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【2137】Encountering obstacles

Then he turned his head and looked towards the operating table.

Now the surgery is at a critical stage.

Several surgeons tried their best to remove the artificial mitral valve that had been installed in the patient's stopped heart. It was really sticky and filled with blood clots.

Doctors must be careful to remove the blood clots to avoid residual blood clots. Otherwise, once the heart recovers, the blood clots will pump along with the blood flow of the heart, leading to pulmonary embolism or cerebral thrombosis.

Du Meng'en and Zhang Shuping stood in the corner until their ankles ached. It was not easy to be a medical student. They were observing and studying here without working. The more they watched, the more anxious they became. They wished the operation could be over as soon as possible. In fact,

Looking at the operation, there are very few so-called technical scenes. The scene that medical students see most is nothing more than the scene where the doctor is forced to grind slowly like now. It's not enough if you don't grind. A little carelessness will bring a lot of surgery to the patient.

The next question.

Dr. Du Yeqing is a conservative and will pay more attention to every detail of the surgery within the limit of time.

Touching the sore back of his neck, Du Meng'en was no longer interested in becoming a cardiac surgeon. Extracardiac surgeries took too long and were torturous. In comparison, routine gynecological surgeries were relatively short, and obstetric surgeries were even shorter.

.

Zhang Shuping, who was standing next to him, had a stiff face and was obviously erecting with all his strength.

"It's not working here." The surgeon on the operating table muttered.

"What's wrong?" Du Meng'en asked Zhang, a more experienced student.

Zhang Shuping is just a trainee. He doesn't usually practice in his uncle's hospital. He rarely sees this kind of surgery. He thought about it for a long time and answered: "Is it because the valve opening is not working?"

Valve opening? Zhang should not only refer to the opening and closing opening of the valve, but also to the location of the valve.

When the surgeon removes the broken artificial valve, he needs to consider what valve to replace next. It is necessary to explore and judge the surrounding environment of the valve site to select the appropriate valve type.

To put it simply, artificial valves are roughly divided into two types: mechanical valves and biological valves. This patient used a mechanical valve before, but something went wrong. According to inertial thinking, if something doesn't work, he must need another type.

Perhaps a bioprosthetic valve can be replaced to avoid the same problem.

However, there is never such a simple thinking path map to refer to in solving medical problems.

First of all, let’s review, why did this patient choose a mechanical valve for his first surgery?

The doctor who performs the surgery for the first time should know that the patient is a young woman and the patient herself needs to become pregnant. Since the mechanical valve requires long-term use of anticoagulants such as warfarin after surgery, it is easy to produce blood clots, which will affect women's pregnancy and childbirth. Various

The shortcomings indicate that the mechanical valve does not seem to be the first choice for this young woman in need.

Like this patient, it was due to the special hypercoagulable state during pregnancy that the mechanical valve developed thrombosis and blocked the valve opening, and had to be operated on again urgently.

In this way, the doctor who performed the surgery on the patient for the first time did not consider the patient well?

On the contrary, cardiac surgeons routinely introduce various valves to patients before surgery. In other words, as long as the patient's physical condition allows, it is completely up to the patient to decide which valve he wants to install. Let the patient make the choice first.

This is because patients have their own financial calculations about the cost of medical treatment. How much money a patient is willing to spend on medical treatment is something that non-doctors can decide for the patient.

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