Back in 2002 as a doctor

Page 529

Chapter 0911 heart really broken?

"Director Teng, come out." Zhou Congwen pressed the button of the intercom.

Teng Fei was staring at the radiography image in a daze. She had never seen this kind of blood flow in radiography before.

There seems to be a switch in the patient's coronary artery, which turns on and off, so that the blood flow is not stable, but it can barely be said to be unobstructed.

But it is impossible to say that it is blocked, after all, there is still blood flowing through the coronary artery, and there is no obvious stenosis, but whether the blood flow is smooth or not, it seems that it does not make sense.

Knowing something was wrong, but Teng Fei didn't know where the problem was.

Hearing Zhou Congwen calling her, Teng Fei immediately left the operating room.

"Xiao Zhou, you're back." Teng Fei greeted, and before she had time to gossip, she frowned and asked, "What's going on with this image? I didn't understand it. You can see it."

This was in 2003, and circulatory interventional surgery had just been rolled out on a large scale across the country, and both the number of patients and clinical experience were scarce.

Especially the director of a hospital like Teng Fei, who is between the basic level and the high end, is in the period of accumulating experience, and it is normal to not see the blood flow like milking.

What is clinical experience?

This is.

Teng Fei encountered it once, and after going through a clear diagnosis and treatment process, the next time she just glanced at it, she was frightened into a cold sweat.

"Director Teng, I highly suspect that the patient's heart has ruptured." Zhou Congwen didn't talk nonsense, what he had to do at this time was to race against time, not to be polite.

"..." Teng Fei's heart seemed to stop beating in an instant, as if her heart had ruptured just like the patient.

"Have you talked to the patient's family before the operation?" Zhou Congwen asked.

"I said..."

"Transfer to the operating room and prepare for coronary artery bypass under extracorporeal circulation." After Zhou Congwen finished speaking, seeing Teng Fei's confused face, he emphasized, "Emergency, hurry up!"

Teng Fei hesitated for a moment, but then nodded.

Zhou Congwen had already proved himself with his strength. Since he could speak in such a positive tone, he almost patted his chest to ensure that the diagnosis was clear—the patient had a ruptured heart.

Coupled with the images that had never been seen before, Tengfei did not dare to question or delay the appearance of blood flow in sections, and immediately turned around and said to the assistant, "Withdraw the tube, and prepare to go to the operating room with Professor Zhou."

"Professor Zhou, I'm going to explain the condition to the patient's family, and I'll trouble you to send the patient there."

Zhou Congwen nodded, "You're welcome."

After talking about minimally invasive surgery, the psychological expectation of the patient's family members is that they will be like normal people 8 hours after the operation.

But the operation failed, and he had to go to a large operating room for thoracotomy. How can the patient's family members accept this fact?

Doctor-patient communication is a technical task, no less difficult than surgery.

Each is busy.

Zhou Congwen contacted the operating room and Zhang You.

The radial artery catheter of the patient on the operating table was removed, and after a simple pressurized bandage, he was carried on a flat car.

Zhou Congwen took the flat car and took the patient all the way to the operating room.

When passing by Teng Fei and the patient's family, a patient's family ran a few steps and said a few words to the patient.

"Director Teng." Seeing that the patient's speech was normal and there was no problem, the family members of the patient returned to Teng Fei with strange expressions, "You're just scaring us."

"Yeah, Lao Li is fine, it's quite normal, how do you say it's a broken heart."

"Although we don't know what a broken heart is, let's just think stupidly. People should be in a coma. What you said is so scary. Really, it almost made me cry."

Teng Fei frowned, looking at the patient's family members seriously.

In fact, she didn't know whether the diagnosis of the patient's heart rupture was correct, but since she had explained it to the patient's family, she couldn't be cowardly at this time.

As a doctor, as a director, if the patient's family members say what they are, the majesty will disappear, and then the trust of the patients and the patient's family members will also disappear.

"This is early discovery." Teng Fei said solemnly, "The patient is in the early stage of heart rupture and will die at any time. If it is here..."

With that said, Teng Fei glanced at the interventional catheterization room.

"The heart broke directly, and it was too late to rescue."

"Really?" The patient's family hesitated.

