Chen Si, a resident doctor for two years, did not have much contact with Zhao Yuan, but he knew Zhao Yuan's name very well.
Everyone in the emergency center knows that an intern has just arrived and his diagnostic skills are very high.
However, there is currently no equipment and it would be a bit exaggerated to be able to determine the condition solely by physical examination.
Chen Si couldn't restrain his curiosity and humbly asked, "How did you come to the conclusion?"
Zhao Yuan explained, "Aortic dissection is more dangerous than acute myocardial infarction, and the pain occurs in a wider area. Acute myocardial infarction is mainly precordial pain, while aortic dissection is mainly chest pain, shoulder pain, back pain, abdominal pain, and the pain is more severe.
Direct, like a knife cutting."
Chen Si asked, "The patient is already unconscious. How do you determine her pain symptoms?"
Zhao Yuan pinched the patient's shoulder bone. "Although the person is unconscious, the contraction reaction of the muscles stimulated by pain can be seen through careful observation. To be precise, it should be acute type A arterial dissection."
Chen Si's eyes widened with disbelief, "I've learned."
It is said that Zhao Yuan's level is comparable to that of a great doctor at the deputy director level. Only when you put yourself in his shoes can you realize that other people's success is not accidental, but a result of strength and talent.
Of course, Chen Si still has doubts in his heart, whether Zhao Yuan made a wrong judgment.
Zhao Yuan was unable to go to the hotel to attend the meeting, so he called Zhou Guangchen in the ambulance to explain the reason.
Zhou Guangchen heard that Zhao Yuan happened to meet a patient with acute type A arterial dissection, and he had an idea and called Jiang Qiang.
During the phone call, Zhou Guangchen suggested that the cardiac surgery group activities this morning should be changed and they should go to Tianhua Hospital to conduct an "acute type A arterial dissection" surgery observation and seminar.
Jiang Qiang immediately realized that Zhou Guangchen was indirectly helping.
It is a great thing for Tianhua Hospital that so many famous cardiothoracic surgery experts from across the country go to Tianhua Hospital together, it is no less than pie in the sky.
Jiang Qiang quickly called Chang Hongbo to explain the matter. 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. If a hospital wants to be at the top of the comprehensive strength list, the rating of thoracic and cardiac surgery plays a large role.
Although the level of thoracic and cardiac surgery in Tianhua Hospital is pretty good today, it can only be ranked eighth or ninth. Many difficult surgeries cannot be performed by oneself and one needs to hire someone from another hospital.
On the one hand, this is because our expert team is limited in strength, and on the other hand, we do not have many resources.
Why does Southern Union Hospital spend so much energy hosting national conferences?
They are not just eating enough to hold on, but hoping to accumulate more resources through such activities.
Many cardiac specialists come to Tianhua together, and the hospital can take this opportunity to build a good relationship with them. If the cardiac specialist wants to change hospitals one day, Tianhua will be given priority.
No matter how difficult it is, with the emotional foundation, it will be easier to invite these top experts to perform difficult surgeries to help.
…
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 were consistent with Zhao Yuan's judgment!
When Chen Si, the doctor on board the train, heard the result, he secretly admired Zhao Yuan. The nurse on the train also spread the news, adding a bit of charm to Zhao Yuan's mysterious aura.
At the same time, a bus took the cardiac surgeon from the hotel to the hospital.
Chang Hongbo led several senior hospital officials to greet him at the parking lot. Shang Yong got out of the car first, and Chang Hongbo took the initiative to greet him, "Academician Shang, welcome!"
Shang Yong shook hands with Chang Hongbo and said, "I apologize for disturbing you without prior notice."
Chang Hongbo quickly smiled and said: "Look at what you said, you brought so many experts to Tianhua and made us shine."
Shang Yong and Chang Hongbo have met several times, and their relationship is not particularly close. However, Shang Yong and Jiang Qiang's father have been friends for many years.
The organizer of this chest and heart conference intentionally or unintentionally ignored the importance of cardiac surgery, so Shang Yong felt uncomfortable.
Therefore, Jiang Qiang and Shang Yong proposed to temporarily adjust the activity plan, and Shang Yong followed suit.
The Southern Union Hospital was so worried that they called Shang Yong several times in succession. Shang Yong handed the calls to his assistant.
We can’t blame Shang Yong for being unkind, it’s mainly because the organizer didn’t think well.
