Huang Dazhi's doubts about the surgery did not lie in the diagnosis but in the technique.
Zheng Ren could demonstrate the technique. As for how to use it during the surgery, it would depend on each person's comprehension.
Even if Zheng Ren did not hide anything, most people would not be able to understand it.
After Professor Huang asked for advice on two more difficult techniques for superselection and thrombectomy, Xie Yiren finished the handover and walked out.
He knew that this was not a good time to chat, so he brought Zheng Ren and the others to the intervention department with a smile.
On the way, Professor Huang did not say much because Zheng Ren and Su Yun were about to fall asleep while walking. He was just careful not to let the two of them fall asleep while walking, fall, or get hurt.
After entering the ward, Professor Huang came to the door of the chief's office and said with a smile, "The chief specially left the door open for you. He said that as long as you need it, you can come and rest at any time."
"Thank you," Zheng Ren said vaguely.
Suddenly, there was a burst of hurried footsteps in the corridor, and the sound of wheels rubbing against the ground was loud.
Subconsciously, Zheng Ren opened his eyes. In his trance, he thought that he was in Sea City General Hospital.
"What's wrong?" Zheng Ren asked in a daze.
"Boss, it seems to be an emergency." Su Yun was also in a daze. When he saw the nurse pushing the stretcher trolley to a ward, he guessed.
"Let's go take a look." Zheng Ren also saw the situation clearly and immediately became a little more energetic.
Xie Yiren wanted to say something but hesitated for a moment. In the end, she let Zheng Ren go.
She originally wanted to take a look at where Zheng Ren was sleeping and then drive around to see what she could buy to eat.
Unexpectedly, as soon as she came down, she encountered another emergency in the ward.
Zheng Ren strode into the ward and saw a patient whose hands and feet were twitching slightly. He wanted to dance but could not do so. His mouth was mumbling something, but it was not clear.
The nurses, doctors, and volunteers who acted as caregivers were in front of the bed. No one could be seen, so the System panel did not give a diagnosis for the time being.
"Boss, this person is probably a programmer. All he talks in his sleep is code. He's really dedicated," Su Yun said softly.
"Programmer?"
"From his delirium, that should be the case," Su Yun said.
"Isn't this the patient after the surgery? What happened? "Professor Huang was a little surprised, so he quickly asked.
"Teacher Huang, the patient underwent blood transfusion and blood pressure reduction after the stent surgery. Symptoms such as dyskinesia and blurred vision appeared. Then, he began to experience delirium, dizziness, headache, nausea and vomiting. The vomit was stomach contents," the doctor reported.
"Stent?" Zheng Ren was stunned.
The current patients were basically patients with hemorrhagic shock. Blood transfusion was enough, and there was no way to lower blood pressure.
With the addition of the stent, Zheng Ren immediately remembered a patient with abdominal aortic dissection when he first arrived.
The patient had a stent. Zheng Ren was sure that there would be no problems with the stent surgery. His own surgical experience and the surgery completion rate given by the System could prove it.
What was going on?
He took a step forward and saw the patient when the volunteer went to get something.
The System panel on the upper right corner of his field of vision gave the following diagnoses: pelvic fracture interventional embolization, abdominal aortic dissection aneurysm stenting, thiocyanate poisoning.
He was so sleepy that he misread the diagnosis.
His first reaction was cyanide poisoning!
This was a big deal. Could it be that someone had poisoned them?
Zheng Ren was so shocked that he woke up.
When he saw that it was thiocyanate poisoning, he quickly recalled the matter and his expression changed slightly.
Su Yun saw that something was wrong with Zheng Ren, so he squeezed in and asked, "What's wrong, Boss?"
"I'm fine." Zheng Ren shook his head. He could not tell Su Yun about the cyanide poisoning. If he did, Su Yun would talk about it until next year.
"It's the patient I treated after the abdominal aortic dissection, right?" Zheng Ren asked.
"Yes, Teacher Zheng." Professor Huang felt the powerful aura of a senior doctor and subconsciously addressed him as teacher.
"What should I use to lower my blood pressure?" Zheng Ren asked.
Even after surgery for aortic dissection, one had to maintain stable blood pressure. They just had to wait for the peritoneal shelf to completely block the rupture. Usually, it would take one to two days of antihypertensive drugs, and then it could be stopped. There was nothing special about it. It was just the usual treatment.
"Sodium nitroprusside, micro pump, dose 8.
Μg/kg/day. "The junior doctor immediately reported the dosage.
Zheng Ren then knew what had happened.
"Stop the Sodium Nitroprusside and immediately contact the Nephrology Department for dialysis."
Professor Huang was stunned. What kind of operation was this? Acute renal insufficiency? Under normal circumstances, renal insufficiency was manifested in urine volume, and this patient's urine volume was normal.
Although hemorrhagic shock caused less urine, it was not to the extent of less than 50ml per hour of renal insufficiency.
He had doubts, but when he heard Zheng Ren's words, he immediately stopped the micro pump and pumped in the sodium nitroprusside.
"There's no need to give too much treatment. Just be careful not to let the vomit be inhaled and cause suffocation," Zheng Ren said.
"…" Professor Huang was puzzled. He arranged for the junior doctor to immediately contact the Nephrology Department. He came to Zheng Ren's side and asked, "Teacher Zheng, is it acute renal failure?"
"Sort of," Zheng Ren replied.
He was sweating … sweating …
Sort of. What kind of answer was that?
For the first time, Professor Huang felt that Zheng Ren was a little unreliable. However, this thought was nipped in the bud as soon as it appeared.
As a candidate for the Nobel Prize, his identity could prove many problems.
That was not all. He had seen the surgery with his own eyes. He was definitely the most awesome one he had ever seen. Generally, such doctors had rich clinical experience.
His own doubts could only prove that he had little clinical experience and that his diagnosis was wrong.
Professor Huang looked at Zheng Ren with a questioning gaze, waiting for his explanation.
"It's thiocyanate poisoning," Zheng Ren said.
Uh … It was common to use sodium nitroprusside in the clinic. Many patients had high blood pressure and had to use sodium nitroprusside to control it. After so many years, Professor Huang rarely heard the diagnosis of thiocyanate poisoning.
It was not very few, but basically none.
Thiocyanate poisoning sounded so unfamiliar to him.
"It's a problem with the metabolism of sodium nitroprusside, right?" Su Yun immediately thought of some possibilities and asked.
"Yes," Zheng Ren said. "Sodium nitroprusside is a kind of nitrohydrocyanate. It's a strong dilator that acts directly on the arteriovenous vascular bed.
Sodium nitroprusside continues to be pumped in. First, it is converted from red blood cells to cyanide, and then it is converted by thiocyanase in the liver to the final metabolite, thiocyanate.
Thiocyanate is excreted by the kidney. The half-life of a person with normal kidney function is four to seven days. Patients with kidney failure have accumulation. If the dosage is too high, the metabolite thiocyanate in the blood is too high, and it is easy to cause poisoning. "
"But the patient doesn't have abnormal kidney function," Professor Huang said as he tried to recall the patient's test results.
"There wasn't before, but there is now."
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