nucmednet Chapter 313 Is there any difficulty for Mr. Song?
Chapter 313 Is there any difficulty for Mr. Song?
Kuncheng Central Hospital is located on a busy street. The morning sunlight shines on the floors of the hospital and refracts into the conference room through the windows.
The members of the surgical team sat together with solemn expressions, and Dr. Liu and the team leader looked at each other.
Doctor Liu spoke first, his voice steady and professional: "This time, under the lead of Professor Jiang, we have successfully completed the initial dredging of the coronary arteries and partial vascular reconstruction of Song Wenxuan's heart surgery.
Specifically, we used advanced intravascular ultrasound technology to accurately locate multiple stenotic lesions in the coronary arteries, and through balloon angioplasty, we effectively dilated the stenotic sites of major blood vessels such as the anterior descending branch and circumflex branch, thereby improving myocardial blood perfusion.
At the same time, drug-eluting stents have been implanted in some blood vessel segments with more serious lesions to prevent restenosis of the blood vessels. About half of the surgical procedures have been completed.
Through continuous monitoring of Song Wenxuan's various cardiac function indicators over the past few days, including dynamic observation of myocardial enzyme spectrum, brain natriuretic peptide level and cardiac echocardiography,
It was found that his heart function was gradually recovering, myocardial damage was effectively controlled, and other body functions were also improving positively.
Judging from the current recovery situation, the second stage of surgery will be carried out in three weeks to fine-tune the remaining vascular lesions and further optimize the electrophysiological function of the myocardium to complete the entire heart repair and functional reconstruction work. In theory, there will not be too many obstacles. "
Doctor Liu sighed slightly, with a hint of worry in his tone: "However, Professor Jiang has now fallen into a deep sleep without any signs, which undoubtedly brings great uncertainty to the subsequent surgical plan.
The next part involves more complex key operations such as repairing the cardiac conduction system and improving myocardial microcirculation. It is a difficult problem that we need to solve urgently, which experienced expert should be in charge of the operation. "
The team leader frowned and said seriously, “This special situation must be explained in detail to President Song in a timely manner.
If Professor Jiang remains in a coma for a long time, we must quickly activate the emergency plan, contact experts in the field of cardiac surgery at home and abroad as soon as possible to come for consultation and take over subsequent operations.
After all, the subsequent steps play a decisive role in the ultimate success of the operation.
For example, repairing the cardiac conduction system requires precise operation at the microscopic level, which requires precise connection or repair of damaged cardiac conduction bundles.
Even the slightest deviation may lead to serious complications such as cardiac arrhythmia;
To improve myocardial microcirculation, a variety of advanced technologies are needed, such as laser myocardial revascularization or cytokine therapy.
To promote the regeneration and functional recovery of myocardial capillaries, these operations are extremely complex and delicate, and are the most critical and challenging part of the entire operation."
For a moment, everyone in the conference room was talking about it. "Yeah, what should we do? We were mainly cooperating with Professor Jiang in the operation, and it is beyond our professional ability to perform such a difficult part."
"Professor Jiang is young and in good health. How could he suddenly fall into such a coma? I haven't heard of any underlying diseases before."
"I'm not sure, but the female police officer said that he had seen several similar coma cases before, and each time the patient woke up naturally after four or five days."
Doctor Liu tapped the table lightly, signaling everyone to be quiet, and said, "Let's end today's meeting here.
Everyone must continue to pay close attention to changes in Song Wenxuan's heart condition. Not only should we regularly monitor routine indicators such as electrocardiogram and dynamic blood pressure, but we should also pay special attention to changes in the activity of myocardial cells and the hemodynamic parameters inside the heart.
Make sure that when the next surgery is performed three weeks later, his heart function and overall physical condition can withstand the subsequent complex surgery."
The medical staff responded in unison: "Okay, Director Liu."
Doctor Liu nodded: "Okay, let's adjourn the meeting. You two follow me to Professor Jiang's ward and help him with some rehabilitation physical therapy.
He has been sleeping for three days. Nutritional support alone is far from enough. Long-term lack of physical activity will lead to a series of complications such as muscle atrophy and joint stiffness.
Even if they wake up, it will seriously affect their body function recovery and they may even become disabled. "
After that, everyone dispersed, and the two medical staff who were called followed closely behind, striding towards the elevator.
As soon as they reached the elevator door, family members, patients, and hospital staff came out one after another. After the three of them came out, they stepped into the elevator and went directly to the VIP ward.
After getting out of the elevator, he went straight to Jiang Chengyu's ward, and when he opened the door, he saw Shen Rou holding a bowl of carefully prepared liquid food and patiently feeding Jiang Chengyu.
In Jiang Chengyu's outstretched arms on the hospital bed lay the little stinky baby, the little fellow closed his eyes and made the soft moaning sounds that only a baby can make;
He moved his little mouth, as if there were countless delicious foods tempting him in his dream and he was "enjoying" them non-stop.
