bookmarkrole Chapter 308
Chapter 308
Chapter 308
Chapter 3 Nine Intervention
The patient's wife frowned, thought for a while and said, "Doctor, we will do this examination, just..."
Before he finished speaking, he was directly interrupted by the patient.
"Don't do it, absolutely can't do it. I'm just a minor illness. It's just that this little doctor is fooling you and trying to cheat us of money." The patient snorted coldly, "The current doctors are completely incomparable with the previous ones. If you don't do the examination, you will be fine." No way, when there were no such machines before, how could doctors see good illnesses?"
Qin Feng was speechless for a while, and he really had nothing to say to this kind of person.
Sighing in his heart, Qin Feng felt tired.
"As a doctor, I have already told you the diagnosis result. As for whether you go for the examination, it is up to you. But let me remind you, don't lose your life for a small amount of money."
"Hmph, I've already seen through your little tricks after living for so many years." The patient was about to get up.
"Old man, why don't we check it out, it's only 200 yuan, buy a safe one." The patient's wife advised.
"200 yuan is not money? What a prodigal." The patient waved his hand impatiently.
The patient's wife also got angry and quarreled with the patient in the consulting room.
Qin Feng and the two nurses kept silent, as long as they did not fight, Qin Feng would not intervene.
As for the damage to the hospital, I'm sorry, there is monitoring, and the original price will be compensated.
After arguing for five or six minutes, the two stopped panting, and finally the male patient agreed to go for an examination.
"I'll just use the 200 yuan as money to feed the dog."
The patient's words were ugly, Qin Feng also frowned, really wanted to let the patient fend for himself, and he was insulted like this for him with good intentions.
Qin Feng was a little worried, but followed.
There is no way for the profession of a doctor. The insults of the patients can only be hidden in the heart, otherwise they will be infinitely magnified by those who are interested.
After 10 minutes, the CT results came out.
The patients who learned about their condition from the CT doctor were completely dumbfounded.
I really have an aortic addition. Near the pulmonary aorta, about 5cm away, there is a 1cm-sized aortic dissection, which is what we call a hemangioma.
It's not like a tumor, like those big bumps on tires.
When the patient's wife saw the result, her back was covered in cold sweat. If she hadn't insisted strongly, she would have gone back like this. One can imagine the consequences...
"Doctor, I'm sorry." The patient bowed to Qin Feng.
"It's okay, as long as the results come out, I'll arrange for you to be hospitalized first, and then we'll see how to perform the surgery." Qin Feng said.
"Okay, doctor, I'll listen to you. You can do whatever you say." The patient looked like Qin Feng was the leader.
It's completely different from the one I questioned just now.
This kind of person, before knowing the result, will always be the kind of person who slaps himself in the face.
Qin Feng took the patient for a CTA examination of the aorta. CTA refers to the angiography of the aorta under CT, that is, aortography.
While the doctors in the CT room were busy, Qin Feng was also thinking about the operation plan.
Aortic dissection must be treated with surgery and drugs.
There are two surgical options, the first is surgery.
Radical treatment is carried out by replacing diseased blood vessels, eliminating false lumens, and rebuilding the blood supply of branch vessels.
The second type is interventional surgery, which is mainly endovascular repair/isolation. Through the elastic expansion force of the stent graft, the artificial blood vessel is seamlessly fixed on the arterial wall at both ends of the diseased artery to seal the dissection breach.
Both methods have disadvantages.
For example, the disadvantage of surgery is that it is traumatic and the postoperative recovery effect is relatively poor. After all, it is an operation, which is debilitating.
In the case of interventional surgery, the trauma is small and the postoperative recovery is fast, but the lesion cannot be cured, and there is a possibility of recurrence.
For a while, Qin Feng couldn't make a decision, so he could only wait for the CTA results to come out before deciding on the surgery plan.
The speed of CTA is slower than that of CT, and imaging technology is used, and it takes a little time to image.
When the results came out, Qin Feng took a look through the film reader and made a simple assessment of the condition. He was more inclined towards interventional surgery in his heart.
Qin Feng called Mr. He again and asked for a batch of interventional equipment.
Because Mr. He is now the head of the interventional department of Ruijin Hospital, Mr. He is still qualified to directly approve an interventional device for surgery.
When Mr. He heard that Qin Feng was going to have an operation for aortic dissection, he offered to be Qin Feng's assistant. Qin Feng didn't want to agree to it at first, but Mr. He had too much influence for him to be his assistant.
It was so big that Qin Feng felt that he might not be able to bear it anymore, and after this operation, the relationship between Qin Feng and He Lao would also be announced to the public.
However, under the threat of He Lao, Qin Feng could only agree.
He Lao said that the entire Ruijin Hospital will not provide Qin Feng with interventional equipment, it is definitely not a joke.
It is possible for Qin Feng to become or even surpass the existence of He Lao, but He Lao has already stood at the top.
One is looking forward to the future, and the other is looking forward to the present.
Qin Feng also made it clear to the patient about the price of the interventional surgery.
The patient agreed directly without any hesitation. Finally, when he was arranging the hospitalization, Qin Feng found out that this couple is actually the charterer of the magic city...
Damn, the charterer still deducts like this? 200 yuan inspection fee is not willing?
Qin Feng made an appointment for the operating room at [-] o'clock in the evening, and went to Mr. He's side to pick up equipment in the rest of the time. After arriving at the o'clock, he went directly to the operating room with Mr. He.
"Adrenaline blockers and sodium nitroprusside." Qin Feng said after getting dressed.
After the patient's blood pressure reached 115mmhg, Qin Feng then shouted: "Intravenous infusion of sodium nitroprusside at 20ug/min, gradually increasing until 800ug/min to maintain balance, and at the same time intravenous injection of 5mg of betaloc every 5 minutes."
Looking at Qin Feng's medication application, Mr. He nodded with satisfaction.
"Yes, the medicines are all used correctly, but if the patient's blood pressure is normal, what medicine would you use?" Elder He asked.
"That is propranolol 1mg/4h or oral metoprolol." