blenderwars Chapter 289
Chapter 289
Chapter 289
harmonious,
Heart surgery.
Early in the morning, Professor Yang Hanmei, the director of the Department of Cardiac Surgery, entered the department and heard the surrounding doctors discussing last night’s news quickly.
“Dr. Lin is so good that he actually performed a treatment for mitral regurgitation!”
“Now, the more than 8 million patients in our country are saved!”
“Those people abroad have been blocking these advanced technologies. This time, Dr. Lin broke through.”
Professor Yang Hanmei wondered.
Mitral regurgitation?
Lin Feng developed a new technology? Treat this thing?
He returned to the office, called the students, and asked for details.
Professor Yang Hanmei was surprised when he understood the whole situation!
“Lin Feng, would you have this operation?”
…
Intervention Department,
The doctors in the interventional department were equally surprised at this time.
Lin Feng actually broke through mitral regurgitation surgery!
Shock!
Shouting 666 in my heart~~~
in,
Zhu Zhi’an, Lin Feng’s senior, knelt on the ground, admiring him in his heart!
…
The news spread throughout the Harmony Hospital,
Countless medical staff are talking excitedly, shouting 666…
As for the dean, he also learned the news from the secretary. After being shocked, he thought to himself:
“Lin Feng is our harmonious talent!”
“Lin Feng must be asked to build a project team for mitral regurgitation surgery in our Harmony Hospital!!”
So I called Zhang Guofeng, director of the emergency department.
Borrow someone!
Director Zhang Guofeng listened.
Hard work!
Of the Gobi,
Lin Feng only returned to the imperial capital. He hasn’t gone to work yet. Are you going to borrow someone?
No pit or not, hey!
…
…
at this time,
Lin Feng, returned to work in the emergency department.
Early in the morning,
Sit up.
Turn on the call machine.
08 “Huang*han, please go to Clinic No. 3…”
soon,
A 58-year-old man with a painful face, supported by his son, walked slowly into the consulting room step by step.
“Sit down and talk about what’s going on…”
After some inquiries,
Summarized as follows:
·Huang Wenhan, male, 58 years old, with a history of hypertension for 10 years, the highest is 180/100mmHg, and he has not been treated regularly. 30 years of smoking history.
·I felt pain in the precordial area after getting up 3 hours before admission (the area of myocardial infarction mentioned in the previous medical record, meaning: the projection of the heart on the body surface), the range is about 1 palm size, and it can radiate to the back and left neck. Accompanied by chest tightness and suffocation.
After Lin Feng listened,
The first reaction is: “angina”, “myocardial infarction”! !
Lin Feng: “Is there any relief from rest?”
The patient Huang Wenhan said with a painful face: “No, it has been painful…”
Lin Feng: “Have you taken any medicine? On the way?”
Son: “Yes, I went to the pharmacy and asked the clerk. I bought nitroglycerin. Originally, I wanted to buy Suxiao Jiuxin Pills, but the clerk said that the effect of nitroglycerin is faster and better…”
Lin Feng nodded,
Both drugs are used to treat angina pectoris.
Lin Feng: “Is there any effect?”
Son: “A little bit, but it’s gone soon…”
Nitroglycerin is the best and most effective targeted medication for the treatment of angina pectoris.
If nitroglycerin does not work, then the patient can rule out angina.
Then consider “myocardial infarction” and “aortic dissection.”
“Acute aortic dissection” and “acute myocardial infarction” are common clinical causes of acute chest pain.
There are similarities between the two in terms of clinical manifestations, symptoms and signs, predisposing factors, and mortality.
However, the treatment principles of the two are contradictory. Therefore, in clinical treatment, if the two are misdiagnosed, it will greatly increase the mortality of patients.
Aortic dissection usually needs to be confirmed by aortic CTA (enhanced CT, angiography). But not every patient with chest pain can do this, especially those who are critically ill. It is more important to be cautious, often unable to perform aortic CTA examination.
And the electrocardiogram may be misdiagnosed.
To continue to check.
“Draw some blood and do a coagulation test.”
