Chapter 470

Chapter 470 median sternotomy

In the evening, Chen Qun thought he could wait for his girlfriend's good news, but what he was waiting for was an unexpected help, from the Department of Cardiology.

Academician Yang Xiaoquan called in person.

"Xiao Chen, I have a patient who has undergone a heart transplant. He is in shock again and may need surgery. Can you come right now? Wait, forget it. I'll send the ambulance directly to your emergency center. I'll come to consult with you as soon as I arrive! "

Yang said, thought about it, and then continued to explain the situation.

"The patient has been given two and a half units of dobutamine intravenously and added dopamine to raise blood pressure. If you come, he needs to do blood gas analysis and ECG first! If the situation is bad, you need to give him an injection of milrinone to make sure he can survive the test

For the first time, Chen Qun saw Mr. Yang explain everything. He was just wondering why he didn't send it to the cardiovascular department. Then he remembered that Gu Ning had gone to the capital for a meeting. If you change to another doctor, I'm afraid that this kind of heart transplant patients, dare not take over.

For Mr. Yang, there is no such worry. He is not a student, but he comes to see his surgeon. Most of the patients have some special conditions, so he will choose himself.

At the thought of Yang's operation, Chen Qun knows that it's time to wake up the girl Xueba anyway. Otherwise, she will complain about it all her life. He has offended the girl Xueba once, and this time he will be atoning for her sins.

When his girlfriend is not around, Chen Qun doesn't know which room the female nurses who are going to enjoy the five-star hotel on holiday live in. With a change of heart, he simply dials Wang Qiong's number and asks her to help and calls Qi Hong over.

When all this was arranged, he had come to the ambulance Lane in front of the emergency center and made preparations for rescue. Before the ambulance arrived, Qi Hong called.

"I just got the medical record form from my teacher, and his heart transplant operation has only been done for less than half a year. Is there any rejection reaction in his body?"

"Anything is possible! It can only be determined after the inspection is completed! "

"But we can rule out the diseases that are probably impossible, so as not to waste more time. I've imagined a few possibilities. You can get back to me when you see the patient. Myocardial infection accounted for 30%, myocarditis accounted for 20%. I just received the ambulance data. His blood pressure is 110 / 70, he is short of breath, but there is no ST segment elevation. Myocardial infarction is ruled out

"I think Mr. Yang told me to prepare for an operation. You go to ask your master what is the most likely disease, so that we can prepare. If you don't have an operation, Mr. Yang won't send the patient to me. Because operating on a transplanted heart is something all doctors try to avoid. But Yang still has this plan, indicating that he has given the worst estimate. "

When Qi Hong heard Chen Qun's explanation, he understood what he meant, but he still had to correct one of his misconceptions.

"The patient's operation was performed in Union Medical College Hospital, not my teacher's patient. My teacher asked you to be the master, but he gave you a chance. Don't think you are so good... "

Qi Hong said two unreasonable words, but she couldn't go on. For fear that she would laugh, she hung up the phone and asked the teacher.

"Teacher, what symptoms do you think this patient is most likely to have before they need to be sent to our operating room for rescue?"

After pondering for a while, Yang Koizumi said his guess.

"I suspect that there were complications in the original transplant operation, but when I was in the capital, I was rescued in a very dangerous way, and now it may have recurred. You tell Xiao Chen that I asked him to perform this operation. If there is any problem or responsibility, I will be responsible for it. You can rest assured and implement it boldly. "

When Qi Hong saw the phone hung up again, she naturally knew the teacher's concerns. This kind of operation for patients with heart transplantation again was extremely high-risk.

"Any act of reoperation for a heart transplant patient is dancing on the tip of the knife, because as soon as there is bleeding, the patient will die on the operating table. Even if you enter the chest successfully, scar tissue will prevent you from seeing the heart clearly, and then you will probably hurt the blood vessels by mistake. Only lunatics and geniuses will operate again. "

Qi Hong dials Chen Qun again.

"Is the patient here?"

"It just arrived. I saw the color Doppler ultrasound on the ambulance, and I have determined the cause of the disease. It's aortic root dissection, which is completely in line with Yang's prediction. It's a common problem in the surgical complications. A slight increase in blood pressure will lead to the deterioration of a fissure, and the last one is out of control! Therefore, we must do surgery to solve the problem. It seems that the cardiopulmonary bypass instrument we prepared in the morning can finally be used. "Chen Qun did not expect to encounter two heart operations in a day, but with a little excitement. Besides, the patient has a very luxurious private ambulance, which means that the family is not generally rich. The ambulance doctor is also very professional. In addition, the equipment inside saves him a lot of time.

As he was preparing to take the patient to the operating room with the ambulance staff, he saw a bicycle coming from the side, and an old man, academician Yang Xiaoquan, jumped down from it. As soon as we met, Mr. Yang asked in a hurry.

"What is the situation?"

"It's the aortic root tribe. I'm going to use median sternotomy. I'm going to cut along his original scar and pry his sternum open for surgical treatment."

Chen Qun answered with confidence that at the moment he saw the patient, he used the system space operating room again and carried out four or five drills, almost without fail. What's more, his current drill is not the same as before. Instead, he deliberately creates all kinds of problems and accidents, and then carries out rescue. No longer the original rookie level will complete the operation, even if it is done.

Pushing the old bicycle, academician Yang immediately asked a question.

"If the scar tissue is too dense to open the chest, how do you deal with it and knock on his sternum to continue the operation?"

"No, I can use the Bowie cautery to treat the scar tissue, use the thoracotomy device to complete the thoracotomy, use the extracorporeal circulation device to deliver blood to his whole body, and finally use the polyester graft to repair the aortic problem."

"Good boy, all the situations are preset first. Let's go. My old man will see how you solve this problem that no one dares to take over. "

Chen Qun felt a touch in his heart, knowing that academician Yang simply let go this time. If the operation is successful, all the credit will go to Chen Qun. If the operation fails, academician Yang will go up and carry the pot.

Such a doctor is the treasure of the hospital and the mainstay of the hospital. With his words and deeds, Yang laozheng teaches him by example and believes him as a young man without reservation.