Medical road Qingyun

Chen Si, a two-year resident doctor, usually has not had much contact with Zhao Yuan, but he knows Zhao Yuan's name like thunder.

The emergency center knew that an intern had just arrived, and the level of diagnosis was very high.

However, at the moment, there is no equipment, and it is a bit exaggerated to be able to determine the condition based on a physical examination alone.

Chen Si couldn't hold back his curiosity, and humbly asked, "How did you come to your conclusion?"

Zhao Yuan explained, "Aortic dissection is more dangerous than acute myocardial infarction, and the pain is more extensive. Acute myocardial infarction is mainly pain in the precordial area, while aortic dissection is mainly chest pain, shoulder pain, back pain, and abdominal pain, and the pain is more direct, like a knife cut.

Chen Si asked, "The patient is already in a coma, how can you determine her pain symptoms?"

Zhao Yuan pinched the patient's shoulder bone, "Although the person is already in a coma, the contraction response of the muscles stimulated by the pain can be seen through careful observation." To be precise, it should be acute type A arterial dissection.

Chen Si's eyes widened, revealing disbelief, "I learned." It

is said that Zhao Yuan's level is comparable to that of a great doctor at the level of deputy director, and when I put myself in my shoes, I know that the success of others is not accidental, but strength and talent.

Of course, Chen Si is still hiding doubts in his heart, whether Zhao Yuan is wrong.

Zhao Yuan couldn't go to the hotel to attend the meeting, so he called Zhou Guangchen in the ambulance and explained the reason.

Zhou Guangchen heard that Zhao Yuan happened to meet a patient with acute type A artery dissection, and he had an idea and called Jiang Qiang.

On the phone, Zhou Guangchen suggested that this morning, the cardiac surgery group activity might as well change the plan and go to Tianhua Hospital to carry out an observation and discussion activity of "acute type A artery dissection".

Jiang Qiang immediately reacted, Zhou Guangchen was indirectly helping.

It is a great thing for Tianhua Hospital that so many famous cardiothoracic surgeons from all over the country go to Tianhua Hospital, which is no less than pie in the sky.

Jiang Qiang hurriedly called Chang Hongbo to explain the matter, and Chang Hongbo immediately communicated with the administrative department and asked to organize the reception activities.

Thoracic and cardiac surgery is a first-class department in any hospital, and if a hospital wants to be at the top of the comprehensive strength list, the score of thoracic and cardiac surgery occupies a large proportion.

For example, although the level of thoracic and cardiac surgery in Hua Hospital today is not bad, it can only be ranked eighth or ninth, and many difficult surgeries cannot be done by yourself, so you need to go to the outer hospital to ask for someone.

On the one hand, it is because of the limited strength of its expert team, and on the other hand, it is not a lot of resources.

Why does Union Medical College Hospital spend so much energy to host a national conference?

They are not fed to support themselves, but they hope to accumulate more resources through such activities.

Many extracardiac experts came to Tianhua together, and the hospital could take this opportunity to establish a good relationship with them, and if the extracardiac boss wanted to change his court one day, he would also give priority to Tianhua.

No matter how bad it is, with an emotional foundation, it will be easier to invite these top experts to come to the surgeon and help for difficult surgeries.

......

The ambulance arrived at Tianhua Hospital and first sent the patient for a full body examination.

It didn't take long for the results to come out, which was consistent with Zhao Yuan's judgment!

When Chen Si, the doctor on the car, heard this result, he secretly admired Zhao Yuan. The nurse in the same car also spread the news, and the mystery on Zhao Yuan's body added a bit of charm and aura.

At the same time, a bus took the cardiac surgeon from the hotel to the hospital.

Chang Hongbo led several high-level officials of the hospital to greet him at the parking lot, Shang Yong took the lead to get out of the car, Chang Hongbo took the initiative to greet

him, "Academician Shang, welcome!" Shang Yong shook hands with Chang Hongbo, "I didn't notify you in advance, I bothered rashly, please understand."

Chang Hongbo hurriedly smiled and said: "Look at what you said, you brought so many experts to Tianhua, let us shine." Shang

Yong and Chang Hongbo have met a few times, and the relationship between the two is not particularly familiar. However, Shang Yong and Jiang Qiang's father have been friends for many years.

In this chest and heart meeting, the organizer intentionally or unintentionally ignored the importance of cardiac surgery, so Shang Yong felt uncomfortable.

So, Jiang Qiang and Shang Yong proposed to temporarily adjust the activity plan, and Shang Yong pushed the boat down the river.

Southern Union Medical College Hospital was so anxious at the moment that he made several calls to Shang Yong, and Shang Yong handed over the phone to the assistant to answer it.