In the coagulation function test, one indicator is “D-dimer”.
“D-Dimer”: A special degradation product of human cross-linked fibrin.
It is an important method to check aortic dissection.
Sensitivity is very high.
When aortic dissection occurs, the arterial intima is torn and damaged, a large number of tissue factors are released into the blood, the coagulation system is activated, and a false cavity thrombus is formed, which triggers the coagulation cascade reaction, activates the fibrinolytic system, and causes D-dimerization in the plasma Body level rises rapidly.
When the cut-off value of D-dimer level is 500ng/mL, its detection sensitivity is 98%; when the cut-off value of D-dimer is defined as 100ng/mL, its detection sensitivity is as high as 100%.
…
after an hour,
The patient came back with the results of the examination.
·D-dimer index increased by 4 times!
·At this level, the possibility of arterial dissection is much higher than myocardial infarction.
Later, Lin Feng made an electrocardiogram for the patient Huang Wenhan. Its dynamic evolution was also inconsistent with the dynamic evolution after myocardial infarction, but was consistent with the aortic dissection.
finally,
Lin Feng made a diagnosis:
“Your father, there is an aortic dissection now!”
“Doctor Lin, what should I do next?”
“I will send you to the interventional department for interventional treatment, minimally invasive and painless, and it will be done in 1 hour!”
This disease is quite simple,
Interventional guide wire catheter,
Then insert the gelatin sponge to block the interlayer.
Lin Feng brushed the bills and made a call to the Intervention Department.
Half an hour later,
The Intervention Department reported that after aortic CTA examination, it was indeed an aortic dissection and was preparing for surgery.
…
The eighth patient…
A patient in a suit in his 40s was supported by a beautiful woman.
Push the door to enter.
The patient in the suit yelled: “They all said not to come to the hospital. I’m fine, isn’t it just chest pain?”
In the voice, there was a kind of domineering and arrogance that lashed out at Fang Qiu.
“Mr. Chen, you can’t underestimate any chest pain. Let’s talk about it after seeing the doctor…”
Lin Feng probably learned a part of ‘intelligence’ through these just a few seconds. ’
A man in a suit should be a leader, what a boss, and he is in a high position and speaks domineeringly. And also looks very disdainful to the doctor.
And that beautiful woman should be the secretary.
The secretary took Mr. Chen and walked into the consulting room.
“Doctor Lin…”
When the female secretary saw that the doctor was Lin Feng, her eyes flashed and she cried in her heart: So handsome! ! !
“Sit down and talk about the situation…name, ID…”
Lin Feng said blankly.
When President Chen heard this, he was unhappy: “You don’t know me?”
Lin Feng: “???”
who are you?
Why should I know you?
The female secretary hurriedly smiled beside him: “Dr. Lin, this President Chen is the vice president of our food delivery group…”
Lin Feng suddenly.
The takeaway group is a big group with a market value of tens of billions. Mr. Chen estimated that he was used to calling five and six drinks at the company and its affiliated companies, thinking that the hospital was also a place where he could call five and six drinks.
Lin Feng: “Say your name, ID card…”
The female secretary said it quickly.
Lin Feng found the registration information, and then began to consult.
“what is the problem?”
“Here (pointing to the precordial area) is a bit stuffy, painful, nauseous, uncomfortable…”
“………………”
Lin Feng’s brain was over. It seems that the first patient with aortic dissection today is also painful here, right?
Is this patient myocardial infarction or aortic dissection?
Lin Feng’s face was weird.
Lin Feng: “Is there any illness before?”
President Chen is impatient: “No, I have always been healthy…”
Lin Feng: “Really? No medical history?”
President Chen was a little angry: “Hey, I said you doctor, curse me?”
Lin Feng is neither salty nor indifferent: “I am a doctor, so naturally I have to ask clearly…”
Lin Feng wrote on the medical record: Chief complaint, no medical history.
Lin Feng continued to ask: “What kind of medicine should I take when I come?”
The secretary shook his head: “I didn’t eat…”
Lin Feng: “Is there any relief halfway?”
