When doctors have a simulated operating room

Chapter 247

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After Zhang Yi finished speaking, he asked again: "Then Director Mai, do you remember any cases of tetralogy of Fallot with reduced compliance after heart failure?"

Mai Xiaofeng shook his head:

"No, at present. Tetralogy of Los is a ventricular septal defect, so the blood between the two ventricles can't find an exit or an entrance, and all of it is mixed together, so there is no such thing as reduced compliance. "

"That's right, so this is a girl One of the reasons for this problem.

I had a ventricular septum repair eleven months ago, and this problem occurred so soon after the repair.

This means that the problem may be in the repair. After the repair, the two ventricles were separated. The blood flow has a destination.

At the same time, the flow rate also appears. In addition, this child has a coarctated aorta and ventricular hypertrophy.

Therefore, when you perform the repair surgery, Director Mai, the space reserved for the two ventricles must not be Are they equal in size?

The ventricles are not equal in size, one side is bigger while the other side is smaller. The blood outflow outlets of the mitral valve and the ventricle are not equal in size.

Then the flow rate in the atrium and ventricle may become different.

At this time, we have to talk about the Bernoulli equation again.

That is, the mechanical energy of the fluid Conservation, kinetic energy + gravitational potential energy + pressure potential energy = constant.

If your outflow path is different and gravity remains unchanged, you can only increase the flow rate if you want to conserve.

Once the flow rate increases, a pressure difference will be generated between the ventricle and the atrium.

This The pressure difference will suck away the mitral valve when it opens to eject blood.

It will block the aortic valve, so the solution to this disease is to resolutely stop using cardiotonic drugs.

This drug can The faster the heart beats, the faster the flow rate, and the greater the pressure difference.

The only way to slow down the heart is to return the flow rate to normal.

Otherwise, you should have surgery immediately to solve all the problems of tetralogy at once. See if we can alleviate the pressure difference caused by different flow rates. "

Zhang Yi explained.

I don't know if you can understand.

But we are all doctors, and we have all learned this stuff. If I explain it briefly, you should be able to understand it.

Right now, the most important thing is to hurry up and perform the surgery.

Mai Xiaofeng was silent for a while before saying:

"You mean, this is a Dynamic obstructive heart disease? It only occurs when the heart is moving. If the heart is not moving or moving very slowly, this lack of oxygen will disappear? ? "

"That's right! Of course, it is not certain whether it is a repair surgery. So I suggest surgery as soon as possible to avoid mutations. ”

Everyone present is a medical student.

Of course, they know the Bernoulli equation and the pressure difference problem.

So just a few simple words and everyone will understand .

So there is such a disease!

Some doctors at the scene have never heard of it.

After all, this disease is very rare, and some doctors may not encounter a case in their lifetime.

But...

Such a rare problem...

Zhang Yi actually came Found it? ?

This guy is amazing!

He found the problem after just a few glances at the checklist!

I knock, no wonder he is so awesome now!

There is a reason for it!

Many young doctors who came to watch, especially female doctors, showed admiration to Zhang Yi.

A big boss is a big boss!

Enough Awesome!

On the chairs beside them, the family members and He Biao both looked confused.

It seemed that they understood, but it also seemed that they didn’t understand anything.

The medical knowledge involved was too complicated, and those who had not studied medicine felt like they were listening to a meaningless speech. The book is a mystery.

But those who are good at science can actually understand the general idea.

He Biao didn't understand anything, but he still walked to Mr. Wang and whispered:

"Mr. Wang, how is it? The doctor I introduced to you is quite good. Not bad, right? I don’t understand what he said at all, but it doesn’t affect his ability at all. ”

Mr. Wang only understood the general idea, but he still needs to ask Zhang Yi about the details later.

"Well, it seems... he is much better than ordinary doctors."

At this moment, Mr. Wang's eyes also revealed a glimmer of hope.

I hope that Dr. Zhang can really cure my granddaughter's disease!

As long as he can cure it, Everything is easy to say!

Next to Zhang Yi, Shen Wei, the director of gastrointestinal surgery, suddenly spoke up:

"I seem to have some impression of this disease. Pressure difference is only generated when the heart moves. As long as the heart does not move, there is no pressure difference, right?! This disease is difficult to detect and very dangerous.

Some patients may be classified as common without even finding out the cause.

Tong died of a heart attack.

Moreover, this child also suffers from tetralogy of Fallot, and the ventricles are also thickened.

So it’s understandable that you, Director Mai, didn’t find out the reason.

A normal person's first thought is definitely to find the problem of the tetralogy. "

After Shen Wei said this, he felt like something was wrong?

Zhang Yi turned his head and glanced at Shen Wei, somewhat dumbfounded.

Co-author, what you are saying is that I am not a normal person, Director Shen? ?

Shen Wei chuckled twice and said:

"Now that the results are out, you should hurry up and prepare for the surgery."

Only then did Mai Xiaofeng realize it, nodded and said:

"Dr. Zhang, you are really knowledgeable and well-informed. Although I, Mai Xiaofeng, am so much older than you...

But it's not as careful as your observation, nor as accurate as your analysis.

Okay, we will arrange surgery for this child right away. By the way, are you the one who will perform this surgery, Dr. Zhang? "

Rao Shi has already reached the position of director of the provincial hospital.

You should also continue to learn and enrich yourself.

Today, Zhang Yiye really taught him and all the doctors at the Cardiac Surgery Department of the Provincial Hospital a deep lesson.

It seems that the best thing to do is to read more domestic and foreign medical journals to learn about the latest diseases, especially those related to cardiac surgery, as soon as possible.

Zhang Yi nodded: "I can do the surgery, it depends on the family's decision."

After finishing speaking, Zhang Yi turned his attention to the family members.

When Mr. Wang heard this, he quickly stepped forward and said directly:

"Dr. Zhang, since you are so powerful, I won't beat around the bush.

My granddaughter is the treasure of our family. As long as you can cure our granddaughter, I will directly give you this number! "

As he said that, Mr. Wang directly extended his index finger.

Ten thousand?

Zhang Yi thought, since he said so, it shouldn't be ten thousand.

One hundred thousand?

Seeing how wealthy this family is, it doesn't look like one hundred thousand.

Could it be...

The doctors around looked at the family member in shock.