Medical road Qingyun

After Ren Min left Tianhua, the third medical group is currently scattered.

The team members did not trust Deng Yunlun's ability.

The treatment of the three groups, which had previously ranked first from the department, had been reduced to the bottom.

The team members who were not convinced by Deng Yunlun all wanted to see Deng Yunlun make a fool of himself.

Especially those senior directors who are a few years older than Deng Yunlun.

They originally thought that after Ren Min left, they should take over the position of the treatment team leader.

Deng Yunlun suddenly landed in the air, which made them very unconvinced.

The two senior directors pulled a group separately, excluding Zhao Yuan, Sun Liang, and Deng Yunlun.

Although they were on vacation, they were not idle, chatting and gossiping,

"I just heard that Team Leader Deng picked up a patient with a broken leg and foot and a chest injury. Tsk, Team Leader Deng really has the courage and self-confidence!

" "Did he do such a difficult operation?"

"It's okay, if you can't do it, Director Xie and Director Tong will wipe the dog's legs." "

Alas, I miss the days when the boss was there. At that time, we were not afraid of any surgery. "

......

Operating Room 8.

Doctors and nurses are busy preparing for surgery.

"Zhao Yuan, Sun Liang, you two are responsible for suturing the tendons and blood vessels of the limbs, and I am responsible for the chest gunshot wound. Deng Yunlun entered the operating room and arranged the next division of labor.

Experienced doctors know that although the tendons of the hands and feet are broken and look scary, they are not the most serious problem for patients at the moment.

A gunshot wound to the chest is fatal and must be treated urgently, and the slightest mistake can kill the patient.

"Senior brother, why don't I be responsible for the gunshot wound in the chest. If the bullet does not penetrate completely, there is a high probability that it will remain in the body, and there may be scattered projectiles in the heart and lungs. Zhao Yuan said with a solemn expression.

"Why do you have this conclusion?" Deng Yunlun did not have much contact with gunshot wounds, and most of them were theoretical knowledge that he was exposed to during his time at school.

Zhao Yuan patiently explained, "The bullet has a strong inertia, and after being fired head-on, if it is completely penetrated, there will be a great trauma to the back. But now there is no window in the back, and there is no penetration, so it should be a scatter bomb, which explodes directly in the body. "

Do you also know about gunshot wounds?" Deng Yunlun looked at Zhao Yuan in surprise.

Zhao Yuan is too familiar with gunshot wounds.

He nodded, opened his eyes and said nonsense, "I am a military fan, I have studied traumatic ballistics, and the murderer used a 12-gauge shotgun with 9 projectiles inside. "

Okay!" Deng Yunlun sighed, "You try to deal with it, don't force it." With

Deng Yunlun's authorization, Zhao Yuan asked the anesthesiologist to hurry up and inject anesthetics.

Deng Yunlun and Sun Liang are still studying the plan of wrist treatment, and Zhao Yuan has already opened his chest with a sternum saw.

Deng Yunlun knew that this was not a minor operation, and that it involved thoracotomy surgery, which generally had to be done by a specialist in thoracic and cardiac surgery.

But Deng Yunlun has confidence in Zhao Yuan.

Zhao Yuan will not fight a battle that he is not sure of.

Xie Changtian got out of the operation at this time, and when he heard that there was a special patient, he hurriedly rushed to the operating room.

There weren't many people in the operating room, and his face became solemn.

"Why don't you wait for me!" Xie Changtian frowned and looked at Deng Yunlun.

Deng Yunlun said: "The patient's condition is very bad, and there is no need to delay, so we will do first aid first."

Deng Yunlun knew why Xie Changtian was displeased.

First, the patient's status is special, and the pressure on him must be made to ensure the effectiveness of the treatment.

Second, the patient's condition is special, and it is best to apply for multi-department linkage surgery to ensure the success rate of the operation.

Third, Xie Changtian complained a little about Deng Yunlun, if such an important operation fails, he must bear the corresponding consequences.

can also understand Deng Yunlun's thoughts.

He desperately needs a blockbuster surgery to prove his worth.

Bell, a crisp sound.

Xie Changtian followed the sound and looked at it, and a yellow-orange-orange bullet was taken out of the cavity by Zhao Yuan and placed on the silver tray.

In the shortest possible time, Zhao Yuan took out the first projectile.

Deng Yunlun breathed a sigh of relief and whispered to Xie Changtian: "No problem, please rest assured."

