Chapter 1787： Occult disease
"And you are not right." Zheng Rendao: "Bradley A. Gross and others systematically review and combine the current literature on vascular intervention for moyamoya disease and smoke syndrome. The study was published on NeurosurgRev."
"He only summarized 28 patients with vascular intervention, including 11 intravascular stents and 17 angioplasty. Successful surgery, only 7 patients."
"25 percent." Su Yundao.
“First of all, Dr. Bradley A. Gross is biased in interventional surgery. This is unquestionable. At the end of the article, he said that the results clearly do not support the use of vascular intervention for moyamoya and smog syndrome, and they will need to do more in the future. Research and collect more data to prove this point."
Su Yun grinned and looked at the phone. The dripping car was very close.
"I believe that all research work, as long as it can not adhere to an objective and fair attitude, the conclusion is doubtful." Zheng Rendao.
"What do you say, the interventional treatment of moyamoya disease... I asked Sanbo or the Temple of Heaven to see if they have done it. I think that there are not many people who know neurosurgery, and no one knows the neurosurgery of Huashan. What?"
Su Yun squatted, and a car flashed over.
On the train, Su Yun holds the phone to contact the matter, Zheng Ren recalls the connection between moyamoya disease and coronary surgery.
It is self-evident that if the emergency department is undergoing surgery, what kind of risks will be faced.
But Zheng Ren is not afraid.
Be prepared first, and others will wait until you see the patient and go to the system operating room for surgery to prove your point of view.
Although there are still some training sessions, Zheng Ren is not habitually wanting to “was”.
In the past two days, I have used surgery time to think about my condition twice.
Once, the thyroid gland that ate the animal caused hyperthyroidism and thyroid crisis. Another time, it is a complete waste, because I am licking garlic.
This matter has to be counted on Changyue’s head, and Zheng Ren’s heart secretly thought of it.
Soon came to 912, the distance is not far, the run will arrive, but Su Yun habitually called the car, it does not matter.
Zhao Yunlong in the EICU, the two did not hesitate to go directly to the EICU.
The 912's EICU is a U-shaped building. Each patient is isolated and there is a small table in the hallway. This is where the medical staff can sleep for a while while tired.
The medical staff simply did not have time to rest in the duty room, and the EICU was such a strange existence.
It was already ten o'clock in the evening. After the two entered the EICU, the first thing that caught their eye was the busy workstation.
The four trainees on duty, including the night shift last night, are still busy. For 40 hours in a row, the doctor did not see fatigue, and the whole person was in a state of morbid hyperactivity.
Zheng Ren shook his head. If the emergency department is not going to be seen, the ICU and EICU are definitely not going to be seen.
The ICU of the first hospital in Haicheng is still good to say that there are fewer critical illnesses. The 912's EICU is another world, and 40 beds are always running at full capacity.
If there is no such thing as a doctor, the operation of the 912 will directly collapse.
Not only this, but the community hospitals of Zheng Ren are the same. At present, the nursing power of community hospitals is enough, but doctors are basically practicing medicine.
Zheng Ren didn't have time to feel these things. He quickly followed Sun Yun and walked into an isolation room.
Zhao Yunlong stood very seriously in front of the hospital bed, staring at the patient's ECG monitoring.
"Old Zhao, what is the situation?" Su Yun asked.
"Three cases of rapid ventricular arrhythmia have occurred after operation, and electric defibrillation has been corrected. The situation is not optimistic. Let's take a look." Zhao Yunlong did not look back, but snorted.
"Talk from the beginning." Zheng Rendao.
Zhao Yunlong turned back and saw Zheng Ren also walked in, and then he turned around. "Zheng Zong, you are here too."
"It’s also Zheng’s general, called the boss.” Su Yun said as he squatted down and looked at the chest bottles on both sides.
There is not a lot of drainage, and the surgery should be no problem. It is estimated that the patient's own physical condition leads to rapid ventricular arrhythmia after bypass.
"The patient concealed the disease before surgery." Zhao Yunlong did not pay attention to Su Yun's embarrassment, it seems that he is used to it, but directly reports the condition.
Zheng Ren’s eyebrows wrinkled.
Hidden onset? This... Zheng Ren feels interesting.
The so-called concealed onset is that the patient does not have any symptoms, but in the case of coincidence, the condition is very serious and must be treated.
Too big to say that all tumors in the early stages are considered to be insidious. However, this is not accurate, and the early onset of the tumor is not serious.
