few months. Wu Baihe was more famous than Director Hu Kan, but his appeal and popularity within the department were far less than that of Director Hu Kan.
When it comes to imparting surgical experience and techniques, Wu Baihe's patience is much worse.
When guidance is given, it is often not very detailed.
Junior doctors need to guess, improve and understand on their own.
Director Hu Kan is a very good teacher, very patient when explaining problems. When junior doctors ask for advice, he will patiently explain the key points until the junior doctors understand.
Zhou Can was originally a disciple of Dr. Xu and was considered a potential competitor of Director Hu Kan.
But he has been selflessly cultivating Zhou Can.
For example, in this operation, without his approval, how could Director Le dare to call Zhou Can to come over and learn?
Zhou Can has heartfelt respect for such a respectable and lovely chief physician.
After helping Director Hu Kan sit down on the round stool by the wall, Zhou Can let him go.
"I'm fine, you don't have to stay with me. You stand in front of the operating table and watch and learn more. Such an extremely difficult surgical opportunity is extremely rare." Director Hu Kan waved to Zhou Canzhi.
"OK!"
Zhou Can walked towards the operating table, but he chose to stand on the other side.
The viewing angle of watching Director Le perform surgery was a little poor, but it was convenient for Zhou Can to check on Director Hu Kan's condition at any time.
Based on my intuition, Director Hu Kan’s condition is not as simple as being exhausted.
At this age, people are often under high-pressure work and are prone to cardiovascular disease and high blood pressure.
The patient was in danger just now, and Director Hu must have been greatly stimulated. He may have high blood pressure or tachycardia.
Director Le's surgical skills are obviously much worse than Director Hu Kan's.
However, it should be completely sufficient to separate thymomas.
Time is passing quickly and the patient's condition is actually not good.
The operation faced great difficulties.
The lead surgeon Hu Kan was forced to withdraw due to poor health.
Multiple crises combined together made the operation even more dangerous. The atmosphere in the operating room became increasingly depressing.
"Speed ​​up the operation as much as possible. The patient's blood pressure is dropping. His breathing is also weakening."
Doctor Feng urged Director Le and others.
If the patient's condition was not very serious, he would not have urged the surgeon to perform the surgery.
Because this will bring great psychological pressure to Director Le.
The most frightening thing about having surgery is being nervous.
"It's too close to the heart's major blood vessels, and the adhesions are very severe. I'm a little worried about breaking it."
When doctors are talking during surgery, they usually subconsciously avoid using words like "accident" or "accident".
If the heart's large blood vessels are ruptured, heavy bleeding will immediately occur.
A blood vessel has been ruptured.
If one more is broken, this operation will be the worst ever performed.
"Director Hu, Director Hu!"
From time to time, Zhou Can glanced at Director Hu Kan who was sitting against the wall.
It was discovered that Director Hu's body was leaning to one side.
He called out as he rushed over and held the man up.
"I...have some chest pain and tightness!"
Director Hu's breathing was rapid, his forehead was covered in sweat, and his body was shaking violently.
"Does Director Hu have heart disease?"
Zhou Can asked Director Le and others.
Some of them have been performing surgery with Director Hu Kan for many years and should have some understanding of it.
"Director Hu never discloses his physical condition. We don't know either." Director Le had stopped the operation at this time, and the other medical staff all looked at Director Hu.
"His symptoms are a bit like a heart attack. He was emotionally stimulated just now, which may have aggravated the heart attack. I will take Director Hu to get a check-up first. Director Le, do you think it's okay?"
Hu Kan fell down, and the highest-ranking person in the operating room was Director Le.
"Go!"
Director Le urged him.
"Director Hu, don't worry, we will complete this operation well."
After urging Zhou Can, he spoke to comfort Hu Kan.
The doctors present were all cardiothoracic surgeons, and Director Le was good at cardiovascular surgery. After Zhou Can's reminder, they also found that Director Hu Kan's condition was very serious.
Zhou Can carried the person out of the operating room.
Without even changing his clothes, he rushed to the cardiothoracic surgery clinic wearing the operating room protective suit.
Along the way, many family members and medical staff came to watch.
Don’t they know what’s going on?
Director Hu was performing surgery on a patient, but ended up having to rescue himself.
"Where is Director Xue's clinic?"
