MTLNOVEL I can see the status bar
Chapter 222 Difficult, Difficult, Difficult
Chapter 222 Difficult, Difficult, Difficult
Zhou Jun has a very bad temper these days.Even if Sun Lien is blind, after the Zhou Jun Joint Security Department conducted three "anti-medical trusteeship scalpers" drills in two days, he can guess that his senior brother is in a very bad mood, and he probably has a relationship with Yituo or scalpers. There are relationships.But now Zhou Jun is the largest in the emergency room, and Liu Pingchuan, who is in charge of "supervising", not only has no objection to Zhou Jun's behavior, but is also giving various supports.
There is actually nothing to say about this kind of exercise without precedent and plan. The basic routine is that the medical staff leave the conflict scene as soon as possible, and the staff of the security department quickly intervene.It's just that after practicing too much, Sun Li'en gradually felt that something was wrong.So taking advantage of the end of the third exercise and when everyone was leaving, Sun Lien bravely went to ask Zhou Jun what was going on.Then came a shocking answer.
"Director Liu was arrested?" Sun Li'en was so shocked that he didn't even notice that he almost shouted these words.
"I just spent one night at the police station." Zhou Jun frowned and explained, "Are you afraid that others will not know or something? Pay attention to the impact!"
What the capital police comrades were worried about really happened.The five doctors insisted that they didn't mean to guide others, they were just bragging and chatting.As for what to do next, it's just four people doing what is right.He insisted that he had no malicious intentions, and at the same time, these five people had no criminal records. As a result, Liu Tangchun would not be able to leave for a while.The entire case can only be handled as "picking quarrels and provoking troubles."On this side, Liu Tangchun was left to record his statement overnight, while on the other side, several comrades from the police took turns to interrogate the five doctors over and over again.Finally, I found the surveillance video near the unlicensed small clinic, which proved that the five people often took other people to the clinic together, and also found two patients who were deceived in the clinic. Liu Tangchun got out of this trouble.
Criminals will do everything possible to attack the brave masses.Only by making everyone start to worry about the consequences of their brave actions, can they cheat more recklessly without worrying about being found out.But Liu Tangchun insisted on his own opinion - the behavior of these people is considered to be lenient in terms of fraud.Think about the example of Xiao Yanran, who tricked patients who needed to see a doctor to go to this small unlicensed clinic for treatment, which should be treated as murder.
Although the troubles in the capital have finally come to an end.But the fact that Liu Tangchun was detained for a day by the police comrades still reached Zhou Jun's ears.The method Zhou Jun used to exert pressure was also very simple. He directly called the office of the dean of the No. [-] Hospital of Beijing Medical University and told the dean the "reason" for a long time.
As mentioned earlier, Zhou Jun's greatest ability is that he doesn't utter a single dirty word, but he can scold people uncomfortable.
Although the dean of the No. [-] Hospital of Beijing Medical University was also very innocent and was scolded for no reason, how could Zhou Jun control this? His mentor was in their territory. In order to protect their patients, he was taken into the police station stayed all day.And your hospital didn't even go to the police station to give condolences.Based on this, if it weren't for the fact that he couldn't leave now, Zhou Jun even wanted to fly to the capital to have a passionate collision of fists and flesh with the dean.
Sun Lien sighed.Zhou Jun was in a bad mood, so the emergency doctors like them had to suffer.Many doctors have begun to complain about the back and forth practice—our Fourth Central Hospital is an emergency central hospital with a large emergency model. When will patients have to make an appointment before they can see a doctor?Even if you want to practice, it should be practiced at the outpatient clinic, right?Even if Yituo is eloquent, it may not be able to lure patients with broken arms, broken legs, internal bleeding and poisoning to small unlicensed clinics?Even if they dare to cheat, which family member would dare to believe it?
The Fourth Central Hospital can be said to have no conflicts with Yituo and scalpers.Because it was impossible for them to intervene from here, not to mention that Lao Wu, who was on standby at the gate every day, was full of hope to catch a batch of scalpers to relieve his boredom.
After checking today's room, Sun Li'en watched Yang Jianqiang's wife sitting quietly on the stool outside the ICU, sighed, and did not bother her.