Secretary: “No…”
Well, rule out angina.
Make another ECG…
When the electrocardiogram comes out, the waveform and dynamic evolution, Lin Feng considers “myocardial infarction”…
Lin Feng glanced at Mr. Chen.
Originally, the average patient Lin Feng had as little examination as possible, but Mr. Chen was so arrogant and had money, so let’s do a few more examinations.
I, Lin Feng, think about the patient!
then,
Lin Feng began to open the order.
“Go be a “heart marker”, “myocardial enzyme spectrum”, “coronary angiography”, “echocardiogram”…”
Three in a row…
President Chen looked angry!
“I know your hospital is dark, okay, I just have a chest pain, and I will come directly to three checklists. How much does it cost?”
Lin Feng expressionlessly: “It’s probably more than 1,000…”
Mr. Chen Lenghe: “It’s so dark!”
The secretary covered his forehead, and he dared to say anything about Mr. Chen.
Who is the opposite?
Doctor Lin Feng Lin, his medical ethics, anyone who knows will give thumbs up!
The female secretary hurriedly pulled Mr. Chen: “Mr. Chen, let’s go for a check. It’s not much money anyway, right? Buy a peace of mind…”
Mr. Chen heard: “Yes, Laozi is rich, with a mere over 1,000, cut…”
…
after an hour,
The secretary took Mr. Chen back to the clinic,
Bring the results of various inspections.
Mr. Chen cursed: “This broken hospital cost me an hour. I dealt hundreds of millions of dollars per second. I lost hundreds of millions in this hour… I won’t come to this Harmony Hospital again next time, just go to Hemu. The hospital is ready, 990 is a bit more expensive, but don’t have to wait, I have money…!”
The patients and family members behind him looked at him like crazy.
The secretary already feels ashamed to meet people.
Lin Feng chuckled lightly.
Received a few inspection results.
·Myocardial enzyme spectrum: myocardial tissue necrosis…
·Ultrasound: The blood flow of 2 branches of coronary arteries is blocked…
·Other: Insufficient blood supply to the heart…
Lin Feng took a look,
Did not run away!
Myocardial infarction!
Because a branch of the coronary artery is blocked, the blood supply is insufficient, which leads to myocardial ischemia and necrosis…
“Dr. Lin, Mr. Chen, he…”
“The result of the examination is obvious: myocardial infarction…needs to be admitted to the hospital and undergo an operation…”
Lin Feng said.
The purpose of admission is not only surgery, but also to detect the recovery, or aggravation, and continuous treatment of cardiac necrosis and myocardium.
“Huh? Admission?”
Upon hearing this,
That President Chen had a violent temper on the spot!
Asking him to wait for an hour to check the results, all his patience has been worn out, and now he is going to be admitted to the hospital?
Lin Feng: “In your case, myocardial infarction, there is a falling thrombus that blocked two of the arterial tributaries, causing heart ischemia and myocardial necrosis… Therefore, you need to be admitted to the hospital, undergo surgery, and then continue. Treat for a few days…”
After listening to this, President Chen not only didn’t panic, but instead looked contemptuous and sneered:
“Flicker, continue to flicker…you doctors, don’t you just want to cheat some money?!”
Female secretary: “………………”
She knew that President Chen had always been taboo from doctors, but she didn’t expect it to be so serious.
Doctor Lin wants to scam you money?
joke!
Your net worth is not as much as that of Doctor Lin!
The heart keeps spitting out.
Lin Feng had no fluctuations in his heart at this time, and even wanted to laugh.
This President Chen is really a weird flower!
However, according to the doctor’s guidelines, he gave the patient Mr. Chen a detailed explanation of his condition.
“It’s impossible to be hospitalized… Let’s go!”
Mr. Chen was very impatient, called the female secretary, got up and left.
correct,
He still had chest pain, but his anger and pride made him forget the chest pain.
Lin Feng stopped: “Wait, if you really don’t want to be hospitalized, please sign and say that you refuse to be admitted to the hospital for treatment. If anything happens later, our hospital does not need to take any responsibility…”
. .