Chapter 1356： National well-known may not do well in surgery
Zheng Ren and Ringer came to cardiothoracic surgery. In the office, Zhao Yunlong was standing in front of the reader and frowned at the film.
Because I have already got off work, the professors of the second line of other departments have not arrived yet. It is normal to wait for this time.
"Old Zhao, what patient." Zheng Ren asked.
"Cheng Zheng, take a look." Zhao Yunlong saw Zheng Ren and Ringer come in together, did not say hello to Ringer, directly pulled Zheng Ren to see the film.
Zheng Ren glanced at him and his heart sank.
The patient has a white sputum in the mediastinum, which is severely infected and has invaded the visceral pleura and aorta.
"The patient is 62 years old. I bought a mandarin fish at home two weeks ago and got a fishbone. I later took the vinegar and took the steamed bread and wanted to squat." Zhao Yunlong said.
It turns out that it is no wonder that the big pig hoof tube is called a **** case caused by a hoe.
Zheng Ren nodded and began to watch the film.
"There was no strong symptoms at that time. Cough and cough began to appear after 3 days. After 1 week, the breathing was difficult. The cough was yellow-green. The cough became black and yellow one day ago. The local hospital doctor suggested that the Emperor should be treated." Zhao Yunlong introduced .
"The mediastinum abscess is very heavy, you must hurry to surgery." Zheng Rendao.
"Well, I think that the aorta is invaded and I need a lower aortic shelf." Zhao Yunlong said: "You can use artificial blood vessels without anastomosis. Try not to use it."
"Well, then, the surgery is too big. And the infection is too heavy, and the possibility of bacteremia, sepsis... basically surely there will be complications." Zheng Ren immediately understood the meaning of Zhao Yunlong.
"I still want to see who will come to the intervention department for a consultation. If the level is high, I will call Su Yun." Zhao Yunlong said with a smile.
"Who are you on?" Zheng Ren asked.
"I am on the second line, Professor Zhang is not good at all." They are all their own people, Zhao Yunlong said very straightforwardly.
This is the case in clinical practice. The level of teaching is not necessarily higher than that of hospitalization. It is not necessarily the level of well-known professors in the country that is higher than others.
Generally speaking, the well-known professors in the country are not necessarily high in level. Many people in their forties were over, and when they started to fall from the peak, they gave up the clinic and started running around the country.
In this case, the popularity of the whole country is up, but the level of surgery is correspondingly down.
Some things are difficult to do. People who are really good at surgery, who are obscured in the hospital, have very few opportunities to let everyone know.
Even if someone knows it, it is also famous in the small circle.
"Professor Zhang..." Zheng Ren said, looking back and seeing that only Linger was sitting in a chair and reporting on the mobile phone, he whispered: "Aortic arch replacement can be done."
"Can do it, but the mortality rate is particularly high." Zhao Yunlong said.
Zheng Ren has counted in his heart.
He did not continue to ask, the quality of other people's surgery is not related to himself.
Continue to hold the film to see the film, Zheng Ren is like a stone sculpture, let the wind and rain hit, not moving.
After more than ten minutes, the second-line teachers in the relevant departments have come in. I have a greeting with Zheng Ren. Most of them do not know Zheng Ren, and they have passed.
"This is the patient's film?" A voice came from behind.
"Professor Zhang, is the film of the emergency patient." Zhao Yunlong screamed.
Zheng Ren sideways, see a 50-year-old doctor with a gray hair standing behind him.
His hair is careless, and the white dress is like a white swordsman. He can dance with the wind. The whole person looks special and carries a subtle elegance.
"Professor Zhang, hello." Zheng Ren politely said.
"Zheng boss, you have also studied our cardiothoracic surgery?" Professor Zhang said, not cold or not.
"This is not a matter of surgery, the next aortic stent, the risk is very small." Zheng Ren smiled: "The stent is good, but to remove the abscess, the difficulty is still high."
"This surgery can't be done at all." Professor Zhang listened to Zheng Ren about the operation and directly denied it.
Zheng Ren did not speak, just smiled. The muscles on Zhao Yunlong’s face shook a few times and they did not talk.
"People are all here, General Zhao, introduce the patient's situation." Ringer sat in the middle, and he began to preside over the meeting on behalf of the Medical Service.
Zhao Yunlong reported the history of the disease, which was much more detailed than when Zheng Ren described it.
