I Can See Health

"Sister Jiao, I think your idea is very possible." said the young attending physician.

Pericardiocentesis is a risky clinical skill operation.

If the puncture needle accidentally penetrates a few centimeters more, it is very likely to touch the heart and pierce the heart. Even a small rupture can cause pericardial effusion.

However, Lu Chen shook his head slightly.

"I don't think this possibility is very high. Because the cardiac ultrasound before the puncture indicated a large amount of pericardial effusion, the puncture needle can draw out the fluid without inserting the needle too deep."

For a large amount of pericardial effusion, the puncture needle can drain the fluid as long as it penetrates the pericardium.

There is no need to go deep into the pericardium.

This operation can be completed by doctors in even a county-level hospital.

Moreover, most of the current pericardial punctures are completed under the guidance of cardiac ultrasound, and it can be seen whether the heart is touched or not.

"Lu Chen, what you said is quite reasonable." Jiao Jingqiu nodded slightly, "If the puncture needle touches the heart, the heart rupture caused may be not small. Will the patient still be like now?"

Everyone talked about it.

There is no definitive answer to the cause of the patient's pericardial effusion.

"Lu Chen, what do you think?"

Jiao Jingqiu asked when she saw that Lu Chen had not made any comments.

Lu Chen had not been in the Magic City Hospital for a long time, but his clinical thinking was particularly meticulous, which was recognized by everyone.

However, Lu Chen said helplessly: "Everyone has actually talked about the causes of pericardial effusion in a whole circle, and I really can't say anything else."

There are so many causes of effusion, and everyone said one.

Basically, all of them were summarized.

"Alas." Seeing this, Jiao Jingqiu sighed slightly.

After gathering everyone's opinions, they still couldn't discuss the reason.

This makes people very melancholy!

What if the patient's pericardial effusion swells again after the drainage tube is removed, what should we do?

At this time, Lu Chen thought about it and said softly: "Sister Jiao, this patient has not had a cardiac ultrasound recheck since admission. Let's do this, I will go and do a cardiac ultrasound for the patient to see."

"Can you do an ultrasound?" Jiao Jingqiu was stunned.

In fact, she originally wanted to recheck the patient's cardiac ultrasound.

However, the patient is currently unable to move, so it is definitely inconvenient to go to the ultrasound room, so the only option is to do a bedside cardiac ultrasound.

"I know a little bit." Lu Chen nodded slightly.

His current cardiac ultrasound technology has reached an advanced level.

"Okay, then, go and try it."

The department always has a small ultrasound machine, but not many people can use it.

After all, ultrasound requires systematic learning and training.

...

Lu Chen quickly got the portable ultrasound instrument.

The group followed Lu Chen to the bedside.

"In fact, ultrasound is very simple, practice makes perfect." Lu Chen took the ultrasound instrument, sat on the right side of the patient, and introduced it to everyone, "Practice on the patient a few more times, and you will be able to do it."

Cardiac ultrasound is a non-invasive examination.

Unlike invasive operations such as coronary intervention and electrophysiology, it is simple and harmless, and it is easy to accumulate a lot of experience.

"It sounds simple, but it's hard to do!" Jiao Jingqiu shook her head. She tried to learn cardiac ultrasound, but because it was too difficult and she had no time to practice, she gave up.

Lu Chen took the cardiac ultrasound probe, applied coupling agent, and placed it on the surface of the heart skin.

"This is the short axis section of the heart, here is the left ventricular outflow tract, aortic arch..."

While Lu Chen examined the patient, he also explained to everyone.

This kind of opportunity is rare.

Ordinary ultrasound doctors do not have this leisure time to explain ultrasound to everyone.

"The liquid dark area here is pericardial effusion."

"It is easy to distinguish between effusion and normal heart tissue."

Lu Chen placed the probe at the apex of the patient's heart.

"This is the section of the apical four-chamber heart..."

Everyone heard Lu Chen's voice and felt it pause. Looking back, they saw him staring at the ultrasound screen.

