Chapter 1355 Well-Known Nationwide May Not Necessarily Do Well in Surgery
Zheng Ren and Linger came to the Cardiothoracic Surgery Department. In the office, Zhao Yunlong was standing in front of the film reader, frowning at the film.
Because it was already off work, and the second-line professors from other departments had not yet arrived, it was normal for them to arrive a little later.
"Lao Zhao, what patient?" Zheng Ren asked.
"Mr. Zheng, take a look." Zhao Yunlong saw Zheng Ren and Linger come in together, he didn't say hello to Linger, he directly pulled Zheng Ren over to watch the film.
Zheng Ren glanced at it, and his heart sank.
The patient's mediastinum was a vast white area with severe infection, which had invaded the visceral pleura and aorta.
"The patient is 62 years old. He ate mandarin fish at home two weeks ago and got a fishbone. Later, he ate steamed buns after taking mature vinegar by himself, and wanted to choke." Zhao Yunlong said.
It turned out to be the case, no wonder the big pig's hoof called this a bloody case caused by a steamed bun.
Zheng Ren nodded, hugged his arms and started watching the movie.
"There were no strong symptoms at that time, and cough and sputum began to appear 3 days later. One week later, it was difficult to breathe, and the sputum was yellow-green. One day ago, the sputum turned black and yellow, and the local hospital doctor suggested coming to the Imperial Capital for diagnosis and treatment." Zhao Yunlong introduced. .
"The mediastinal abscess is very serious. We must hurry up and operate it." Zheng Ren said.
"Well, I think that the aorta has been violated, and the aortic stent needs to be placed." Zhao Yunlong said: "If you can avoid artificial blood vessel anastomosis, try not to use it."
"Well, if you do that, the operation is too big. And the infection is too severe, and the possibility of bacteremia and sepsis... Basically, there will be complications." Zheng Ren immediately understood what Zhao Yunlong meant.
"I also want to see who will come to the intervention department for a consultation. If the tide is high, I'll call Su Yun." Zhao Yunlong said in a low voice with a smile.
"Who will perform the surgery?" Zheng Ren asked.
"I'm going, the second-tier Professor Zhang is not good enough." Zhao Yunlong said bluntly.
This is the case in clinical practice. The level of professors is not necessarily higher than that of hospitalization, and it is not necessarily that the level of nationally renowned professors is higher than that of others.
Generally speaking, the level of nationally renowned professors is not necessarily high. Many people give up clinical practice when they are in their 40s, when their hand speed, eyesight, and energy begin to decline from their peaks, and they start running nationwide and giving speeches.
In this case, the nationwide popularity will go up, but the level of surgery will go down accordingly.
Some things are difficult to achieve. People who are really good at surgery are squatting in the hospital and doing surgery in obscurity. They rarely have the opportunity to let everyone know.
Even if someone knows, it is only famous in a small circle.
"Professor Zhang..." Zheng Ren said, looking around and seeing that only Ringo was sitting in a chair, reporting things on his mobile phone, he whispered, "Can the aortic arch replacement be done?"
"It can be done, but the mortality rate is particularly high." Zhao Yunlong said.
Zheng Ren knew it.
He didn't continue to ask, it had nothing to do with himself whether other people's surgery was good or bad.
Continuing to watch the movie with his arms in his arms, Zheng Ren was like a stone sculpture, standing still despite the wind and rain.
More than ten minutes later, the second-line professors on duty from the relevant departments came in one after another. If you know Zheng Ren, say hello. Most of Zheng Ren didn't know him, so he just passed by.
"Is this the patient's film?" A voice came from behind.
"Professor Zhang, it's a movie of emergency patients." Zhao Yunlong replied in a deep voice.
Zheng Ren turned his head to the side, and saw a gray-haired doctor in his fifties standing behind him.
His hair was meticulously groomed, and his snow-white clothes were like a swordsman in white, and he could fly against the wind. The whole person seems to be very energetic, with a sense of elegance.
"Hello, Professor Zhang." Zheng Ren greeted politely.
"Boss Zheng, do you also have research on our cardiothoracic surgery?" Professor Zhang greeted calmly.
"This is not to think that if it is an operation, the risk of the next aortic stent can be very small." Zheng Ren smiled: "The stent is good, but it is still difficult to remove the abscess."
"This operation can't be done at all." When Professor Zhang heard Zheng Ren talk about the operation, he directly denied it.
Zheng Ren didn't say anything, just smiled. The muscles on Zhao Yunlong's face trembled a few times, but he couldn't help but say nothing.
"Everyone is here, Mr. Zhao, please introduce the patient's situation." Linger sat in the middle, and he began to preside over the meeting on behalf of the medical department.
Zhao Yunlong reported the medical history, which was much more detailed than what he had described with Zheng Ren.
The patient had been running a high fever, a sign of a serious infection. Bacterial culture, mainly Pseudomonas aeruginosa, and the existence of other drug-resistant bacteria.
The film is very obvious, mediastinal gas, mediastinal abscess, the diagnosis is particularly many, and complex.
But when it comes to treatment, it's even harder.
"Let me tell you my opinion." Professor Zhang stood in front of the film reader and said calmly.
His gray hair seemed to speak of a wealth of clinical experience. The whole person looked clean and calm, and a bookish air rushed towards his face, which made people unconsciously develop a kind of trust.
"I don't deny that the patient needs surgery. But after reading the film, we can see that part of the aortic adventitia has been damaged due to the long delay in the lower-level hospital." Professor Zhang's voice is very nice, There is a slight hoarseness in the thick.
"In this case, there is no chance to strip the abscess. If the operation is forced, the probability of the patient dying on the operating table is greater than 95%." Professor Zhang said loudly: "If the patient's family insists on surgery, I suggest at least a thoracic cavity. We will talk about it after the 64-slice CT 3D reconstruction.”
Zheng Ren shook his head inwardly.
64-slice CT 3D reconstruction of the thoracic cavity... He should be talking about vascular CTA and 3D reconstruction of the mediastinum.
This kind of slow diagnosis examination, even if the medical department comes forward, can at least be done tomorrow. According to the normal process, the results can be obtained early the day after tomorrow.
What he said was clear, and the underlying meaning was clear. Surgery can't be done, at least not tonight.
Because today is Professor Zhang's second-line class. If something goes wrong, he needs to take responsibility.
Even if you do, you have to talk about it tomorrow and the day after.
At that time, he is not on duty, just sit and watch the operation, success or failure has nothing to do with him.
However, what Professor Zhang said was more tactful, first emphasizing the seriousness of the condition. For such a serious illness, it is also necessary and necessary to do 3D reconstruction to understand the condition before surgery.
What a slick Tai Chi master, Zheng Ren thought.
Seeing that everyone was silent, Professor Zhang picked up the medical records and started talking nonstop.
From the laboratory examination of white blood cells, neutrophils, and c-reactive protein, to the changes in pathophysiology, everything is straight forward.
The lecture was really good, Zheng Ren thought to himself.
"Do you have any comments?" Linger paused and asked.
"Let me say a few words." Zheng Ren stood up, smiled gently, and said.
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