v3 Chapter 2710： Little bit of accumulated clinical experience

"You may not know about the ophthalmology. Always cut the gallbladder." Su Yun stared at the ECG monitor, moved a footstool on the left side of the patient, and talked with Yu always.

"Uh, is it reflexive?" Yu asked.

"Yeah, what is the most afraid of cutting the gallbladder? What is common bile duct cut is very serious, but not as severe as the biliary reflex. Like the eye-cardiac reflex, the heart rate caused by the gallbladder is reduced during biliary surgery, or the biliary tract is explored. Blood pressure drops, and severe cases can cause myocardial ischemia, arrhythmias, and even cardiac arrest due to reflex coronary spasm. "

"Especially in the rescue of patients with hemorrhagic shock, the probability goes up and down."

General Yu is okay, after all, it is the total hospitalization of 912. But Gu Xiaoran's heart pounded while listening.

He has already begun surgery in his home hospital.

The hospital at home is relatively small, and the divisions are not so detailed. The director has contact with Zhou Chunyong, so Gu Xiaoran seized an opportunity that everyone was unwilling to come to the capital.

This time when he came to study in the emperor, Gu Xiaoran's life has changed tremendously. Every day he has a brand new change. For example ... today.

When he thought of what he usually explained to the patient's family before the cholecystectomy, he had no biliary reflex, and he had no idea what the biliary reflex was.

Not to mention Gu Xiaoran, even their director should not know. The probability of this situation is extremely low, and it is not necessary to encounter one case for 1000 operations, let alone Gu Xiaoran.

"Brother Yun, what to do after it appears?" Gu Xiaoran asked quietly.

"Rescue, can you still watch the patient die?" Su Yun said contemptuously: "If you are not sure, call your Daniel in the hospital, whoever is the most powerful. Of course, you only need to It ’s okay not to cry on the operating table. Pollution in the operation area is not enough trouble. "

Su Yun finally made a joke about Gu Xiaoran.

"Hey." Gu Xiaoran smiled, but his smile was stiffer than the total.

"Xiao Ran, right." General Director Yu, "Biliary reflexes are really rare, and urinary retention in the bladder is less common to pull the vagus nerve. Otherwise, why is Boss Zheng always feeling something before the operation but can't remember it? what is it then."

Gu Xiaoran glanced at Boss Zheng and saw that he was sitting in the corner of the operating room. His eyes seemed to be the same as Yun Geer's, watching the ECG monitoring.

Boss Zheng was still worried about the patient, and Gu Xiaoran raised a slight strangeness in his heart. I always hear Boss Zheng's rich clinical experience ... what is rich clinical experience? This is it.

Although Boss Zheng did not find out at the earliest time, but he stepped forward at the first time, the rescue of the host was successful, and the patient should have no problem.

Thinking of this, Gu Xiaoran glanced at the patient again.

He opened his eyes in confusion, as if he had just fallen asleep and had no idea what was going on.

"The probability is different. The probability of cardiac-eye reflexes in eye surgery is 90%, but the probability of cardiac reflexes induced by the bladder is too low." Su Yundao.

"Uh ... I remember it. Once I had an operation, I saw the patient's appendix after laparotomy." Yu Zong had already completed the fistula, and by the way instructed the visiting nurse to expel the urine in the bladder in 2-3 times. As soon as I pull the hook, the patient's heart rate changes, which was fun at the time. "

"That was caused by reflexes, and the vagus nerve reflexes of the gastrointestinal tract were also very rare, and after that, they did not know what was going on." Su Yun stood on the footstool again, looking up at the ECG monitor, looking down.

"Almost, no experience at that time. Brother Yun, it should be all right this time."

"It should be okay." Su Yun glanced at his boss and saw him sitting on a stool steadily. Although he didn't say a word, even if he was sitting there, it gave a sense of solidness in his heart.

As long as the goods are there, there must be nothing wrong. Su Yun's heart gradually accepted this reality.

Really rich clinical experience? Or is this goods born with a keen sense of smell, like the sunspot?

Su Yun glanced at his boss and wondered.

In this accident, he didn't seem to know what would happen before. It was only at the moment of a sudden cardiac arrest that he started the rescue. Alas, why is the boss so willing to grab the limelight? Su Yun sighed deeply.

"It is not uncommon for the bladder to fill up and cause cardiac arrest," Zheng Ren said suddenly.

"Ok?"

"But generally speaking, it is not thought that it is caused by the bladder filling." Zheng Ren continued: "I urinate in the morning and suddenly empty, the whole person fell into the bathroom. Such examples are often seen, but generally sent Go to circulatory medicine for treatment. "

"..." President Yu froze for a moment.

"When a cavity organ receives a dilation stimulus, it can pass through the celiac plexus or the vagus nerve to the afferent center, excitement is transmitted to the parasympathetic lower sympathetic center, the dorsal nucleus of the vagus nerve, release the impulse, and then reach the heart through the parasympathetic fibers in the left vagus nerve. Zheng Rendao, "A very clear reflection arc."

"Uh ..." Gu Xiaoran suddenly made a stupid voice, and then said, "Boss Zheng, our old director had an operation and a sudden myocardial infarction! Now I think it might be diarrhea. "

"Huh? Then?"

"Heart attack."

"Rescued?" Zheng Ren asked.

"Oh, after all, it was in the operating room, and it was rescued." Gu Xiaoran said, "while dissolving the thrombus, I contacted the municipal hospital, and the 120 ambulance took the stand off."

"You can't even get the stand off?" Su Yun asked.

"Um." Gu Xiaoran nodded, "I went with me, and the doctors in the city said that it was almost impossible. Fortunately, I was sick in the operating room, but I felt very lucky at the time, and now I think it might be diarrhea .UU 看书 "

"Boss, do you say this is a work injury?"

"Have you heard of an industrial injury at the hospital?" Zheng Ren asked infrequently.

Gu Xiaoran didn't finish talking, and then turned the topic away. He quickly asked: "Boss Zheng, the vagus nerve is excited, then what?"

"The results of vagus nerve excitement are-coronary vasospasm, reduced atrial node excitability, slower specific conduction system conduction velocity, weakened myocardial contractility, decreased cardiac output, decreased blood pressure, and even cardiac arrest." Zheng Benevolence.

"It's amazing." Gu Xiaoran whispered.

"Not great, I never thought about it before." Zheng Ren sighed and said, "This time I have experience, and I will be fine in the future. Su Yun, you are right."

"I'm right about anything?" Su Yun asked, glancing at Zheng Ren.

"Clinical experience is accumulated a little bit, that Korean professor is a hooligan." Zheng Ren said seriously.