The patient has been suffering from a high fever, which is a sign of a serious infection. Bacterial culture, mainly Pseudomonas aeruginosa, and the presence of other resistant bacteria.
The film is very obvious, the mediastinum, mediastinal abscess, diagnosis is particularly many, and complicated.
But it involves more treatments.
"I will say what I think." Professor Zhang stood in front of the reader and said calmly.
His white hair is like a rich clinical experience. The whole person looked clean and calm, and a book rushed in and out, which made people unconsciously create a kind of trust.
"The patient needs surgery. I don't deny it. But after reading the film, we can see that because the delay in the lower level hospital is too long, the aortic adventitial part of the layer has been damaged." Professor Zhang's voice is very good. There is a slight hoarseness in the thick.
"In this case, there is no chance to remove the abscess. If forced surgery, the probability of the patient dying on the operating table is greater than 95%." Professor Zhang said: "If the patient's family is going to have surgery, I suggest at least the chest. After the 64-row CT three-dimensional reconstruction, I will talk about it."
Zheng Ren shook his head in his heart.
Three-dimensional reconstruction of the chest 64-slice CT... He should say that the vascular CTA and the three-dimensional reconstruction of the mediastinum This kind of slow examination, even if the medical office comes forward, at least tomorrow can be done. According to the normal process, the results will be early after tomorrow.
He said it was clear and the potential meaning was very clear. Surgery, can't do it, at least not tonight.
Because today is Professor Zhang on the second line. If something goes wrong, he needs to take responsibility.
Even if you do, you have to say it tomorrow.
When you are not on duty, just sit down and look at the surgery. Success and failure have nothing to do with him.
However, Professor Zhang said that it is relatively smooth, first of all, stressing the seriousness of the disease. Such a serious illness, it is necessary and necessary to do a three-dimensional reconstruction before surgery to understand the condition.
Really very slippery Tai Chi master, Zheng Ren thought.
Professor Zhang saw that everyone was silent, and he took up the medical record and began to talk about it.
From the examination of white blood cells, neutrophils, c-reactive protein, from the beginning to the pathophysiological changes, the head is the road.
The class is really good, Zheng Ren thought.
"Do you still have any opinions?" Lingerton asked, and asked.
"I will say a few words." Zheng Ren stood up and smiled softly and said.
......
......
Ask for a monthly ticket and ask for a monthly pass at the beginning of next month.
Because I have already got off work, the professors of the second line of other departments have not arrived yet. It is normal to wait for this time.
"Old Zhao, what patient." Zheng Ren asked.
"Cheng Zheng, take a look." Zhao Yunlong saw Zheng Ren and Ringer come in together, did not say hello to Ringer, directly pulled Zheng Ren to see the film.
Zheng Ren glanced at him and his heart sank.
The patient has a white sputum in the mediastinum, which is severely infected and has invaded the visceral pleura and aorta.
"The patient is 62 years old. I bought a mandarin fish at home two weeks ago and got a fishbone. I later took the vinegar and took the steamed bread and wanted to squat." Zhao Yunlong said.
It turns out that it is no wonder that the big pig hoof tube is called a **** case caused by a hoe.
Zheng Ren nodded and began to watch the film.
"There was no strong symptoms at that time. Cough and cough began to appear after 3 days. After 1 week, the breathing was difficult. The cough was yellow-green. The cough became black and yellow one day ago. The local hospital doctor suggested that the Emperor should be treated." Zhao Yunlong introduced .
"The mediastinum abscess is very heavy, you must hurry to surgery." Zheng Rendao.
"Well, I think that the aorta is invaded and I need a lower aortic shelf." Zhao Yunlong said: "You can use artificial blood vessels without anastomosis. Try not to use it."
"Well, then, the surgery is too big. And the infection is too heavy, and the possibility of bacteremia, sepsis... basically surely there will be complications." Zheng Ren immediately understood the meaning of Zhao Yunlong.
"I still want to see who will come to the intervention department for a consultation. If the level is high, I will call Su Yun." Zhao Yunlong said with a smile.
"Who are you on?" Zheng Ren asked.
"I am on the second line, Professor Zhang is not good at all." They are all their own people, Zhao Yunlong said very straightforwardly.
This is the case in clinical practice. The level of teaching is not necessarily higher than that of hospitalization. It is not necessarily the level of well-known professors in the country that is higher than others.
Generally speaking, the well-known professors in the country are not necessarily high in level. Many people in their forties were over, and when they started to fall from the peak, they gave up the clinic and started running around the country.
