Doctor Peerless

Chapter 647 This Is Type A

No one told Dean Cheng, he certainly didn't know that Boss Zhu was hospitalized in the emergency center.

The informer is Director Tian.

It turned out that Dean Cheng heard about Boss Zhu's car accident from Director Tian last night.He also felt a little sorry, so he came here to take a look early this morning.

Zhou Sheng didn't know that Dean Cheng and Boss Zhu were old acquaintances.

He immediately went up to greet Dean Cheng and said, "Dean Cheng, the situation was too urgent yesterday, so I didn't have time to ask colleagues outside my heart for consultation, so I took over the operation on my own initiative..."

Dean Cheng waved his hands with a smile and said, "I didn't come here today for this matter. Boss Zhu is an old friend of mine. I came to see him."

"Oh, I thought you, Dean Cheng, were coming to criticize me for doing this kind of operation without asking for instructions."

"Criticize what you are doing. Director Tian also told me on the phone yesterday, your surgery is beautiful, Xiao Zhou, it seems that you are hiding your secrets, and how many skills you have yet to show."

Zhou Sheng was a little embarrassed by Dean Cheng's words.

He thought to himself, he has nothing to hide, but he is just making progress.However, my own progress is a bit like mushrooming, reaching a new height every day.

"Dean Cheng, I didn't hide it either, I just got some exercise when I went abroad before. In an emergency, I'm a little bolder."

"When it is broken, it is broken! This is also an essential quality of an emergency doctor. You have done a good job. You are not a team leader for nothing. If you can do it, just let it go! Director Jiang and I will support you." Dean Cheng said happily at this time.

As someone who came out of the emergency center, he was of course a little selfish.He is the hope emergency center, not simply doing some triage work.

To become bigger and stronger is the purpose of upgrading the emergency department to the center.

Of course, the venue has grown and the hardware has improved.Talent must also keep up.

The appearance of Zhou Sheng just made up for some defects in talent.

"Thank you! Dean Cheng!" Zhou Sheng was naturally happy to be affirmed by Dean Cheng.

The two are talking.

Cao Xin ran in panting.

"Hello, Dean Zhou..."

Cao Xin was originally looking for Zhou Sheng, but when he saw Dean Cheng, he immediately greeted him.

Dean Cheng saw that Cao Xin was in a hurry, "Don't worry about me, I'll be leaving in a while."

Cao Xin hurriedly said to Zhou Sheng: "Group Leader Zhou, Dr. Su asked me to call you, another one with a heart problem."

Heart problems are not minor illnesses.

Zhou Yisheng said goodbye to Dean Cheng, and immediately followed Cao Xin out of the ward.

……

In the emergency room, a male patient in his 20s was lying on a hospital bed in pain.

Su Quan was devastated in front of the hospital bed.

And beside him, there is Bai Mingming who is helpless.

The patient in this hospital bed was first treated by Su Quan. Later, when he found out that his condition was serious, he asked Cao Xin to find Bai Mingming.

Bai Mingming saw that he couldn't figure it out, so he immediately asked Cao Xin to find Zhou Sheng.

Monday arrives.

Su Quan immediately reported the current situation to Zhou Sheng.

A 25-year-old male patient came to the emergency department for about an hour because of chest tightness and sweating profusely.

Su Quan asked the patient to check the electrocardiogram, which indicated ST-segment elevation in the inferior wall.

Su Quan said, "Could it be an acute myocardial infarction?"

Chest tightness and sweating are indeed symptoms of acute myocardial infarction.

Zhou Sheng nodded.

Bai Mingming added: "The blood pressure of both upper limbs of the patient is 86/46mmhg."

Zhou Sheng frowned, the blood pressure of the upper limbs of normal people would be a little different.But it should be within 15mmhg, which is a difference of 40mmhg. The high probability is the manifestation of heart failure caused by heart disease.

Su Quan was introducing the situation to Zhou Sheng.

Cao Xin over there suddenly yelled, "The patient has passed out."

Zhou Sheng, Su Quan, and Bai Mingming immediately surrounded him.

Myocardial infarction has caused heart failure, and now I have developed unconsciousness.

This is a fatal matter, and the situation is urgent.

While turning on the system scan, Zhou Sheng ordered, "Get ready for the operating room and do a coronary angiogram."

Although coronary artery radiography is also a kind of radiography, it is much more complicated than general radiography.Specifically, a catheter is inserted through the femoral artery of the thigh or other arteries to the coronary artery, and a contrast agent is injected to visualize the coronary arteries.

Coronary angiography is currently the only diagnostic method that can directly observe the shape of coronary arteries, and the medical profession calls it the "gold standard".

Why do you need to check the coronary arteries for myocardial infarction.

This is because acute myocardial infarction is myocardial necrosis caused by acute and persistent coronary ischemia and hypoxia.

Bai Mingming reminded at this time: "The condition is so serious, do we need to find someone out of our mind to come for consultation?"

At this time, Zhou Sheng's system test had given the results.

Patient's condition: right coronary artery occlusion, resulting in acute myocardial infarction!
Etiology: type A aortic dissection.

Treatment: open thoracotomy.

Condition prediction...

Aortic dissection!
It was actually caused by this myocardial infarction, Zhou Sheng was startled, he was still a type A.

Zhou Yi was too familiar with this disease.

In the dungeon last night, he was the second to come into contact with type B of this disease. In the later dungeon cases, he also came into contact with many of this disease.

He is well aware of this disease.

No need to look at the system's disease prediction, Zhou Sheng also knows that type A disease is much more dangerous than type B disease. Type B can take a while, and can be treated conservatively with minimally invasive stents. Type A can't delay for a moment, there is only one way to open the chest.

When Type A dissection occurs, the mortality rate can reach 48% within 50 hours; if the treatment is delayed, the mortality rate can be as high as 90% within one month, which is almost a close call.

现在系统给出的病情预测：6小时内死亡概率30%，12小时内死亡概率60%，24小时内死亡概率90%。

Zhou Sheng took a deep breath.

The disease did not become milder because the patient was young.

If the consultation is over and the surgical plan is studied again, it is estimated that the patient has long been hopeless.

First do emergency coronary radiography.

Immediately after that, the operation was performed. The operation for type A aortic dissection could not be performed yesterday Monday.

But today, he is already an expert in this field.

When it breaks, it breaks!

Zhou Sheng remembered Dean Cheng's words.

He resolutely said: "It's too late! Arrange immediately!"

At this time, Bai Mingming didn't object anymore.

First of all, he also heard about the heart rescue operation performed by Zhou Sheng.

Secondly, he is a die-hard fan of Zhou Sheng, and he has confidence in Zhou Sheng.

Emergency operating room is ready.

Zhou Sheng operated it himself, and Bai Mingming, Su Quan, and Cao Xin were all there.

Coronary radiography is also a type of arterial puncture.

This is a piece of cake for Zhou Sheng who has done a lot of arterial puncture and minimally invasive surgery in the dungeon.

Local anesthesia with lidocaine.

After disinfection, the femoral artery was punctured.

After the puncture, the needle tip is inserted into the guide wire catheter until it reaches the left coronary sinus of the heart, and the contrast medium is injected into the three coronary arteries of the heart through the left coronary sinus.

After the three blood vessels are filled with contrast agent, X-rays are taken continuously, and at this time, the contrast agent can be seen filling the three coronary arteries...

Results came out quickly.

……

(End of this chapter)