My medical skills add experience

Chapter 504 Tricky aortic dissection, revelation

He was busy until 43:[-], when Zhou Can completed the emergency surgery and the patients waiting for surgery admitted yesterday.

Some trauma and emergency patients in the emergency department need to be treated immediately.

This can't be backlogged.

As long as such patients are received, they often take the time to do an examination. After the cause is found out, the receiving doctor simply judges whether it can be dealt with in the emergency department.If it cannot be dealt with, call the corresponding specialist department to take the patient away.

In more cases, even if it cannot be dealt with, some preliminary rescue work is required for the patient.

For example, helping patients stop bleeding, defibrillation, open the airway, etc.

Needless to say, it is needless to say that patients who can be treated directly in the emergency department.Those patients will be continuously queued into the emergency operating room for surgery like an assembly line.

Zhou Can has recently consciously started to reduce the number of primary and secondary general operations and let other doctors in the operating room handle them.

And he mainly deals with some difficult surgical patients.

The number of tertiary operations has increased from about two before to three or even four.

In the first and second level operations, other doctors are sure to handle the difficult cases.If you are not sure, leave everything to Zhou Can and Dr. Xu.

This arrangement is good for Zhou Can and other doctors in the operating room of the emergency department.

Zhou Can has almost become a new trump card in the operating room of the emergency department.He blindly performs simple minor operations, which is not conducive to growth.The leaders of the department naturally hoped that he would be as strong as possible.

As a leader, how can you lead the emergency department if you are too weak?
Throwing simple minor operations to other doctors can also allow them to get better exercise.

Doctors who have trained their surgical skills can challenge more difficult surgeries.

In the end, a virtuous circle is slowly formed.

Walking out of the operating room, I looked up and saw a middle-aged man in his 40s sitting on a bench across the corridor.Short hair, well-dressed, peaceful eyes, and a poor mental state.

"Excuse me, is this Doctor Zhou?"

Seeing Zhou Can walk out of the operating room, the man stood up and asked.

"it's me!"

Zhou Can walked directly towards the other party.

"Are you the patient who asked me to see a doctor?"

"Yes, yes, it's me!"

The man nodded repeatedly, and just said a few words, but coughed while clutching his chest.There was a faint crackling sound when he coughed, and a more painful expression appeared on the man's face.

"What's uncomfortable? Come on, sit down and talk slowly, don't worry."

Zhou Can is ten years younger than the other party, but he cares about this man like an elder.

"It's okay! I had an operation on my heart, and I've been coughing a lot since then. Recently, I feel flustered and short of breath, and occasionally I have tingling pain in my upper abdomen. I checked in several major hospitals, and they all said it was aortic dissection. And very serious."

As he spoke, the man picked up the information bag on the chair.

Pass the film he took in another courtyard to Zhou Can.

After receiving it, Zhou Can's expression changed slightly.

"Hey, this situation is really serious. This avenue is full of dissections. To be honest, this is the first time I have seen such a large dissection. Moreover, this blood vessel is the aorta. If it ruptures, it may not even be possible to rescue it." It’s too late. I suggest you deal with it as soon as possible, and don’t delay.”

Zhou Can has done a lot of major surgeries with Director Hu Kan.

He has dealt with some very dangerous aortic dissections.

But I have never seen such a serious dissection like the man in front of me.The main reason is that the dissection zone where the tear of the vessel wall occurs is too long.

The blood ejected from the interlayer formed a long water bag-shaped dark zone in the chest and abdominal cavity.

With such a large and long dissection, the risk of rupture is very high.

Even in a hospital as large as Tuya, as long as a patient is diagnosed with aortic dissection, even if there is no angina pectoris, they will immediately issue a critical illness notice to the patient.

Only doctors understand how dangerous aortic dissection is.

"I asked a lot of big hospitals in a row, and they all told me that artificial vascular replacement of the cardiovascular aorta is needed to replace the entire diseased blood vessel. The incision is from the chest cavity to the thigh. There are still many operations risks, including paraplegia, intraoperative death, and more.”

The man spoke clearly and knew the contents and risks of the entire operation.

Explain that you have learned about the entire operation in detail from other doctors.

With such a long aortic dissection, it is almost impossible to place a stent.

