Chapter31: To hit the nail on the head
The catheterization interventional room currently has no dedicated personnel and is affiliated with the Department of Cardiology.
In a few years, more patients would need interventional procedures, not just those with acute myocardial infarction, and the cath lab would slowly begin to separate from the overall management of the cardiology department and become an independent department.
Currently, the only person who can perform this surgery at Shancheng City Hospital is Sun Lili, who has just returned from learning and is at a semi-professional level.
The cath lab is relatively simple, with a rest area, a work viewing area, and an operating room.
There is a huge transparent glass between the operating room and the viewing area, and the operating table is placed next to it to facilitate people outside to perform some operations.
There is a speaker to communicate with the doctor during the operation.
The nurse who went out to study with Sun Lili was named Zhou Miao, and she was making final preparations at this time.
Zhang Zhongyi was lying on the operating bed, with his right lower limb externally rotated, exposing the groin area.
Sun Lili has been disinfected and draped and is undergoing puncture.
only,
Zhang Zhongyi is relatively fat.
At this time, arrhythmia occurs, blood pressure is unstable, and the condition is poor.
The pulse of the right femoral artery cannot be felt at all!
Sun Lili tried to get a needle, but it failed!
The difficulty of puncture suddenly increases!
A thin layer of sweat appeared on Sun Lili's forehead.
The more this time, the more nervous I am!
A full twenty minutes,
Even Sun Lili failed to get punctured!
Zhang Zhongyi's situation is becoming increasingly unstable!
Xiao Jie was also standing nearby, his face full of anxiety!
But, she can't do arterial puncture
"Let me try it!"
Jiang Chu said.
"Okay!" Sun Lili didn't know whether Jiang Chu knew how to perform arterial puncture.
However, at this time, someone is willing to give it a try, which is a relief for me.
Standing up, Xiao Jie helped wipe the sweat off Sun Lili's forehead, and the latter let out a long sigh of relief.
at this time,
Jiang Chu had already put on surgical clothes and sterile gloves.
Come closer,
He reached out and touched Zhang Zhongyi's right femoral artery, but the fluctuation was unclear.
Logically speaking,
Jiang Chu should choose the left femoral artery to continue puncture. After all, the right side has failed. On this basis, the difficulty of puncture will increase a lot!
Or, use color ultrasound to locate and perform puncture!
However, for Jiang Chu,
Femoral artery puncture is not difficult and is equivalent to a nurse doing an ordinary peripheral puncture!
"Don't move, it hurts a little, it will be fine in a moment!"
Jiang Chu re-administered local anesthesia and said to Zhang Zhongyi at the same time.
At this time, the patient's cooperation is required, otherwise the position will change if the patient moves.
The next moment, Jiang Chu picked up the puncture needle, pointed the needle toward the patient's navel, and inserted it at an angle of about 45 degrees!
"Poof!" A burst of bright red blood shot back into the puncture needle!
The blood is bright red and the pressure is high!
Arterial blood!
One shot successful!
Jiang Chu never stops,
Place the introducer sheath into the femoral artery,
At the same time, heparin saline is injected to prevent blood clotting.
Before Sun Lili could react,
Jiang Chu has already sent two angiography catheters into the openings of the left and right coronary arteries!
"Contrast agent, change your position and prepare for imaging!" Jiang Chu's voice was slow but full of majesty.
"Ah?" Sun Lili was shocked at this time.
What's happening here?
Isn't Jiang Chu a general surgeon?
How can I become better at angiography than myself, a cardiologist who has gone out to study for half a year?
Judging from the other party's smooth movements, it doesn't look like it's the first time he's done such an operation!
Could it be that Jiang Chu has done this before?
However, in a small place like Shancheng City Hospital, this technology has just been launched this year. It has treated a few patients before, but it was all done by experts from the First Hospital of the Medical University!
I haven't heard that people from this hospital can do it?
In this era, there are opportunities for doctors to go out and study, but not many.
On the Internet, Baidu has just been established, many functions have not yet been perfected, and there is no platform for doctors to learn.
Therefore, no matter how hard Sun Lili thought about it, she still didn't know how Jiang Chu mastered this skill?
"The contrast agent is ready."
Sun Lili immediately handed the camera to Jiang Chu.
"Change your position and start injecting contrast agent!"
Jiang Chu gave an order, and Zhou Miao began to perform a series of body changes according to Jiang Chu's requirements!
Every time, Jiang Chu pushed the contrast agent with his hands
Time passed little by little.
Soon, the results of the angiography came out!
Localized severe concentric stenosis in the proximal left anterior descending coronary artery 96! The length of the lesion is about 15-20!
Moreover, there is retention of contrast agent!
No obvious abnormalities were found in the circumflex branch.
The second segment of the right coronary artery has moderate concentric stenosis of about 50%, and the length of the lesion is about 15%.
"Perform PTCA and stent implantation immediately!" Jiang Chu looked at the image displayed on the imaging machine with a solemn expression.
"Do you have a balloon and a stent?"
Jiang Chu suddenly realized this problem and turned around to ask.
At this moment,
Sun Lili had long been stunned by Jiang Chu's imaging techniques!
During the whole process, Jiang Chu's movements were smooth and skillful, without any sloppiness!
Even Sun Lili had an illusion,
Jiang Chu's statement is comparable to his own teacher!
There are a few more things that are different from what I studied at the First Hospital of the Medical University.
It seems that after Jiang Chu's operation, the whole process is more reasonable!
"Yes, yes!" Sun Lili came back to her senses when Jiang Chu asked.
"Our hospital is going to carry out the work, and the hospital has prepared sufficient supplies."
"Okay, let's start balloon expansion now!"
Jiang Chu nodded and walked into the room again.
The treatment method is to use a balloon to expand the narrowed area and then insert a stent.
In this way, the narrow blood vessels are supported open and blood can flow smoothly without causing damage to the distal myocardial cells due to ischemia and hypoxia, resulting in necrosis, which is myocardial infarction!
Just as Jiang Chu was sending balloons one by one into the left anterior descending coronary artery, Ma Mingchen and his party finally arrived.
The entrance to the emergency building.
Chen Mingqiang, director of the cardiology department, was anxiously waiting for Ma Mingchen's arrival.
Just twenty minutes ago, Ma Mingchen called himself and told him that he was almost at the hospital. He hoped that someone could coordinate and let him enter the catheterization room as soon as possible.
Chen Mingqiang knew Ma Mingchen very well. The future director of the Department of Cardiology at the Medical University Hospital and the next director of the Department of Cardiovascular Medicine in the province had a high position of authority, and he did not dare to neglect him.
Therefore, after receiving the call, Chen Mingqiang immediately walked to the door of the emergency building, preparing to greet Ma Mingchen in person.
At the same time, Chen Mingqiang was a little dissatisfied with Sun Lili. From Chen Mingqiang's tone, the patient was the father of his good friend!
For such an important person, Sun Lili didn't even say hello to me. Does this mean that she, the director, is taking her seriously? !
However, now is not the time to lose your temper. It will not be too late to settle the accounts later!