What is really troublesome is that the condition is extremely serious, but the body does not respond, at least the patient is not aware of the condition.
This kind of situation is rare, I did not expect to encounter it today.
The patient has a heart attack and also concealed the disease... Zheng Ren has 80% of this time to determine the moyamoya disease in the patient's brain may be a key factor, causing the patient not to notice the pain in the precordial area.
Of course, this is just a guess.
"Patients with chest tightness and shortness of breath for three months, aggravated three days to see the hospital respiratory department. Chest CT showed severe aortic calcification, heart enlargement, so went to the Department of Cardiology. Cardiac angiography showed three lesions, 90% of the anterior descending artery blocked The right crown is blocked by 95% and the maneuver is blocked by 95%."
With a good coronary heart disease, Zheng Ren can already guess what the patient has experienced.
Sure enough, Zhao Yunlong later confirmed Zheng Ren’s speculation.
"During the hospitalization of the Department of Circulation, the patient's family refused to undergo cardiac interventional surgery. After the angiography, the family was still discussing the sudden onset of the disease, rapid cardiac ventricular arrhythmia after cardiac arrest ~ www.novelhall.com~ Zhao Yunlong said: "Emergency Cardiopulmonary resuscitation, cardiac stenting. ”
Zheng Ren’s mind outlines the emergency rescue that caused the excessive secretion of hormones in the Department of Internal Medicine and Cardiothoracic Surgery this afternoon.
Sudden cardiac arrest, a press, and sent to the circulation catheter room.
This process is simple to say, and it is estimated that the doctors in the Cycling Division have not slowed down yet.
"In the process of lowering the stent, the patient suddenly had two rapid ventricular arrhythmias." Zhao Yunlong said: "The balloon is opened, and as soon as the stimulus is stimulated, the heart stops. Later, only the chest can be opened urgently, and coronary artery bypass surgery is performed."
It is almost the same as Zheng Ren’s thought.
"Post patients have less drainage of bilateral chest vessels, and there is not much pericardial drainage, but rapid ventricular arrhythmia is frequent, and defibrillation has been performed three times." Zhao Yunlong said, "Prepare to do IABP, but the patient's family has not yet responded." ”
IABP, also known as intra-aortic balloon counterpulsation, is one of the mechanical assisted circulation methods. It is a means of improving the intra-aortic diastolic pressure, increasing coronary blood supply and improving myocardial function through physical action.
"He only summarized 28 patients with vascular intervention, including 11 intravascular stents and 17 angioplasty. Successful surgery, only 7 patients."
"25 percent." Su Yundao.
“First of all, Dr. Bradley A. Gross is biased in interventional surgery. This is unquestionable. At the end of the article, he said that the results clearly do not support the use of vascular intervention for moyamoya and smog syndrome, and they will need to do more in the future. Research and collect more data to prove this point."
Su Yun grinned and looked at the phone. The dripping car was very close.
"I believe that all research work, as long as it can not adhere to an objective and fair attitude, the conclusion is doubtful." Zheng Rendao.
"What do you say, the interventional treatment of moyamoya disease... I asked Sanbo or the Temple of Heaven to see if they have done it. I think that there are not many people who know neurosurgery, and no one knows the neurosurgery of Huashan. What?"
Su Yun squatted, and a car flashed over.
On the train, Su Yun holds the phone to contact the matter, Zheng Ren recalls the connection between moyamoya disease and coronary surgery.
It is self-evident that if the emergency department is undergoing surgery, what kind of risks will be faced.
But Zheng Ren is not afraid.
Be prepared first, and others will wait until you see the patient and go to the system operating room for surgery to prove your point of view.
Although there are still some training sessions, Zheng Ren is not habitually wanting to “was”.
In the past two days, I have used surgery time to think about my condition twice.
Once, the thyroid gland that ate the animal caused hyperthyroidism and thyroid crisis. Another time, it is a complete waste, because I am licking garlic.
This matter has to be counted on Changyue’s head, and Zheng Ren’s heart secretly thought of it.
Soon came to 912, the distance is not far, the run will arrive, but Su Yun habitually called the car, it does not matter.
Zhao Yunlong in the EICU, the two did not hesitate to go directly to the EICU.
The 912's EICU is a U-shaped building. Each patient is isolated and there is a small table in the hallway. This is where the medical staff can sleep for a while while tired.
The medical staff simply did not have time to rest in the duty room, and the EICU was such a strange existence.
It was already ten o'clock in the evening. After the two entered the EICU, the first thing that caught their eye was the busy workstation.
