I Can See Health

At this moment, the resident doctor just now hurried over again.

"Director Tian, ​​Professor Shi, the emergency laboratory department called just now. This patient is in critical condition!"

Shi Langqin was stunned for a moment, and then immediately found a computer.

Open the inspection system.

The patient's laboratory indicators immediately popped up.

"Brain natriuretic peptide (BNP)\u003e35000pg/ml, urea 28mmol/L, serum creatinine 175.0μmol/L, serum potassium L."

"Aspartate aminotransferase 2373IU/L, alanine aminotransferase 1788IU/L, total bilirubin 131.7μmol/L and direct bilirubin L."

"Arterial blood gas prompts: pH 7.288, carbon dioxide partial pressure 53mmHg, oxygen partial pressure 67mmHg (mask oxygen inhalation 6L/min), base remaining L."

"Myocardial markers: myoglobin 152.30ng/ml, troponin 125.0ng/ml."

Serum potassium, liver function, blood gas analysis, and troponin are all critical values!

When everyone saw this test indicator, their eyelids couldn't help but twitch.

Lu Chen's face was solemn. In his sight, the patient's health was declining rapidly!

"In this case, dialysis is necessary first!" Director Tian couldn't help but said.

Each organ is basically in a state of failure, and the cause is cardiogenic shock, resulting in insufficient blood supply to each organ.

"This kind of cardiogenic shock cannot tolerate dialysis!" Shi Langqin immediately rejected Director Tian's idea, "If the cause of cardiogenic shock is not solved as soon as possible, any other operation will be redundant. The effect is also very poor!”

"Professor Shi, you mean...emergency surgery?!"

Director Tian's eyes widened.

For this kind of patient to undergo emergency surgery, they are basically putting themselves on the fire!

A patient with a narrow chance of death, an operation with a narrow chance of death.

When these two meet, what are the chances of success in the end?

"What is the patient's family's willingness for treatment?" Shi Langqin continued.

"I have already communicated with the family." Director Tian said in a low voice, "The family members are very active in the treatment and they are not short of money. The only request is to let the patient live one more month."

"Live one more month?" Shi Langqin frowned, "Why is there such a need?"

Director Tian said: "He has a grandson who is getting married next month, and I want him to leave after that."

Shi Langqin fell silent immediately and looked at Lu Chen beside him.

Lu Chen had already put on a white coat and was conducting a physical examination on the patient himself.

A long while.

He just put down the stethoscope in his hand.

"Director Lu, how are you?" Shi Langqin said quickly.

What he asked was naturally about the patient's condition and the chance of surgery.

"Surgery can be done, but the risk is extremely high!" Lu Chen said in a deep voice, "We must discuss it clearly with the patient's family. Now it is a dead horse and a living horse. The doctor can save him, let alone one month, two months or even half a year." There is a period of survival, but if you are not saved, you will be punished here tonight!”

"Director Lu, if you say you can do the surgery, that's fine." Shi Langqin nodded, "Are you going to be the chief surgeon of this surgery?"

Lu Chen smiled and shook his head: "I have resigned from Mayo and do not have any position in the country. Although I have a medical license, practicing medicine outside the scope of the license is also illegal practice!"

"Then...this surgery..." Shi Langqin immediately backed down.

The source of all his confidence is Lu Chen.

Now considering Lu Chen's identity, it would be troublesome!

"Although I can't go on stage, I can coach."

Just when Shi Langqin was frowning, Lu Chen suddenly said again.

"The technique of this operation is not difficult. The key is that we don't know the shape of the valve before the operation. There are many unknown factors. As long as this problem is solved, the operation will be simple."

"That's okay!" Shi Langqin's eyes lit up, "Can you do an esophageal ultrasound?"

"Okay!" Lu Chen nodded.

Lu Chen is right, most patients have similar vascular conditions.

The reason why this patient is complicated is mainly because he has too many underlying diseases and his physical condition is too poor, so he may not be able to tolerate surgery.

As for the difficulty of the surgery itself, the main reason is that the patient's valve condition is unknown.

Generally speaking, before performing TAVR surgery, a detailed examination of the patient's valve, such as CT examinations, is required.

After a comprehensive analysis of the valve's shape, leaflets, calcification, etc., a detailed surgical plan will be specified.

But for this patient now, it may be too late for a CT scan.

The only way now is to do a transesophageal echocardiogram!

Excellent surgeons can determine the status of the valve through esophageal ultrasound.

During the operation, an esophageal ultrasound can be performed to clearly see the general condition of the patient's valve.

When Shi Langqin heard this, he immediately turned around and said to Director Tian: "Director Tian, ​​please communicate with the patient again. Just as Director Lu said just now, a dead horse is a living doctor!"

