"And what you said is wrong," Zheng Ren said.
A.
Et al. conducted a systematic review of the current literature on vascular interventional treatment of moyamoya disease and moyamoya syndrome.
Enter Rev. "
"He only summarized 28 patients
With vascular interventional treatment, 11 of them
With intravascular stents, 17
With angioplasty. There were only seven successful surgeries. "
"Twenty-five percent," Su Yun said.
"First, Bradley
A.
Dr. Gross is biased against interventional surgery. There is no doubt about that. At the end of the article, he said that the results clearly do not support the use of vascular interventional treatment for moyamoya disease and moyamoya syndrome. In the future, they need to do more research and collect more data to prove this point. "
Su Yun pursed his lips and looked at his phone. The car was already very close.
"I think that all research work, as long as it does not uphold an objective and fair attitude, the conclusion is questionable," Zheng Ren said.
"Whatever you say. The interventional treatment of moyamoya disease … I'll ask Sanbo or the Temple of Heaven if they have carried it out. Let me think, there are not many people who know the neurosurgery department. Does anyone know the neurosurgery department of Huashan? "
As Su Yun nagged, a car drove over with a double flash.
After getting into the car, Su Yun held his phone and contacted people. Zheng Ren recalled the connection between moyamoya disease and coronary artery surgery.
If he performed the surgery in the emergency department, it was self-evident what kind of risks he would face.
However, Zheng Ren was not afraid.
He had to make preparations first. The rest was to wait for the patient to go to the operating theater to perform the surgery to confirm his point of view.
Although there was still some time left for surgical training, Zheng Ren habitually did not want to 'waste' it.
In the past two days, he had used the surgical training time to think about the condition twice.
The first time was because he ate the animal's thyroid gland, causing hyperthyroidism and a thyroid crisis. The other time was a complete waste because he had peeled the garlic himself.
'This matter has to be blamed on Chang Yue,' Zheng Ren thought to himself.
Soon, they arrived at the 912. It was not far away and they could reach it by running. However, Su Yun habitually called a car, so it did not matter.
Zhao Yunlong was in the EICU. The two of them did not hesitate and went straight to the EICU.
The 912's EICU was a U-shaped building. Each patient was isolated separately. There was a small table in the corridor. This was a place for the medical staff to lie down and sleep for a while when they were tired.
The medical staff did not even have time to rest in the on-call room. The EICU was such a strange existence.
It was almost ten o 'clock at night. When the two of them entered the EICU, the first thing they saw was the busy workstation.
The four people on duty, including the one on the night shift last night, were still busy. After 40 consecutive hours of sleepless rest, the in-service doctor did not seem tired at all. Instead, he seemed to be in a morbid state of excitement.
Zheng Ren shook his head. If the emergency department was unpopular, the ICU and EICU were even more so.
The ICU of Sea City General Hospital was not bad. There were fewer critical cases there. On the other hand, the EICU of the 912 was another world. The 40 beds were always operating at full capacity.
If it were not for the existence of the doctors, the operation of the 912 would have directly faced collapse.
It was not only this side, but also Zheng Ren's community hospital. Currently, the nursing capacity of the community hospital was still sufficient, but the doctors were basically in-service training doctors.
Zheng Ren did not have time to lament about these things. He quickly followed Su Yun into an isolation room.
Zhao Yunlong stood solemnly in front of the bed and stared at the patient's ECG monitor.
"Old Zhao, what's the situation?" Su Yun asked.
"After the surgery, there have been three rapid ventricular arrhythmias, which were corrected by electric defibrillation. The situation is not optimistic. Come and take a look, "Zhao Yunlong said in a low voice without turning his head.
"Tell me from the beginning," Zheng Ren said.
Zhao Yunlong turned his head and saw that Zheng Ren had also followed him in. Only then did he turn around. "Chief Zheng, you're here too."
"Chief Zheng, Chief Zheng. Call me boss," Su Yun said as he squatted down to look at the chest bottles on both sides.
The drainage was not very much, so the surgery should not be a problem. It was probably the patient's own physical condition that caused the rapid ventricular arrhythmias after the bypass surgery.
"The patient had a hidden preoperative illness." Zhao Yunlong ignored Su Yun's nagging. It seemed that he was already used to it. Instead, he directly reported the patient's condition.
Zheng Ren's eyebrows suddenly furrowed.
Hidden illness? This … Zheng Ren found it interesting.
The so-called hidden illness was when the patient did not have any symptoms, but by chance, they found that the illness was very serious and had to be treated.
To put it more broadly, all the early stages of tumors were considered hidden illnesses. However, this was not accurate. The early stage of the tumor was not serious.
The real trouble was when the illness was extremely serious, but the body did not respond. At least, the patient did not notice the illness.
This kind of situation was very rare. He did not expect to encounter it today.
The patient had a heart attack, but it was still hidden … Zheng Ren was 80% sure that the patient's brain moyamoya disease might be a key factor, causing the patient to not notice the pain in the precardiac area.
Of course, this was just a guess.
"The patient had chest tightness and shortness of breath for three months. It worsened for three days and came to the respiratory department of our hospital for treatment. Chest CT showed serious calcification of the aorta and enlarged heart, so he went to the circulatory department to be hospitalized. The cardiogram showed three lesions. The anterior descending artery was 90% blocked, the right coronary artery was 95% blocked, and the circumflex artery was 95% blocked. "
It was a serious coronary heart disease. Zheng Ren could already guess what the patient had experienced.
Sure enough, Zhao Yunlong confirmed Zheng Ren's guess.
"During the hospitalization in the circulatory department, the patient's family refused to undergo interventional surgery. After the angiogram, while the family was still discussing, the patient suddenly had an attack and had a sudden cardiac arrest after rapid ventricular arrhythmia, "Zhao Yunlong said." Emergency cardiopulmonary resuscitation and a cardiac stent was performed. "
Zheng Ren's mind outlined the emergency rescue that the Department of Circulation and the Department of Cardiothoracic Surgery had carried out this afternoon.
The cardiac arrest was performed while pressing on the chest and sending it to the circulatory catheter room.
This process sounded simple, but the doctors in the circulatory department had probably not recovered yet.
"During the process of removing the stent, the patient suddenly had two rapid ventricular arrhythmias," Zhao Yunlong said. "The balloon was opened. As long as it was stimulated, the heart stopped. Later, we could only perform an emergency thoracotomy and coronary artery bypass surgery. "
It was similar to what Zheng Ren had thought. It was basically the same process.
"After the surgery, the patient's bilateral chest bottle drainage was not much, and there was not much pericardial drainage either. However, rapid ventricular arrhythmias occurred frequently. We have already defibrillated three times," Zhao Yunlong said. "We are preparing to do IABP, but the patient's family has not replied yet."
IABP, also known as intra-aortic balloon counterpulsation, was one of the mechanical auxiliary circulation methods. Through physical effects, it increased the diastolic pressure in the aorta, increased coronary blood supply, and improved myocardial function.
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