nucmednet Chapter 318 When to prepare for surgery
Chapter 318 When to prepare for surgery
The next day, the sun shone into the conference room of the City Central Hospital, creating a solemn and dignified atmosphere.
Jiang Chengyu sat upright, his eyes firm, and went straight to the point: "Mr. Song Wenxuan's second surgery will be scheduled for 8 o'clock the day after tomorrow.
Since the last coronary bypass surgery was completed, the focus this time is on the treatment of arrhythmias and the repair and adjustment of heart function."
“Before the operation, the electrophysiological status of the heart needs to be evaluated again in detail, and multi-lead electrocardiogram monitoring and electrophysiological examination of the heart are used to accurately locate all abnormal pacemakers and conduction block areas, and clearly mark the range and depth.
Prepare high-energy and low-energy radiofrequency ablators, and flexibly switch them according to the actual situation during the operation to ensure that abnormal electrical activity can be effectively eliminated while protecting myocardial tissue to the greatest extent. "
“At the beginning of the operation, an intracardiac ultrasound probe was used to comprehensively explore the internal structure and blood flow status of the heart, confirm the patency of the previous bypass blood vessels and the degree of improvement in myocardial blood supply.
When treating arrhythmias, for abnormal pacemakers that are superficial and easy to operate, ordinary radiofrequency ablation catheters are used.
Ablation is performed with precise techniques and stable power output, and changes in myocardial potential are continuously monitored during the process. Once abnormal fluctuations occur, the operation is immediately stopped and adjusted.”
"For abnormal areas that are located deeper and close to important conduction bundles, a three-dimensional electromagnetic navigation radiofrequency ablation system is used. Under its guidance, a special cold saline perfusion ablation catheter is delivered to the designated location, using low-temperature saline to lower the myocardial temperature during ablation and reduce thermal damage.
After each ablation, myocardial protective fluid is immediately injected to promote the recovery of myocardial cells.”
"During the operation, we closely monitor cardiac function indicators. If cardiac function declines, we prepare an intra-aortic balloon counterpulsation device to assist at any time and regulate the blood perfusion and load of the heart.
At the same time, we work closely with the anesthesiologist to accurately adjust the depth of anesthesia and drug dosage according to changes in vital signs such as blood pressure, heart rate, and blood oxygen to maintain a stable circulation."
"After the operation, a dedicated person was arranged for continuous ECG monitoring, and emergency equipment such as defibrillators were prepared to prevent sudden malignant arrhythmias.
Use vasoactive drugs to maintain stable blood pressure, and adjust the dosage and duration of medication according to changes in myocardial enzyme spectrum, troponin and other indicators.
In addition, an early rehabilitation plan should be developed to gradually transition from passive limb movement to active rehabilitation training to promote the full recovery of cardiac function."
After thinking for a moment, Dr. Liu said, "Dr. Jiang's plan is very clear. I recommend the preventive use of antiarrhythmic drugs before surgery to stabilize the myocardial cell membrane potential and reduce the risk during surgery.
After the operation, we used a combination of traditional Chinese and Western medicine rehabilitation methods, using Chinese herbal medicine prescriptions to improve myocardial microcirculation and help repair heart function. "
The team leader had a serious expression and a firm tone: "Professor Jiang's plan is feasible, and I fully agree with it.
Before the operation, we organize the team to conduct emergency drills, especially to deal with severe arrhythmias and heart failure during the operation.
During the operation, we strictly controlled the quality of each link, and strengthened monitoring and rehabilitation guidance after the operation to ensure the success of the operation, leaving no health risks to the patient, and allowing the elderly to recover and be discharged smoothly. "
Jiang Chengyu slowly stood up, looked around carefully, and asked in a calm and gentle tone:
"Does anyone have any questions or discussions about this surgery?"
Everyone in the conference room shook their heads in response, and the sound of "no more" echoed in the room.
Jiang Chengyu nodded slightly and said seriously: "In the next few days, everyone must strictly follow the established preparation process and conduct detailed inspections of various precautions.
We must pay close attention to the patient's vital signs without relaxing for a moment, and ensure from all aspects that the second operation can proceed smoothly without any unexpected situations or complications.
"Okay, let's adjourn the meeting!" After that, he began to organize the materials in front of him, ready to devote himself to the intensive preoperative preparations.
In the somewhat cold VIP8013 ward on the eighth floor of the hospital, the atmosphere was so quiet that it was a bit depressing.
Song Wenxuan leaned steadily on the soft mattress, his face slightly pale, with a few strands of hair scattered messily on his forehead.
All around, various advanced instruments and equipment were flashing cold lights. Those densely packed lines and jumping numbers seemed like a countdown to the fickle fate.
Jiang Chengyu walked in front with steady and powerful steps. His eyes showed concentration and determination. His deep gaze seemed to be able to penetrate all appearances and reach the core of things.
Doctor Liu followed closely behind, his steps slightly hurried, his white coat swaying gently in the wind, and in his hand he tightly held the medical record folder, which contained detailed records of Song Wenxuan's medical history and every subtle physical change.
The team leader looked solemn, his brows slightly furrowed, his eyes full of attention to the upcoming task and a hint of barely perceptible worry.
