Back in 2002 as a doctor

Now it's all up to me...

"Director Zhang, Professor Zhou asked you something." Xiao Kai pulled a chair and sat down, "What are the complications of pericardiocentesis?"

Director Zhang's lips moved, and the atmosphere was full of embarrassment. He knew very well that the young Professor Zhou must be thinking of slapping his face with the clip of the medical record.

"Dean Xiao, I didn't hire the experts from the imperial capital." Director Zhang defended in a low voice.

Zhou Congwen almost lost his voice.

"It has nothing to do with the experts in the imperial capital." Zhou Congwen shook his head and said, "Then, let me talk about it, whoever calls for a bedside X-ray and a bedside echocardiogram."

"I'll go. Echocardiography is off work now. I want to find their director." Xiao Kai said.

What Zhou Congwen did was a little too much, but Xiao Kai knew that it was something between himself, the dean and himself that made Professor Zhou Xueye come here, and it was normal to be a little angry.

He took a deep look at Director Zhang and went out to make a phone call.

"Pericardiocentesis is a technique that doctors above the attending level must master, especially those who perform cardiac interventional surgery."

"First of all, pericardial puncture may cause lung injury and liver injury. It is best to have an echocardiogram to locate the appropriate needle insertion site and direction to avoid damage to surrounding organs."

"Secondly, for bleeding caused by myocardial injury and coronary artery injury, select the site with a large amount of effusion, and try to make the puncture site as close as possible to the centrifuge bag. Use echocardiography to locate before operation, and measure the distance from the puncture site to the pericardium to decide whether to proceed. the depth of the needle while slowly advancing the needle."

"again……"

"fifth……"

"No. 12..."

Zhou Congwen talked with his fingers for a full 10 minutes, only to stop when he heard the roar of the bedside chest X-ray machine crushing the floor outside the door.

"How to explain to the patient and the patient's family, Director Zhang, think about it carefully. If my judgment is correct, emergency surgery is necessary. Does our hospital have an occluder?"

Director Zhang shook his head blankly.

Zhou Congwen sighed and took out his phone.

"Manager Wang, it's me, Zhou Congwen."

"Is there a muscular VSD occluder? Emmm, it needs to be about 8mm in diameter and about 7mm in height."

"No, I'm not in the second year of Medical University, I'm in the First Hospital of Baishui City now. Please take me there, it's snowing, drive slowly."

"Then I'll hang up and contact you again."

Zhou Congwen hung up the phone, turned around and found a seat to sit down, and continued to review the medical records.

The expression on Director Zhang's face seemed to have been stuffed into his mouth by force, it was terribly ugly, and he even had the feeling of turning blue when he had an acute myocardial infarction.

Although Zhou Congwen didn't have a single dirty word, and he spoke professionally from beginning to end, every sentence made Director Zhang feel more uncomfortable than pointing his nose and scolding his mother.

He snapped his fingers and said one, two, three, four, five, but the point was that he was still speechless, unable to say "no" even if he wanted to.

This young doctor is very arrogant, really arrogant, isn't it because Dean Xiao wanted to invite Professor Zhou to perform the operation, but was rejected by Dean Guan, so he was unhappy.

This is a disaster for myself.

Wait for Teacher Qin from the imperial capital to come and see how arrogant he is!Director Zhang thought to himself.

Zhou Congwen ignored what Director Zhang was thinking. The bedside chest X-ray was taken to confirm that there was a moderate amount of pleural effusion in the left side of the chest. He performed an echocardiogram on the patient himself and found echoes in the catheter in the left ventricle, so he considered placing a pericardial catheter into the left ventricle. , a small amount of pericardial effusion.

"Communicate with the patient and the patient's family and prepare for the operation," Zhou Congwen said.

Looking at the various inspection reports, Director Zhang knew that Zhou Congwen's judgment was correct, so he had no choice but to bite the bullet and explain to the patient's family.

"Professor Zhou, our hospital..." Xiao Kai was a little embarrassed.

"Consumables? I've got someone to deliver them. When the time comes, I'll go through the pre-purchase procedures. Dean Xiao, please help me." Zhou Congwen said lightly.

"Oh, the basic level of hospitals is like this." Xiao Kai sighed and said helplessly.

"Normal, it's fine." Zhou Congwen smiled slightly.

After waiting for several hours, Zhou Congwen read all the medical records, and he had a clear understanding of the level of the hospital under Xiao Kai's command.

Director Zhang's technical level is still in the groping stage.

At the beginning of the 21st century, very few hospitals across the country carried out interventional cardiac surgery, and even if they did, they were still in the exploratory stage. It was normal for Zhou Congwen to see what happened right now.

