My medical skills add experience

Chapter 499 Chapter 499 Double exits from the right ventricle, the competitor made a foolish move

Zhou Can examined the little girl and found that her precordial area had obvious bulge, and there was obvious tremor between the third and fourth ribs on the left side of the sternum.

Especially when pressing on this part with the belly of the finger, the tremor is more obvious.

Try examining the area with a stethoscope and hear a very distinct murmur.This is the noise made by the heart muscle when it contracts.

"Is there a problem with the right ventricle?"

Zhou Can didn't dare to be too sure, but made a first diagnosis of the patient's lesions based on experience.

He again listens carefully for the patient's intercostal murmur.

Frowning slightly, this noise was very strange, he was sure he had never heard it before.

There are many types of congenital heart disease.

What kind of lesion can make such a murmur?

An echocardiogram is a good option for the patient.

Considering the particularity of congenital heart disease, a cardiac X-ray should be done as an auxiliary diagnosis.

After investigation, the results of the inspection came out soon.

The patient's aorta was 2 cm, left ventricle was 3.3 cm, right ventricle was 2.6 cm, and pulmonary artery was 1.2 cm.

The ventricular septal echo was interrupted by about 2.2 cm, and the defect was located in the perimembranous outflow tract. The left ventricular blood flowed into the aorta through the ventricular septal defect, and the echogenicity of the pulmonary valve leaflet was enhanced, and the valve orifice was narrowed with a diameter of only 0.3 cm.
At this moment, Zhou Can finally understood what was going on with that strange noise.

It turned out that the patient had double outlet right ventricle.

The diameter of the patient's pulmonary valve is so narrow, no wonder the blood oxygen is so poor.

After investigation, the forward blood flow velocity of the pulmonary valve was only 3.1m/s, the transvalvular pressure difference was 10.44kpa, and a slight regurgitation signal could be seen in the pulmonary valve.

Cardiac X-ray examination showed that the patient's bilateral pulmonary field vessels were finely textured, the pulmonary artery was retracted, the right ventricle was enlarged, and the right atrium was enlarged.

At this point, congenital heart disease has undoubtedly been diagnosed.

The patient had double outlet right ventricle and pulmonary artery stenosis.

This requires surgery to cure.

Surgery is risky and difficult.

The cost is also not cheap.

"Your daughter's condition is a congenital heart disease. The condition is serious and needs to be corrected by surgery as soon as possible. We can't do this kind of major surgery in the emergency department. We need to go to the cardiothoracic surgery room for further inquiries. I just want to go to the cardiothoracic surgery room. If you want, I will take You go over."

Zhou Can said to his family.

Director Xueyan has already called two times to urge Zhou Can to come over.

But because the girl's test results haven't come out yet, Zhou Can can only wait.

After all, the little girl's condition is very bad. The doctor Xie on duty lacks rescue experience. If it is not handled well, it will be a life!

Seeing Zhou Can's enthusiasm, the family members were naturally happy to follow him to the cardiothoracic surgery department.

Tuya Hospital is too big, and it is not easy for them to find a cardiothoracic surgery room at night.

Follow the procedures in the emergency department, and it is estimated that they will have to wait for a long time, even tomorrow, before a cardiothoracic surgeon will pick them up.

When he arrived at the cardiothoracic surgery room, Zhou Can arranged a doctor for the child and gave a few instructions before rushing to the operating room.

Looks like I won't be able to eat dinner today.

Director Xue called him before and learned that he met a patient with congenital heart disease just after the operation, guessed that he hadn't eaten dinner, and had already prepared two slices of bread and a bottle of milk for him.

Zhou Can was not too polite, he took a couple of mouthfuls, and his stomach felt better.

There is still a tough battle to fight.

The difficulty of today's cardiovascular catheter interventional surgery must be hell level.

……

Stepping into the operating room, the patient made a special request.

"Doctor, can I live broadcast the entire surgical treatment process?"

Because this surgery does not require general anesthesia.

The patient is awake throughout the procedure.

He wanted to broadcast the entire operation live and share the surgical treatment process with fans.

"Why do you have to broadcast live during the operation? You can also share the operation experience with netizens after the operation is over!"

Director Xueyan was obviously not very happy.

Under normal circumstances, the hospital will definitely directly reject this request.

As for the reason, the direct one involves patient privacy and does not comply with relevant regulations.

Patients are vulnerable groups in the hospital, and it is impossible to fight against the hospital.

Unless you don't want to be treated.

"I have posted multiple videos before the operation and told my more than 200 million fans that I will broadcast the operation process tonight to share my treatment experience. If you can help me make the operation a success, it will be for your hospital and your department , and even you doctors yourself, is a big publicity. This is equivalent to a free advertising opportunity!"