In this case, the popularity of the whole country is up, but the level of surgery is correspondingly down.
Some things are difficult to do. People who are really good at surgery, who are obscured in the hospital, have very few opportunities to let everyone know.
Even if someone knows it, it is also famous in the small circle.
"Professor Zhang..." Zheng Ren said, looking back and seeing that only Linger was sitting in a chair and reporting on the mobile phone, he whispered: "Aortic arch replacement can be done."
"Can do it, but the mortality rate is particularly high." Zhao Yunlong said.
Zheng Ren has counted in his heart.
He did not continue to ask, the quality of other people's surgery is not related to himself.
Continue to hold the film to see the film, Zheng Ren is like a stone sculpture, let the wind and rain hit, not moving.
After more than ten minutes, the second-line teachers in the relevant departments have come in. I have a greeting with Zheng Ren. Most of them do not know Zheng Ren, and they have passed.
"This is the patient's film?" A voice came from behind.
"Professor Zhang, is the film of the emergency patient." Zhao Yunlong screamed.
Zheng Ren sideways, see a 50-year-old doctor with a gray hair standing behind him.
His hair is careless, and the white dress is like a white swordsman. He can dance with the wind. The whole person looks special and carries a subtle elegance.
"Professor Zhang, hello." Zheng Ren politely said.
"Zheng boss, you have also studied our cardiothoracic surgery?" Professor Zhang said, not cold or not.
"This is not a matter of surgery, the next aortic stent, the risk is very small." Zheng Ren smiled: "The stent is good, but to remove the abscess, the difficulty is still high."
"This surgery can't be done at all." Professor Zhang listened to Zheng Ren about the operation and directly denied it.
Zheng Ren did not speak, just smiled. The muscles on Zhao Yunlong’s face shook a few times and they did not talk.
"People are all here, General Zhao, introduce the patient's situation." Ringer sat in the middle, and he began to preside over the meeting on behalf of the Medical Service.
Zhao Yunlong reported the history of the disease, which was much more detailed than when Zheng Ren described it.
The patient has been suffering from a high fever, which is a sign of a serious infection. Bacterial culture, mainly Pseudomonas aeruginosa, and the presence of other resistant bacteria.
The film is very obvious, the mediastinum, mediastinal abscess, diagnosis is particularly many, and complicated.
But it involves more treatments.
"I will say what I think." Professor Zhang stood in front of the reader and said calmly.
His white hair is like a rich clinical experience. The whole person looked clean and calm, and a book rushed in and out, which made people unconsciously create a kind of trust.
"The patient needs surgery. I don't deny it. But after reading the film, we can see that because the delay in the lower level hospital is too long, the aortic adventitial part of the layer has been damaged." Professor Zhang's voice is very good. There is a slight hoarseness in the thick.
"In this case, there is no chance to remove the abscess. If forced surgery, the probability of the patient dying on the operating table is greater than 95%." Professor Zhang said: "If the patient's family is going to have surgery, I suggest at least the chest. After the 64-row CT three-dimensional reconstruction, I will talk about it."
Zheng Ren shook his head in his heart.
Three-dimensional reconstruction of the chest 64-slice CT... He should say that the vascular CTA and the three-dimensional reconstruction of the mediastinum This kind of slow examination, even if the medical office comes forward, at least tomorrow can be done. According to the normal process, the results will be early after tomorrow.
He said it was clear and the potential meaning was very clear. Surgery, can't do it, at least not tonight.
Because today is Professor Zhang on the second line. If something goes wrong, he needs to take responsibility.
Even if you do, you have to say it tomorrow.
When you are not on duty, just sit down and look at the surgery. Success and failure have nothing to do with him.
However, Professor Zhang said that it is relatively smooth, first of all, stressing the seriousness of the disease. Such a serious illness, it is necessary and necessary to do a three-dimensional reconstruction before surgery to understand the condition.
Really very slippery Tai Chi master, Zheng Ren thought.
Professor Zhang saw that everyone was silent, and he took up the medical record and began to talk about it.
From the examination of white blood cells, neutrophils, c-reactive protein, from the beginning to the pathophysiological changes, the head is the road.
The class is really good, Zheng Ren thought.
"Do you still have any opinions?" Lingerton asked, and asked.
"I will say a few words." Zheng Ren stood up and smiled softly and said.
......
......
Ask for a monthly ticket and ask for a monthly pass at the beginning of next month.
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