Zhou Congwen suddenly remembered that many small doctors in later generations were oppressed by these "accomplished" big directors, calling them Daqianlang.

Directors Zhang have indeed earned the dividends of the times, but when they are on the scene, I am afraid that few of them can resist the tremendous pressure of one operation failing another.

There are also reasons for the big front wave. Any success includes the reasons of the times and the reasons of people.

Not talking about making money, nor talking about all kinds of refurbished stent consumables, just talking about medical accidents and medical accidents requires a big heart.

When Zhou Congwen saw that Director Zhang had communicated with the family members of the patient with cardiac tamponade, the family members of the patients gratefully held Director Zhang's hand and smiled knowingly.

Everyone has their own reasons for their success. In terms of the level and ability of Director Zhang to communicate with patients' families clinically, it can be said that he is outstanding.

If you don't have this ability, just like the obstetrics and gynecology department of the Third Hospital of Jianghai City, you will push it to the assistants and the little doctors. The circulatory department here has been fucked up.

Just as she was about to undergo surgery, there were hurried footsteps and a different voice calling for help from outside the door.

Myocardial infarction...

Zhou Congwen knew that the first aid for myocardial infarction was the same as that of hemorrhagic shock, and every second must be raced, and a little slower would mean a life.

Now that you're here, let's take a look at Director Zhang's surgical skills and mention a few words by the way.

Although the teaching of experience has no visible benefits, it can save a few people from dying. This kind of intangible benefit cannot be quantified, but Zhou Congwen likes to do it.

It was the "stinky problem" brought out by the boss, Zhou Congwen smiled and thought of Liu Xiaobie's complaint.Copy [-] copies of the Eighteen Palms of Subduing the Dragon and give them to everyone in the world?

The book talks about mind and comprehension for the sake of logical self-consistency, but Zhou Congwen doesn't think so.

If you want to talk about serving the country and the people, your own boss is a great hero!

……

……

"Dean Guan, the snow in the Northeast is really heavy. The emperor has not seen such a big snowflake for many years." Professor Qin walked into the inpatient department, shook the scattered snowflakes on his body and said with a smile.

Chapter 0628 Three Lesions

"Professor Qin, you have worked hard all the way." Dean Guan said with a smile, "The leaders in the city are sick, and you know that interventional heart surgery is not up to standard in local hospitals like ours, including medical universities. Howling invited you here."

Snow howling?

Professor Qin was taken aback when he heard Dean Guan's description. He knew the meaning of this sentence, but he had to think carefully when he heard it suddenly.

Northeast dialect is indeed interesting, Professor Qin smiled slightly.

For example, in the legend of the imperial capital that year when there was a mountain fire in Daxing’an Mountains, the province and the central government reported it, and the leader who made the call said directly in a hurry—the whole wave was caught.

After the mountain fire was extinguished, the whole word wave spread in the imperial capital.

Daxue howling, seems to have both spirit and form, Professor Qin nodded, "It's okay, everything should be done."

"Look at what you said, don't leave after the operation this time, just in time for the heavy snow, I'll take you to the snow hot spring." Dean Guan said while rushing to the inpatient department with Professor Qin, "Soak in the In the hot spring pool, there is heavy snow in the sky, we chat and drink tea, this kind of experience is very good."

"Then I'm welcome."

"Hahaha." Dean Guan was in a good mood when he heard that Professor Qin didn't refuse, "It's so glorious to invite such a great god like you to our small temple! Our deputy director in charge of clinical practice is fooling around, guess what? Who do you want to invite over?"

Professor Qin smiled.

Please anyone is different?This side is barren and remote, what kind of experts can we invite.

But in a flash, he suddenly thought of someone.

"Old Huang from the Department of Cardiothoracic Surgery has set up an academician workstation in the provincial capital, as you know."

"I just found out." Professor Qin said, "I had an operation yesterday, and the people from the cardiac surgery department were waiting nearby. If the operation succeeded, they would leave, and if it failed, the stage would be opened immediately. We heard about it when we were chatting. It is said that Huang The old and newly recruited closed disciples preside over the work."

"Yes!" Director Guan said, "If we are doing bypass surgery, we must invite Mr. Huang. But Mr. Huang is the right choice for heart intervention surgery, isn't it right?"

Youngest Huang?

The old man's level of cardiac interventional surgery is really high, and Professor Qin knows this well.

However, Professor Qin doesn't approve of the so-called closed disciples.

Although the cardiothoracic surgery doctor blushed with excitement when he mentioned this man, he said that he had changed the general thoracic surgery method, using thoracoscopic cuff incision, double cuff incision, and so on.

But heart intervention, hey!