Xie Changtian chose to stand aside and watch, if Deng Yunlun and the others couldn't control it, he would come forward to take over.

In the blink of an eye, Zhao Yuan had already taken out seven projectiles.

His face became more and more solemn.

Two more projectiles were not found.

A 12-gauge shotgun could never have only seven projectiles.

The only explanation, the projectile ran to a place where the field of view could not be seen.

Xie Changtian noticed that something was wrong, and frowned: "What's wrong?"

Zhao Yuan made a judgment based on experience, and said in a deep voice: "Two projectiles have entered the heart."

Deng Yunlun questioned, "If a bullet hits the heart, won't it directly shatter the heart? Judging from the appearance, there are no traces of trauma to the heart."

Zhao Yuan pointed to the location of the subclavian vein, "There are traces of fractures in this position, and it is not a direct shot to the heart from the subclavian vein."

Xie Changtian was silent for a few seconds.

He didn't have that kind of experience either.

"I'll have to ask someone from the cardiothoracic surgeon to come and take a look. Jiang

Qiang came quickly, and he also brought Gao Qian and a director-level doctor.

On the way, Gao Qian expressed her dissatisfaction with Jiang Qiang.

"Director Jiang, Zhao Yuan has not participated in the training camp in the past few days, although he has been removed, but he still has to participate in the training, right?"

Jiang Qiang smiled: "Zhao Yuan's level is good, it doesn't matter if he participates in the training camp or not." He has surgery every day, and you don't have to worry about him getting hands. If there is a more classic surgery, we can give advance notice and let him participate. "

Zhao Yuan's specifications are too high!

Gao Qian was a little dissatisfied with Jiang Qiang's connivance with Zhao Yuan.

She knew that Zhao Yuan's strength was not bad.

But it is not as familiar as Jiang Qiang with Zhao Yuan.

When they came to the operating room, Jiang Qiang and the three of them figured out the situation in the shortest possible time.

Like everyone else, Jiang Qiang was also confused.

"The heart has abundant blood circulation, and if a bullet gets into it, there will be symptoms of cardiac tamponade, but the patient has no signs of anything, and it is difficult to determine that a bullet has penetrated the heart. Gao Qian asked.

Zhao Yuan is very sure, "I have seen similar cases in the New England Journal of Medicine.

Jiang Qiang groaned slightly and did not express his position.

He had seen similar reports.

However, there are significant risks.

What should I do if the pericardium is cut open

and the bullet is not found? This will be a medical accident!

However, if Zhao Yuan's judgment is correct and the bullet remains in the patient's heart, it is absolutely impossible for the patient to undergo another thoracotomy operation, which will eventually cause a cardiac embolism, and who will bear the consequences?

Zhao Yuan saw that Jiang Qiang and the others were still hesitating, and suggested: "Is it possible to perform interventional surgery without opening the pericardium, so that even if the bullet cannot be found, the damage to the patient will be reduced to the minimum."

Gao Qian couldn't hide her surprise.

Zhao Yuan's idea is too bold!!

The senior attending of the three groups has received news from some sources in the operating room.

There was a heated discussion in the WeChat group.

"I heard you right, right? The bullet wandered into the right ventricle? It's unbelievable! Such a ridiculous idea, this Zhao Yuan is doing Deng Yunlun a favor, right?"

"I have seen a case before, a female patient suffered unexplained left neck trauma near the shooting range, with a small amount of bleeding, and was sutured after simple debridement. After 14 years, he went to the cardiac surgery department with asthma as the main complaint, and it was found that the bullet passed through the jugular vein, the innominate vein, the superior vena cava, the right atrium, and entered the right ventricle, and finally deposited on the diaphragmatic surface of the right ventricle. "

The odds are smaller than winning the jackpot.

"! I found a bullet in the pericardium, so I ate it. "

......

In the operating room.

After a brief discussion between Jiang Qiang and Xie Changtian, they decided to trust Zhao Yuan's judgment.

If you are not afraid of 10,000, you are afraid of what happens.

Zhao Yuan broke the routine for more than the first time.

He was proven right every time.

What's more, Zhao Yuan's plan is safe.

With interventional methods, even if no bullet is found, it will not cause excessive damage to the patient.

Zhao Yuan completed the "oblique puncture".

The guidewire and catheter entered smoothly.

The guidewire passes from the inferior vena cava into the pericardial lumen.

In the right ventricle, a clear image appeared.

A projectile!