Song Shijie stood up quickly, and asked anxiously and expectantly, "Doctor Liu, look at this... is there really no other way?"
Doctor Liu shook his head helplessly and explained in detail: "Mr. Song, Professor Jiang is in a coma. We have used brain magnetic resonance imaging,
EEG monitoring, blood biochemistry and neuroelectrophysiological examinations, and other advanced testing methods.
A comprehensive and in-depth assessment of his nervous system, cardiovascular system, and endocrine system revealed no obvious organic lesions or signs of poisoning.
Based on past experience, this spontaneous coma may be related to his own unique abnormal brain wave rhythm or neurotransmitter imbalance, but the specific cause is still unclear.
All we can do now is maintain his basic vital signs and body functions.
Or you can contact Dr. Mu, who has worked very well with Professor Jiang before. He may have unique insights and rich experience in dealing with such difficult conditions and subsequent surgeries.
And as I said before, Song Wenxuan's recovery from surgery is going smoothly. He will be able to undergo a second surgery in about three weeks to complete the remaining part. Based on the current medical evaluation, the probability of success is high."
When Song Shijie heard that he was asked to find his son, his brows slightly frowned, a complex emotion flashed in his eyes, and he fell into deep thought. Seeing this, Dr. Liu asked softly: "Is there any difficulty, Mr. Song?"
Song Shijie's eyes showed a hint of hesitation and entanglement, and he slowly responded: "Doctor Liu, please give me some time to think about it carefully."
Doctor Liu nodded slightly, then quickly walked to the bedside, and said to Shen Rou with a serious and focused expression: "Madam,
Professor Jiang has been sleeping for too long. When the human body lacks independent activity for a long time, the muscles will not receive effective stimulation from nerve signals, which will lead to an imbalance in the metabolism of muscle fibers.
Specifically, protein synthesis in muscles will gradually decrease, while catabolism will continue to increase. If this continues for a long time, muscle tissue will inevitably atrophy and degenerate.
If no timely intervention is made, once he wakes up in two days, he will face extremely serious motor dysfunction, which may even affect his cardiopulmonary function and other body functions, leading to a series of complications with disastrous consequences.
So we now have to give him some targeted rehabilitation activities to maintain the basic muscle function and activity as much as possible."
After saying that, Shen Rou gently put down the small bowl in her hand and gently reached out to lift the quilt.
She carefully picked up the stinky baby, her eyes full of love and concern, then turned her head to Song Shijie.
Song Shijie hurried forward, gently protected Shen Rou and Chou Bao, stood aside and watched Dr. Liu and the others quietly, his eyes revealing a hint of worry and expectation.
Dr. Liu and two medical staff began to perform basic physical fitness exercises for Jiang Chengyu.
First, they performed passive movements on Jiang Chengyu's limb joints, starting from the shoulder. The medical staff held Jiang Chengyu's upper arm firmly with both hands.
Perform flexion, extension, abduction, and adduction slowly and with moderate force, repeating each movement several times.
At the same time, carefully observe Jiang Chengyu's expression and muscle reactions to ensure that the strength is controlled within a range that can effectively move the joints without causing damage to them.
This series of movements helps maintain the mobility of the shoulder joint and prevent joint adhesion and muscle contracture. Then, they turned their attention to Jiang Chengyu's elbow and wrist.
The medical staff held the patient's forearm with one hand and held the palm with the other hand, gently flexing and extending the elbow and wrist joints.
It is like carefully adjusting a precision instrument, so that the muscles and ligaments around the joints can be properly stretched and relaxed.
During the activity, Dr. Liu would occasionally use his fingers to gently press the muscle groups around the joints to check the changes in muscle tension and elasticity, and use his rich experience to judge whether the muscle condition was normal.
Afterwards, they performed rehabilitation exercises on Jiang Chengyu's lower limbs. They first gently lifted Jiang Chengyu's thighs, and performed internal rotation, external rotation, and flexion and extension movements with the hip joint as the axis. The movements were slow and rhythmic, aiming to maintain the flexibility and stability of the hip joint.
For the knee joint, medical staff hold the calf with both hands and perform flexion and extension exercises regularly, while paying attention to whether there are abnormal sounds or jamming inside the knee joint, which may indicate potential problems with the articular cartilage or meniscus.
Finally, when it comes to the ankle joint, they carefully dorsiflex and plantar flex the ankle joint to stimulate the contraction and relaxation of the calf muscles, promote blood circulation in the lower limbs, and prevent the formation of deep vein thrombosis in the lower limbs.
During the entire activity, Dr. Liu reminded medical staff from time to time to pay attention to changes in Jiang Chengyu's vital signs, such as whether there were abnormal fluctuations in heart rate, blood pressure and other indicators.
Once any abnormal situation is found, they will immediately stop the activity and take appropriate first aid measures.
After a period of meticulous rehabilitation activities, Dr. Liu breathed a sigh of relief. Although Jiang Chengyu was still in a coma, they had done their best to lay the foundation for maintaining and recovering his body functions.