Yang Jianqiang's situation is still very dangerous. Just as Sun Li'en worried and expected, after taking sulfadiazine and pyrimethamine, abscesses gradually appeared in multiple organs in his body.Fortunately, his immune system has been suppressed to a very low level, and various life support measures in the ICU are quite in place.Yang Jianqiang's brain abscess has begun to show signs of shrinking, and his cardiac edema and liver damage are barely within the safe range, but the performance of his kidneys is relatively poor.Fortunately, his kidney function has not been completely lost, and he does not need to use a continuous blood purification regimen.Just do dialysis every two days.
If no other mistakes are made, Yang Jianqiang has a great chance of surviving.As for Yao Zhuangxian who "keeps his heart in his belly", the situation is not so optimistic.
The stabbed knife pierced through Yao Zhuangxian's chest wall cleanly. Although he didn't directly hurt the lungs, it still caused a very serious problem.Doctors from the Fourth Central Hospital transferred Yang Jianqiang to the inpatient area of general surgery after emergency sealing and chest drainage.Logically speaking, this patient has nothing to do with Sun Lien.But for such a rare case, how could Sun Li'en have no curiosity at all?
However, because this case is so rare, the cardiologists at the Fourth Central Hospital were not psychologically prepared for Yao Zhuangxian's situation.The long-term compression of the heart and the excessively long aortic veins connecting the heart caused Yao Zhuangxian's heart to be overloaded.And the knife on the chest, like the finger that pulled the trigger, made Yao Zhuangxian's condition worsen rapidly.
According to the discussion between Sun Lien and Yuan Ping'an, the situation is probably like this.
Congenital heterotopia is actually not "without side effects" for Yao Zhuangxian.In fact, because the aorta is about 30% longer than normal, Yao Zhuangxian himself should have the problem of increased ejection resistance of the left ventricle during systole.In order to overcome this resistance, in most cases, the human body will have compensatory hypertrophy in the ventricular muscles, increasing the muscle density so as to ensure the cardiac ejection volume during contraction.However, because the position of his heart is different from that of ordinary people, and there are many organs around the heart being squeezed, Yao Zhuangxian's cardiac hypertrophy does not actually appear as an outwardly expanding hypertrophy, but has taken another path of compensation. Lu Zi——His resting heart rate was almost twice as high as that of a normal person.At the same time, compensatory hyperplasia occurred in Yao Zhuangxian's coronary artery.According to the B-ultrasound results, Yao Zhuangxian's coronary artery is about 60% longer than normal, which helps his heart muscle to get more blood, so as to maintain high-frequency beating.
However, the normal metabolism of the human body has limits.No matter how much oxygen the heart muscle gets, it is impossible to turn into a small electric motor and keep beating.Like the compensatory cerebral blood vessels of moyamoya disease, the massive hyperplastic coronary arteries are complex in shape and small in diameter, which means that they can be easily blocked.
Yao Zhuangxian, who was stabbed and frightened, had a higher heart rate.And the primary myocardial ischemia caused by hyperplasia coronary artery blockage became the last straw that broke the camel's back—although the straw itself could kill the camel—Yao Zhuangxian's heart rapidly expanded and failed signs.The heart dilation that oppressed the stomach, the most direct symptoms were Yao Zhuangxian's frequent vomiting and acute dyspnea.
In order to correct his vomiting and support breathing, the Department of Cardiac Surgery and Critical Care Medicine initiated preventive care.Although it has not yet reached the point where ECMO support is needed, if his heart cannot be put back in the correct position as soon as possible, then Yao Zhuangxian can only gamble on a heart transplant.
The problem is that the cardiac surgery of the Fourth Central Hospital is not very good at correcting heart heterotopia.In fact, the hospitals that are best at correcting heart heterotopia should be children's hospitals around the world.The reason is also very simple. Few children will not show obvious deformity features after suffering from heart heterotopia.This is the question that Sun Lien and Yuan Pingan couldn't figure out the most. It is obviously a symptom that can be easily detected in infancy. Why has Yao Zhuangxian's heterotopic heart not been discovered?
However, this question is doomed to never be answered.Yao Zhuangxian has no relatives, at least according to the police investigation, he has no living relatives.Fortunately, Yao Zhuangxian's company is quite kind, and the company bought supplementary commercial insurance for everyone.At the same time, because Yao Zhuangxian was injured during the team building period of the company, his injury was classified as a "work injury".This allowed the company leaders to act as Yao Zhuangxian's medical proxy and make some key medical decisions for him.Especially in order to correct his vomiting and struggling, the hospital must not use anesthesia to induce a coma, this characterization is very important.
