Director Jiang gave up his position: "Come here, Xiao Yang, look at the color ultrasound image. The catheter is close to stenosis. I'm starting to plan to go to the interventional operating room. The interventional room has better surveillance, but I don't dare to move the patient anymore. A little
Move it and the blood oxygen will drop immediately."
Although there is no X-ray monitoring in the interventional room, the color ultrasound monitoring now is better than trying to cross the stenosis with bare hands. Yang Ping said to the color ultrasound doctor: "Just maintain this position, don't move, I will start to advance the tube now."
The color Doppler ultrasound doctor's hand was very steady, fixed in a position that Yang Ping thought was good. He was sitting on the edge of the bed. Because he could not press the abdomen, his hand was hanging in the air, so it was very hard. In order to maintain stability, he held the probe with his other hand.
Hand.
"Miss Ning, could you please go out for a moment?" Yang Ping said.
When doctors perform operations, family members are generally not allowed to be present, because sometimes family members will interfere with the operation, especially at critical moments. Family members do not understand the principles of the operation and can easily misunderstand it. Once they interfere, it is easy for something to happen.
Miss Ning hesitated and reluctantly left the ward. When leaving, she said to Yang Ping: "Please!"
Yang Ping nodded firmly towards her.
"Be careful! Xiao Yang, the blood vessel wall is very thin, and it will break if you poke it even slightly." The deputy chief physician of the vascular surgery department reminded him, out of the kindness of his colleagues.
Director Jiang suggested from the side: "Should we withdraw the catheter, use interventional tools to insert the vascular stent, stretch out the stenosis, and then re-insert the catheter?"
This method is good, but it cannot be used now. The catheter cannot be withdrawn. Once withdrawn, the circulation of the entire human body is interrupted. Mr. Ning's own lungs have no function at all, so the direct consequence is that dominoes will collapse and multiple organ failure will occur.
No matter how you save it, it’s useless.
"The narrow part can just pass through the tube. As long as the direction is adjusted correctly, it should be able to pass. The tube cannot be retreated. Once it retreats, the blood oxygen will plummet!" Yang Ping stared at the color ultrasound screen and said.
Director Jiang stopped talking. Yang Ping was right. Once the tube is withdrawn and before a new tube is inserted, the patient's blood oxygen will be extremely low, causing ischemia of the brain tissue, which will then lead to multiple organ failure.
Color Doppler ultrasound cannot replace hand feeling, not to mention that the images displayed on Color Doppler ultrasound are flat and distorted.
Yang Ping judged the depth and state of the catheter based on the length and condition of the exposed part of the catheter. He gently pinched the catheter with his thumb, index finger and middle finger, and rotated it very gently.
He stepped back about one centimeter, and the image in his mind was a little blurry. Yang Ping strengthened it again to make it clearer. Because the composition was too difficult, there was sweat on his forehead. After trying to add it a few times, the image became clear.
Just like ordinary people remembering an object and retaining its appearance in their minds, it will be very clear at first, but after a while it will become blurry, especially the details, and they cannot be recalled at all.
"Xiao Yang! If it doesn't work, don't force it-"
Director Jiang was worried. Newborn calves are not afraid of tigers, so they must not cause heavy bleeding. If they die on the spot, even if the family does not pursue the case, it is not a good thing.
"Don't worry, I know what I know." Yang Ping said.
The catheter gently walked up and touched the stenosis. The catheter made slight contact with the stenosis. This subtle contact was transmitted to the hand through the catheter. The hand made fine adjustments based on this indirect tactile feedback, just like threading a thread.
Pass through the eye of a needle.
Little by little, while passing and adjusting, everyone is staring at the color ultrasound screen.
"No, I can't hold my hand steady anymore." The color Doppler ultrasound doctor's hanging hand was shaking a little.
Yang Ping immediately and gently moved the tube back: "Relax your hand and take a rest. I'll wait for you!"
After a short rest, the color Doppler ultrasound doctor pressed down the probe again.
Yang Ping's hand holding the catheter just now didn't move at all. He waited until the color ultrasound image reappeared with the images of blood vessels and catheters. His hand adjusted the tube again, and the tube began to slowly pass through the stenosis.
The blood oxygen fluctuated violently and suddenly dropped. Mr. Ning was a little restless. The tube in Yang Ping's hand retracted again, extremely dexterously, without touching the blood vessel wall.
"Give me some more sedative medicine!"
There was an anesthesiologist next to me, but he kept silent until he was needed.
The catheter can just pass through the stenotic part, but if the direction is a little off, it will be impossible to pass. If the patient is restless when passing through, the catheter will most likely pierce the blood vessel.
