Back in 2002 as a doctor

"I saw 22 of them, and none of them went through the hospitalization procedures." Zhou Congwen shrugged and said helplessly.

Teng Fei was taken aback, then laughed.

"Xiao Zhou, you look too young!"

"Yes." Zhou Congwen admitted.

"What are you going to do?" Teng Fei asked curiously.

Can Zhou Congwen, a "miraculous" little doctor, solve the problem in front of him?Teng Fei thought it was possible, so she was very curious.

"Nothing to do." Zhou Congwen smiled, "If there is no patient, just rest for a few days, don't worry."

This mentality, stable group!Teng Fei admired it in her heart.

At Zhou Congwen's age, presiding over the work of the academician workstation, even his first thought was to get off to a good start, open the situation in the shortest time, and reassure Mr. Huang.

But Zhou Congwen was not in a hurry at all. This kind of calm and not impatient attitude is more impressive than a few operations.

"Xiao Zhou, what is the scope of your surgery?" Tengfei asked, "I will screen the patients in my ward, and the directors of the relevant departments will also tell me. By the way, the director of the Department of Respiratory Medicine is very familiar with me, and we have time to work together." Have a meal."

"Thank you." Zhou Congwen smiled slightly.

Teng Fei's favor is very solid, and Zhou Congwen understands it.

The name of the upstream department is justified.

There are two upstream departments of cardiothoracic surgery, the upstream department of cardiothoracic surgery - circulatory medicine; the upstream department of general chest surgery - respiratory medicine.

If you can't screen patients by yourself, the Department of Respiratory Medicine will do it for you, and you will be able to open up the situation soon.When word of mouth spreads, I'm afraid that even my outpatients won't be able to see it.

"You're welcome." Teng Fei said, "I heard that you performed a demonstration operation at the annual meeting a few days ago. Not only esophageal cancer, but also sleeve resection and double sleeve resection were performed with laparoscopy?"

"Well, I showed the operation." Zhou Congwen said, "The main purpose of the academician workstation is to carry out thoracoscopic work and plant a seed."

Teng Fei nodded, "Okay, someday you have time, I will ask Director Tang from the Department of Respiratory Medicine to have a meal together, and then you two will have a detailed chat."

Just after finishing speaking, Teng Fei's cell phone rang.

She smiled at Zhou Congwen, picked up the phone, "It's your old Zhang."

Zhang You, Zhou Congwen smiled.With Zhang You's behavior in the world, he may not have a particularly good relationship with the upstream departments.

"Director Zhang, what's the matter?" Teng Fei answered the phone and asked casually.

The phone's voice was not loud, and Zhou Congwen couldn't hear what Zhang You said.But Teng Fei frowned quickly.

"Impossible, why didn't I see it when I was doing the radiography." Teng Fei said, "Okay, I'll take a look."

After hanging up the phone, Teng Fei asked, "Xiao Zhou, do you want to go back and change?"

"Let's go." Zhou Congwen stood up, "Director Teng, what patient?"

"For patients with three-vessel disease, the anterior descending and circumflex branches are basically blocked." Teng Fei said, "Transfer to Director Zhang for bypass surgery. Just now Director Zhang said that he had an echocardiogram before the operation and found that there was a Moderate pericardial effusion, right atrium problem too."

"Oh, let's take a look." Zhou Congwen said flatly.

Teng Fei's heart skipped a beat, "Xiao Zhou, how is your cardiac surgery?"

"good."

"..." Teng Fei looked at Zhou Congwen helplessly.

Not bad what the hell!

"Director Teng, don't worry about the operation. If you have any problems, Director Zhang dare not accept it, just call me directly, and I will go up to help you solve it. Emmm, it's okay, which means that no matter what kind of operation, I'm okay and I can get it off. You can do it with confidence and boldly, and I have the bottom line." Zhou Congwen said.

It turned out to be such a good one!Teng Fei was overjoyed.

Surgeons who can perform double-sleeve resection are very rare in the whole country, let alone Zhou Congwen performed double-sleeve resection with thoracoscopic surgery.

Although sleeve resection is a general thoracic operation, it involves tracheal anastomosis.Double sleeve resection has vascular anastomosis, which is a prerequisite skill for heart bypass surgery.

Teng Fei was overjoyed.

"Xiao Zhou, then I'm really welcome."

"Look at what you said, it's not polite." Zhou Congwen smiled, "Is there any problem with Director Zhang?"

Zhou Congwen asked more reservedly.

"Old Zhang is timid, and after all, he is old. A few days ago, I had a patient who suspected that his heart might rupture. I asked him to take a look, but it took a long time and he didn't come back."

