Chapter 630 The trouble caused by gray matter in the brain, this is a feeling

Author: Jiangbian Yuweng

Chapter 630 The trouble caused by gray matter in the brain, this is a feeling

There is not much blood in the cranial cavity.

Usually, there are two sources of blood accumulation during craniotomy. One is that the patient has intracranial hemorrhage before surgery, resulting in fluid accumulation. The other is intraoperative bleeding, which is caused by the surgery.

Zhou Can's incision skills are already at the level of a director, and his hand feel is extremely strong.

Blood vessels, nerves, tendons, etc. can be identified one by one.

This kind of hand ability is definitely not something that ordinary surgeons can possess. It is often possible only if the surgical experience is extremely rich and the incision level is above that of a chief surgeon.

Its functions and benefits are self-evident.

This allows the surgeon to minimize surgical bleeding during the operation.

Zhou Can now performs various major surgeries, and his bleeding control is enough to make every doctor envious.

When others perform a caesarean section, they will bleed at least 300ml.

If Zhou Canlai performs the surgery, not only the operation speed is extremely fast, but the amount of blood loss is pitifully small. During laparotomy surgery, he can usually control the blood loss within 100ml. In fact, the blood loss during his laparotomy surgery is usually within 50ml.

This is not just as simple as incision in the abdominal cavity, but also includes intraoperative removal of abdominal tumors or appendix, etc.

From the perspective of ordinary doctors, this is almost unimaginable.

Because it is really difficult to achieve such little bleeding.

All I can say is that surgery requires not only good skills but also experience.

Before Zhou Can removes a certain lesion, he can clearly know which larger blood vessels are around the lesion, and those that need to be ligated should be ligated in advance. For small blood vessels, he can directly electrocoagulate to stop bleeding during the operation.

"The source of the bleeding was found. It was a broken artery."

After the blood was drained, the bleeding point was clearly visible.

Of course, finding the bleeding point was completely logical and easy for Zhou Can. It took almost no effort and time to find the bleeding source easily.

But if someone were to perform the surgery, unless he was a chief physician like Wu Baihe, most people would not be able to reach this level.

It is easy to see things but difficult to do things.

Zhou Can was very relaxed when he was doing the surgery, but if it were another doctor on site doing it, he would probably be as nervous as if he were facing an enemy, and he might even be very nervous and have various problems.

When performing such a fatal surgery, it is definitely the patient's luck to have surgeons of Zhou Can and Wu Baihe's level to perform the surgery.

Zhou Can did not ask Wu Baihe this time and directly electrocoagulated the bleeding point to stop the bleeding.

The blood vessels are small and the blood supply paths are highly replaceable.

After the small arteries are electrocoagulated to stop the bleeding, this blood pathway is blocked. But don't worry, there is an extremely rich vascular system in the body. They are as densely packed as tree roots and spread throughout every corner of the body.

After this artery is blocked, other nearby arteries and smaller blood vessels will automatically take on new blood supply tasks.

It won't be long before a new blood route will be formed.

However, larger blood vessels cannot be easily coagulated or ligated to stop bleeding. Sometimes they must be repaired.

Because the larger blood vessels are equivalent to the main roots of the tree, cutting off one will reduce the number of blood vessels.

It is difficult to form new alternative blood routes in a short period of time.

This can lead to ischemic organs and tissues quickly becoming necrotic, or their functions being severely affected.

"Hey, there is a blood vessel here that seems to be narrowed and blocked."

Zhou Can's words attracted everyone's attention.

When everyone looked at the imaging screen, they could only see the scarlet intracranial tissue, and the white was the brain. No blocked blood vessels could be seen at all.

Wu Baihe kept staring at the screen.

He himself assisted Zhou Can in the surgery.

Some brain tissue needs to be pulled apart, which is basically done by him.

Wu Baihe tried his best, but still couldn't find the problematic blood vessel.

"Where?"

He could only lower his face and ask.

Don't think that these top chief physicians don't care about anything. What they care about most is their face. Especially the authority and status in their fields of expertise, which they take very seriously.

People who have studied a certain field for most of their lives must be proud of their achievements in this field.

We are all mortals with the naked eye. Zhou Can has decades less medical experience than Wu Baihe. However, Zhou Can discovered the problem, but Wu Baihe did not. His face must have been confused.

What's more, he also called some of his team members over.

There are doctors and nurses, and all of them respect and worship him like a god.

Now that he is at a disadvantage, what do his doctors and nurses think of him?

"Actually, I'm just guessing. Do you think there is a problem with this gray matter?"

Zhou Can removed part of the brain tissue so that Wu Baihe could have a wider field of view and see more clearly.

He said this just to save face for Wu Baihe.

Which doctor would guess whether a certain blood vessel is diseased when performing surgery?

Even if you want to guess, it is difficult to have this ability.

Wu Baihe stared at that gray matter carefully and quickly discovered the problem.

"Atrophy, there seems to be signs of degeneration... This is obviously a problem with the nutritional supply. From an anatomical analysis, the gray matter in this area has only one larger artery to provide blood supply, and two venous circuits..."

As he spoke, Wu Baihe's eyes suddenly lit up.

Yes, there must be something wrong with the arteries that supply blood to the gray matter in this area.

Only then did he realize that Zhou Can was trying to help him save face.

"Let's enlarge the patient's head examination film. I knew it would be more accurate to have a color Doppler ultrasound, but the CT film is just fine."

The biggest advantage of color ultrasound is that it can scan the blood flow in blood vessels in real time.

It is used to check whether the blood supply of blood vessels is smooth. Its accuracy and diagnostic significance are even better than many high-precision instruments.

Some young doctors blindly advocate the high definition and high accuracy of MRI.

In fact, this is an incorrect clinical diagnostic thinking.

Color ultrasound, B-ultrasound, and X-ray each have their own advantages. They can always be used and have not been eliminated, so they naturally have their merits.

A color ultrasound only costs more than 100 yuan for a patient. How much does an MRI cost?

It's at least a few hundred yuan, and the ones with higher accuracy can cost more than 2,000 yuan.

When it comes to checking whether blood vessels are open, apart from CT angiography, there should be no other examination method that is more intuitive than color ultrasound.

Wu Baihe stared at the CT film of the patient's head and examined it carefully.

"Enlarge this area a little more."

After zooming in and looking at it for a while, Wu Baihe was still a little undecided.

"The patient also had a head MRI done in another hospital, right? Take a look too."

He seemed very strict.

Even if the problem has been discovered after Zhou Can's reminder, he still wants to obtain examination data to support it. This is also the inertial thinking of most veteran doctors.

Just two words, safe.

Why do you say this?

Because many veteran doctors have been sued by patients and their families. When filing a lawsuit, you must present evidence!

When the doctor defended his case, no one believed him.

At this time, I provide the examination data and then tell the judge or the staff of the competent department that the basis for my treatment of the patient is based on the examination data. I strictly abide by the medical regulations.

Then the leaders saw that it was indeed the case.

As long as it is found that the doctor did not make any mistakes in diagnosis and treatment, the lawsuit will basically be won.

Surgery has strict indications.

Doctors cannot just perform surgery on patients directly because they think there is a problem with the artery that supplies blood to the gray matter in the brain.

That's definitely against the rules.

The problem must be discovered from the inspection data, and then the surgical solution can be decided.

The disease in this blood vessel was not discovered before the operation, so it was actually a missed diagnosis.

However, this is very common in clinical operations.

Some lesions are so hidden that even experienced doctors cannot easily detect them.
To be continued...