Chapter 1440

Pulmonary embolism, also known as pulmonary infarction.

It refers to the clinical disorder of pulmonary circulation caused by endogenous or exogenous emboli blocking the pulmonary artery or its branches.

Its main source is thrombosis, others are amniotic fluid embolism, fat embolism, air embolism, foreign body embolism and so on.

For example, amniotic fluid embolism is a very serious complication after caesarean section. Thrombolytic therapy is not available yet. Ten years ago, it was almost a disease without solution.

One of the most feared complications of orthopedic surgery is fat embolism.

After pulmonary embolism, patients will have severe pain in the front chest and back and dyspnea.

However, early patients generally feel that tolerance is over, delaying the best treatment time.

But even in the hospital, when the earliest symptoms are not typical, the embolic site is not as typical as this patient, which is easy to be missed.

From the film, there is no doubt that the thrombus from the pulmonary valve blocked the main pulmonary artery.

There is no way to remove the thrombus, grinding... The blood vessel wall is too thin, which is completely different from the coronary artery. Plus, the embolus from the pulmonary valve can't be treated.

Grinding surgery is impossible.

Zheng Ren's first impression, like many directors of 912, believes that patients can only be treated with thrombolysis.

But when his eyes were about to move away from the image, Zheng Rensheng stopped his eyes again.

For a moment, the vestibular nerve trembled violently, so uncomfortable.

It's like taking a roller coaster for a moment.

Aware that Zheng Ren was wrong, Director Wei asked, "boss Zheng, are you a little tired after a day's tossing?"

"No, there's something wrong with the film." Zheng Ren looked straight at the film and said.

"Huh?" Director Wei didn't understand.

The image is very typical. The whole hospital is consulted. No one has any objection to the diagnosis. There are some differences, but there are some differences in treatment.

"Wait a minute, I'll think about it." Zheng Rendao immediately began to use the reconstruction ability.

The image of this position, three-dimensional reconstruction, magnetic resonance enhancement and vascular CTA are of little use.

According to the most basic image data, Zheng Ren used dual energy CT reconstruction mode to re observe the lesions originating from pulmonary valve.

Dual energy CT system can use two kinds of X-rays with different energy to image the object, and can accurately obtain the composition proportion of the object.

Its principle was put forward in the 1970s.

The composition of the object can be accurately calculated by using the difference of energy absorption curves of different substances.

Of course, to be very close to the truth, the doctor reading the film needs to have a deep understanding of the image.

And Zheng Ren is this person.

Reconstruction ability, very handy. But doing dual energy CT, Zheng Ren felt a little difficult.

The brain is full of horsepower and roars like a machine. The CPU quickly processes all kinds of data, and Zheng renlue is a little overwhelmed.

But dual energy CT images are still established.

It's a little fuzzy. It's still different from the image made by the standard machine. Nevertheless, Zheng Ren thought it was enough.

The image shows another situation, which is completely different from the previous judgment.

The large filling defect near the pulmonary valve is not a thrombus!

It's not a thrombus, but an echo of abnormal body tissue.

Zheng Ren looked at the dual energy CT image added in his mind. After an instant of excitement, he was silent.

Although it was not an embolus, it overturned the previous diagnosis.

But abnormal body tissue... Means that there is a tumor tissue in the patient's pulmonary valve area!

Whether benign or malignant, it is a tumor tissue!

Pulmonary valve tumor, which is quite rare.

"Su Yun, call Fuguier up." Zheng Ren said in a deep voice.

Director Wei and Ringer were stunned. What does boss Zheng mean?

After a brief and embarrassing silence, Zheng Ren immediately realized that he was in the doctor's office in the ICU, and Su Yun was not with him.

"Sorry, director Lin, Director Wei." Zheng Ren smiled.

"Boss Zheng? What did you find?" Director Wei asked in a low voice.

In this case of pulmonary embolism caused by pulmonary valve thrombosis, boss Zheng should also be treated with surgery?

Because some thrombi are not fixed in the original position, there is a great possibility of embolism in other positions during surgery.

So, this is a surgical contraindication!

Boss Zheng is going to attack the restricted area? Impossible.

No, he's going to call Professor Rudolph Wagner. Is he going to use interventional surgery?

No, Director Mao didn't say anything.

"Director Wei, I began to think it was pulmonary embolism." Zheng Ren said: "but after watching the film, I felt something wrong."

"What's the problem?" Director Wei asked.

"How to say? In the subtle sense, I preliminarily judged that the filling defect in the pulmonary valve area is the body tissue."

"...." Director Wei was dumbfounded.

This passage is slightly astringent for ordinary people. But for doctors, the presence of body tissue in the pulmonary valve area means that there are benign or malignant tumors!

I'll... A tumor in the pulmonary valve area?

Boss Zheng dares to think.

But director Wei didn't refute. Some time ago, he chatted with Feng Jianguo and said that boss Zheng may not be good at endoscopic surgery.

Then he was beaten in the face by a standard endoscopic emergency hemostasis and foreign body removal operation.

Boss Zheng immediately diagnosed pulmonary valve tumor. Director Wei really wanted to spray boss Zheng, but he held back.

Forget it, listen up and don't make the same joke as endoscopic surgery.

"Go and see the patient." Zheng Rendao.

Ringer felt that boss Zheng was out of control at this time, like a little beast.

His mind is full of surgery and patients.

Give boss Zheng more opportunities for surgery? I can't seem to do it myself. Besides, director Kong has contacted boss Zheng with the community hospital.

Others did what they should do. They came a little late.

So what do we do?

Zheng Ren took out his mobile phone and walked out of the doctor's office in ICU.

"Su Yun, ICU, call Fuguier."

"Busy, that's OK. I'm looking for Zhao Yunlong for the tumor of pulmonary valve. You're busy."

With that, Zheng Ren hung up without waiting for what Su Yun said on the phone.

But he didn't keep calling.

"Boss Zheng, do you want someone with heart?" Ringer immediately approached and asked.

"No, Su Yun will be there soon."

"Isn't Dr. Su busy?" Ringer wondered if he had heard wrong.

"Among the patients with pulmonary valve tumors, there are only 37 cases reported in the world, of which 35 cases are known by autopsy after death, and 2 cases are surgery, but the operation failed." Zheng Ren said, "in case of such a case, he has to put down his big things."