I can see health

Chapter 166 Is perfusion effective? (Yesterday's third update)

After Wang Zihao accepted the WeChat transfer, Lu Chen felt a little relieved.

The 3M stethoscope in my hand is not so hot anymore.

After changing into a white coat, I came to the doctor's office.

He replaced the Yuyue brand stethoscope around his neck and put on a brand new 3M stethoscope.

Sure enough, expensive things are good.

Lu Chen felt that his whole temperament was different.

"Junior Brother, your new stethoscope is not bad."

Sun Guoguo saw Ke Luchen's 3M stethoscope at a glance.

It seems that the younger brother is really not short of money, and can use such a high-end stethoscope. She has only seen it at Teacher Li Yao.

Lu Chen smiled and didn't say much.

keep a low profile...

……

Finish the shift.

The most important thing this morning was Zhang Fengying's ablation surgery for hypertrophic cardiomyopathy.

"Mother-in-law, let me explain the precautions and risks of ablation surgery again."

Lu Chen came to the hospital bed and took the trouble to communicate with Zhang Fengying and Yuan Hang about the risks of surgery.

"The risk of surgery is that it may lead to acute myocardial infarction, malignant arrhythmia, and even the risk of sudden death..."

"Doctor Lu, you have explained it many times, and I will recite it." Zhang Fengying smiled, "Everything is under your arrangement."

"That's good." Lu Chen nodded, "Mother-in-law, you wait by the hospital bed first, and a nurse will pick you up to the cath lab soon."

nine in the morning.

The nurse in the catheterization room came to pick up Zhang Fengying on time.

Yuan Hang helped push the bed, and went to the CCU catheterization room on the fourth floor with Zhang Fengying.

The surgeon is arranged by the cath lab.

Now, Lu Chen is waiting for the final result.

After getting along these days, Yuan Hang's view of Lu Chen has changed a lot.

The halo of "Professor Lu Chen" has faded, and now it is the young doctor Lu Chen.

The young Lu Chen is more real and more responsible.

In addition, since Lu Chen told Fan Zhiping on WeChat that "the patient came to Jinghua Second Hospital".

Fan Zhiping never took the initiative to contact Lu Chen again.

Even if a difficult and interesting electrocardiogram appeared in the Jinghua electrophysiology group, Fan Zhiping did not speak.

If we say that Fan Zhiping used to be a talker in the group.

But now he is just a squid who loves to dive, and he hardly bubbles anymore.

"It's probably because he discovered my identity, so it would be embarrassing." Lu Chen couldn't help guessing in his heart.

But he didn't care.

In line with the original intention of improving the electrocardiogram level and earning gratitude at the same time, he is still active in the electrophysiology WeChat group every day.

It has not been a month since he entered the group chat.

The title "Professor Lu Chen" is already quite famous in the group.

……

11:30am.

Zhang Fengying's ablation surgery ended and she returned to the eighth area of ​​her heart.

"Grandma's surgery was a success!"

On the hospital bed, Zhang Fengying was still a little weak.

But when she heard Lu Chen's words, she grinned, "Thank you, Dr. Lu."

Lu Chen picked up his 3M stethoscope and auscultated Zhang Fengying's heart valve area.

"Compared with pre-operation, the murmur has been significantly weakened."

In patients with hypertrophic cardiomyopathy, pathological murmurs can be heard in the heart valve area.

After the ablation operation, the obstruction will be relieved and the murmur will be weak.

"Doctor Lu, thank you so much." Yuan Hang looked excited, "Well, when will my mother be discharged from the hospital?"

Another eternal topic.

As soon as the operation was done, I thought about leaving the hospital.

Lu Chen smiled, "Although the operation was successful, I still have to be careful of postoperative complications, such as acute myocardial infarction, high-grade atrioventricular block, and other malignant arrhythmias. Usually, I observe for a week and there is no problem, mother-in-law. You can leave the hospital."

This time, Yuan Hang nodded cooperatively: "Doctor Lu, I'll just listen to you, if you say stay for a week, it will be a week."

Next, the most important thing is to perfect the echocardiography.

Echocardiography is the most non-invasive test for understanding the structure of the heart.

Postoperatively, the effects of the surgery can be further evaluated.

Sun Guoguo directly requested a bedside emergency echocardiogram.

Bedside echocardiography showed that the pressure gradient of the left ventricular outflow tract decreased significantly to 30mmHg, and the contraction of the hypertrophic myocardium in the interventricular septum was weakened, and the left ventricular outflow tract was widened.

"Well, the result of the operation is good." Sun Guoguo looked at the echocardiography report, "I will be discharged from the hospital at an elective date, let's have regular checkups."

