world famous doctor

Chapter 152 Aortic Dissection

Zhou Chen's smile suddenly disappeared.

The next moment, he shot like lightning, grabbed the opponent's right hand, and twisted it hard with his backhand.

"ah……"

The skinny young man suddenly felt a huge irresistible force twisting his whole body around.

Right arm twisted behind his back.

Then, there was only a crisp sound of "click".

This is the skinny young man with a broken right arm.

He let out a piercing cry from his throat.

At that moment, he almost passed out from the pain.

Zhou Chen couldn't help laughing:
"Don't blame me for not reminding you just now... It seems that I will stay in the hospital for a few more days."

The other fat young man who had a stab wound on his thigh was furious when he saw his accomplice being dealt with.

He raised the crutch in his hand and slammed it down on the back of Zhou Chen's head.

After seeing this, several nurses screamed in fright and shouted to Zhou Chen:

"Watch out behind you."

With the skills of these ruffians, they are nothing to mention in front of Zhou Chen. They are like ants, let alone being able to hurt Zhou Chen?
Zhou Chen seemed to have eyes on the back of his head, he stretched out his hand and snatched the opponent's crutch.

Taking advantage of the situation, he swung it hard, and hit the fat young man's face heavily.

The fat young man was immediately hit with nosebleeds, and his front teeth were knocked out.

Zhou Chen reprimanded coldly:

"Don't you know how many catties and taels you have? You just went wild in the hospital!"

The fat young man staggered back a few steps, suddenly feeling dizzy.

He sat down on the ground and raised his hand to touch his head. A big bump swelled up, and the burning pain made him take a breath.

"hiss--"

He wanted to stand up and continue to fight Zhou Chen.

But there were stars in front of my eyes, and I was so dizzy that I couldn't tell the difference between north, south, east, and west.

At this time, the security guards in the hall rushed over.

"Doctor Xiao Zhou, what's the matter?"

Zhou Chen clapped his hands, and ordered lightly:
"It's nothing. Take these two patients back to the ward and take a good look at them. They may be a little mentally disturbed. Then they will be transferred to the psychiatric department..."

After several security guards nodded, they stepped forward two by two, one of them took one of their arms, and carried them back to the ward.

Several female nurses stood in the nurse's station tremblingly, and they didn't come back to their senses for a while.

Thinking back to the scene just now, they were almost scared out of their wits.

Zhou Chen knocked on the countertop of the nurse's station, and smiled freely:
"Hey, I said. It's all right."

Only then did the female nurses come to their senses, and they looked at Zhou Chen with extremely complicated eyes, full of some kind of respect and admiration.

Unexpectedly, Zhou Chen was young, a regular trainee who had just come to the hospital for regular training, not only had superb medical skills, but also had no ambiguity in fighting people.

Skilled, both civil and military.

This is simply their ideal Prince Charming.

"Okay, if the nurse's station encounters these hooligans again in the future, please go to the emergency room or the doctor's office and call me."

After speaking, Zhou Chen waved his hand and turned back to the emergency room.

At this time, in the emergency room.

Dr. Zhang Jian, who is on duty with Zhou Chen, is consulting an elderly man in his 70s.

Beside the old man, followed by a young man.

He stood up straight and looked like the president's bodyguard.

This old man was dressed gracefully and luxuriously, with a greasy back, and his status seemed to be a bit prominent.

But this is not important.

In the eyes of doctors, there are only patients, there is no difference in the status of patients, and there is no differential treatment.

Zhou Chen walked over and stood aside watching.

The elderly complained of chest pain for about 4 hours.

Judging by his expression, the pain was still severe.

And it is accompanied by pain in the left lower extremity, which gradually increases and will not be relieved.

After further medical history inquiry, it was learned that the old man had a history of hypertension for more than 30 years.

Zhang Jian conducted a physical examination for the elderly man.

Zhou Chen was recording on the side.

Refreshing, acute face.

右上肢血压168/94mmHg，左上肢血压142/80mmHg，右下肢血压146/93mmHg，左下肢血压测不出。

Superficial lymph nodes were not palpable.

Both pupils are sensitive to light reflex.

The tonsils are not enlarged.

Breath sounds in both lower lungs were slightly low, and biphasic mild murmurs could be heard in the aortic valve auscultation area, and there was no abdominal tenderness.

The skin of the left lower extremity was warm and cool, and the physiological reflex of the nervous system was normal.

Doctor Zhang Jian and Zhou Chen looked at each other solemnly.

According to the past clinical experience of the two of them, it is estimated that the situation is not good.

So they immediately prescribed aortic CT examination, cardiac echocardiography and other related examinations for this patient.

With the support of the young man, he took the old man for an examination.

Soon, they returned to the emergency room with the checklist.

The young man hastily handed the checklist to Zhang Jian:
"Doctor, please help me to see if there is any problem!"

Zhang Jian took the checklist, looked at it calmly for a while, and his complexion gradually became a little heavier.

Aortic CT examination showed.

The type A long layer of aorta involves the brachiocephalic vessels, the diameter of the sinus is 35mm, the diameter of the ascending aorta is 51mm, and the diameter of the descending aorta is about 43mm.

Echocardiography showed.

Aortic valve leaflet morphology can be mild, moderate regurgitation...

This is a typical Stanford type A aortic dissection in the elderly.

The elderly are a high-risk group, and this disease is also a clinically common cardiovascular crisis, which seriously threatens the health of patients.

When the dissection involves the aortic arch and the descending aorta, the lesion ranges widely, and the case fatality rate is extremely high if surgical treatment is not actively taken.

According to previous clinical experience, surgical treatment should be performed for patients with proximal aortic dissection or ruptured or near-ruptured aortic dissection with aortic insufficiency.

However, there has always been some controversy regarding the surgical treatment of the elderly patient with type A aortic dissection.

Zhang Jian looked up at Zhou Chen, and discussed with him the choice of surgical method.

How can we improve the efficacy of surgery.

"Xiao Zhou, take a look at his medical checklist, what kind of corresponding operation do you think should be adopted?"

After Zhou Chen took the checklist, he looked at it carefully.

According to the location of the dissection rupture, the extent of involvement, and the condition of the aortic root, each patient has a different method for surgical treatment.

If you can choose the right one and implement the best surgical method, you can significantly reduce the mortality rate of patients and improve the prognosis of patients.

Zhou Chen didn't hesitate, he immediately opened the famous doctor system in his mind, and spent more than 1 likes in exchange for relevant plans and clinical experience in the surgical treatment of elderly Stinford type A aortic dissection.

A subtitle of holographic projection gradually began to rotate and play in front of Zhou Chen's eyes.

A piece of extremely complicated medical information was quickly entered into Zhou Chen's mind.

(End of this chapter)