Chapter 1632： Corrected echocardiography

Zheng Ren did not have any mood swings. He did not notice the rudeness of the other party. He inserted the film into the reader.

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

The bullet enters about 1/3 of the inside of the right clavicle. The chest X-ray shows that the bullet is in the heart shadow of the lower edge of the heart, without hemothorax and pneumothorax.

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

The CT 3D reconstruction did not find the specific location of the bullet.

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

According to the casualty, when he was injured, he had a body leaning forward. There is no other reference to the rest of the medical history.

Looking at the surgical records of the Medical University Affiliated Hospital, there is still no meaning.

Zheng Ren is somewhat confused.

The flat is flat, the bullet is below the shadow of the heart, but the CT three-dimensional reconstruction does not. This is not a technical level problem. I have rebuilt it in my mind and I have not seen the image of the bullet.

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

Zheng Renhe hesitated a bit. According to the logic, the bullet was missing.

But two X-rays show that the bullet did not change position.

The patient's hemodynamics were stable with a heart rate of 96 bpm, a blood pressure of mmHg, and a respiratory rate of 17 beats/min. Blood parameters such as electrocardiogram and troponin T were normal.

Is it said in the heart? Zheng Ren suddenly came up with this idea.

Ordinary echocardiography does not see bullets, then try to correct it.

M-mode echocardiography is prone to the phenomenon that the detection result is distorted due to the irregular orientation of the ultrasonic beam.

Regarding the problem of echocardiographic azimuth error, and looking for a simple and effective method to correct the error, there is a special study, but the clinical use is relatively rare.

The measurement of cardiac structure parameters must follow the orthogonal rule. According to the mathematical principle of the left ventricle geometry mode, it is proved that there is a deviation from the azimuth cos θ between the error value and the true value.

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

Seeing Zheng Ren’s silent look at the film, Director Tian grinned and said coldly: “Mr. Ma, Gu is not coming, we can go. What do you mean by bringing a small doctor?”

"Director Tian, ​​you are enough!" Director Ma said with anger: "This is the candidate for this year's Nobel Prize winner Zheng Ren Zheng, not a small doctor."

"Nobel Prize?" Director Tian stunned, but still disdain, "is that the interventional department? Nonsense, clinical surgery can not get the Nobel Prize. This is with..."

Said, he sneered twice.

"Just like the combination to buy a prize at the National Music Awards, go up to reveal a face, fake sing fake jump." Professor Tian said next to the band group professor.

Director Ma really couldn’t sit still.

He thought that this was a big probability, but you said it, and in front of the parties, isn't it a face?

People are willing to sing a small apple or a small apple, what does it have to do with you?

912 is willing to play these, let people play. You have to make it, have the ability to get it, do it yourself! Is it meaningful to stand here and directly dismantle the emperor's new clothes?

If this matter is not handled well, I will definitely have two big deans to come forward.

Things go to that step, and finally go to the ministry...

Director Ma has not dared to continue thinking about it.

This kind of tearing has happened two or three times in the past 20 years, and every time it happens, it has shaken the entire medical community.

It’s great to stand on the sidelines, but it’s definitely not a pleasant thing to do with yourself.

"Director Ma, what do you mean by this?" said Linge Yinsen. "Comrade Zheng Ren is a member of the health care team. He just went to Nanyang to perform his mission and returned to China. Hey, your hospital affiliated hospital is not going to consult, you can't find it. The problem is, let the people of 912 come to cheer?"

"..." Ma is helpless.

This special thing, looking for opportunities must die to suppress the cardiothoracic surgery, so that they are so arrogant.

"CT looks at nothing, but the imaging is caused by a stack of shadows. After the correction, you can determine that the bullet is in the heart." Zheng Ren suddenly said faintly.

Linge was a bit hesitant. If Zheng Bo couldn't find the bullets, it would be useless to make a fuss.

However, Zheng boss found the bullets, occupying the commanding heights, and they will not die!

As for what Zheng boss said, Ringer can't care. According to his "rich" clinical experience, Zheng boss has never been wrong!

Zheng Ren still has nothing to do with what other people are doing. After he found the problem in the 3D reconstruction, he came to the system space and clicked on the surgery to enter the system operating room.

Surgical training begins!

Open the chest, open the sternum, and the sound of the sternum saw in the system operating room echoes.

Zheng Ren feels a little dangerous while doing it. It may be dangerous to come from Su Yun.

Such a large operation, or the removal of the bullet into the heart, do not call him, will he turn his face? !

Regardless of this, it is up to the anatomical structure to determine that the bullet is inside the heart.

Open the mediastinum, Zheng Ren used the eight-claw to fix the heart and cut the right ventricle.

A yellow orange orange pops out in the field of vision.

It is not an imaginary shot, but a standard bullet.

The bullet is in the diaphragm of the right ventricle. After removal, the heart is sutured and no active bleeding is detected. The operation is announced.

Surgery is not difficult for Zheng Ren.

At the moment of the operation, Zheng Ren’s mind suddenly had another thought.

This position seems to be able to remove the bullets by interventional surgery without opening the chest.

The incredible thoughts scared Zheng Ren himself.

The original "simple" surgery has become extremely complicated.

Do you want to try?

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

Try?

Try it and try it.

With a calm heart, Zheng Ren recalled the location of the bullet and the possibility of taking it out.

It is still possible.

Gunshot wounds, the patient is lucky without major damage, this is a fortune. However, Zheng Ren still wants to let the personnel working overseas to be less hurt and smaller.

Do you take the time to experiment with new surgical procedures, shouldn't it be?

It should be, and it is necessary.

Zheng Ren himself has full respect for their employees of state-owned enterprises who are rushing overseas. Although it seems to be "wasted" because surgery can solve the problem.

But he still wants to try.

The procedure was different from the previous procedure. Zheng Ren used the 16-Fr E-sheath to perform right femoral vein puncture by echocardiography in the conscious and sedative state of the experimental body.

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

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