When they pushed open the spotless yet seemingly heavy door of the ward, the first person who came into view was Song Shijie, who was sitting beside the bed and answering the phone.
Song Shijie's voice was gentle and kind, carrying deep concern and longing for his family.
"Mom, we've been away from home these days. Are you okay?" There was a hint of guilt in his eyes. Although he tried to maintain a relaxed tone on the phone, one could still sense his inner worry and uneasiness.
"Okay, okay, has Xiaoyue given birth?" A kind and anxious voice came from the other end of the phone, which was full of anticipation and joy for the new life.
"Yes, mom. She gave birth not long after I arrived at the hospital that day." A faint smile finally appeared on Song Shijie's face, as if the birth of a new life was a rare ray of hope in this difficult moment.
"Hey, so fast?" The voice was full of surprise and unexpectedness.
"You've been looking forward to it every day. Now you can finally feel relieved!"
Song Shijie's smile became more and more obvious. He raised his head slightly and looked at the blue sky outside the window, as if imagining the excitement and happiness of his old mother at home when she heard the news.
"Ajie, is it a boy or a girl?" The voice from the other end of the phone came again, full of curiosity and excitement.
"It's a big fat boy." Song Shijie's voice was filled with pride and joy that was hard to conceal, as if the arrival of this new life could bring endless hope and strength to the whole family.
"Oh my, that's great, haha. Ajie, when are you coming home? I can't wait to see my great-grandson!"
The voice was almost drowned out by joy, and the strong family affection could be clearly felt through the phone.
"Mom, the little brat is too noisy. I'm worried that he'll give you a headache when I get home! Besides, my sixth uncle has to undergo another operation in a few days. Don't worry, wait until I've made the arrangements, and then we'll go back together."
A trace of worry flashed in Song Shijie's eyes. He sighed softly and his gaze returned to Song Wenxuan, who was lying on the hospital bed with a calm expression.
At this time, Song Shijie saw Jiang Chengyu approaching the bed. Jiang Chengyu's slender and powerful fingers operated the instrument skillfully, carefully checking the data. His eyes were focused and calm, and he did not miss any tiny changes.
At the same time, he held the medical record in his other hand, recording every key value quickly and accurately. The rustling sound of writing was particularly clear in the quiet ward.
Doctor Liu stood aside, leaning forward slightly, his eyes fixed on the instrument screen, and from time to time he exchanged glances with Jiang Chengyu, his eyes full of discussion and communication about the patient's condition.
When Jiang Chengyu saw the data that Dr. Liu pointed out, he expressed his concern that something might go wrong.
Then Jiang Chengyu shook his head calmly: "It's okay, it's not a big problem. Pay attention to it these days. If it's still the same during the operation, we will strengthen the drug measures."
The team leader paced slowly in the ward, observing the environment and facilities, as if thinking about every detail arrangement before and after the operation.
Song Shijie said hurriedly: "Mom won't tell you anymore. Cheng Yu has come to see Uncle Six and is preparing for another surgery! I'll call you later."
After saying this, he hurriedly hung up the phone. He stood up, looking at Jiang Chengyu and others with a hint of expectation and uneasiness in his eyes, waiting for their further explanation on matters related to the operation.
After Song Shijie hurriedly hung up the phone, he gently placed the phone on the cabinet beside him. His eyes quickly moved between Jiang Chengyu and his sixth uncle Song Wenxuan on the hospital bed.
At this moment, Jiang Chengyu had a smile on his face, full of concern and professional confidence. He leaned slightly closer to Song Wenxuan.
The voice was gentle and clear, "Old man, you seem to be recovering well these days. We are going to perform another operation. What do you think? Do you have any concerns?"
Song Wenxuan's originally slightly tired face seemed to be injected with a bit of vitality the moment he saw Jiang Chengyu. The corners of his mouth slightly raised, revealing a faint smile.
His eyes showed trust and reliance on Jiang Chengyu, and he said slowly: "No, I believe you, Professor Jiang, and I will follow your arrangements."
Jiang Chengyu gently patted Song Wenxuan's shoulder. The action was gentle but firm, as if conveying some kind of power. He comforted him, "You are right to think so. I will definitely let you go home healthy after being discharged from the hospital."
There was a gleam of determination in his eyes, as if in his world, as long as he made up his mind, there were no medical difficulties that could not be overcome.
Song Shijie heard the conversation between the two people from the side, and his heart was full of tension and expectation. He took a small step forward, approached Jiang Chengyu, and asked with a hint of urgency in his tone: "Chengyu, when are you going to have the surgery?"
Jiang Chengyu stood up, turned around and faced Song Shijie. His deep eyes revealed a reassuring calmness, and he said slowly:
"Uncle Song, the old man's various indicators have recovered very well. If there are no other changes in three days, we will start the completion of the latter part of the surgery in three days."
As he spoke, he raised his hands and clasped his arms habitually. His sharp eyes were focused and calm, as if he had already begun rehearsing the surgical procedures three days later in his mind. Every detail and every possible emergency situation was within his thinking, and he would not allow for the slightest mistake.