The risk of passing slowly like this was too high, so Yang Ping decided to seize the opportunity to pass quickly.
At this time, I don’t know when Director Han also came in. Director Kong should have called him. After all, he was borrowing his people to do high-risk operations. How could he do it without notifying him?
Director Han heard the news at home and rushed over immediately. No matter how powerful Yang Ping is, he is still a human being. He can come over to help with ideas.
"Director!" Yang Ping greeted Director Han.
Director Han nodded slightly, meaning you can continue and don’t get distracted.
After saying hello to Yang Ping, Director Han walked to the reading lamp to watch the movie, studied it for a while and said:
"Xiao Yang, in this case, it is best to pass quickly, but the risk is extremely high, but it is better than passing slowly."
This idea coincides with Yang Ping's.
"Call Miss Ning in!" Yang Ping wanted to talk to her about the risk. This can only be a gamble. It's done! Mr. Ning can hold on for a few more days, or even dozens of days; no! His heart may be beating and breathing at this moment.
Stop.
Director Kong knew what Yang Ping meant and said: "We discussed it carefully before the operation. The risk is extremely high, and the heart and breathing may stop immediately."
Yang Ping still insisted on the need to talk: "I'll talk to her again."
Director Kong called Miss Ning in. Miss Ning had been in the corridor just now and was very nervous. Although she had been mentally prepared for it, she still couldn't accept it when it came to this moment.
"Ms. Ning, now this catheter must pass through the stenosis, otherwise Mr. Ning will not be able to survive today. However, the risk is very high when crossing this stenosis. I have to seize the opportunity to quickly put the tube in. Success or failure is only one second. Only
One chance. It works! Mr. Ning can persist for several days, or even dozens of days; if he fails! His heart and breathing may stop on the spot. I want to hear your opinion, are you willing to take the risk--"
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Now that the anesthesiologist has given him sedatives, Mr. Ning can no longer express his position, even nod his head. Miss Ning is in a dilemma. Her facial muscles tremble, and she wants to open her lips several times to speak, but she only moves slightly and does not speak. "We are not given much time. The oxygen pressure we are given now is very high. We cannot give this pressure for too long!" Yang Ping said calmly.
If you don't take risks and can't survive today, it's no different from stopping on the spot. The father wants to hold off because he wants to see his brother, Miss Ning analyzed in her heart.
Although she is young, she has been in the business for several years and is calmer than ordinary people, and is better able to seek advantages and avoid disadvantages.
"How sure are you?" Miss Ning asked.
Yang Ping shook his head: "It's hard to explain clearly!"
Miss Ning gritted her teeth and said decisively: "Dr. Yang, I believe in you. Just go ahead and fight for it. I am willing to take risks. I am willing to accept no matter what the consequences are."
"Okay, I understand, you go out and wait again!" Since the family members are willing to take risks, they take the gamble themselves.
However, Yang Ping still has a good idea and is very confident. However, this kind of thing must be explained clearly to the family members, and he cannot be too sure.
When Miss Ning went out, the door of the emergency ward was closed again by a doctor.
"Can you still hold on to the color Doppler ultrasound? If not, let go and take a rest." Yang Ping told the color Doppler ultrasound doctor.
The color ultrasound doctor said: "You can persist!"
"Keep still for 30 seconds and I will be able to complete the tube delivery. It will not move at all. It's best to take a rest." Yang Ping saw that he had been persisting for a while.
"Okay!" The color Doppler ultrasound doctor withdrew the probe and began to move his wrist, which felt sore and numb.
After resting, he picked up the probe again and pressed down on the right lower abdomen. When the image reached the best state, he stopped the action.
"Okay, don't move!"
Yang Ping and the color Doppler ultrasound doctor confirmed their eyes.
"Stay steady, look for opportunities, and pass them one at a time!" Director Han encouraged.
Everyone held their breath, stopped talking, and stared at the color ultrasound screen.
The color Doppler ultrasound doctor clenched his teeth tightly and motionless with his hands, as if he were a sculpture.
The screen image is very stable, without any shaking, and the red and blue colors representing blood flow flash.
Yang Ping adjusted his breathing, holding the catheter in his hand, not loose or tight, adjusting it to the best direction, breakthrough!
For a moment, it was like a sniper who had been aiming for a long time and finally pulled the trigger.
Great! The catheter passed through the stenosis smoothly without touching the wall, and then it went deep for a full twenty centimeters before Yang Ping let go.
Everyone raised their voices and felt relieved.
The blood oxygen saturation on the monitor slowly rose, 90, 92, 95, 99--
Success! Director Han suppressed his voice.
With the help of this magic lung, Mr. Ning can survive for a few days without any problem. If he is lucky, he can survive for dozens of days.
