"Okay, Dr. Wang Yang, thank you for your comments. We will consider using it. The patient needs us to go for surgery, so we will leave first."

The director of neurosurgery took a look at the time and found that it had been delayed for nearly ten minutes.

Director Ding glanced at Wang Yang and felt that he seemed to be very interested in this patient.

"Do you want to go to the operating room with me and be my assistant?"

Director Ding said.

Wang Yang was a little disappointed, after all, there were still many things that had not been raised. Although Wang Yang had not seen this situation in the literature, combined with the treatment plan for stroke patients I had read before, the treatment of stroke patients was actually not that scary. Even compared with some diseases, the treatment of stroke patients was extremely simple.

But Wang Yang was urged to leave before he proposed a treatment plan, which made Wang Yang feel like he was hitting the cotton with one punch.

Hearing Director Ding's words, he just nodded.

Due to the surgical and interventional surgery in this operating room, a hybrid operating room was chosen.

The surgical plan was also discussed by them, first carrying out craniotomy and hematoma removal, debridement and suture, arterial ligation, and then undergoing interventional surgery to remove the thrombus.

This plan also takes into account the radiation problem of interventional surgery. No one can guarantee that there will be no radiation in the operating room after the interventional surgery is over. As they grow older, and these doctors have seen too many separations of life and death, they value their bodies more.

However, when Zhao Ming, director of the Vascular Department, was about to let the director of the neurosurgery department take the stage for craniotomy, he was stopped by Wang Yang.

"You are too slow, and the efficiency of craniotomy is too low to clean up the hematoma. Over time, the patient is more likely to have heart failure."

Wang Yangdao.

This time, Director Ding made an opinion, but Director Ding didn't stop him. In Director Ding's opinion, the surgical plan had been decided, but Wang Yang suddenly raised an objection. Isn't this slap them, the old guys in the face?

"Doctor Wang, remember your current identity. You are just an assistant, not a surgeon."

The neurosurgeon was not well-behaved.

“Even if I am just an assistant, I have the right to express my own opinions, right?

Wang Yang frowned.

“Can your opinion save people?

Can you go on stage to surgery?”

The neurosurgeon shouted dissatisfiedly that he was the most annoying to such a low-level doctor who was ignorant of the world.

If Wang Yang said something about it before, it makes some sense. After all, the surgical plan has not been released yet, everyone can give their opinions and finally take the safest method of surgery.

But now the surgical plan has been decided, and Wang Yang is simply questioning the ability of their group of surgeons.

When Director Ding saw Director Yao of the Department of Neurosurgery lose his temper, he quickly pulled Wang Yang over and apologized to Director Yao: "Old Yao, I'm sorry, Dr. Xiao Wang just came to Union Health and I don't understand some things, so I'll understand."

"It's not me, Lao Ding, why did you hire such a doctor?"

Director Yao snorted coldly and went to the operating table with his body on his back.

Wang Yang wanted to say something, but Director Ding grabbed it and instructed him: "Xiao Wang, you are watching from the side. I know you must have some unique insights. When the operation is over, you will tell me alone."

Seeing Director Ding's appearance as an elder, Wang Yang nodded in disappointment, stood aside and began to watch the stage.

The patient's blood pressure is 180/110 and his heart rate is 146 beats/min. Director Yao started to inject Kajinning and dexamethasone when he came on stage. When he opened the intravenous approach, Wang Yang opened his mouth and frowned.

The current situation of the patient, due to the long discussion of the surgical plan, there has been a brain hernia in the patient's brain, but Director Yao has opened a second-way venous approach without brain hernia, although there is no major problem with this approach.

However, in Wang Yang's view, the best choice is to use a three-way venous approach. The second-way venous approach will cause the colloidal fluid to not be fully absorbed, and blood pressure will become unstable during the operation.

"Bone-opening forceps."

Director Yao and the general surgeon cooperated on the stage and were planning the shape of the skull. The skull cannot be opened casually. If the patient's brain is opened at any time, it is possible that the patient's brain will flow out and die on the spot.

The surgeon should consider not only the success rate of the operation, but also the patient's recovery after surgery.

"Let's use the large bone flap craniotomy."

Doctor General UAI suggested.

Large bone flap craniotomy is a necessary surgical technique for craniotomy doctors in my country. With the continuous communication and improvement in recent years, large bone flap craniotomy has become a necessary surgical procedure for cerebral hemorrhage surgery.

Human cerebral hemorrhage will lead to an increase in the brain volume, just like a balloon. If it is not released, it will lead to an increase in intracranial pressure. The formation of brain hernia is born when the intracranial pressure reaches a certain level.

Large bone flap craniotomy is also called universal craniotomy. When encountering surgery that cannot be grasped, it is correct to use large bone flap craniotomy.

Wang Yang did not know this craniotomy surgery because the first cerebral hemorrhage surgery was performed. Wang Yang had thalamic hemorrhage and endoscopic assistance, which was a small wound.

But I have never eaten pork and I have seen pigs running. Director Yao of the neurosurgery department still has a good understanding of craniotomy.

Generally speaking, ordinary craniotomists use trapezoidal to enter layer by layer, which can reach their destination bit by bit along the knowledge in the textbook.

Director Yao's craniotomy was different, and he was a little deviated. This approach was to avoid special circumstances on the main road. It is impossible to determine the intracranial condition by CT and MRI alone. If it is a little bit biased, further operation can be performed when the surgical field needs to be expanded.

The patient was lying on the bed, and Director Yao's scalpel deviated from the starting point about 45° from the lateral position, followed the stork bow up to 1.5cm in front of the tragus, and formed a shape similar to a question mark along the midpoint of the marked sagittal line.

Open the loose tissue under the cape-shaped aponeurosis, open the skin flap, and separate the temporal muscle and periosteal flap. Director Yao's eyes never left the skin edge, staring at him tightly.

Because this separation is similar to the peritoneal separation, and due to the particularity of the temporal muscle, Wang Yang cannot cut through the flap range of this layer and can only be close to the edge of the skin. Since the temporal muscle is attached to the temporal periosteum, it is also a technical activity to separate the periosteum.

It is necessary to prevent blood loss of temporal muscles from being exposed and bleeding from superficial artery branches without being ligated and cut off in time.

This is different from the craniotomy surgery before Wang Yang. Director Yao's craniotomy surgery is the real surgical craniotomy surgery.
Chapter completed!