Teng Guihua also wanted to come over and ask a few words, but was stopped by Chang Juan, who didn't want this woman to interfere with the doctor's treatment.

Although she is Fang Xiaoyun's mother, this mother has no daughter in her heart at all, and her daughter is just a money-making tool that has been squeezed.

If it can be sold, this mother will not even blink an eye, and will sell this daughter for money, and pay a down payment and decoration for her son's house.

"The doctor on duty in the interventional operating room is busy on the stage, a spontaneous intracranial hemorrhage, interventional embolization, to put on a few coils, I reported to the general duty, he is coordinating, call the preparer over."

Song Zimo contacted the interventional operating room and spinal arteriography, which had very high requirements for the interventional doctor's technique, and required the interspinal arteries to be super-selected one by one, and the contrast agent was pushed to identify them one by one.

In addition, there was an anterior spinal artery that was embolized at that time, and the thrombectomy was cut and re-anastomosed during the operation, and once the imaging was performed, the risk of re-embolization increased a lot.

"How is it, Fang Xiaoyun's condition!" Professor Zhang rushed to the general orthopaedic surgeon's office.

Yang Ping immediately reported his analysis and arrangement to Professor Zhang, who sat down and took a breath: "I have also been pondering, too much like a dural arteriovenous fistula, I have encountered a case like this before, but the symptoms did not appear so quickly, at that time, the patient had low back pain, numbness and weakness in the lower limbs, went to other hospitals as lumbar disc herniation, did surgery, the postoperative symptoms were not relieved, and he was completely paraperatic, and then I considered this disease, did DSA, and spent 6 hours doing spinal arteriography to find the fistula, Later, surgery was done to deal with the arteriovenous fistula, and the patient regained the sensation and muscle strength of the lower limbs, Fang Xiaoyun's condition was more complicated, spinal tuberculosis and dural arteriovenous fistula were mixed together, and the onset of the disease at the same time, and at the same time caused paraplegia, if it was true, it was too rare. The emergency department arranges for DSA, and if the diagnosis is confirmed, the patient will be operated on immediately and the patient will be placed in the hybrid operating room of the interventional department. ”

Hybrid operating room is a kind of composite operating room, generally in the 100-level laminar flow operating room, the DSA equipment and surgical equipment are fully integrated, and interventional treatment, surgery and imaging examination can be completed in one operating room, so that some complex operations do not need to be decomposed, so that they can be completed at one time, reduce surgical risks, reduce patient handling, and save surgical time.

"We have arranged, the doctor on duty in the interventional department is busy, there is no manpower, the general duty is scheduling, and the person who is on duty has been called to come over." Yang Ping introduced.

Director Han also hurried over: "Xiao Yang, I contacted Director Shi of the interventional department, and they arranged for Director Ji to come over, Director Ji is the best in the interventional department, and he has also done the most spinal arteriography." ”

Great, at a critical time, Director Han can coordinate in the middle to create conditions for Yang Ping, and at the same time take risks for Yang Ping.

Although the general duty can also be dispatched, it will not be as attentive as Director Han, as soon as Director Han communicates with Director Shi, people will know who you need, and they will immediately transfer Director Ji over, instead of casually calling a doctor to deal with it.

"Have you communicated with the patient?" Director Han asked.

Yang Ping nodded: "I just communicated, signed, the patient himself is very good at communication, her mother, I don't seem to be good, always dodging, doubting this and that." ”

Director Han snorted: "She is an adult, just agree to it, the family doesn't have to worry about it for now, Xiao Zhang, bring the medical records." ”

Zhang Lin immediately took the medical records, Director Han flipped through the medical records, and signed his name in front of Yang Ping's name on the informed consent form for surgery.

"Do it according to your ideas, I have something to do, we are doctors, how can we not take risks, as long as we start from the interests of patients, make full preparations, and control the risks."

Director Han handed over the medical records to Zhang Lin, and Professor Zhang beckoned, took the medical records, and added his name: "Let it go, this case is relatively rare, remember to collect information." ”

"Xiao Wu, you are responsible for collecting information, Song Zimo and Zhang Lin will come to the stage with me, and the fat man will be anesthetized." Yang Ping made arrangements on the spot.

"The interventional department called and asked us to send the patient, and they came with two doctors and a nurse and opened a hybrid operating room for us." Song Zimo answered the phone and said.

Su Yixuan took Zhou Can to quickly push the surgical instruments and microscope to the interventional operating room, orthopedic surgery requires a lot of specialized instruments, spine surgery has a complete set of spine surgical instruments, and the interventional hybrid operating room only has some general instruments, no orthopedic specialized instruments.

"Let's go, send the patient!" Director Han groaned.

Zhang Lin Xiaowu sent the patient and pushed Fang Xiaoyun to the interventional operating room with a flat cart for transport, which was located on the second floor of the emergency building, and the chest pain center was also located there.

The flat car of the comprehensive orthopedics is newly bought, with inflatable wheels, and with shock absorption, there is no big sound and vibration when pushed, Fang Xiaoyun's mother followed behind: "Hey! Ay! Ay! What are you going to do---"

"What nonsense you have!" Chang Juan blocked her, for fear that she would make some kind of moth and affect the doctor's work.

There is a barrier-free operation path between the buildings, and the flat car is hurriedly pushed to the interventional operating room, where Director Ji and his assistants and nurses are already waiting in the operating room.

"Elder Zhang! Director Han! Director Ji greeted respectfully.

"Doctor Yang!" Director Ji also greeted politely, and the others ignored it.