"In his current situation, it is definitely unrealistic to transfer to another hospital." Sun Lien and Yuan Ping'an discussed for a while, and even attracted Xu Yourong and Zhou Ce to join. "Or, can you consider asking the cardiologist from the Children's Hospital for a consultation?"
"Infants with heterotopic hearts, the biggest difficulty in surgery is actually that their organs are too small, and the anastomosis of blood vessels is difficult." Xu Yourong thought for a while, then shook his head and said, "It's okay if it's just a relatively common exposed heart. In one fell swoop, open the chest cavity and return the heart to its normal position."
Sun Li'en smiled bitterly, "Your summary is really concise."
Xu Yourong ignored Sun Li'en, and continued to analyze, "Abdominal ectopic heart is different. First, his heart must be cut out from the abdominal cavity, and then the aorta and vein connecting the heart must be ligated, and his physical signs should be maintained through extracorporeal circulation. Then Then open the chest cavity, trim off the excess blood vessels, and then use the remaining blood vessels to recreate the arteries and pulmonary arteries, and at the same time connect the left and right pulmonary veins and the superior and inferior vena cava, and six anastomoses need to be sewn."
Zhou Ce continued, "From the perspective of workload, this is roughly equivalent to a heart removal, an aortic replacement, and a heart transplant."
"There is another PCI intervention. Don't forget that he has a myocardial infarction." Yuan Ping'an added, "Basically, this is basically equivalent to three level [-] surgeries and one specially approved level [-] surgery together."
Under Xu Yourong's calm gaze, the three men shook their heads together, "It's not easy!"
I, Luo Sanguan, even if I googoo, even if I jump from here, I won’t stay up all night typing!
Sudden death... (This is the rhythm of taking away a few readers before sudden death...)
Calvin is a little serious, and I'm still looking for a feeling.
PS: Yao Zhuangxian's condition is quite special, and I will write a separate chapter to explain it later.Let me inform readers in advance that his disease...in fact, there is no case information that can be used as a reference.
(End of this chapter)
Zhou Jun has a very bad temper these days.Even if Sun Lien is blind, after the Zhou Jun Joint Security Department conducted three "anti-medical trusteeship scalpers" drills in two days, he can guess that his senior brother is in a very bad mood, and he probably has a relationship with Yituo or scalpers. There are relationships.But now Zhou Jun is the largest in the emergency room, and Liu Pingchuan, who is in charge of "supervising", not only has no objection to Zhou Jun's behavior, but is also giving various supports.
There is actually nothing to say about this kind of exercise without precedent and plan. The basic routine is that the medical staff leave the conflict scene as soon as possible, and the staff of the security department quickly intervene.It's just that after practicing too much, Sun Li'en gradually felt that something was wrong.So taking advantage of the end of the third exercise and when everyone was leaving, Sun Lien bravely went to ask Zhou Jun what was going on.Then came a shocking answer.
"Director Liu was arrested?" Sun Li'en was so shocked that he didn't even notice that he almost shouted these words.
"I just spent one night at the police station." Zhou Jun frowned and explained, "Are you afraid that others will not know or something? Pay attention to the impact!"
What the capital police comrades were worried about really happened.The five doctors insisted that they didn't mean to guide others, they were just bragging and chatting.As for what to do next, it's just four people doing what is right.He insisted that he had no malicious intentions, and at the same time, these five people had no criminal records. As a result, Liu Tangchun would not be able to leave for a while.The entire case can only be handled as "picking quarrels and provoking troubles."On this side, Liu Tangchun was left to record his statement overnight, while on the other side, several comrades from the police took turns to interrogate the five doctors over and over again.Finally, I found the surveillance video near the unlicensed small clinic, which proved that the five people often took other people to the clinic together, and also found two patients who were deceived in the clinic. Liu Tangchun got out of this trouble.
Criminals will do everything possible to attack the brave masses.Only by making everyone start to worry about the consequences of their brave actions, can they cheat more recklessly without worrying about being found out.But Liu Tangchun insisted on his own opinion - the behavior of these people is considered to be lenient in terms of fraud.Think about the example of Xiao Yanran, who tricked patients who needed to see a doctor to go to this small unlicensed clinic for treatment, which should be treated as murder.
