Director Kong looked anxiously at the elevator entrance, and as soon as Yang Ping came out, he immediately greeted him.

"Doctor Yang, I'm sorry to call you over on the weekend!" Director Kong's face was embarrassed.

Yang Ping said modestly: "Director Kong's words are serious, Xiao Yang is on call, what is there to need me?"

In the emergency, Director Kong was also unambiguous and straightforward: "Mr. Ning suddenly had respiratory failure in the morning, and his blood oxygen could not come up, hovering around 70. They punctured and placed catheters in the emergency ward, and connected ECMO after catheterization, although the blood oxygen went up some, but it was still low, only 78, they considered that the tumor squeezed and invaded the right external iliac artery and vein, resulting in narrowing of the lumen, the flow rate of blood drawn out was not good, and the amount of blood drawn out for oxygenation per unit time was too small to meet the demand, Miss Ning took the initiative to ask you to come here. ”

ECMO, also known as the magic lung, is a modified artificial heart-lung machine, also known as extracorporeal membrane oxygenation, which can replace the function of the human lung or heart to a certain extent and for a certain period of time.

It draws the body's blood out of the veins, oxygenates it through a machine, and turns it into oxygen-rich blood, which is then transfused back into the body through veins or arteries.

If it is given back to the body through a vein, it can replace the function of the lungs; If it is infused back to the human body from the arteries, it can replace the functions of the heart and lungs, and the magic lungs are called the last straw to save lives by doctors!

However, the price of this kind of machine is very expensive, so the cost of use is also very expensive, and it cannot be covered by medical insurance. It costs 60,000 yuan to start up, and one to 20,000 yuan per day for the follow-up, which is a sky-high price for ordinary people, and for Mr. Ning, this does not need to be considered at all.

While the two walked towards the ward, Director Kong introduced the situation to Yang Ping, and when they walked to the emergency ward, the situation was also introduced.

The emergency ward of Huaqiao Building is equivalent to a small ICU, with all kinds of first-aid equipment, including expensive magic lungs, and these equipment are not bought by the hospital itself, many of them are donated by patients who live here or have lived here.

Inside, Director Jiang of the ICU was placing the catheter with his assistant, but he had stopped, probably waiting for Yang Ping. Next to it, there are also chief physicians or deputy chief physicians of vascular surgery, general surgery, oncology surgery, and color ultrasound room.

Insert an app: a perfect replica of the old version of the book-chasing artifact can be changed to the source of the APP--Mimi Reading.

"You can't go in again, hurry back a little, the blood vessels will break if you go in again!" The deputy chief physician of the Department of Vascular Surgery reminded Director Jiang.

"Hold it down! Look clearly! Director Jiang commanded the doctors in the color ultrasound room.

The ultrasound doctor's probe was slightly lowered, and the blood vessels on the ultrasound image were clearer.

Mr. Ning was lying on the bed, his face was yellow, his consciousness was a little unclear, his body was covered with a blue sterile sheet, Director Jiang had just completed the catheterization of the bilateral femoral veins, and the left femoral vein was successfully catheterized, but there was a stenosis on the right side, and the catheter did not dare to go deeper. Now on the right is the tube that leads out the blood, and on the left is the tube where the blood is injected.

Because of the stenosis of the right external iliac vein, the blood that is drawn out does not flow as expected. If you swap it over, the right side is the input pipe, and the left side is the output pipe, and the result will not be different. Even if enough blood is drawn out from the left side for oxygenation, the flow rate of blood back is too slow to achieve the intended purpose.

"Doctor Yang, I'm going to trouble you again!" Miss Ning said.

She has been by her side, squatting on the side of the bed, grabbing her father's hand, and smiling: "Dad, don't be afraid, Dr. Yang is here, he has a way." ”

When Mr. Ning heard his daughter's words, he seemed to know in his heart, but he couldn't speak, so he nodded effortlessly.

In fact, for a patient with advanced liver cancer and systemic failure, Yang Ping is also very helpless.

Doctors are like the epitaph of Dr. Trudeau in New York, USA: sometimes healing, often helping, always comforting.

Mr. Ning stretched out a hand with difficulty, trembling, and Yang Ping held his hand tightly, cold and thin.

His lips trembled, and he said something, Yang Ping's ears came to his lips, and he heard a few words that were indistinct.

"Help --- me--- --- delay for a few more days---" Saying these words, Mr. Ning seemed to use all his strength.