Now Yang Ping is also a celebrity in the hospital, everyone knows his ability, the hospital is a place where technology is king, technology is good, everyone respects him; If the technology is not good, even if there is a backstage to support it, it is useless, and if you don't talk about it, you will definitely look down on it in your heart.

"Is this patient considering a dural arteriovenous fistula? The operation will take a long time, and it will take one blood vessel by one to over-select, to test, and there is a possibility of failure, so I tried my best. ”

Director Ji said very truthfully, but he was very happy, he had never encountered this rare case before, when he was studying in Fuwai, he listened to the teacher, and now he has encountered it clinically, so he is naturally happy.

Professor Zhang encouraged him and said, "Don't worry, I have done DSA for this kind of patient, you do it, I will help you watch it from the audience." ”

That's the best, the older generation of doctors is not like now, they can only guard their own one-third of an acre. At that time, it was normal for them to dabble in some cross-cutting techniques, and many old doctors would take X-rays themselves.

"A week ago, the anterior spinal artery of thoracic 9 in this patient had an embolism, and the thrombectomy was cut and re-anastomosed during the operation." Yang Ping introduced, and then Zhang Lin introduced the patient in detail.

Director Ji said: "The amount of intraoperative contrast agent should be strictly controlled, otherwise it is easy to cause re-embolism. ”

After the handover of the patient's condition and the bed, the young doctor under Director Ji signed the informed consent for DSA and iodine contrast medium for the patient.

The fat man does anesthesia, tracheal intubation and general anesthesia, the people in Yang Ping's team are different, the fat man's anesthesia is fast and good, he is still talking here, and the anesthesia is good there, so he can brush his hands.

Director Ji admires this young team very much, the business quality is excellent, this fat anesthesiologist is much more powerful than his anesthesiologist, and his anesthesiologist is afraid of this and that.

"Then let's go up first, do the DSA of the spinal artery, and we will do the femoral artery puncture, one by one, it will take five or six hours, or you will go out to rest first."

Director Ji, assistants and nurses put on lead clothes, everyone looked for lead clothes to wear, Professor Zhang also wanted a lead suit, the lead clothes were not breathable, very heavy, dozens of pounds in weight, worn on the body for several hours, eighty-year-old people, it would be very uncomfortable.

"We are now using the supine position to do DSA, find the fistula, and then change the prone position for you to do the surgery, is it okay?"

Director Ji brushed his hands and came back, disinfected the sheets, and wore gloves.

"Good work, Director Ji!"

"It's okay, they're all doctors, this kind of thing is common, today is my wife's birthday, I said to have a meal with her, I just sat down, I called, no way, who made us doctors."

Isn't it okay to change someone?

It's really not necessarily, this kind of case requires a doctor with good techniques to have a high success rate.

Director Ji is in his forties, gray-haired, lean, and one of several group directors in the interventional department.

The interventional department is divided into several wards, neurointerventional group, cardiovascular interventional group, tumor interventional group, Lao Ji is the cardiovascular intervention group, and the cardiovascular intervention group is also an important part of the chest pain center.

Lao Ji came from the Department of Cardiovascular Medicine, and after getting married and having children, he began to engage in intervention, generally engaged in intervention, often exposed to X-rays, and those who were not married and had children were unwilling to engage in it, and the hospital would not pick people from the unmarried.

The femoral artery was punctured, the catheter guidewire was inserted, and the first interspinal artery was successfully superselected.

You can only check one by one, if you have more contrast media, you can't do it if you have less, the dose should be accurate, and the technique should be gentle and accurate when the blood vessels are overselected.

"Push the contrast, Onipike!"

Onepac is a non-ionic iodine contrast agent, which is a safe neuraxial contrast agent, and spinal arteriography must select a contrast agent that can enter the spinal canal.

"Okay, that's enough, a little less, isn't it? Zhang Lao! Lao Ji asked Professor Zhang.

"Yes, too much, it is easy to cause embolism." Professor Zhang's knowledge and experience are comprehensive.

"Yes! When I went to Fuwai for further study, a colleague said that there was a spinal arteriography in their hospital, and after the angiogram, it caused spinal artery embolism, caused spinal cord blood supply disorder, spinal cord ischemia and necrosis, paralysis, and the lawsuit was fought for several years. ”

But too little can play a role in development, so the grasp of the quantity must be very old.

"No, the next one!"

There are twenty-four intercostal arteries alone, and this is just the beginning, and one blood vessel can't be solved in more than ten minutes.

"Teacher Zhang, will you go out and rest for a while? I'll do it here. ”

Director Han was afraid that he wouldn't be able to stand it, so he stayed up late and wore such a heavy lead suit.

Professor Zhang waved his hand: "It's okay, I have experience with this kind of case, and I have also done this kind of DSA, I can give them a little advice, you can go out, go outside and rest, a few young men will have surgery later." ”

Professor Zhang's tone was stern, more like an order, and he was motivated by the idea of protecting young people, after all, everyone is not married and has children, and the exposure to X-rays should be minimized.

"It's okay, I'm in there, I want to see how the imaging is going." Yang Ping also wore lead clothes, and everyone wore lead clothes.

Professor Zhang lost his temper: "Why are you disobedient, let you go out, so many people watch the excitement!" ”

Director Han immediately ordered Yang Ping: "Professor Zhang and I are inside, you all go out, do you hear!" ”

Five or six hours of X-ray exposure, with lead clothing can not be completely protected, and surgery will be required later, orthopedic surgeons often deal with X-rays, try to avoid unnecessary exposure.

Okay, Yang Ping took everyone out and rested on the blue plastic chair outside.

Lean on a nap, if Director Ji finds a fistula, he will call everyone.