Chen Tianlin saw that Director Jiang had done the second disinfection before the operation, and estimated the patient's skull according to the surgical site he had drawn, and immediately picked up the craniotomy instrument and began to operate on the patient.

Perhaps because of the habit of teaching students in his previous life, Chen Tianlin introduced to the observing doctors while performing the operation: "We can usually treat a normal aneurysm in three ways. ”

"First: middle cerebral aneurysm clipping, which is suitable for mild conditions after the rupture of the middle cerebral aneurysm, and can be operated on within 3 days. ”

If the "second" middle cerebral aneurysm is more severe after the aneurysm ruptures, then the patient's condition must be stabilized or the physical condition has improved significantly before surgery. ”

"Thirdly, if a life-threatening intracranial hematoma develops after a ruptured middle cerebral aneurysm like the patient's current one, surgery must be performed immediately. ”

"However, during this period, it is first necessary to determine whether the patient has severe systemic diseases, such as heart disease, diabetes, kidney disease, lung disease, etc., and the patient's aneurysm is ruptured, complicated by severe cerebral vasospasm and cerebral edema, and the operation can be postponed. ”

While speaking, Chen Tianlin carefully cut the patient's dura mater, and introduced: "We must be very cautious when cutting the patient's dura mater, if the aneurysm is adherent to the dura mater, it is easy to tear and bleed when it is opened, and there are three main ways to expose the aneurysm in the brain. ”

"First: the medial pathway, which begins at the base of the lateral fissure and gradually separates laterally, is suitable for those whose aneurysms are located in the main trunk of the middle cerebral artery or in its bifurcation. ”

"The advantage of this approach is that it facilitates the control of the proximal segment of the middle cerebral artery to prevent and control aneurysm rupture and hemorrhage. The disadvantage is that the frontal lobe is lifted before the lateral fissure is opened, which is more severe in the traction of the brain, and when the middle cerebral artery M1 segment is separated, it is easy to injure the branches that emanate from this segment, such as the anterior temporal artery and the lenticular artery. ”

"Second: the lateral pathway, starting from the lateral side of the lateral fissure, cutting the arachnoid on the frontal side of the superficial lateral fissure, gradually dividing the lateral fissure medially, finding the branches of the middle cerebral artery, and separating them in reverse until the aneurysm is revealed. ”

"The advantage of this approach is that the lateral fissure is open, less traction to the brain, and the opening of the lateral fissure to release cerebrospinal fluid can make the brain retract, and the disadvantage is that the proximal segment of the aneurysm-carrying artery is not visible first, once the aneurysm ruptures it is not easy to control the bleeding, such as the rupture of the aneurysm, you can first use an aneurysm clamp to clamp the aneurysm body on the proximal side of the rupture, and then continue to separate the aneurysm neck after temporarily stopping the bleeding. ”

"Third: through the superior temporal gyrus route, this surgical method is suitable for the patient's current symptoms, incision of the superior temporal gyrus cortex, into the hematoma, to remove the hematoma, but in this process, it is necessary to pay attention to leaving a small amount of blood clots that are tightly adhered to the aneurysm and do not need to be removed, so as not to cause rupture. ”

"The disadvantage of this approach is that it does not first reveal the proximal segment of the aneurysm-carrying artery, and it is also difficult to find the aneurysm in the hematoma, the advantage is that the removal of the hematoma helps the collapse of the brain and avoids the step of separating the cerebral stern and the lateral fissure, but eventually it is necessary to enter the lateral fissure to fully expose the aneurysm and aneurysm neck, if the hematoma is in the frontal lobe, the frontal lobe can also be incised. ”

Time passed by minute by second, and Chen Tianlin at this time was like a medical professor with very rich clinical experience, focusing on the operation while imparting surgical knowledge to the observing doctors.

In the observation room outside the glass wall, all the doctors who observed the operation carefully watched the details of the operation while recording the precautions for the operation introduced by Chen Tianlin.

As night fell, the operating room was still brightly lit, and the brothers of the Yao family, standing in the observation room, looked at Chen Tianlin, who was focusing on the operation, and prayed in their hearts that the operation would be successful.

At more than eleven o'clock in the night, a operation that lasted for more than nine hours was finally successfully completed, all the way, coupled with a long period of surgery, Chen Tianlin felt a feeling of physical exhaustion for the first time, and he couldn't help but think of what the medical auxiliary system said at the beginning, an excellent doctor first needs a strong body, so as to be able to provide enough physical strength for a long operation.

After making sure that the patient's physical characteristics were basically stable, Chen Tianlin dragged his tired body out of the operating room, Yao Qingdong saw Chen Tianlin, hurriedly stepped forward, and asked Chen Tianlin anxiously: "Xiao Chen, is my father's operation successful?"

When Chen Tianlin heard Yao Qingdong's inquiry, he saw the worried expressions of the Yao brothers and sisters, and replied: "Mayor Yao! The operation was very successful, and the patient's life has been saved. ”

"As long as the postoperative care can be done properly, the patient's condition can be stabilized, and now Director Jiang is conducting the postoperative examination for the patient in the operating room, and when the examination is over, you will be able to see the patient. ”

For the Yao brothers, the existence of the old man is related to their future development, and when the Yao brothers learned the news that the old man had been successfully rescued, their faces showed excited expressions.

Yao Qingbei held Chen Tianlin's hand tightly, shook it vigorously, and thanked Chen Tianlin: "Doctor Chen, thank you for saving my dad!"

It took more than six hours to set off from Jiangcheng to Yanjing, plus the operation consumed another nine hours, Chen Tianlin did not eat for a full fifteen hours, and the long-term operation consumed a lot of Chen Tianlin's physical strength, making Chen Tianlin feel very tired.

Chen Tianlin let Yao Qingbei keep shaking his arm, and said to Yao Qingdong with a little tiredness: "Mayor Yao! The operation has been completed, and I have already explained to Director Jiang the specific circumstances that need to be paid attention to after the operation. ”

When Yao Qingdong heard Chen Tianlin's words, he obviously felt Chen Tianlin's tiredness, and then he remembered that Chen Tianlin had been running all the way and hadn't eaten anything until now, which made him suddenly wake up and say to Chen Tianlin apologetically: "Xiao Chen! Look at my memory, you rushed from Jiangcheng to Yanjing in order to operate on the old man in our family. ”

"All the way over, you haven't eaten anything, and you have undergone a nine-hour operation, people are iron rice and steel! Now you urgently need to replenish energy, go! I will take you to the hotel to stay first, and then take you to taste the special delicacies of our Yanjing. ”

When he heard Yao Qingdong's words, he subconsciously shook his head and replied: "Mayor Yao......!

"How can this work, if this spreads, people will not rub the bridge of my nose Yao Qingdong, saying that I Yao Qingdong does not know how to be a man. Yao Qingdong saw that Chen Tianlin wanted to reject him, and without waiting for Chen Tianlin to finish speaking, he directly denied Chen Tianlin's decision.