I can see health

Chapter 523 Calcified Plaque Moving Inwardly (Part [-])
CCU entrance.

Lu Chen, Zhou Bin, Gu Xinyue and others surrounded the hospital bed.

The family member of the patient looked very nervous. He kept looking around, looked at the CCU ward, and then lowered his head and swiped his mobile phone.

On the hospital bed, the patient's condition is still very bad.

"Dissection! This should be aortic dissection!" Lu Chen said suddenly.

Gu Xinyue and Fatty Cheng were stunned by this sudden sentence.

Fatty Cheng leaned in front of Lu Chen again, blinked his eyes, and asked in confusion, "Lu Chen, did you see the interlayer from this ordinary CT?"

Gu Xinyue looked at Lu Chen suspiciously.

He had already looked at this CT film very carefully, and there was no sign showing the possibility of aortic dissection. . .

"Yes!" Lu Chen nodded slightly.

Asking Lu Chen to answer in the affirmative, Gu Xinyue and Fatty Cheng were even more confused.

At this time, Lu Chen smiled, picked up the CT image in his hand, and placed it in front of the two of them.

"Actually, what Lao Gu said is right. On this film, only white calcified plaques can be seen, but have you noticed the characteristics of the plaques?"

"Features..." Gu Xinyue frowned, and he carefully looked at the spots and characteristics of the plaques, "I didn't see any other differences except for the plaques on every picture..."

Fatty Cheng also nodded, spread his hands and said, "I can't see any difference either."

Hearing this, Lu Chen smiled, "Look, is there any difference in where the plaques appear, especially on each level?"

Gu Xinyue and Fatty Cheng were taken aback when they heard this, and then turned their attention to the CT image in Lu Chen's hand.

half an hour.

Gu Xinyue took the lead and said: "I feel that the position of this white plaque is not fixed on every level."

"Yes, it seems to be moving down." Fatty Cheng nodded slightly.

A smile appeared on Lu Chen's face, "You read that right, the white calcified plaques on the CT are constantly moving towards the intima."

Simply put, the plaques on each layer are located differently, and they are getting closer to the intima of the blood vessel.

Gu Xinyue frowned deeply, and said: "According to common sense, blood vessels should be flat, so the position of calcified plaques is fixed on every level, why do they move inward?"

Fatty Cheng scratched the back of his head with a puzzled look on his face.

Lu Chen smiled easily, "Because the blood vessel is dissected and divided into two layers, the calcified plaque will always move inward!"

"Is this caused by the interlayer?!" Gu Xinyue and Fatty Cheng were slightly taken aback.

"Yes! It's caused by dissection!" Lu Chen nodded affirmatively, "In the CT images, if the calcification points move inward, the inner diameter of the aorta widens, or there are independent calcification points, once these symptoms appear, you can be highly suspicious The possibility of mezzanine..."

Hearing Lu Chen's explanation, Gu Xinyue and Fatty Cheng suddenly realized.

Zhou Bin on the side also noticed the abnormality of the three of them.

Lu Chen handed the CT film to Zhou Bin.

"Teacher Zhou, take a look at this CT image."

Zhou Bin took it for a look, then was startled suddenly, and looked at Lu Chen.

"Calcification moved inward, aortic dissection!"

Lu Chen nodded slowly.

After hearing Zhou Bin's words, Gu Xinyue and Fatty Cheng confirmed Lu Chen's judgment.

This is indeed the CT sign of aortic dissection!

The two looked at each other, and couldn't help feeling a little bit of admiration in their hearts.

The longer they spend with Lu Chen, the more they can feel Lu Chen's "scary".

"Doctor, what were you talking about just now?"

On the side, the family members of the patient saw several doctors discussing enthusiastically, so they hurriedly asked.

Holding the CT film, Zhou Bin said solemnly: "We just re-read the CT film you took at the county hospital, and considered that there is a high probability that it is an aortic dissection!"

"What?" The patient's family was stunned. "You, didn't you just say that you need an enhanced CT to make a diagnosis? Why do you just need a plain CT scan now?"

"Also, the plain CT scan I asked for at the county hospital didn't report the possibility of aortic dissection?!"

Zhou Bin paused and explained patiently.

"Aortic dissection cannot be seen in ordinary plain CT, but some special CT signs can still diagnose aortic dissection!"

The family member of the patient showed bitterness. He glanced at the patient on the hospital bed, frowned and said, "Doctor, how sure are you that this is aortic dissection?"

"The patient's symptoms plus the chest CT findings, the probability is more than 80%!" Zhou Bin said.

This probability is still a conservative estimate by Zhou Bin!
Chest pain, high blood pressure, enlarged aortic diameter, and inward movement of calcifications, combined with all the clues, the probability of diagnosing aortic dissection can be at least 90%!

At this time, the family members of the patient were completely stunned when they heard the probability that Zhou Bin said.

If the probability is more than 80%, then this can basically confirm the diagnosis of aortic dissection!
"Doctor, if it is really aortic dissection, what should we do next?" the patient's family asked.

"No matter what type of dissection, surgery is generally required." Zhou Bin said, "Thoracotomy for blood vessel catheterization."

"What about the cost?"

"A conservative estimate is about 20." Zhou Bin paused and said, "This does not include the cost of post-care."

"What... 20 million?"

The family members of the patient were taken aback when they heard this.

Zhou Bin continued: "And as far as I know, the success rate of the current operation is only 50%. In other words, there is a half chance that the patient will not be able to get off the operating table."

The patient's family members did not speak, his eyes wandered, he glanced at the patient on the bed, and pursed his lips again.

Lu Chen also knew the embarrassment of the family members.

20 is not a small amount for any family!

What's more, this patient does not have any medical insurance.

20 yuan at their own expense, which is a bit scary.

And the patient is not his immediate family.

"Doctor, if we don't do surgery and treat conservatively, how long will it last?" The patient's family members whispered again.

"Conservative..." Zhou Bin frowned, "I told you before that aortic dissection is an extremely dangerous disease. If the torn opening of the intimal membrane becomes larger, people may die from massive blood loss and shock at any time. .It’s like a ticking time bomb. It could go off at any moment, and none of us know when it will go off. It’s likely to be the next second we speak.”

"Time bomb..." the patient's family member murmured to himself with a bitter face, and then looked up at Zhou Bin, "Okay, I see, thank you doctor, then we will not be hospitalized, and we will go back to our hometown."

"What?" Lu Chen was taken aback when he heard the words.

He diagnosed aortic dissection through ordinary CT, but made the patient's family members give up treatment in advance?

This is something Lu Chen never expected!
"Doctor, you guys, you are all high-level doctors, and the doctors in the county hospital didn't even notice it, otherwise I wouldn't have to go there." The patient's family member sighed softly, "I'm doing my best now. I really don’t have the money to treat my uncle, and he is a widowed old man himself, let alone have money, let’s forget it, let’s go home.”

Seeing this, Zhou Bin did not continue to dissuade him.

Lu Chen watched the family members carry the patient into the rented wheelchair and slowly walked out of the CCU ward. He couldn't help but sigh in his heart, "Doctors can only control the diagnosis and treatment of diseases, and they can't make decisions about anything else!"

(End of this chapter)