"How dead?" Zhou Congwen asked.

This question was too direct, and Teng Fei was a little embarrassed to ask.

Too many patients died in the doctor's hands, it can't be justified anyway, but it is really difficult to say that the circulation interventional surgery was done well at the beginning, including now.

"Oh, how should I say it?"

"To be honest, it's okay." Zhou Congwen smiled, "912, the earliest interventional surgery was escorted by the boss, and it went well. But other hospitals didn't have such good luck. If the extracardiac level can't keep up, people will definitely die. "

Teng Fei felt sorry for her.

"Director Li of Jianghai People's Hospital is a graduate of the third class."

"Amazing." Teng Fei praised.

"I went to university at the age of 16, which is a young achievement. Later, I got a Ph.D., saw the way of interventional surgery, and came back to start this business. Because my heart level can't keep up, so I almost did it at first."

"..." Teng Fei sighed.

This is also impossible.

Patients with myocardial infarction are sent in, and if there is no relief from medication, there is a high probability that they will die.Emergency bypass surgery is still not possible, so I can only try cardiac interventional surgery.

But it is such a difficulty when you start, it is difficult to guarantee that no one will die.

"Director Li's emotions collapsed at the beginning." Zhou Congwen said lightly, "If you do it, you will die, if you don't do it, you will die, but so many patients died at his own hands, he almost didn't feel depressed."

"Does the courtyard support it?"

"Thanks to the support from the hospital, they said that even if it is done, the patient will die if he stays below, and there may be a way to survive if he tries."

……

Note: When the interventional heart surgery was first carried out, listening to Da Qianlang's description did almost make the surgeon depressed.Repeatedly denying themselves, many people retreat in spite of difficulties.In short, different people have different opinions.

Chapter 0606

"Director Teng, how did you start?" Zhou Congwen asked.

"Stumbling and stumbling." Teng Fei smiled, "I haven't been doing catheters for a long time, and I'm a few years later than Director Li in Jianghai City. At the beginning, there was no way. The effect of treatment is indeed limited.”

"However, without surgery, not many patients would survive, so I tried to apply with the hospital many times, but they failed.

Later, the dean was changed, and the current dean Ye supported the new technology, so he bought the machine and began to operate.Sometimes I envy you Jianghai City. Relying on the fact that the group company is not short of money, I will make a plan below, and buy a set of the latest equipment as soon as I say it. "

"Hehe." Zhou Congwen smiled.

What Teng Fei was talking about was the actual situation. Jianghai City was backed by the group company, and in terms of hardware level alone, it completely crushed the provincial capital in 2002-2003.

Even the smaller hospitals in the imperial capital and the magical capital are not as good as Jianghai City's hardware.

For example, the HIS medical work system, several hospitals under the Jianghai City Group Company started to introduce it at the end of 2002, half a year earlier than the provincial capital.

"It was difficult at first, but fortunately, the Cardiac Surgery Department has a good relationship with us, and it is very convenient to ask them for consultation and surgery in the middle of the night."

As he spoke, Director Teng Feiteng showed a strange smile on his face.

Zhou Congwen understood Teng Fei's meaning. After all, it is the upstream department of Cardiac Surgery. Even if the Circulatory Department "robs" patients, the Cardiac Surgery Department can only hold its nose and bear it.

This is what the boss hates the most.

In fact, cardiac surgery has the difficulties of cardiac surgery. After all, it is not an internal medicine department. All patients with myocardial infarction can be accepted regardless of whether they are suitable for surgery or not.

The number of patients in cardiac surgery was quite good around 2002, and they were not in the mood for interventional surgery.

After that, boil the frog in warm water.

"In the future, I am optimistic about Professor Chen, and I have cooperated with him a lot. Who knew that Professor Chen would be engaged in thoracoscopy." Teng Fei said, suddenly smiled, "Xiao Zhou, what did you say at the annual meeting? Are those words true?"

"I have completed the most difficult breast surgery, do you have any questions?"

The two talked endlessly, but they knew each other well.

Zhou Congwen completed radical resection of esophageal cancer, sleeve lobectomy, and double-sleeve lobectomy successively under laparoscopy. Standing in front of thoracic surgeons across the country, it is not too much to say that all general thoracic operations can be performed with laparoscopy.

"I just think you are amazing." Teng Fei said with emotion.

"Ha ha."

"My concept is still at the level that thoracoscopic surgery can do very few operations."

"At this level, there is not much that can be done with circulatory interventional surgery." Zhou Congwen said lightly.

Teng Fei's mind moved, and she stared sideways at Zhou Congwen's face, "Xiao Zhou, what do you mean..."