Because this aorta has multiple branches, it supplies blood to multiple organs in the thoracic and abdominal cavity.

Placing a stent can certainly block the gap in the blood vessel dissection, but it will also block the other branches of the blood vessel at the same time.This can cause loss of blood supply to multiple organs.At that time, it is not saving people, but killing people.

Replacing the entire aortic vessel is very difficult, but as long as the surgical level is good, you can still try to challenge it.

As long as Zhou Can raises ligation to level six, he is fully capable of challenging this kind of surgery.

"The trauma is large, the risk is high, and the intraoperative and postoperative risks are unpredictable. There are indeed many problems. However, your aortic dissection is already so serious. If you don't treat it, it will be more dangerous than wearing an indefinite time bomb."

The patient's condition can no longer be delayed.

Any time of excessive emotion or uncontrolled blood pressure may cause the dissection to rupture.

At that time, the blood will pour into the chest and abdomen like an uncontrolled flood.

Basically any rescue measures are too late.

Heart aortic rupture has a much higher mortality rate than carotid artery rupture.

The prognosis is extremely poor, and the mortality rate is close to 100%.

Having their necks and throats cut, bleeding is also very scary, but as long as they are sent to the doctor in time, most of them can be saved.

The aorta of the heart is in the thoracic and abdominal cavity. Once it ruptures, the bleeding cannot be stopped without opening the chest.

And even if the chest is opened, there is a high probability that it will still be useless.

Ligate the aorta, or clamp it with a hemostat, which is equivalent to cutting off the supply to most organs and tissues in the body.If the body's limbs are ischemic for more than half an hour, there is a risk of necrosis.

Organs are more delicate, and some organs will gradually undergo necrosis after only 3 minutes of ischemia.

You must know that most of the necrosis of the body's organs is irreversible.

"Doctor Zhou, I came here to see you this time, just to ask you to help me find a solution. See if I can solve this aortic dissection without replacing the whole blood vessel. I also heard a subordinate tell me He said that he watched a live online surgery yesterday, and you successfully cured a cardiovascular disease that neither the Renhe Hospital of the Imperial City nor the Japanese cardiologists could cure."

This person was able to come to find Zhou Can in such a short time, which was enough to show that he had a lot of energy.

Because the accent is not like a local accent.

"Where are you from?"

"Oh, I'm from Modu, and I run a small business at home. After learning about your deeds last night, I thought about it and came here from Modu this morning."

"Thank you for your trust. I am actually an ordinary doctor in Tuya Hospital. The success of the operation yesterday was half due to luck, and it was not as powerful as you imagined."

Zhou Can didn't believe that this person was running a small business.

There are not a few rich and powerful people he has come into contact with.

From this person, one can feel a faint majesty, as well as that kind of indescribable self-confidence.If you guessed right, this person not only has strong economic strength, but also has a lot of power in the official world.

This kind of person is either the second generation of a top family or the second generation of officials.

In case someone is put to death, Zhou Can doesn't want to be the second Xu Yidao to fall.

He saw Dr. Xu's desolation deeply.

So, try to shirk as much as you can.

Doctors must learn to protect themselves, so that they have the opportunity to save more people.

"If not, you go to eat first. I can wait until you have time, and then have a good chat with you. I can feel that there is a trace of fear in the depths of your eyes. Don't worry, I am definitely not that This kind of nonsense, unreasonable person, not to mention an ungrateful person."

The man is so powerful that he can even clearly see the trace of fear that Zhou Can inadvertently showed in his eyes.

During the conversation, Zhou Can was already a billionaire with a net worth of over [-] million.

But being crushed by this man the whole time, the aura of the other party is very terrifying.

Generally speaking, a person's aura comes from all aspects of comprehensive strength.Including one's own wealth, knowledge, ability, contacts, and the strength of the family, the resources that can be mobilized.

Those who can easily mobilize a large amount of resources, the official first, and the rich businessman second.

This has been the case throughout the ages.

However, with the evolution of modern civilization, capital has gradually become a take-all.

The man told Zhou Can that he was not an ungrateful person.It means that as long as Zhou Can cures his illness, he will be his savior.

In the future, it will definitely come and go.

This person did not disclose his real identity for half a cent from the beginning to the end, but he was using his identity as a hole card.

