I Can See Health

   Chapter 453 Accidents in Surgery

   When Lu Chen returned to the first ward of the Department of Respiratory Medicine, it was not yet ten o'clock in the morning.

   Seeing Lu Chen coming back, Fan Yujing was also slightly taken aback.

   "Lu Chen, didn't you go to the Cardiology Department's catheterization room for surgery today? Didn't you do it?"

   "Mr. Fan, I'm done." Lu Chen smiled.

  Fan Yujing looked up at the clock on the wall, it was only ten o'clock, "Are you so fast? What kind of surgery?"

   "Electrophysiological surgery, ICD puncture implantation." Lu Chen said softly.

   Fan Yujing heard the words, and her eyes showed a hint of doubt.

   She is also very knowledgeable about cardiology surgery. Can ICD surgery be done so quickly?

impossible!

   She glanced at Lu Chen suspiciously again, could he be lying?

  Lu Chen naturally didn't know what Fan Yujing was thinking. He asked, "Teacher, when will your bronchoscopy begin?"

   "About half past ten." Fan Yujing said, "There is still half an hour."

   "Can I go take a look?" Lu Chen asked.

   "You can go as long as you have written all the illnesses for today." Fan Yujing frowned.

   "Okay!" Lu Chen immediately turned on the computer and started writing the course of the disease.

  Fan Yujing glanced at Lu Chen and ignored it.

   She was still suspicious that Lu Chen went to the cardiologist for surgery, just under the guise of asking for leave.

  …

  10:30.

  Lu Chen typed the last word on the computer.

   "Phew! I've finally finished writing!" A smile appeared at the corner of Lu Chen's mouth, and he was ready to observe the interventional bronchoscopy.

   The endobronchial operating room at this time.

  Fan Yujing is communicating the risk of interventional surgery to the patient again.

   "Auntie, are you aware of these risks? It may lead to bleeding, infection, and even shock."

   "Don't worry, I get it." The patient nodded slightly, "Your Doctor Lu, has told me many times, and I have listened to it four or five times, and my ears are all cocooned!"

   "That's fine." Fan Yujing said.

   Doctors should not be afraid of trouble, especially when communicating with patients.

   More communication is an important way to guarantee yourself.

   At this time, Lu Chen quietly pushed the door and entered.

  Fan Yujing looked back.

   "Did you finish writing the course record?"

   "Well, I'm done." Lu Chen nodded and walked to Fan Yujing's side.

   During his internship, Lu Chen had seen fiberoptic bronchoscopy.

   But at the time, he was just ignorant. No matter how many operations he watched, he couldn’t see why.

   However, Lu Chen has always been interested in this kind of interventional surgery.

   Taking advantage of today's opportunity, he has to observe and learn.

   "Lu Chen, you're going to fight by the side, get me a bottle of anesthesia first."

"it is good."

  This fiberoptic bronchoscope is different from the electrophysiological interventional surgery just now.

  Lu Chen was the first assistant in the operation just now, and he almost completed the entire operation alone.

   And now, he has become a little valet handing things.

   The role has changed so much that Lu Chen couldn't help shaking his head slightly.

  …

   At this time, Fan Yujing had finished the preoperative anesthesia preparation and started the operation.

  The patient lies supine, Fan Yujing stands on the patient's head, holds the control part of the mirror body with his left hand, and controls the adjustment button with his thumb.

   With the right hand, the lens is sent into the nasal cavity to the larynx or through the perforated tooth pad of the oral cavity, along the posterior pharyngeal wall to the larynx.

   "Generally, when the depth of the lens is about 15cm, the epiglottis can be seen. If the epiglottis cannot be seen, do not blindly insert it forward, otherwise it will be easily inserted into the esophagus by mistake."

   Fan Yujing said to Lu Chen while doing it.

   "Yes." Lu Chen nodded, watching Fan Yujing's operations carefully.

   At this time, Fan Yujing said to the patient again: "Take a calm breath."

   The patient obeyed Fan Yujing's words and took a calm breath.

   And while the glottis opened, Fan Yujing quickly inserted the mirror end into the trachea from the back of the glottis.

   "Add a small amount of anesthetic!" Fan Yujing said solemnly

   "Received." Lu Chen immediately understood and added a small amount of medicine into his trachea.

  Fan Yujing adjusted the distal end of the scope to the natural beauty, aiming at the tube, and checked the shape of the trachea, mucosal color, activity, etc. from top to bottom.

  Of course, the most important thing is to pay attention to the "stenosis" of the patient!

   On the chest CT, Lu Chen and Fan Yujing both saw a very small stenosis at the opening of the bronchus.

  As Fan Yujing continued to go deeper, Lu Chen stood aside, looking at the operation screen, staring at it without blinking, for fear of missing any screen.

   At this moment, Fan Yujing made a sound.

"found it!"

  Lu Chen hurriedly looked at it, and sure enough, there was an oval-shaped foreign object within his field of vision!

  Its color and size are completely inconsistent with the surrounding bronchial tissue.

   Is this "foreign body" that causes the patient to keep coughing and expectorating sputum?

   Airway foreign bodies, common in the elderly and children.

  Loose teeth in elderly patients may fall into the airway during sleep at night, eating too fast or laughing while eating can also cause food to choke into the airway.

  Children are highly curious and inhale foreign objects into the airway... This is related to the insufficiency of laryngeal protection and weak cough reflex in the elderly and children.

   At this point, Fan Yujing began to try to take it out.

   Immediately, she frowned: "It's not easy to take it out, the foreign body and bronchial tissue are wrapped in granulation tissue!"

A large foreign body in the airway can cause acute airway obstruction, which is life-threatening. In children, foreign bodies in the airway are the leading cause of death from asphyxiation in children.

  Small airway foreign bodies can irritate the tracheal wall and cause coughing, wheezing discomfort, and secondary infection can lead to fever and difficulty breathing.

  The edges of the airway are not only neat, but sharp foreign bodies in the airway can also lead to the puncture of the capillaries of the tracheal mucosa or the surrounding large blood vessels, causing hemoptysis!

   Fan Yujing was quite nervous.

   I thought it was just a small foreign object, just take it out.

  I didn't expect the foreign body to stay in the bronchus for a long time, and granulation tissue has grown. It is not easy to remove it smoothly.

   "I will use electrodes to cauterize this piece of tissue before the foreign body can be removed!" Fan Yujing said.

  Lu Chen understood, put on gloves, and helped Fan Yujing get the electrodes.

  …

   on the surgery screen.

  Lu Chen saw Fan Yujing's electrodes deep inside.

   After the electrode is energized, it is in close contact with the bronchial tissue, and the tissue is cauterized.

   As the electrocautery continued, the "foreign body" was obviously loosened.

  Fan Yujing's face was overjoyed, it worked!

   As long as the foreign body in the patient's bronchi is removed, her persistent coughing and coughing symptoms should be resolved.

   "Lu Chen, look good." Fan Yujing slowly took out the "foreign object" and prepared to remove the electrode.

   But at this moment, Lu Chen felt a bright red blood appear in the field of vision of the surgery screen!

   In an instant, this smear of blood infected the entire surgical area.

   "Bleeding!" Lu Chen was shocked, "And it's bleeding!"

   The smile on Fan Yujing's face has disappeared.

   (end of this chapter)