"This..." Director Tian glanced at Lu Chen, a trace of doubt flashed in his eyes, who is this person?

So young, only in his early thirties, right?

Why does Professor Shi Langqin listen to him so much?

Director Tian recently came to Guanghai from the north and didn't know Lu Chen very well yet.

Even though I have heard of Lu Chen's name, I have never actually seen him.

"Go quickly, don't waste time!" Shi Langqin urged.

"Oh, okay, I'll go now."

Seeing that Shi Langqin had given the order, Director Tian had already put away his doubts and went to the doctor-patient communication room to communicate with the patient's family.

…

five minutes later.

Director Tian ran all the way back to the CCU ward.

"Teacher Shi, the patient's family agrees to the operation at their own risk!"

Shi Langqin perked up and immediately stood up and said, "Okay, notify the cath lab and prepare for surgery!"

Everyone immediately started to get busy.

There are doctors contacting the cath lab and preparing patients for transport.

Everyone split up and moved quickly.

The patient entered the operating room with the support of high-dose vasoactive drugs and IABP.

Upon entering the room, HR was 109 times/min, BP was 80/40mmHg, and SpO2 (oxygen concentration 50%) was 92%.

The first step of today's surgery is not to perform a puncture, but to perform an esophageal echocardiogram.

To put it simply, the ultrasound probe is inserted deep into the esophagus and stops at the level with the heart.

Through ultrasound of the esophagus, the condition of the patient's heart can be seen more clearly.

Including the status of the valves, whether there are blood clots in the atrium, etc.

"Director Lu, can we start?" Shi Langqin, as the chief surgeon, looked at Lu Chen aside.

"Okay." Lu Chen nodded slightly.

Although I cannot perform the main operation today, the transesophageal cardiac ultrasound is the focus of this operation.

The difficulty and importance are no less than the valve delivery process of the entire operation.

…

General anesthesia was induced smoothly.

Place the TEE probe after induction.

Lu Chen began to control the esophageal ultrasound and enter the patient's body.

Upon reaching the heart, an image immediately appeared on the ultrasound screen.

Lu Chen recorded the image content while operating.

"The aorta is widened, the ascending aorta is obvious, the aortic valve is bicuspid, the valve leaflets are obviously thickened and calcified, and the opening is obviously restricted."

"The aortic valve area (Ava) was 0.5cm2, the peak aortic valve flow velocity (AV) was 12.33m/s, and the left ventricular ejection fraction (LVEF) was significantly reduced by 27.7%."

"Brother Shen!"

"Um!"

When Shen Changqing walks on the road, whenever he meets someone he knows, he will say hello or nod to each other.

But no matter who it is.

There was no unnecessary expression on everyone's face, as if they were indifferent to everything.

To this.

Shen Changqing has become accustomed to it.

Because this is the Demon Suppression Division, an organization that maintains the stability of the Qin Dynasty. Its main responsibility is to kill monsters and monsters. Of course, there are also some other side jobs.

It can be said.

Everyone in the Demon Suppression Division has a lot of blood on their hands.

When a person is used to seeing life and death, he will become indifferent to many things.

When he first came to this world, Shen Changqing was a little uncomfortable, but he got used to it over time.

The Demon-Suppressing Division is huge.

Those who can stay in the Demon Suppressing Division are all powerful masters, or those who have the potential to become masters.

Shen Changqing belongs to the latter.

Among them, the Demon Suppressor Division is divided into two professions, one is the Guardian Envoy and the other is the Demon Slayer.

Anyone who enters the Demon Suppression Department starts from the lowest level as a demon slayer.

Then he will be promoted step by step, and he is expected to eventually become a guardian envoy.

Shen Changqing's predecessor was a trainee demon slayer in the Demon Suppression Division, and he was also the lowest level among the demon slayers.

Possessing the memory of a previous life.

Regarding the environment of the Demon-Suppressing Division, UU Reading www.uukanshu. net is also very familiar.

It didn't take long for Shen Changqing to stop in front of a loft.

Unlike other places in the Demon Suppressing Division that were full of chills, the attic here seemed to stand out from the crowd, showing a different kind of tranquility in the bloody Demon Suppressing Division.

At this time, the attic door was open, and occasionally people came in and out.

Shen Changqing only hesitated for a moment before stepping in.

Enter the attic.

The environment changes in vain.

The fragrance of ink mixed with the faint smell of blood hit his face, causing him to frown instinctively, but then relaxed it quickly.

There is almost no way to cleanse away the smell of blood on everyone in the Demon-Suppressing Division.

:,!