Although the troubles in the capital have finally come to an end.But the fact that Liu Tangchun was detained for a day by the police comrades still reached Zhou Jun's ears.The method Zhou Jun used to exert pressure was also very simple. He directly called the office of the dean of the No. [-] Hospital of Beijing Medical University and told the dean the "reason" for a long time.
As mentioned earlier, Zhou Jun's greatest ability is that he doesn't utter a single dirty word, but he can scold people uncomfortable.
Although the dean of the No. [-] Hospital of Beijing Medical University was also very innocent and was scolded for no reason, how could Zhou Jun control this? His mentor was in their territory. In order to protect their patients, he was taken into the police station stayed all day.And your hospital didn't even go to the police station to give condolences.Based on this, if it weren't for the fact that he couldn't leave now, Zhou Jun even wanted to fly to the capital to have a passionate collision of fists and flesh with the dean.
Sun Lien sighed.Zhou Jun was in a bad mood, so the emergency doctors like them had to suffer.Many doctors have begun to complain about the back and forth practice—our Fourth Central Hospital is an emergency central hospital with a large emergency model. When will patients have to make an appointment before they can see a doctor?Even if you want to practice, it should be practiced at the outpatient clinic, right?Even if Yituo is eloquent, it may not be able to lure patients with broken arms, broken legs, internal bleeding and poisoning to small unlicensed clinics?Even if they dare to cheat, which family member would dare to believe it?
The Fourth Central Hospital can be said to have no conflicts with Yituo and scalpers.Because it was impossible for them to intervene from here, not to mention that Lao Wu, who was on standby at the gate every day, was full of hope to catch a batch of scalpers to relieve his boredom.
After checking today's room, Sun Li'en watched Yang Jianqiang's wife sitting quietly on the stool outside the ICU, sighed, and did not bother her.
Yang Jianqiang's situation is still very dangerous. Just as Sun Li'en worried and expected, after taking sulfadiazine and pyrimethamine, abscesses gradually appeared in multiple organs in his body.Fortunately, his immune system has been suppressed to a very low level, and various life support measures in the ICU are quite in place.Yang Jianqiang's brain abscess has begun to show signs of shrinking, and his cardiac edema and liver damage are barely within the safe range, but the performance of his kidneys is relatively poor.Fortunately, his kidney function has not been completely lost, and he does not need to use a continuous blood purification regimen.Just do dialysis every two days.
If no other mistakes are made, Yang Jianqiang has a great chance of surviving.As for Yao Zhuangxian who "keeps his heart in his belly", the situation is not so optimistic.
The stabbed knife pierced through Yao Zhuangxian's chest wall cleanly. Although he didn't directly hurt the lungs, it still caused a very serious problem.Doctors from the Fourth Central Hospital transferred Yang Jianqiang to the inpatient area of general surgery after emergency sealing and chest drainage.Logically speaking, this patient has nothing to do with Sun Lien.But for such a rare case, how could Sun Li'en have no curiosity at all?
However, because this case is so rare, the cardiologists at the Fourth Central Hospital were not psychologically prepared for Yao Zhuangxian's situation.The long-term compression of the heart and the excessively long aortic veins connecting the heart caused Yao Zhuangxian's heart to be overloaded.And the knife on the chest, like the finger that pulled the trigger, made Yao Zhuangxian's condition worsen rapidly.
According to the discussion between Sun Lien and Yuan Ping'an, the situation is probably like this.
Congenital heterotopia is actually not "without side effects" for Yao Zhuangxian.In fact, because the aorta is about 30% longer than normal, Yao Zhuangxian himself should have the problem of increased ejection resistance of the left ventricle during systole.In order to overcome this resistance, in most cases, the human body will have compensatory hypertrophy in the ventricular muscles, increasing the muscle density so as to ensure the cardiac ejection volume during contraction.However, because the position of his heart is different from that of ordinary people, and there are many organs around the heart being squeezed, Yao Zhuangxian's cardiac hypertrophy does not actually appear as an outwardly expanding hypertrophy, but has taken another path of compensation. Lu Zi——His resting heart rate was almost twice as high as that of a normal person.At the same time, compensatory hyperplasia occurred in Yao Zhuangxian's coronary artery.According to the B-ultrasound results, Yao Zhuangxian's coronary artery is about 60% longer than normal, which helps his heart muscle to get more blood, so as to maintain high-frequency beating.
