I can see health

Chapter 420 Missing Inspection Items

The First Affiliated Hospital of Kyoto University, Department of Cardiology Catheterization.

This is the second time Lu Chen has come here.

He will remain in the cath lab for the next month.

As long as Lu Chen participated in the electrophysiological surgery, all will be recorded in detail, including the degree of completion, difficulty and quantity of the operation.

"Lu Chen, you were actually sent to our catheterization room?!"

There happened to be a coronary intervention today. When Fang Ruzhang came to the catheterization room, he happened to see Lu Chen.

"Yeah." Lu Chen just changed into the surgical gown, and was following his teacher, who was the chief surgeon during the first stage of the assessment, Xiao Shikang.

"That's great. If you have any questions later, I'll come to ask you." Fang Ruzhang has seen Lu Chen's level and admired him very much.

The ablation of the epicardial ventricle in that hand is really impossible for ordinary people to learn.

"Are you here for coronary intervention?" Lu Chen watched as Fang Ruzhang pushed the patient to the opposite coronary intervention lab.

"That's right, a patient on my hospital bed." Fang Ruzhang smiled, "But it wasn't me who did it, Director Wan did it. This is a leader in the city, so Director Wan did it himself."

"Director Wan did it himself?" Lu Chen smiled, "I guess Director Wan rarely performs surgery now."

Fang Ruzhang spread his hands, "There is no way, the leader asked, and we can't do anything."

In fact, professors at the level of Director Wan seldom perform surgery in person, and most of their energy is devoted to scientific research or administration.

It's better to let some deputy directors of the department or senior attending doctors do it, maybe the effect of the operation will be better.

After all, these doctors are the ones who have been working in the front line for a long time and have developed their skills.

Lu Chen chatted with Fang Ruzhang for a while, and saw Director Wan Jingshui came to the catheterization room, said hello, and left.

……

Currently, there are eight operating rooms in the catheterization room, including six coronary intervention rooms and two electrophysiological intervention rooms.

After the price reduction of the heart stent, an electrophysiological interventional room was temporarily added (the price of electrophysiological equipment has not yet been reduced).

With the price reduction of domestic stents for the heart, the enthusiasm for coronary intervention is gradually fading.

Many new scholars of cardiology intervention are hesitant between coronary artery and electrophysiology, and most of them would choose coronary intervention in the past.

But now, more and more people learn electrophysiological intervention.

This is also driven by interests.

Doctors are also normal people, and they must go to places with more money.

Therefore, high-risk departments, such as the emergency department and pediatrics, have a large number of gaps every year.

……

Lu Chen's current job is very simple, waiting for electrophysiological surgery.

As long as there is an electrophysiological operation, then he has the opportunity to be an assistant on stage.

When not operating, he studied in the cath lab.

Most of the electrophysiological surgeries are routine surgeries, except for a small number of surgeries that require the installation of a temporary pacemaker.

"Lu Chen, there is no operation today, but two are arranged for tomorrow. One is for patients in the third area of ​​the heart, and it seems that one needs a pacemaker. The other is for the fifth area of ​​the heart, and needs radiofrequency ablation for atrial fibrillation. , you can evaluate it later." Xiao Shikang came to Lu Chen's side and brought him a medical record.

Any patient undergoing surgery requires thorough preoperative preparation.

The most important point is to determine whether there is an indication for surgery. Simply put, it depends on whether the patient needs surgery.

"Oh, good." Lu Chen nodded, took the medical record folder and read it carefully.

A pacemaker, as the name suggests, is a machine that helps the heart beat.

When the heart is diseased and the beating is slow, there is a problem with the heart pumping blood at this time, and the blood cannot enter other organs of the body, such as the liver, kidney, brain, etc., each organ ischemia and hypoxia, resulting in multiple organ dysfunction. failure, and even sudden death.

At this time, outside help is needed. A device is placed in the heart to help it beat and maintain the normal blood supply to various organs. This is called a pacemaker.

There are many reasons for bradycardia, the common ones are coronary heart disease, electrical conduction system disorder, endocrine disease, intracranial hypertension, in addition, there are some drug-induced bradycardia.

"Ms. Xiao, I'll go to the third area of ​​my heart to see this patient." Lu Chen looked through the medical records, but there wasn't much useful news.

"Okay, go ahead, you need to see the patient yourself." Xiao Shikang nodded slightly.