It is not to blame Shang Yong for not being emotional, mainly because the organizer is not considerate.

With so many experts in cardiac surgery this time, it is difficult to get one of them.

Their qualifications are enough to make any hospital call "X" boss.

Although the Southern Union Medical College Hospital contracted the travel expenses, that money was really nothing to these people.

Jiang Qiang led a group of people to conduct a detailed examination of the patient to see if the operation could be carried out immediately.

He glanced at Zhao Yuan, and the first aid was handled properly in the early stage, especially β receptor blockers to avoid aggravation of the condition.

The patient is eligible for surgery.

Jiang Qiang was inevitably a little nervous at the moment.

Today's operation, there are many experts who have observed, and if there is a slight mistake, there will be nothing to hide.

However, from another point of view, this will also be the battle for the fame of the cardiothoracic surgery department of Tianhua Hospital.

If the operation can be done very beautifully, the strength of cardiac surgery in Tianhua Hospital will inevitably be recognized by everyone.

Aortic dissection is divided into type A and B, regardless of the origin of the lesion, all dissections involving the "ascending aorta" are type A aortic dissection;

Dissection involving the "descending aorta" distal to the inferior opening of the left clavicle artery is type B aortic dissection.

The aorta in the human body is made up of the intima, media, and adventitia. The so-called aortic dissection is a dissection caused by the rupture of the intima and the medial flow of blood that originally flowed in the aortic lumen into the intima and the media. If left untreated, it can lead to rupture of the aorta, causing massive bleeding or ischemia of vital organs.

The danger of aortic dissection, among all diseases, is one of the best, and it is known as a catastrophic vascular bomb.

The cause of aortic dissection is not clear in the academic community, and this disease is not uncommon, there are 50,000 patients in China every year, but only about 8,000 surgeries can be performed.

Because the operation is complicated, the process is cumbersome and time-consuming.

Jiang Qiang glanced at his nephew Jiang Jing, and had a heart, "How do you think it should be treated?" There

are twenty or thirty treatment options for aortic dissection surgery.

In the selection of surgical methods, it is necessary to fully consider the morphological factors of the ascending aneurysm, whether the sinus or arch is involved, the type of aortic valve lesion and other factors, and then select the appropriate surgical method to ensure the treatment effect.

The error tolerance rate of aortic dissection surgery is too low, and it is impossible to withstand a little mistake, so

if you choose the wrong surgical plan for other types of surgery, you can also bypass it during the operation, or use other plans to make up for the gap.

Patients with aortic dissection cannot withstand the toss, and once they make mistakes, they often declare failure.

"Type A dissection avulsed 2 aortic valve junctions and tore around the opening of the right coronary artery, requiring ascending aortic replacement and aortic replacement hybridization. Jiang Jing said thoughtfully, with a serious expression.

It can't be said that Jiang Jing's answer is wrong, but he is more slippery and more general.

Zhou Guangchen coughed, his eyes swept to Zhao Yuan, and asked, "Xiao Jiang is not very specific, there are many options for ascending aortic replacement, and there are also many kinds of aortic replacement hybrid surgery. Zhao Yuan, can you elaborate a little more?

Zhao Yuan didn't expect Zhou Guangchen to call his name, and when he saw that everyone's eyes were looking at him, he didn't twist, "Bentall surgery and Sun's surgery!"

Ascending aorta replacement includes a variety of procedures such as Bentall, Cabrol, Wheat, and David.

Aortic replacement hybrid surgery, also known as elephant trunk surgery, is an innovative Sun's surgery based on elephant trunk surgery, which was designed by a domestic cardiac surgeon in 2007 and has become a classic standard surgery.

Zhang Guoping, who was standing next to Zhou Guangchen, nodded with a smile and agreed, "The two programs have a common advantage, after the operation, there are relatively few complications." "

The mortality rate after aortic dissection reached 20 percent, and Zhao Yuan took this into account and proposed a treatment plan.

"Zhao Yuan, Jiang Jing, you two are going to have surgery. Jiang Qiang gave an order.

Jiang's decision was not a surprise.

Although Jiang Jing is not a doctor at Tianhua Hospital, he is a leader among young doctors and a returnee.

Zhao Yuan is a rising star in Tianhua Hospital, and he has worked with him many times, Jiang Qiang is familiar with him, and there will be no problem when he is an assistant!

On such an important occasion, Jiang Qiang has the heart to push the two of them.

Zhang Guoping's face was full of anticipation.

He had seen the traces of Zhao Yuan's surgery, but he had not seen Zhao Yuan's surgery scene.

He always had a question, is this kid really worth 20 million?