"Lu Chen, what's wrong?" Jiao Jingqiu said quickly.

"Sister, look here." Lu Chen pointed to the screen, "This is the apex of the patient's heart."

Jiao Jingqiu blushed, "Even if you point it out to me, I can't understand it..."

"Sister, you don't have to understand it."

"Ah?"

"That's not what I meant." Lu Chen said quickly, "I mean there is an obvious protrusion here. Even if you can't understand the specific picture, you can still see the strong echo strip of the protrusion."

"Oh, it seems to have a strong echo." Jiao Jingqiu came over and took a closer look, "What is this? Normal people don't have this?"

"Definitely not!" Lu Chen said seriously, "I feel it's most likely the pericardium."

"Pericardium?" Jiao Jingqiu was stunned.

"Yes!" Lu Chen had paused the picture of the heart ultrasound and circulated it to everyone.

"The protruding pericardium... could this be..." Suddenly, Jiao Jingqiu was startled and looked at Lu Chen beside him in surprise, "Pericardium... heart rupture?" Lu Chen also nodded slightly, "Yes, it should be a complication after myocardial infarction - free wall rupture." Heart rupture is divided into free wall rupture and ventricular septal perforation, but the mortality rate of free wall rupture is close to 100%. It was the first time that Lu Chen saw someone survive a heart rupture.

"The patient has a break at the apex of his heart. It is considered to be caused by myocardial infarction. The local visceral pericardium will gradually seal the break."

Lu Chen couldn't help but sigh. Fortunately, with the help of the pericardium, he saved his life.

This man is still very lucky!

On the side, Jiao Jingqiu swallowed and her right eyelid twitched.

She immediately said to the graduate student behind her: "Xiao Zhang, please call the Department of Thoracic Surgery and Ultrasound Department for emergency consultation!"

"receive!"

The graduate student ran out in a flash.

Everyone in the ward couldn't help but break into a cold sweat.

Heart rupture, with a mortality rate of nearly 100%, is actually in this ward!

"Patients must absolutely stay in bed, avoid emotional agitation, and cannot get out of bed to urinate or defecate!" Jiao Jingqiu ordered, "If the stool cannot be relieved, we will prescribe laxatives!"

…

five minutes.

All the doctors from the thoracic surgery department and the ultrasound department came.

The director of the ultrasound department came with a regular cardiac ultrasound machine.

Portable ultrasound instruments are too small and many functions are incomplete.

Jiao Jingqiu asked the ultrasound department to perform bedside ultrasound to further confirm the diagnosis.

"Yes, the apex of the heart is the protruding pericardium!" The director of the ultrasound department made the same diagnosis as Lu Chen. "After myocardial infarction, the myocardium is damaged and the myocardium becomes weak. This may lead to free wall rupture or ventricular septal perforation. !”

Heart rupture with a mortality rate of nearly 100% was diagnosed!

Why is the mortality rate said to be 100%?

Once it ruptures and bleeds, it will cause cardiac tamponade in a very short time, restricting the beating of the heart.

Surgery is usually too late!

However, in this case, the patient was not suitable for hospitalization in the general ward and was immediately transferred to the cardiology intensive care unit.

…

In the doctor's office.

Jiao Jingqiu looked at Lu Chen beside her, UU reading www.uukanshu. net has a feeling of surviving a disaster.

Fortunately, Lu Chen did an ultrasound and discovered the protruding pericardium in time.

In case, the pericardium ruptures and the heart ruptures and bleeds massively.

Then this man is something that cannot be saved by gods!

However, Rao was able to save a small life.

The prognosis of this patient will not be good, and the risk of severe heart failure and heart rupture is still high.

"Congratulations, I received a +5 thank you from Jiao Jingqiu!"

"Congratulations, received from..."

Several more prompts popped up in the system, a wave of gratitude points were refreshed, and the system upgrade completion level also increased.

－－－－－－Digression－－－－－

Asking for a monthly ticket

.