"Okay." Lu Chen nodded.

"Congratulations, received the thank you from Yuan Hang +1!"

"Congratulations, received the thank you from Zhang Fengying +1!"

The system's prompt made Lu Chen very happy.

Zhang Fengying can be regarded as his first "fan" in the true sense on his way to practice medicine.

Now the task is successfully completed.

……

A busy day at the clinic.

In the afternoon, Lu Chen went to the Skill Center of the Second Academy again.

This time, Dai Wansong did not stop him.

Since the school released the latest rewards last time, everyone has worked hard to enter the school team and get a good ranking.

Lu Chen's arrival did not attract everyone's attention.

He came to the corner alone and started training basic skills.

Prompts pop up continuously in the system panel:
Skill proficiency rises...

Skill proficiency rises...

……

He waited until the proficiency of some basic skills rose to 80% before he finished his smooth training and left the skill center.

After dinner, go back to the dormitory.

At present, Lu Chen still has the last universal card for virtual training, and he wants to further improve his internal medicine skills.

Thinking of this, his consciousness entered the virtual space training, and began targeted internal medicine training.

After using this universal card for two hours, he should be able to complete 1/3 of the operation of the internal medicine system.

……

Fengmei County People's Hospital, Department of Cardiology.

"Damn it, how did the emergency department take the patient poisoned by this drug into our hearts?"

When Fan Zhiping saw the patient in front of him, he couldn't help cursing in the emergency department.

He was on night shift today, and as soon as he took over the shift, the emergency department sent him a patient who was taking medicine.

A 17-year-old female patient took orally 50 propafenone tablets, 1 bottle of atenolol, and some adenosine triphosphate an hour ago.

The patient's condition is not very good, the spirit is extremely listless, and he complains of persistent palpitation and chest tightness.

After gastric lavage in the emergency department, he was immediately sent to the cardiology department.

"Director Fan, she is taking anti-arrhythmic drugs, so I brought them to you." Seeing that Fan Zhiping's face was not looking well, the emergency doctor quickly explained.

All the patients have been sent here, what else can Fan Zhiping do, he can only bite the bullet and admit him for treatment.

"This is the electrocardiogram taken in the emergency department." The emergency doctor handed the electrocardiogram to Fan Zhiping, "I look like atrial fibrillation."

Fan Zhiping took the electrocardiogram and frowned.

The electrocardiogram showed rapid atrial fibrillation and wide QRS, consistent with the electrocardiographic findings of propafenone poisoning and atenolol poisoning.

But their cardiology department will not treat this kind of drug overdose!

"Immediately ask the nephrology department and the ICU for an emergency consultation to see if hemoperfusion can be done!" Fan Zhiping immediately ordered.

"Received!" The nurse on duty responded and began to contact the relevant departments.

In the emergency department of the primary hospital, there is no ability to diagnose and treat drug poisoning. Most poisoned patients will be sent to the nephrology department, or it is recommended to go to a higher-level hospital.

The nephrologists and ICU consultants came soon.

Physicians in both departments were hesitant about hemoperfusion.

"The patient's blood pressure cannot be stabilized, and the effect of blood perfusion is not good!"

"Director Fan, why don't you transfer the patient to a higher-level hospital?"

Fan Zhiping looked anxious.

"Stop talking nonsense, you two. If the patient's family members are willing to transfer, they won't be admitted. And now that the patient's blood pressure is not stable, what should I do if something happens during the transfer?"

The ICU consultation doctor shook his head helplessly, and said: "Director Fan, we have never seen this kind of drug poisoning before. Hemoperfusion costs tens of thousands of dollars once the machine is on, and it is not reimbursed, and the effect is uncertain. If the family members insist Perfusion, you can come to our ICU."

Both the ICU and the Department of Nephrology wrote consultation opinions, and hemoperfusion was performed when necessary.

Fan Zhiping was very helpless. Isn't this equivalent to not writing anything?
Outside the doctor's office, the patient's family members are still urging outside, wanting to understand the condition and how to treat it next.

"What should we do?" Fan Zhiping didn't know what to do.

He was taken aback for a moment, thinking of the Jinghua Electrophysiology Exchange Group.

Now I can only try it out.

Fan Zhiping sent all the electrocardiogram and the medicine the patient took to the group with text.

"Is perfusion effective after taking these medicines?"

Since communicating with Lu Chen last time, he finally bubbled up in the group again.

　Yesterday, I made a minimum guarantee of three changes, and I will add more changes when I rest.

　　
　
(End of this chapter)