Chapter 1632

Zheng Ren didn't have any mood swings. He didn't notice the other party's rudeness. He inserted the film into the reader.

Like the films seen in the system space, two standing X-rays and one CT three-dimensional reconstruction.

The bullet entered about 1 / 3 inside the right clavicle. Chest X-ray showed that the bullet was in the heart shadow at the lower edge of the heart, without hemothorax and pneumothorax.

The location of the clavicle fracture has been treated with external fixation, which is clear.

However, CT three-dimensional reconstruction did not find the specific location of the bullet.

Zheng Ren took a look at the film and began to look through the medical records.

According to the personal account of the injured, he had a forward leaning movement when he was injured. There is no reference for the rest of the medical history.

Looking through the operation records of the Affiliated Hospital of Medical University, it is still meaningless.

Zheng Ren is a little confused.

In the standing plain film, the bullet was under the shadow of the heart, but the CT three-dimensional reconstruction did not. This is not a matter of technical level. I reconstructed it in my mind and didn't see the image of bullets.

Cardiac color Doppler ultrasound, conventional four chamber color Doppler ultrasound, still did not see the bullet, only mild tricuspid regurgitation.

Zheng renslightly hesitated. According to the logical judgment, the bullet was missing.

But two X-rays showed that the bullet had not changed its position.

The patient had stable hemodynamics, heart rate of 96 BPM, blood pressure of 110 / 70 mmHg and respiratory rate of 17 beats / min. ECG, troponin T and other blood indexes were normal.

Is it in the heart? Zheng Ren suddenly had this idea.

If you don't see a bullet in ordinary echocardiography, try to correct it.

M-mode echocardiography is prone to distortion of detection results due to incorrect incident orientation of ultrasonic beam.

There are special studies on the problem of echocardiographic azimuth error and looking for a simple and effective method to correct the error, but it is rarely used in clinic.

According to the mathematical principle of left ventricular geometric model, it is proved that there is an azimuth deviation cos between the error value and the real value θ Functional relationship.

Thus, the mathematical expression of correlation correction error is created, and the cos for measuring deviation angle is provided θ A simple method for correcting error by function.

Seeing Zheng Ren silently watching the film, Director Tian curled his lips and said coldly, "director Ma, if Gu doesn't come, we can go. What do you mean by bringing a little doctor?"

"Director Tian, you've had enough!" Director Ma angrily said, "this is Dr. Zheng renzheng, a candidate for this year's Nobel Prize, not a small doctor."

"Nobel Prize?" Director Tian was stunned for a moment, but still disdained, "that's the one in the intervention department? Bullshit, the clinical operation won't win the Nobel Prize. It's like..."

Then he sneered.

"Just like that group buying awards at the national music awards, they show their face, lip synch and jump." The professor with the group beside Director Tian said.

Director Ma really can't sit still.

He thought it was a matter of high probability, but you said it in front of the party. Isn't that a slap in the face?

What does it matter to you whether people are willing to sing or eat small apples?

If 912 is willing to play these, let others play. If you want to do it and have the ability to do it, do it yourself! Is it meaningful to stand here and directly tear down the emperor's new clothes?

If this matter is not handled well, two presidents must come forward in the end.

When things get to that stage, they will finally go to the Ministry

Director Ma has dared not continue to think.

There have been two or three such incidents in the past 20 years, each of which has shocked the entire medical community.

It's great to stand aside and watch the excitement, but it's definitely not pleasant when it comes to yourself.

"Director Ma, what do you mean?" Ringer said darkly, "Comrade Zheng Ren is a member of the health care team with a high level. He has just returned home from a mission to Nanyang. In the same way, the Affiliated Hospital of your medical university either wants to consult or can't find the problem. Ask our 912 people to vent their anger?"

"..." director Ma was helpless.

This is so special. You must die when you find a chance to suppress cardiothoracic surgery and make them so arrogant.

"CT looks fine, but it's caused by overlap on imaging. After correction, it can be determined that the bullet is in the heart." Zheng Ren suddenly said faintly.

Ringer was a little hesitant. If boss Zheng couldn't find out where the bullet was, it would be useless to make trouble on his face.

But boss Zheng found the bullet and occupied the commanding height. He couldn't kill them!

As for what boss Zheng said, ringer didn't care. According to his "rich" clinical experience, boss Zheng is never wrong!

Zheng Ren still didn't care what others were doing. After he found the problem in three-dimensional reconstruction, he came to the system space, clicked to buy surgery and entered the system operating room.

Surgery training begins!

Thoracotomy, sternal split, and the buzzing sound of sternal saw echoed in the system operating room.

Zheng Ren feels some danger while doing it. The danger may come from Su Yun.

Such a big operation, or the removal of bullets floating into the heart, if you don't call him, will he turn against himself?!

Regardless of this, we have to determine from the anatomical structure that the bullet is in the heart.

Open the mediastinum, Zheng Ren fixed the heart with an eight claw device and cut open the right ventricle.

A yellow bullet appeared in sight.

It's not an imaginary shotgun, but a standard bullet.

The bullet was in the right ventricular septum. After removal, the heart was sutured. No active bleeding was found. The operation was declared over.

The operation is not difficult for Zheng Renlai.

At the moment of finishing the operation, another idea suddenly appeared in Zheng Ren's brain.

In this position, it seems that the bullet can be removed through interventional surgery without thoracotomy.

The unimaginable idea startled Zheng Ren himself.

The original "simple" operation has become extremely complicated.

Would you like to try?

However, the idea rose from the bottom of his heart, and Zheng Ren could no longer contain his desire for this strange technique.

try?

Just try.

Calmly, Zheng Ren recalled the location of the bullet and the possibility of taking it out.

It's still possible.

Shooting injury, the patient was lucky that there was no major injury, which was a bad luck. But Zheng Ren still wants to make the injury to overseas staff smaller and smaller.

Shouldn't you spend some time experimenting with new surgical methods?

Yes, and it is necessary.

Zheng Ren himself has full respect for the employees of state-owned enterprises who travel abroad. Although it seems a little "wasteful", because surgery can solve the problem.

But he still wants to try.

Different from the previous operation, Zheng Ren performed right femoral vein puncture with 16 fr e sheath under the guidance of echocardiography in the conscious and sedated state of the experimental body.

The guide wire and catheter enter the femoral vein, then the inferior vena cava, and finally the right ventricle.