This doctor is great

Chapter 7 Cardiac Stent...

bed 29,

A large group of doctors, like people eating melons, surrounded the 29 beds.

In front is Director Niu, and next to him is Zhou Mo, the doctor in charge of the bed.

Other doctors continue to go out in the order of deputy director, attending, hospitalization, and training.

As for Huang Yiming, he was on the outside.

Huang Yiming was a little happy, because he was afraid that he would be questioned. Now that he is outside, he should be able to pass the test.

"Tell me about the patient's condition..."

Director Niu looked at Zhou Mo, thinking about the school exam in his heart.

Last night, his student Chen Bing called him on purpose and mentioned Zhou Mo, which aroused Director Niu's interest.

Perhaps it is because he is about to retire, so he is more willing to give young people a chance and is more tolerant.

Zhou Mo nodded: "Yes..."

Then I began to describe the medical records of my grandmother on the 29th bed.

"Bed 29, Wang Zhaodi, admitted to the hospital at 3:150 p.m. the day before yesterday. The patient complained of 90-year-resistant hypertension, and the blood pressure was [-]/[-]..."

"The patient's condition has the following characteristics: First, the patient's antihypertensive regimen has been changed several times, but the blood pressure has not been well controlled. Second, the patient has long-term headache symptoms."

"During the ward round yesterday, I found that the patient was depressed and asked about poor sleep at night, so I considered whether he had sleep apnea syndrome... So I started using a sleep apnea monitor at 9 o'clock last night, and the final result was... The AHI value is 25 beats/hour, and the lowest blood oxygen saturation at night is 80%..."

"Considering that the patient has had refractory hypertension for 10 years, and the blood pressure is not well controlled, I have reason to suspect that one of the causes or the main cause of the patient is - nocturnal sleep apnea syndrome!"

"At present, consider trying to use a non-invasive ventilator at night to improve night sleep, and carry a 24-hour ambulatory blood pressure monitor at the same time to see if the ventilator can improve this high blood pressure and headache..."

"I'm done."

Zhou Mo said everything very fluently.

Director Niu was a little surprised.

This medical student is a little level.

However, he didn't show it on the surface, but started the real school exam.

"How much is her nocturia?"

"Last night was 1800ml..."

"What about last night?"

"1500ml..."

Zhou Mo is naturally very clear about the data, and there is no need to think about it at all.

Generally, this kind of sleep apnea syndrome will be accompanied by clinical manifestations of sweating and polyuria.

"Does the patient have a family history of apnea?" Director Niu continued to ask.

This kind of problem is generally easier to ignore, especially for newcomers.

Director Niu was testing Zhou Mo's carefulness and understanding of sleep apnea syndrome.

Still can't trouble Zhou Mo.

Zhou Mo replied fluently: "I asked, there is no genetic family history..."

Director Niu is satisfied.

This level, among the new medical students, can be regarded as a good performance.

then,

Director Niu asked a few more questions in a row, all of which were deeper knowledge points, just for school exams, and then Zhou Mo answered them clearly and quickly, showing his profound knowledge.

Director Niu was obviously very happy, and his interest suddenly increased a lot.

As soon as I became interested, I began to impart my experience, and talked about some strange hypertensive patients I encountered before...

For example, after a patient with a deviated nasal septum underwent corrective surgery, it was found that the high blood pressure that had accompanied her for many years disappeared suddenly...

These clinical experiences are undoubtedly invaluable.

"Ding...you listened carefully to the experience of a cardiovascular expert..."

The system sound rang.

"By the way, who is the other medical student?"

Suddenly, director Niu, who was very excited, found that another medical student hadn't seen him.

Huang Yiming, who was happily paddling at the back of the crowd: "..."

The body froze violently!
Oops!

I take pills!
Tremblingly raised his hand: "I'm here..."

Director Niu looked at Huang Yiming with his kind eyes, and he saw Huang Yiming's guilty conscience at a glance, and suddenly lost his mind about the school exam.

"Okay, 29 beds, temporarily follow Zhou Mo's plan, if blood pressure improves, gradually reduce other medications..."

"Yes, Director!"

Huang Yiming was relieved to see that Director Niu didn't ask him a series of fatal questions.

But soon a little frustrated.

Don't ask yourself, it's obviously because you didn't perform well, and the director just ignored him.

For him who has always been a top student, this obviously makes him very disappointed.

……

After finishing bed 29, I didn’t go to see bed 28, because the most critical coronary angiography of bed 28 was not done...

Then go to other wards for bed rounds...

……

10 points,
The ward round team picked and picked, and checked the 9 more important patients.

End rounds.

All the doctors in the five groups dispersed.

Zhou Mo returned to bed 28, and the patients and family members in bed 28 were gone. It is estimated that he had already undergone coronary angiography.

It takes half an hour for coronary angiography to produce results, Zhou Mo is not in a hurry, and returns to the duty room, planning to find a computer to change medical records and doctor's orders.

As a result, looking around,
The computer has been taken over by other people!

Use the computer rush!
I'm late!
Terrible!

Although there are already many computers in the department, they are still not enough, and we have to grab computers every peak time.

Zhou Mo could only take out his mobile phone and start to read books.

After thinking about it, Zhou Mo chose a book named "Famous Doctors Solve Confusion: Rehabilitation After Coronary Artery Stent" and read it.

It is mainly for patients with 28 beds.

……

……

After half an hour,
Soon, the 28-bed patient came back.

Zhou Mo glanced at the duty room, just as a senior brother left his seat.

Zhou Mo flew over and grabbed the computer.

Sit down, first open the 28-bed medical record system, and haven't seen the results of the coronary angiography.

Then I opened the medical records of the 29-bed grandma, and began to revise the medical records, adding the results of nocturnal sleep apnea, and adjusting the doctor's orders, adding a non-invasive ventilator and blood pressure monitoring at night...

It will be changed soon.

Then open the 28-bed medical record system again.

Coronary angiography results are in!

Zhou Mo took a look,
startled.

In this coronary angiography, two problems were found.

Question [-]: One of the coronary arteries is partially narrowed due to atherosclerosis, and the blood flow is insufficient, which should be the cause of angina pectoris and myocardial infarction this time.

Question [-]: It was found that the location of the coronary artery stent and the distal blood vessel were large and small, and the blood vessel was relatively narrow, which did not match the diameter of the arterial stent.

Since Zhou Mo didn't have a lot of knowledge of interventional surgery, he realized that this patient might need a heart stent interventional surgery.

And two brackets... no, three brackets!
The first stent: the stenotic blood vessel that is the culprit of angina this time needs to be placed with a stent to open the narrowed blood vessel and restore normal blood flow.Or use another method: use a balloon to dilate that section of blood vessel to replace the stent, but the effective time of this method is much shorter than that of the stent.

The second and third brackets: the problematic part of the original bracket, two parts at the beginning and the end, one bracket on each side...

One heart, put 4 stents?
sizzle~~~
Then this heart, wouldn't it become a match heart?

.

(End of this chapter)