Yang Ping nodded heavily and clenched his hand to show that he heard what he said. Trust, how precious this trust is, just a few words of conversation on the operating table, you can entrust your life to yourself.

"Definitely, I'll do my best to help you fight for it!" Yang Ping put down his hand.

Mr. Ning once lived in the hospital, for his condition, all the top oncologists in the industry were invited to come over, and even overseas experts were invited to consult, but he was in the advanced stage, the whole body failed, the tumor metastasized in many places, and the opportunity for surgery was lost, and the tumor resection, liver transplantation, and lung transplantation could not be done. Therefore, after the interventional treatment of liver cancer, lenvatinib was used as targeted therapy, and later drug resistance, changed to regofinib, and then asked the famous old Chinese medicine doctor from the Provincial Hospital of Traditional Chinese Medicine to do the traditional Chinese medicine treatment of Fuzheng.

Because the hospitalization conditions of Sanbo's Overseas Chinese Building can be said to be the best VIP ward in G City, I transferred to Sanbo and planned to finish the last journey of my life in Sanbo's Overseas Chinese Building.

"The bilateral subclavian and internal and external cervical vascular areas are seriously invaded by the tumor, and I dare not puncture and place the catheter, so I want to put two tubes in the femoral veins on both sides, the left side is fine, the right tube can not be in place, look at the film, the tumor pushes the external iliac vein open, causing squeezing, the tube can't get in, forcibly push it up, it may break the blood vessels, cause massive bleeding, if you stay here, the blood flow rate that leads to the replacement is too low, it is not up to standard, the blood oxygen still can't go up, you see the blood oxygen is only 80, this is not good--"

Director Jiang didn't care about face at this time, he was a real person, and when it came to life and death, whoever had a way, he would listen to whomever he wanted, whether he was a young doctor or a big professor.

For Yang Ping, he is familiar with it, he has also heard of the nerve root block last time, needless to say, the treasure that Director Han held in the palm of his hand is not at the right level, and he is not qualified to stand here at this time.

"You've worked hard, I'll take a look!"

Yang Ping went to the reading lamp to watch the film, and indeed as Director Jiang said, the bilateral subclavian and internal and external jugular veins could not be punctured, and only bilateral femoral veins could be punctured, and the right femoral artery vein had been invaded and squeezed by the tumor, and the lumen was flattened.

In Mr. Ning's case, if there is a massive abdominal hemorrhage, the whole body will collapse immediately, and multiple organs will fail, and it will not be saved with the magic lungs.

But now, if only the catheter of the demon lung is left in the current position, it is a narrow opening, and the blood flow drawn out is too small, and the oxygenated blood per unit time is too small, which can not meet the needs of vital organs at all.

No wonder the last time he was examined, the temperature of the right lower limb was lower than that of the left lower limb, especially the peripheral circulation was particularly poor.

Yang Pingping used the knowledge gained from systematic anatomical training, combined with Mr. Ning's CT scan, and began to compose a picture in the brain, superimposing sections one by one, and a three-dimensional anatomical diagram was presented in the brain in a long way.

This time it was still very difficult, and I didn't succeed in assembling it several times, but it was a little easier than last time, which means that there has been progress.

According to the blood flow rate of the human body, Yang Ping simulated the blood flow in his mind, and added the dynamic image of the blood flow, and a dynamic three-dimensional anatomical image was presented in his mind, which was quite clear.

It seems that brain composition is very important for the improvement of medical skills, and the ability of the system to use anatomy to spare no effort to train itself is to lay a strong foundation for the improvement of medical skills in the future, Yang Ping understands the intention of the system.

In order to successfully puncture and place the catheter, it is necessary to construct a catheter for the demon lung, Yang Ping kept the image in his brain, turned his head and asked Director Jiang: "Director Jiang, is there still a catheter for the demon lung?" Let me take a look? ”

"Xiao Li, open a tube to show Dr. Yang." Director Jiang instructed a doctor in the ICU next to him.

The cost of a pipe is very expensive, tens of thousands, but this is not the time to care, and there is no need to care.

Xiao Li opened the sterile packaged tube, Yang Ping observed the complete catheter, copied one of these catheters in the brain, and then cooperated with the pattern constructed in the brain to carry out simulated puncture and catheterization, so that Yang Ping knew in his heart.

"That's it!" Yang Ping asked Xiao Li to put away the catheter.

"I'll try!"

Yang Ping wore sterile gloves, put on a disposable sterile gown, and stood beside the bed.