"Now that we have encountered a special situation, I will talk so much for the time being. I will go to the operating room later. I will go in to check the situation and communicate at any time." Teng Fei said.

Seeing director Teng Feiteng's serious face, the family members of the patients were dubious.

Some people looked worried, some whispered, and followed Teng Fei to the operating room like a swarm.

Teng Fei changed clothes, and when she came to the corridor of the operating room, Teng Fei heard Zhou Congwen's voice coming from the operating room.

"Emergency rescue, run!"

"Tell the blood bank, prepare blood, a large amount!"

"Extracorporeal circulation machine, hurry up."

How confident is this, Teng Fei was very puzzled.

Although she was quite certain with the patient's family, Teng Fei also had doubts about Zhou Congwen's diagnosis.

She hurriedly followed the voice to the operating room, and saw that Zhou Congwen had changed his clothes and was disinfecting.

The patient's anesthesia has been completed, and the sound of various instruments diffuses in the operating room, revealing an atmosphere of tension and anxiety.

"Professor Zhou, are you ready to start?"

"Well, Yuan Qingyao will come right away, and he will come up with the informed consent form for the operation. Then you fill in your name and information, and have the patient's family members sign it." Zhou Congwen urged while disinfecting.

"Professor Zhou, how...how did you make the diagnosis?" Teng Fei asked.

"Director Teng, have you ever met a patient with heart rupture during or after interventional surgery?" Zhou Congwen asked a little strangely.

"..."

Teng Fei sweated profusely.

I suspect that there are patients with heart rupture, but the pci surgery in the Second Hospital of Medical University has just started, and the clinical experience is extremely lacking, so I really don't know what's going on.

"You're lucky." Zhou Congwen continued seeing Tengfei's silence, "If there is an acute heart rupture, the full-thickness myocardium from the endocardium to the visceral pericardium will rupture in a very short period of time, resulting in acute heart pressure. Many patients lose their chances of resuscitation even before an accurate diagnosis is made."

"..."

Although Zhou Congwen's words were very simple and only described an objective fact, it still made Tengfei sweat profusely.

The patient was fine a second ago, but suddenly his condition was not right, and he was not given time to think, and died within just one minute.

No practitioner wants to encounter a similar situation.

"What about him?" Teng Fei asked softly, looking at the patient.

"Luck is good, but it's not good." After Zhou Congwen sterilized, the egg-round pliers clamped the wall of the toy plate, clicked, put it on a flat cart, and then sanitized his hands and put on his clothes.

"Generally speaking, female patients are more likely to have heart rupture, and men are only 1/4 of the probability of female patients."

Chapter 0912 Calling the Beast

"But it's true to say that luck is good."

"I estimate that the patient's cardiac rupture was subacute, gradual.

That is, there is a rupture in the endocardium first, and the blood flows into the myocardium to form a dissection hematoma, and then gradually penetrates the visceral layer of the pericardium to cause cardiac tamponade. If this rupture can be diagnosed early and operated quickly, there is a high probability that it can be reversed. Thoracic surgery and successfully stepped down. "

"Luck seems to be good."

Zhou Congwen repeated the words about luck.

He thought so too.

Such a mysterious and mysterious thing like luck, you will really feel it after working in the clinic for a long time.

For example, the patient in front of me is really lucky.

Teng Fei did not know the image of milking-like blood flow, which means that the patient has a high probability of heart rupture during and after the operation.

And the system just gave a task, so it must be said that it was God's will.

"Brother Zhou, I'm here." After Yuan Qingyao walked in, seeing that the surgery was ready, he raised the pre-operative statement in his hand, "Who is this for?"

"Give it to me, I'll explain to the patient's family," Teng Fei said.

Zhou Congwen shopped the list, stood in front of the operating table, and took a look at the patient's vital signs on the ECG monitoring, so he was not in a hurry.

"How well do you do emergency bypass?" Zhou Congwen asked the equipment nurse.

The equipment nurse said angrily, "You basically didn't do it before you came. I said Professor Zhou, you are too busy. Bypass surgery is normal, but emergency surgery is really rare."

"Haha." Zhou Congwen smiled.

He knew that a sudden bypass surgery on the emergency department really distressed the nurses, which meant that the day's shift would be quite hard.