Lu Chen changed out of the surgical gown, put on a brand new white coat, and then put a shoe cover on his hole shoes, and just took the elevator to the third area of ​​the heart.

……

Three areas in the heart.

Yao Jie is sitting in the office, writing the course records for the patients under her care.

"Junior Sister, I already took that patient in for you just now, so you don't have to go." Wu Lang smiled and walked to Yao Jie's side, "This is a patient with bradycardia, who seems to be here for a permanent pacemaker. I have already contacted the teacher in the cath lab. Then you will talk to the patient and their family about the risks of the operation."

"Okay, thank you Senior Brother Wu." Yao Jie said.

Ever since Wu Lang found out that Yao Jie had a boyfriend, he had been depressed for a few days, but on second thought, her boyfriend is from Jinghua, and the long-distance relationship won't last long.

He is now staying by Yao Jie's side every day, and one day he will have a chance.

After all, if you are close to the water, you get the moon first.

At this time, Lu Chen came to the doctor's office in the third district of the heart.

"May I ask the patient in bed 23, who is the doctor in charge of the bed?"

Yao Jie heard this familiar voice, and looked back in surprise, it was indeed Lu Chen.

"Senior brother, you...why are you here?"

Wu Lang was taken aback for a moment, then looked back, damn, what happened to Lu Chen?
He quickly moved away from Yao Jie.

Lu Chen smiled and said, "I've been in the catheterization room of your hospital recently, that 23-bed..."

"Oh, bed 23 is for newly arrived patients, I'll take care of the bed." Yao Jie quickly glanced at the inpatient interface.

"Well, this seems to be a permanent pacemaker, I'll go and see him." Lu Chen said.

"I'll go with you." Yao Jie immediately stood up.

……

Come to bed 23.

Lu Chen glanced at the patient, who was a 65-year-old mother-in-law.

Her electrocardiogram showed a sinus bradycardia, and her heart rate was only 30-40 beats per minute when she was inactive.

"Do you usually feel dizzy or faint?" Lu Chen asked.

The old lady paused, and said: "I didn't faint, but I often feel dizzy, and sometimes my eyes are black, and it will be fine in a few seconds."

Lu Chen nodded slightly. The symptoms of dizziness are dizziness caused by slow heartbeat, less blood pumping, and insufficient blood supply to the brain.

"There are obvious symptoms. At first glance, it needs a pacemaker." Lu Chen said to Yao Jie.

"Well, senior brother, I will talk to the patient about the risks of the surgery." Yao Jie nodded slightly.

"Don't worry." Lu Chen waved his hand, "We need to complete the preoperative examination first..."

Before Lu Chen finished speaking, the mother-in-law on the hospital bed said, "Doctor, I've already done it in the hospital below, so there's no need for another blood test."

"Did you do it in a tertiary hospital?" Lu Chen wondered.

"Well, it's a third-class hospital." The mother-in-law nodded, and then took out a stack of laboratory tests from her bag.

Lu Chen took the test sheet, and the hospital name on it was indeed a third-class hospital.

At this time, Yao Jie also said from the side: "Brother, the superior teacher said that it was checked in other hospitals, so we don't need to check it here."

Lu Chen nodded, did not reply, but carefully looked through the patient's test sheet.

half an hour.

Lu Chen still shook his head, and said to the mother-in-law on the hospital bed: "No, we still need to do a blood test! These test sheets are not perfect, we need to do a few more tubes of blood."

Upon hearing this, the mother-in-law immediately became displeased, "I'm here for surgery, why are you doing my blood test? Wait, my son has parked his car, I'll call him to come over."

Lu Chen smiled helplessly, it's useless to ask anyone to come over!

"Okay, your son is here, let him go to the office to find me." Lu Chen said, and then left the ward with Yao Jie.

"Brother, didn't you say that this patient has evidence for surgery?" Yao Jie asked in a low voice, "She has already done all these tests, why do she still have to do it?"

Lu Chen paused, frowned and said, "What I'm saying is that initially, a pacemaker is needed, but we need to rule out some other diseases. Didn't you read the test sheet that the patient brought?"

"No..." Yao Jie whispered.

"I won't talk about anything else, there is a very important test missing." Lu Chen handed the patient's test sheet to Yao Jie, "Do you know what it is?"

Yao Jie took the test sheet, flipped through a few, and asked puzzledly, "What's missing?"

Lu Chen's eyes narrowed, and he said, "Thyroid function."

(End of this chapter)