This cardiac surgery department has brought together so many experts, and it would be extremely difficult to hire just one.
Their qualifications are enough for any hospital to respectfully call them “boss x”.
Although Southern Union Hospital has contracted the travel expenses, the money is 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 saw that the first aid treatment was done properly, especially beta-blockers to avoid worsening of the condition.
The patient is eligible for surgery.
Jiang Qiang was inevitably a little nervous at the moment.
There were many experts observing today's surgery, and if there was even the slightest mistake, there would be no escape.
However, from another perspective, this will also be a battle for the cardiothoracic surgery department of Tianhua Hospital to become famous.
If the surgery can be performed beautifully, Tianhua Hospital's cardiac surgery capabilities will surely be recognized by everyone.
Aortic dissection is divided into type A and type B. Regardless of the origin of the lesion, all dissections involving the "ascending aorta" are type A aortic dissections;
A dissection involving the "descending aorta" distal to the subclavian artery opening is a type B aortic dissection.
The human aorta is composed of the intima, media and adventitia. The so-called aortic dissection is when the blood originally flowing in the aortic cavity flows into the space between the intima and media due to the rupture of the intima, causing a dissection. If not
If treated promptly, the aorta may rupture, resulting in massive bleeding or ischemia of important organs in the human body.
Aortic dissection is one of the most dangerous diseases among various diseases and is known as a catastrophic vascular bomb.
The cause of aortic dissection is not clear in academic circles, and the disease is not rare. There are 50,000 patients in China every year, but only about 8,000 surgeries can be performed.
Because the surgery is complex, the process is cumbersome and time-consuming.
Jiang Qiang glanced at his nephew Jiang Jing and asked, "How do you think we should treat it?"
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 aortic aneurysm, whether it involves the sinus or arch, the type of combined aortic valve lesions, and other factors, and then select the appropriate surgical method to ensure that the ascending aortic aneurysm is in good condition.
The effect of surgical treatment.
The error tolerance rate of aortic dissection surgery is too low and it cannot afford a single mistake.
If you switch to another type of surgery and choose the wrong surgical plan, you can also bypass it during the operation, or use other methods to fill the gap.
Patients with aortic dissection cannot withstand hardships, and once they make a mistake, they often fail.
"Type A dissection avulses the junction of two aortic valves and tears around the opening of the right coronary artery. It requires ascending aorta replacement and hybrid aortic replacement surgery." Jiang Jing said thoughtfully with a serious expression.
It cannot be said that Jiang Jing's answer is wrong, but that he is more tactful and speaks more generally.
Zhou Guangchen coughed, glanced at Zhao Yuan, and asked: "Xiao Jiang is not very specific. There are many options for ascending aorta replacement surgery, and there are many types of hybrid aortic replacement surgeries. Zhao Yuan, can you give more details?
a little."
Zhao Yuan did not expect that Zhou Guangchen would call his name. Seeing that everyone was looking at him, he did not hesitate, "Bentall surgery and Sun's surgery!"
Everyone suddenly had a picture in their mind.
Ascending aorta replacement surgery includes bentall, cabrol, wheat, david and other surgical procedures.
Hybrid aortic replacement surgery is also called the elephant trunk surgery. Sun's surgery, an innovative procedure based on the elephant trunk surgery, was designed by a domestic cardiac surgeon in 2007 and has become a classic standard surgery.
Zhang Guoping, standing next to Zhou Guangchen, smiled and nodded in approval, "The two options have a common advantage. After the operation, there are relatively few complications."
The mortality rate after aortic dissection surgery reaches 20%. Considering this, Zhao Yuan proposed a treatment plan.
"Zhao Yuan, Jiang Jing, you two are ready for surgery." Jiang Qiang gave the order.
Jiang Qiang's decision is not surprising.
Although Jiang Jing is not a doctor at Tianhua Hospital, he is a leader among young doctors and a talent returned from overseas.
Zhao Yuan is a rising star in Tianhua Hospital, and he has worked with him many times. Jiang Qiang is familiar with him, so being an assistant will not be a problem!
On such an important occasion, Jiang Qiang deliberately recommended the two of them.
Zhang Guoping's face was filled with anticipation.
He had seen Zhao Yuan's surgery marks, but not Zhao Yuan's surgery scene.
He has always had a question, is this guy really worth 20 million?