The four trainees on duty, including the night shift last night, are still busy. For 40 hours in a row, the doctor did not see fatigue, and the whole person was in a state of morbid hyperactivity.
Zheng Ren shook his head. If the emergency department is not going to be seen, the ICU and EICU are definitely not going to be seen.
The ICU of the first hospital in Haicheng is still good to say that there are fewer critical illnesses. The 912's EICU is another world, and 40 beds are always running at full capacity.
If there is no such thing as a doctor, the operation of the 912 will directly collapse.
Not only this, but the community hospitals of Zheng Ren are the same. At present, the nursing power of community hospitals is enough, but doctors are basically practicing medicine.
Zheng Ren didn't have time to feel these things. He quickly followed Sun Yun and walked into an isolation room.
Zhao Yunlong stood very seriously in front of the hospital bed, staring at the patient's ECG monitoring.
"Old Zhao, what is the situation?" Su Yun asked.
"Three cases of rapid ventricular arrhythmia have occurred after operation, and electric defibrillation has been corrected. The situation is not optimistic. Let's take a look." Zhao Yunlong did not look back, but snorted.
"Talk from the beginning." Zheng Rendao.
Zhao Yunlong turned back and saw Zheng Ren also walked in, and then he turned around. "Zheng Zong, you are here too."
"It’s also Zheng’s general, called the boss.” Su Yun said as he squatted down and looked at the chest bottles on both sides.
There is not a lot of drainage, and the surgery should be no problem. It is estimated that the patient's own physical condition leads to rapid ventricular arrhythmia after bypass.
"The patient concealed the disease before surgery." Zhao Yunlong did not pay attention to Su Yun's embarrassment, it seems that he is used to it, but directly reports the condition.
Zheng Ren’s eyebrows wrinkled.
Hidden onset? This... Zheng Ren feels interesting.
The so-called concealed onset is that the patient does not have any symptoms, but in the case of coincidence, the condition is very serious and must be treated.
Too big to say that all tumors in the early stages are considered to be insidious. However, this is not accurate, and the early onset of the tumor is not serious.
What is really troublesome is that the condition is extremely serious, but the body does not respond, at least the patient is not aware of the condition.
This kind of situation is rare, I did not expect to encounter it today.
The patient has a heart attack and also concealed the disease... Zheng Ren has 80% of this time to determine the moyamoya disease in the patient's brain may be a key factor, causing the patient not to notice the pain in the precordial area.
Of course, this is just a guess.
"Patients with chest tightness and shortness of breath for three months, aggravated three days to see the hospital respiratory department. Chest CT showed severe aortic calcification, heart enlargement, so went to the Department of Cardiology. Cardiac angiography showed three lesions, 90% of the anterior descending artery blocked The right crown is blocked by 95% and the maneuver is blocked by 95%."
With a good coronary heart disease, Zheng Ren can already guess what the patient has experienced.
Sure enough, Zhao Yunlong later confirmed Zheng Ren’s speculation.
"During the hospitalization of the Department of Circulation, the patient's family refused to undergo cardiac interventional surgery. After the angiography, the family was still discussing the sudden onset of the disease, rapid cardiac ventricular arrhythmia after cardiac arrest ~ www.novelhall.com~ Zhao Yunlong said: "Emergency Cardiopulmonary resuscitation, cardiac stenting. ”
Zheng Ren’s mind outlines the emergency rescue that caused the excessive secretion of hormones in the Department of Internal Medicine and Cardiothoracic Surgery this afternoon.
Sudden cardiac arrest, a press, and sent to the circulation catheter room.
This process is simple to say, and it is estimated that the doctors in the Cycling Division have not slowed down yet.
"In the process of lowering the stent, the patient suddenly had two rapid ventricular arrhythmias." Zhao Yunlong said: "The balloon is opened, and as soon as the stimulus is stimulated, the heart stops. Later, only the chest can be opened urgently, and coronary artery bypass surgery is performed."
It is almost the same as Zheng Ren’s thought.
"Post patients have less drainage of bilateral chest vessels, and there is not much pericardial drainage, but rapid ventricular arrhythmia is frequent, and defibrillation has been performed three times." Zhao Yunlong said, "Prepare to do IABP, but the patient's family has not yet responded." ”
IABP, also known as intra-aortic balloon counterpulsation, is one of the mechanical assisted circulation methods. It is a means of improving the intra-aortic diastolic pressure, increasing coronary blood supply and improving myocardial function through physical action.
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