Zhou Can asked the nurse.
"Over there!"
The guiding nurse naturally recognized the person Zhou Can was carrying, and hurried to lead the way.
Zhou Can carried the person into the outpatient department. At this moment, Director Hu's condition had become worse.
He was already unconscious and looked extremely scary.
"Doctor Zhou!"
Director Xueyan was examining a patient when she was startled to see Zhou Can suddenly rush in carrying someone on his back.
"Director Hu had a sudden physical problem during the operation. It looks a bit like a heart attack. Please help take a look!"
Zhou Can finished speaking hastily, and apologized to the patients and their families who were seeking treatment, "I'm sorry, our doctor's condition is very critical, please cut in line."
"It's okay, it's okay. It's a chronic disease anyway, so there's no need to rush."
The family members are very understanding.
If you sell it well to the doctor, the follow-up diagnosis and treatment can be taken care of to some extent.
At least that's what the family members and patients think.
"It does look like a heart attack. Go and make an appointment for Director Hu. I'll examine him first and then write him a medical examination application. Judging from the situation, I'm afraid he'll need emergency treatment."
Without registration, there is no way to enter the system.
The doctor cannot issue an application form for examination.
Acute myocardial infarction is characterized by sudden acute occlusion or severe stenosis of at least one blood vessel, leading to acute ischemia of the myocardium supplied by blood, followed by myocardial damage and subsequent necrosis.
The progression of a heart attack is measured in minutes.
Emergency rescue can greatly reduce the patient's risk of death.
Saving the myocardium to the maximum extent possible and preserving heart function is one of the purposes of emergency treatment. Otherwise, even if the patient is saved, the quality of life in the second half of his life will be seriously affected.
"I don't have Director Hu's ID card!"
Zhou Can said.
"Just write your name. Go quickly and I'll add a number."
Director Xue is already at an expert level, so her account must have been sold out long ago.
Add a number temporarily, this is the advantage of having connections.
Zhou Can ran to find the girl at the manual registration window. She was quite sympathetic when she heard that something had happened to Director Hu Kan during the operation. Without saying a word, she helped Zhou Can to get the matter settled.
Zhou Can took the number and returned to Director Xue's outpatient office.
At this point the physical examination is complete.
She is already opening an application form for inspection.
"Go to the heartache center first and get an expedited electrocardiogram, then a chest X-ray."
"OK!"
When Zhou Can was doing a chest X-ray without Director Hu Kan's knowledge, he once again used his "privilege" to jump the queue for the examination.
Human life is at stake, and there is nothing we can do even if other patients and their families are dissatisfied.
In fact, most of the patients who visit the specialist clinic here suffer from chronic diseases.
If it was an emergency, why would they wait in line here? They would have registered for the emergency department and gone through the emergency procedures.
Zhou Can did not take Director Hu Kan to the emergency department, mainly for the purpose of saving time.
Moreover, patients with myocardial infarction like this will eventually have to be transferred back to the cardiothoracic surgery department for surgery, or doctors from the cardiothoracic surgery department will be invited to the emergency department to perform the surgery.
Instead of going through so much trouble, it would be better to directly use the familiarity of the person and go through special procedures to save Director Hu Kan's life.
After examination, Director Hu Kan was found to have acute myocardial infarction.
After reading the examination results, Director Xue immediately arranged the patient's bed, consulted with other chief physicians in the department, and developed a surgical plan.
While notifying Director Hu Kan's family, Zhou Can was busy running around, acting as a temporary family member.
After discussion, it was finally decided to perform interventional surgery on Director Hu Kan.
This is also a commonly used surgical option for acute myocardial infarction.
Opening blocked blood vessels in the shortest possible time is the key to treating myocardial infarction.
After Director Hu's family arrived, Zhou Can quietly left and returned to the operating room.
At this moment, thymoma surgery is still in full swing.
"Xiao Zhou, is Director Hu okay?"
Seeing Zhou Can come back, they asked about Director Hu's situation.
"The diagnosis is acute myocardial infarction. We have developed an interventional surgery plan and will perform emergency surgery on Director Hu soon."
This type of interventional surgery is not considered a difficult operation for cardiothoracic surgeons, who are known for their expertise.
I believe that as long as Director Hu is not too unlucky, he will be able to recover soon.