Chapter 1356

Zheng Ren and Lin Ge come to cardiothoracic surgery. Zhao Yunlong is standing in front of the film reader in the office, frowning at the film.

It's normal for the second-line professors in other departments to arrive a little later because they have left work.

"Lao Zhao, what patient." Zheng Ren asked.

"Mr. Zheng, take a look." Zhao Yunlong saw Zheng Ren and Lin Ge come in together. Without saying hello to Lin Ge, he directly pulled Zheng Ren over to see the film.

Zheng Ren glanced at him and his heart sank.

The patient's mediastinum was a white patch with severe infection, which had invaded the visceral pleura and aorta.

"The 62 year old patient ate mandarin fish at home two weeks ago and got a fish bone stuck. Later, he ate steamed bread after taking aged vinegar and wanted to choke." Zhao Yunlong said.

So it is. No wonder big pig hooves call this a blood case caused by steamed bread.

Zheng Ren nodded, held his arm and began to watch the film.

"There were no strong symptoms at that time. Cough and expectoration began to appear three days later. One week later, it was difficult to breathe, and the expectoration turned yellow. One day ago, the expectoration turned black and yellow, and the doctor of the local hospital suggested to come to DIDU for diagnosis and treatment." Zhao Yunlong introduced.

"Mediastinal abscess is very heavy. We should hurry up for surgery." Zheng Rendao.

"Well, I think the aorta is invaded and I need to remove the aortic shelf." Zhao Yunlong said, "if you can anastomose without artificial blood vessels, try not to."

"Well, then, the operation would be too big. Moreover, the infection is too serious, and the possibility of bacteremia and sepsis... Basically, there must be complications." Zheng Ren immediately understood what Zhao Yunlong meant.

"I also want to see who will come to the interventional department for consultation. If the level is high, I'll call Su Yun." Zhao Yunlong whispered with a smile.

"Who did you operate on?" Zheng Ren asked.

"I'm on the second line. Professor Zhang's level is not good." They are all our own people, Zhao Yunlong said bluntly.

In clinical practice, the level of professors may not be higher than that of the total inpatients, nor may the level of nationally famous professors be higher than that of others.

Generally speaking, the level of well-known professors in China is not necessarily high. In their forties, when their hand speed, eyesight and energy began to decline from the peak, many people gave up clinical practice and began to run across the country and lecture tour.

In this way, the national popularity is up, but the surgical level is down accordingly.

Some things are difficult to achieve. People who really do well in surgery squat in the hospital in obscurity and have little chance to let everyone know.

Even if someone knows, it's just fame in a small circle.

"Professor Zhang..." Zheng Ren said, looked around and saw that only ringer was sitting in a chair and reporting things on his mobile phone, so he whispered, "can aortic arch replacement be done?"

"It can be done, but the mortality rate is particularly high." Zhao Yunlong said.

Zheng Ren knows.

He didn't continue to ask. It had nothing to do with himself whether other people's surgery was good or bad.

Continuing to watch the film with his arms in his arms, Zheng Ren is like a stone carving, standing still despite the wind and rain.

More than ten minutes later, the second-line on duty professors of relevant departments came in one after another. I know Zheng Ren. Say hello. Most of Zheng Ren didn't know him, so he passed.

"This is the patient's film?" A voice came from behind.

"Professor Zhang, it's a film for emergency patients." Zhao Yunlong replied in a deep voice.

Zheng Ren looked sideways and saw a doctor about 50 years old with gray hair standing behind him.

His hair is meticulous and his snow-white clothes are like a swordsman in white. He can fly in the wind. The whole person looks very energetic and elegant.

"Hello, Professor Zhang." Zheng Ren greeted politely.

"Boss Zheng, do you also have research on our cardiothoracic surgery?" Professor Zhang greeted him coldly.

"This is not thinking about whether the risk of the next aortic stent will be much lower if the operation is performed." Zheng Ren said with a smile: "the stent is good, but it is still difficult to peel off the abscess."

"This operation can't be done at all." Professor Zhang heard Zheng Ren talk about surgery and directly denied it.

Zheng Ren didn't speak, just smiled. The muscles on Zhao Yunlong's face trembled a few times, and he didn't speak.

"Everyone is here. Mr. Zhao, please introduce the patient." Ringer sat in the middle. He began to chair the meeting on behalf of the medical office.

Zhao Yunlong reported his medical history, which was much more detailed than when he described it with Zheng Ren.

The patient has been suffering from a high fever, which is a sign of serious infection. Bacteria culture, mainly Pseudomonas aeruginosa, there are other drug-resistant bacteria.

The film is very obvious, mediastinal pneumatosis and mediastinal abscess. The diagnosis is particularly numerous and complex.

But when it comes to treatment, it's even harder.

"Let me tell you my opinion." Professor Zhang stood in front of the film reader and said calmly.

His gray hair seems to tell a wealth of clinical experience. The whole person looked clean and calm, and a stream of bookish spirit rushed forward, which made people unconsciously produce a kind of trust.

"I don't deny that the patient needs surgical treatment. But after reading the film, we can see that part of the aortic adventitia has been damaged due to the long delay in the lower level hospital." Professor Zhang's voice is very pleasant to hear, with a slight hoarseness in its massiness.

"In this case, there is no chance to peel off the abscess. If the operation is forced, the probability of the patient dying on the operating table is greater than 95%." Professor Zhang Langsheng said: "if the patient's family members have to have surgery, I suggest at least 64 row CT three-dimensional reconstruction of the chest."

Zheng Ren shook his head in his heart.

Chest 64 slice CT three-dimensional reconstruction... He should say three-dimensional reconstruction of vascular CTA and mediastinum.

This kind of slow diagnosis examination, even if the medical office comes forward, can only be done tomorrow at least. According to the normal process, it is early to get results the day after tomorrow.

What he said was very clear and the underlying meaning was very clear. Surgery can't be done, at least not tonight.

Because Professor Zhang is in the second class today. If something happens, he needs to take responsibility.

Even if you do, you have to talk about it tomorrow and the day after tomorrow.

He will not be on duty at that time. He will sit there and have a look at the operation. Success or failure has nothing to do with him.

However, what Professor Zhang said was smooth. First of all, he stressed the seriousness of his condition. For such a serious disease, it is necessary and necessary to do three-dimensional reconstruction before operation to understand the condition.

What a slippery Tai Chi Master, Zheng Ren thought.

Seeing that everyone was silent, Professor Zhang picked up the medical record and began to talk endlessly.

From the laboratory examination of leukocytes, neutrophils and C-reactive protein to the changes of pathophysiology, it is reasonable.

The lecture was really good, Zheng Ren thought.

"Do you have any comments?" Rington asked.

"Let me say something." Zheng Ren stood up, smiled gently and said.

……

……

Ask for a monthly ticket. Ask for a guaranteed monthly ticket at the beginning of next month.