"Basically all patients with coronary heart disease can be treated with interventional surgery. Of course, for some special cases, it is better to do bypass surgery, but the number is only 10% at most." Zhou Congwen answered seriously.

Teng Fei was greatly moved.

At present, there are not many interventional surgeries that can be performed in the Circulatory Medicine Department. For example, the patient Zhang Yougang called received interventional thrombolytic therapy. The patient's symptoms were relieved to some extent, but there was no way to completely treat it. He had to be transferred to the Cardiac Surgery Department for bypass surgery.

If Zhou Congwen didn't lie...the operator who can use thoracoscopic double-sleeve resection doesn't need to lie to himself.

"What's the patient's condition?" Zhou Congwen asked.

"Male patient, 49 years old. He was admitted to the hospital for 1 month due to chest pain during activities, which aggravated for 18 days. For the past 1 month, the patient has experienced chest pain intermittently during activities. The chest pain can be induced by going up to 3 floors and relieved within a few minutes after rest."

"After hospitalization, I performed angiography and found that the patient had three-vessel disease, with 90% stenosis in the proximal left anterior descending artery, 80% stenosis in the middle left circumflex artery, 85% stenosis in the proximal right coronary artery, and 90% stenosis in the distal spontaneous dissection. 80% stenosis of the proximal posterior branch of the left ventricle."

Zhou Congwen frowned slightly.

The patient is indeed very heavy and is an indication for coronary artery bypass surgery.

"I did thrombolytic therapy, and the patient's condition improved slightly, with 70% stenosis in the middle section of the left circumflex artery and 75% stenosis in the proximal section of the right coronary artery. The change was not significant. Therefore, he was referred to the Department of Cardiac Surgery, and Director Zhang performed elective surgery."

"Why does Director Zhang want me?" Teng Fei pondered as she walked.

"Anticoagulation therapy in cardiac surgery?"

"Ah."

The two came to the cardiothoracic surgery department and knocked on the door of Zhang You's office.

Seeing Teng Fei and Zhou Congwen come in together, Zhang You was taken aback for a moment. He adjusted his glasses and gritted his teeth, "Director Teng, why are you with..."

"Today in my outpatient clinic, I went to see the academician workstation after work. I saw Xiao Zhou was about to leave work, so I chatted with him for a while, and I just received your call." Teng Fei said, "What's wrong with the patient?"

Zhang You seemed to be in a strange mood, but he concealed it very well, and smiled with his big teeth, "The patient is on anticoagulant treatment, and he is going to stop the drug several times. I had an echocardiogram today and found pericardial effusion on the top of the right atrium." , 3.0mm deep diameter."

"I'll take a look at the radiography image."

Before Teng Fei could speak, Zhou Congwen spoke first.

Zhang You guessed that this was the case. He was a little awkward, but he still took out the patient's imaging data and handed it to Zhou Congwen.

The angiography position is left anterior oblique 45° + head 1°, Zhou Congwen reads the film with his hand curled up.

There was a rustling sound above his head, and after a few minutes Zhou Congwen read the latest relevant information and understood what Zhang You meant.

There was no communication between the aortic sinus and the right atrium in the anatomy of the heart, but various evidences pointed to the catheter of the coronary angiography surgery being strayed into the right atrium.

Generally speaking, the communication between the aortic sinus and the right atrium is more common when the aortic sinus aneurysm ruptures and enters the right atrium.

It is mainly due to the lack of normal elastic fibers and muscle tissue in the middle layer of the aortic sinus wall. Under the impact of aortic blood flow pressure, the sinus wall becomes thinner and expands outward extremely.

After sinus tumor rupture, severe cardiac insufficiency can occur rapidly, and the prognosis is poor. The average survival time is 1.0-3.9 years.

In other words, Director Teng Fei's level was slightly inferior, and there were mistakes in the operation, which resulted in serious complications.

"Xiao Zhou, what do you think?" Teng Fei didn't quite understand, she felt that it had nothing to do with her, but Zhou Congwen didn't say anything, she was very cautious and didn't express her position, but asked in a low voice.

"Director Teng, during your coronary angiography, the multifunctional catheter passed through the aortic sinus and entered the right atrium appendage, so there was a pericardial effusion at the top of the right atrium." Zhou Congwen did not hide Teng Fei's mistake, and said directly .

Zhang You was just guessing before, but what Zhou Congwen said was basically similar to his judgment.

But when Zhou Congwen spoke, a preliminary diagnosis immediately became a confirmed diagnosis.

After hearing what Zhou Congwen said, Teng Fei's expression became particularly ugly.

I thought you were one of us with thick eyebrows and big eyes, but I didn't expect to stab a knife in front of you.