However, the normal metabolism of the human body has limits.No matter how much oxygen the heart muscle gets, it is impossible to turn into a small electric motor and keep beating.Like the compensatory cerebral blood vessels of moyamoya disease, the massive hyperplastic coronary arteries are complex in shape and small in diameter, which means that they can be easily blocked.
Yao Zhuangxian, who was stabbed and frightened, had a higher heart rate.And the primary myocardial ischemia caused by hyperplasia coronary artery blockage became the last straw that broke the camel's back—although the straw itself could kill the camel—Yao Zhuangxian's heart rapidly expanded and failed signs.The heart dilation that oppressed the stomach, the most direct symptoms were Yao Zhuangxian's frequent vomiting and acute dyspnea.
In order to correct his vomiting and support breathing, the Department of Cardiac Surgery and Critical Care Medicine initiated preventive care.Although it has not yet reached the point where ECMO support is needed, if his heart cannot be put back in the correct position as soon as possible, then Yao Zhuangxian can only gamble on a heart transplant.
The problem is that the cardiac surgery of the Fourth Central Hospital is not very good at correcting heart heterotopia.In fact, the hospitals that are best at correcting heart heterotopia should be children's hospitals around the world.The reason is also very simple. Few children will not show obvious deformity features after suffering from heart heterotopia.This is the question that Sun Lien and Yuan Pingan couldn't figure out the most. It is obviously a symptom that can be easily detected in infancy. Why has Yao Zhuangxian's heterotopic heart not been discovered?
However, this question is doomed to never be answered.Yao Zhuangxian has no relatives, at least according to the police investigation, he has no living relatives.Fortunately, Yao Zhuangxian's company is quite kind, and the company bought supplementary commercial insurance for everyone.At the same time, because Yao Zhuangxian was injured during the team building period of the company, his injury was classified as a "work injury".This allowed the company leaders to act as Yao Zhuangxian's medical proxy and make some key medical decisions for him.Especially in order to correct his vomiting and struggling, the hospital must not use anesthesia to induce a coma, this characterization is very important.
"In his current situation, it is definitely unrealistic to transfer to another hospital." Sun Lien and Yuan Ping'an discussed for a while, and even attracted Xu Yourong and Zhou Ce to join. "Or, can you consider asking the cardiologist from the Children's Hospital for a consultation?"
"Infants with heterotopic hearts, the biggest difficulty in surgery is actually that their organs are too small, and the anastomosis of blood vessels is difficult." Xu Yourong thought for a while, then shook his head and said, "It's okay if it's just a relatively common exposed heart. In one fell swoop, open the chest cavity and return the heart to its normal position."
Sun Li'en smiled bitterly, "Your summary is really concise."
Xu Yourong ignored Sun Li'en, and continued to analyze, "Abdominal ectopic heart is different. First, his heart must be cut out from the abdominal cavity, and then the aorta and vein connecting the heart must be ligated, and his physical signs should be maintained through extracorporeal circulation. Then Then open the chest cavity, trim off the excess blood vessels, and then use the remaining blood vessels to recreate the arteries and pulmonary arteries, and at the same time connect the left and right pulmonary veins and the superior and inferior vena cava, and six anastomoses need to be sewn."
Zhou Ce continued, "From the perspective of workload, this is roughly equivalent to a heart removal, an aortic replacement, and a heart transplant."
"There is another PCI intervention. Don't forget that he has a myocardial infarction." Yuan Ping'an added, "Basically, this is basically equivalent to three level [-] surgeries and one specially approved level [-] surgery together."
Under Xu Yourong's calm gaze, the three men shook their heads together, "It's not easy!"
I, Luo Sanguan, even if I googoo, even if I jump from here, I won’t stay up all night typing!
Sudden death... (This is the rhythm of taking away a few readers before sudden death...)
Calvin is a little serious, and I'm still looking for a feeling.
PS: Yao Zhuangxian's condition is quite special, and I will write a separate chapter to explain it later.Let me inform readers in advance that his disease...in fact, there is no case information that can be used as a reference.
(End of this chapter)
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