The patient does things very unreasonably.

In order to increase fans, in order to increase the interaction with fans, there is a first cut and then a play.

And chose to enter the intervention room, and then discussed the live broadcast with the doctors.

When I was in the ward, I didn't say a word.

It's like the bride waits until the man has already entertained the guests, and then asks for an increase in the price of the bride price on the wedding day, and puts the man and future in-laws on the fire to force them to agree.

"Mr. You, please understand that broadcasting the entire operation process will put a lot of pressure on our medical staff who perform the operation. It will virtually increase the obstacles to the operation."

Director Xueyan is still trying to find a way to refuse this matter.

"There is pressure to be motivated! If you refuse to let me live broadcast, it can also be regarded as a sign of lack of confidence. It is only because of the fear of mistakes during the operation, or even the failure of the operation."

The patient's words hit the nail on the head, leaving no room for turning around.

Indeed, as he said, if you are really confident in your surgical skills, why would you be afraid of live broadcasting the surgical process?
At this time, someone called Director Xueyan's mobile phone.

After taking a look, she went outside to connect.

Be back soon.

"Doctor Zhou, let's go out and discuss the patient's live broadcast of the surgery!"

"Row!"

Zhou Can took a deep look at the patient and followed him out.

The patient's face showed a strong confidence.

It seemed that the hospital would definitely agree.

After coming out, Xueyan said directly to Zhou Can, "Vice President Ye will be here soon, and he already knows about it. I guess President Zhu also knows about it. Let's go to the office first!"

Not long after the two of them arrived at the office, Vice President Ye arrived.

He was very familiar with Director Zhou Can and Director Xueyan. After greeting each other, he went straight to the point.

"Director Xue, are you sure about today's cardiovascular interventional surgery?"

"Uh...the operation is very difficult, I'm afraid I can only try to challenge it."

Director Xueyan subconsciously looked at Zhou Can.

Because the real surgeon of this operation is Zhou Can.

"Xiao Zhou was arrested again to be a young man, right?"

Vice President Ye looked at Zhou Can with a smile.

"I'm born to work hard, there's nothing I can do! Sister Yan has a call, so I have to come and help her."

Zhou Can's answer is considered a standard answer.

"Haha, you call it too much work for those who are capable. Tell me, you two, who will perform today's surgery?"

Vice President Ye glanced over the two of them.

It would be crazy to lie to him.

No one would do such a stupid thing.

He asked about this directly in front of the two of them, which meant that he didn't treat them as outsiders.

"We are going to let Zhou Can come to be the chief surgeon. His ability in interventional surgery is very strong, and his intraoperative adaptability is extremely good. There may be some hope for him to be the chief surgeon."

Director Xueyan said seriously.

"Well, I've already guessed a little bit. Xiao Zhou is indeed a young officer in our hospital! Young people, it's a good thing to make more breakthroughs." Vice President Ye nodded, his gaze fell gently on Zhou Can's face. "How sure are you?"

"Very low. I'm afraid it won't exceed [-]%."

Zhou Can replied truthfully.

"As far as I know, this patient has had surgery in two big hospitals before. These two big hospitals are not easy. The first one is Imperial City Renhe Hospital, which is the hospital with the strongest comprehensive strength in China. More than a dozen cardiovascular experts were invited to perform an interventional operation for more than four hours, but it failed."

Vice President Ye revealed a shocking news.

Unexpectedly, this is a patient who failed even at Renhe Hospital.

"When the patient went to see a doctor, he didn't mention that he had seen a doctor in another hospital! This person is really cunning."

Director Xueyan was shocked and angry after hearing this.

If he had known that the patient had been treated in Renhe Hospital, and had assembled more than a dozen of the top cardiovascular experts in the capital, they had failed to perform the operation successfully.She would never agree to perform an interventional operation on a patient.

"This incident really reminded us that we must be extra careful when treating difficult patients in the future. It took nearly a hundred years for Tuya to stand up, and it took nearly a hundred years to accumulate from generation to generation, and it was hard to get to where it is today. I think To destroy this sign, it only needs a big mistake by a doctor with a little influence in the hospital. Xinxiang Maternity and Children's Hospital is a lesson from the past. Of course, it is standing up again now."

Vice President Ye reminded the two of them in a more serious tone.

Xueyan is already a famous doctor, and is being built as a key famous doctor in cardiothoracic surgery.

Zhou Can is a quasi-famous doctor. Although he is still in the reserve queue, he has actually shown his talents and has a certain reputation.

Whether in the emergency department or the pediatrics department, the number of patients who specifically seek Zhou Can for medical treatment and surgery is increasing day by day.