Professor Qin did not speak ill of Zhou Congwen, nor did he sarcasm inside or outside the words.

Although I have nothing to do with Mr. Huang, he is a senior in the medical field. He has worked hard all his life, and he has not left the hospital until he is almost [-] and still works on the front line.

Just this kind of heart, the minimum respect is still to be given.

Professor Qin didn't say anything, but Dean Guan kept nagging, "Surgery people are messing around. Interventional surgery is not in their charge. If you have to meddle in your own business, call the surgeon. I think they just want to bridge the gap." Operation……"

"Not necessarily." Professor Qin smiled slightly, "Don't talk about this, go to see the patient, and then go to surgery. If there are three lesions, it will be difficult. If it is not possible, the surgeon will have to order a bypass surgery in an emergency."

Dean Guan hurriedly laughed, "Professor Qin, look at what you said, with you around, it is impossible to perform surgery!"

With that said, a group of people came to the ward.

Director Zhang was leading people to rescue him, so he hurriedly said hello, and a deputy director took him to see the city leaders.

Professor Qin doesn't care about these cumbersome rules, he just rescues patients with myocardial infarction in the emergency department, and performs his own surgery.

When passing by the doctor's office, he caught a glimpse of a young man sitting in the office, talking to the man in white.

Professor Qin ignored it, took a look at the patient and immediately took him to the stage.

The people in this hospital are also really good. They want to do interventional surgery but they are looking for someone from the thoracic surgery department. How should I put it...Professor Qin has always been a little jealous.

Take the patient to the stage and start imaging.

Angiography showed that it was indeed three-vessel lesions!

It is not impossible for Professor Qin to perform similar operations, and the three-vessel disease is not a strict contraindication, but the operation is very difficult.

But no matter how difficult it is, it will not be difficult for Professor Qin. It's just that the operation takes a long time, and it needs to be done carefully.

"President Guan, I'll go and explain to the patient's family members about the three lesions." Professor Qin got off the operating table and said to Dean Guan.

"Okay, okay!" Dean Guan frowned and sighed, "Fortunately, you are here, otherwise the angiography during the operation revealed that there were three lesions, and he would definitely need to undergo heart bypass surgery. Our hospital does not have extracorporeal circulation. You said this Isn't it nonsense?"

Basic-level hospitals really don’t need anything, and it is basically a consensus that the development of new technologies must be carried out in the highest-level public hospitals.

It's like when Professor Qin was performing surgery in the imperial capital, the cardiologist would squat in the rest room of the operating room and wait. If the intervention fails, the chest will be opened directly. Director Qin doesn't have to worry about anything.

But in Baishui City, there are no such convenient conditions.

Professor Qin came out of the interventional catheterization room in a lead suit and surgical gown. Before he could say anything to the patient's family, the flat car roared over.

Director Zhang commanded in a hurry, feeling a little anxious.

"Director Zhang, keep your voice down." Dean Guan said unhappily, "What patient?"

"Myocardial infarction, I stopped once in the audience, and then I pressed it back. I stopped again during the pre-operative explanation just now. I guess... it may be three-vessel disease, and I need to be operated on immediately." Director Zhang said hastily.

Professor Qin turned his body slightly to get out of the way.

The grass-roots hospitals will definitely not be able to perform interventional surgery for the three lesions. According to Dean Guan, they can't do emergency bypass surgery.

It seems that I have to make another one after I finish one.

But if we catch up, what should we do?I hope... I hope the patient can survive until he steps down.

Professor Qin did not change his face, and explained the condition to the family members of the city leaders, mainly due to some complicated complications.

The patient's family members heard that the situation was urgent, and that Professor Qin was a top domestic doctor from the imperial capital, so they agreed repeatedly without understanding what Professor Qin meant.

Returning to the operating room, Professor Qin heard the busy voice of the operating room next door, and said with a smile, "President Guan, there are actually two operating rooms in your hospital."

"Hehe, it was also to prepare for a rainy day. But who knew that interventional surgery is so difficult, it has been three or four years, and the only doctor in our hospital who can perform surgery is Director Zhang."

While chatting briefly, Professor Qin changed the surgical gown and stood in the operator's position to start the operation.

There was a messy sound from the next door, and Professor Qin thought that he didn't want them to heal, as long as he didn't pierce the coronary artery.

Chapter 0629 the sound of the flat car next door

Professor Qin placed the 6F radial artery sheath.Heparin sodium 3000u, nitroglycerin 100ug, and verapamil 1.25mg were injected through the sheath.

在0.035“，260cm“J”形导丝引导下，将6F4.0造影导管送到右冠状动脉开口；6F3.5造影导管送至左冠状动脉开口。