But the operation is done by myself, not Zhang You, so it should be very fast.

It's normal for a nurse to have a little temper, who can't complain when he's busy and tired.

"Get ready for skinning, get ready for sternum sawing."

"Professor Zhou, don't you do coronary artery bypass surgery with small incisions? I heard that the operation is also very fast." The instrument nurse quickly prepared the things Zhou Congwen wanted, while nagging, "Emergency departments also do small incisions." , I am still a patient."

"Diagnosed heart rupture, I don't know what's going on inside." Zhou Congwen took the scalpel and took dry gauze to make an incision from the center of the patient's sternum.

With one stab, blood splashed.

"Heart rupture, you are not kidding." The equipment nurse said contemptuously. "When the patient came in, he didn't know what happened. He was completely frightened. Do you know what he said to the anesthetist when you went to brush your hands?"

"What did you say?"

"He said never to cut his organs." The nurse gossiped.

"At such an advanced age, the internal organs are useless. If you want to, you can donate the body. But that will be at least 20 years later, and it's too early to think about it now." Zhou Congwen joked casually while using electric heating to stop the bleeding.

"What are the patients thinking now? During the hepatobiliary surgery a few days ago, the patient said that since he was hospitalized, his blood was drawn anemic. The hospital must have drawn the patient's blood to sell it for money."

"You didn't explain it?"

"What does it have to do with me, Professor Wen's patient, let him explain."

The equipment nurse then realized that she seemed to have drifted off the topic, and immediately pulled it back, "Professor Zhou, you are also a beast, can the diagnosis be more reliable."

"If you call a beast and call it a beast, you will know how to call it. There is no reliability." Zhou Congwen began to separate suddenly and stop the bleeding.

"You still know." The equipment nurse pinched Zhou Congwen's eyes with her eyelids, "You called and said that the patient diagnosed a ruptured heart, which scared us so much that our heart almost ruptured.

As a result, all kinds of preparations were prepared. Just two pressurized blood transfusion sets were prepared, and bags of blood were prepared to be poured into them. "

"As a result, look at the liquid next to it, we even have the cover ready, so why don't you show us this?"

Zhou Congwen knew that the nurse was driving, and the cover was the pressurized blood transfusion set.Alas, I have been doing surgery with my boss for a long time, and I am really not used to it.

"It's not very good, at least it doesn't have to be so busy." Zhou Congwen lowered his head while performing the operation, chatting with the equipment nurse, "It's better than emergency rescue."

"The key is that the patient is fine. If you say he has a broken heart, you are really a beast."

The equipment nurse probably took gunpowder today, Zhou Congwen glanced at her and said, "What's wrong today, you have such a bad temper."

"Don't mention it, the obstetrics department proposed an operation, but the family refused to allow the operation, and they have been tossing back and forth for 4 hours." The anesthesiologist sighed, "I went to see it, and it was not possible, but the family said it would be necessary. Narcotics kids will be stupid."

"Our operating table is ready, and we have been waiting, but we can't wait. That family is so fucking fucked!" The equipment nurse said angrily, "Cesarean section, why don't you wait for a section if you can't give birth, wait for a dead body Life?"

"It turned out that I was waiting to come up, right?" Zhou Congwen said with a smile, "You have to have confidence in the Second Hospital of our Medical University, as long as the family members cooperate, there is no such thing as one dead body and two lives."

"I just don't like it." The equipment nurse said, "Who are you, taking human life for nothing, right?"

"Then you can't tell me that my nose is not a nose, and my eyes are not eyes." Zhou Congwen stretched out his hand, "Sternum saw."

The heavy sternum saw hit Zhou Congwen's hand.

"Professor Zhou, it's just that you are unreliable. Seriously, have you been swept in?" The equipment nurse was upset, and began to expose the fault, "After I came back, I made a blind diagnosis, what kind of heart rupture, I think you are It’s not that there’s something wrong with my brain, I don’t believe that a broken heart can talk to us well.”

Zhou Congwen sighed.

Rumors, naturally, the more evil they are, the wider and faster they spread.

There may be many conjectures about the boss, but whether it is the Second Hospital of Medical University or the Third Hospital of Jianghai City, everyone agrees that they have been swept in.

What's the point of this!