"Have you eaten? If you haven't eaten, if you don't mind, I can treat you to the hospital's working meal."

People came all the way to see him.

Now that I have not been treated for my illness, please have a work meal, which is not too much.

"I've already eaten, go and eat! When do you think you'll be free? I'll come and find you when the time comes."

said the man.

"There are still many operations to be performed in the afternoon, and I'm afraid it will have to wait until the evening. It is not easy for you to come all the way. Otherwise, give me the information. I will read it carefully when I eat, and I will give you an exact answer when the time comes." answer."

Zhou Can's words are also tantamount to telling the other party, if it really can't be cured, then I'm sorry, you can only ask someone else.

To communicate with such a 'second generation', attitude is very important.

Show enough sincerity, even if you reject someone, I believe you won't be annoyed.

"Here! Please!"

The man handed him the information bag.

"You're welcome, this is what we doctors should do."

After receiving the information bag, Zhou Can quickly went to the cafeteria to eat.

Qiao Yu has already prepared meals for him.

Watching Zhou Can eating and reading the film, she couldn't help asking curiously, "This patient doesn't look like an ordinary person to me, what's wrong?"

"Aortic dissection is quite serious."

"It seems that you became famous in the live broadcast yesterday, and more people will come to see you for medical treatment in the future."

Qiao Yu said with a smile.

"Well, people are afraid of being famous and pigs are afraid of being strong. When a pig grows fat, it will be stabbed, and when a person is famous, troubles will follow. I really hope that some ordinary patients will come and give me enough time to grow. It's better to come less."

Zhou Can sighed.

All other doctors want to be famous.

But after he became famous, he was worried that the patients who came to see him were difficult to treat.

After all, it is still not strong enough.

Just like banknotes, there is never enough money to spend.

Don't look at him with a net worth of over [-] million, but the things he can do are extremely limited.

If you buy a house in a super first-tier city, you may have no money.

The same is true for the level of medical skills, which will never feel strong enough.Compared with the beginning, his strength is already very strong.

But there is still a thousand miles away from the peak of the medical profession.

"If the patient's identity is too sensitive, it's safer to push it directly. Anyone with a certain identity who suffers from such a serious illness must search for the best doctors all over the world to treat them. Other diseases that cannot be cured by top experts, You'd better not challenge it, the risk is too great."

Qiao Yubingxue was smart, and she understood that it was not easy for Zhou Can to see a doctor.

"Sister Qiao Yu is right. If you have to push back, you have to push it. Don't hesitate. If you find it inconvenient, I'll help you back later."

Ma Xiaolan's mouth and personality have always been like a little pepper.

She also has a good point, she is only cruel to others, but she is extremely caring towards team members and those close to her.

Whether Zhou Can encounters difficult patients or other medical difficulties, she will act righteously.

Sometimes watching her quarrel with patients and family members, Zhou Can admires her even more.

Everyone has shortcomings, and Ma Xiaolan has a lot of shortcomings, but with constant contact, Zhou Can never had the idea of ​​driving her away.

"No, I've already vaccinated the patient. If his treatment is beyond my ability, I can only ask him to go home. He flew here from Shanghai, I'm not dedicated, and I can't justify it."

Zhou Can has always been worthy of his conscience in doing things.

After reading the patient's film and biochemical test report, Zhou Can fell into deep thought.

The man named Chen Zhongzhi is 42 years old and has no other diseases.

Mainly cardiac aortic dissection.

Replacing the entire aorta is risky and traumatic, and placing a stent will hinder the blood supply of other branches.

This operation is really tricky!

Until the end of the meal, Zhou Can still failed to come up with a solution that could be solved without replacing the aorta.

Holding the information bag, he was going to tell the patient to find another Gao Ming.

After searching around, the man named Chen Zhongzhi seemed to have left the emergency department.

There is no other way, Zhou Can can only temporarily put the information bag in the office, and advance to the operating room for surgery.

It is estimated that this person should come over when he gets off work.

One after another, under the treatment of Zhou Can and his team members, the lesions were eliminated.

Most of them go with the treatment, just take some medicine and go home to recuperate.

Severe cases require hospitalization for a period of time.

"Ah yo, ah yo..."

A whimpering patient is wheeled in.

It must not be a small problem for a patient who suffers from such pain.

(End of this chapter)