"In addition to being treated at Renhe Hospital, this patient was also treated at the Third Hospital of this city not long ago. The Japanese cardiologist performed the surgery himself. You know, the Japanese cardiologist performed endoscopic surgery, The strength of interventional surgery is very strong. It is also the main sign of the Third Hospital. The whole operation process was broadcast live, but unfortunately, the Third Hospital also failed."

This person is simply a shit stick.

Obviously already seriously ill, but still stir up the situation everywhere.

They had slapped the faces of Renhe Hospital and the Third Hospital successively, and now it was their turn to tear down the signboard of Tuya Cardiothoracic Surgery.

"No, it stands to reason that he has already been treated in the Renhe Hospital of the Imperial Capital and the Third Hospital of this city. They all ended in failure of the operation, so why should he suffer another crime at our hospital? The operation failed, and the cost will be certain. It’s still going to come out! The patient himself is also suffering.”

Director Xueyan was puzzled.

I went to Imperial Renhe Hospital for surgery because it is the most powerful hospital in the country.

Later, I went to the Third Hospital for treatment, because there were Japanese cardiologists.

These two hospitals have failed, is it still necessary to come to Tuya Hospital for treatment?

Anyway, it is impossible for Tuya Hospital to have a higher level of cardiovascular interventional treatment than the previous two hospitals, right?

"That's exactly what I want to say. According to reliable sources, after the operation failed on this patient, the Third Hospital used their brains to ruin our reputation. The patient came to Tuya Hospital for treatment this time. The expenses are all borne by the third hospital, and after the event is completed, the patient will be given a considerable amount of "hard work". At the same time, through this live broadcast, the patient can also gain a lot of new fans and improve the relationship with old fans. Viscosity. Multiple in one stroke."

Vice President Ye's news is very well-informed.

Whether it is the Third Hospital, the Provincial People's Hospital, or even the Xinxiang Hospital, it is difficult to escape his ears if there is any disturbance.

The big hospitals are actually a bit like countries sending spies to each other.

Intelligence gathering has been a top priority since ancient times.

Even Sun Tzu said in the Art of War that knowing yourself and the enemy is the only way to survive a hundred battles.

"Since this patient is a big deal, I think it's better to just refuse to let him broadcast live, rather than refuse to operate on him and send him away on the grounds that his body does not meet the surgical specifications."

Director Xueyan hated this kind of patients who intentionally made trouble.

Because she has stumbled many times.

"Xiao Zhou, what's your opinion?"

After hearing this, Vice President Ye turned to ask Zhou Can for his opinion.

"I..." Zhou Can looked at Xueyan.

"It's okay, if you have any opinions, just say it directly. We are just discussing now."

Vice President Ye comforted him.

"I think we have no way out. We have already arranged operations for patients, and people have already entered the intervention room. At this time, the sudden cancellation of the operation will only make people belittle the cardiothoracic surgery of Tuya Hospital. The loss of reputation, It is likely to be more serious than the failure of this operation. A gentleman stands between heaven and earth, and he cannot stand without faith. Taking a step back, even if the operation fails, so what? Don’t we already have the Third Hospital and Imperial Renhe Hospital for us? Pad your back?"

Zhou Can talked eloquently and expressed his thoughts.

In terms of strategy, Director Xueyan is far inferior to him even though his education is much higher than his.

Zhou Can has only taken the postgraduate entrance examination so far, and the results of the written examination have not yet come out.It is equivalent to still being an undergraduate, at most a little better than ordinary undergraduates.

Xueyan is a real Ph.D graduate and is currently a professor at Tuya School of Medicine.

Zhou Can is not even a star behind her in terms of academics.

"Xiao Zhou's analysis is very thorough and in place. Our hospital can only advance this time, not retreat. According to my opinion, we can't just let the patient broadcast live. Our hospital also needs to record the entire operation process. In case of failure That’s it, just admit failure. If you succeed, then use all your efforts to publicize it, try to seize this opportunity, and push cardiothoracic surgery to a higher level. Even Tuya Hospital can become famous.”

Vice President Ye is more courageous than Zhou Can.

How else to put it, the leaders are all bear-hearted and leopard-hearted!

When doing things, in addition to the necessary prudence, they will be extremely crazy when it is time to fight.

Of course, some leaders become corrupt and corrupt, and they are equally crazy.There are more than a hundred lovers and billions of bribes.

This crisis is both a challenge and an opportunity for the cardiothoracic surgery department of Tuya Hospital.

The Third Hospital spent money to invite patients to come to Latuya Hospital to back up their backs, but what they did was a bad move and a stupid move.

Due to the failure of the operation, the reputation of Tuya Hospital will suffer some damage, but it will not be particularly large.If the operation is successful, it will reap unimaginable benefits.

(End of this chapter)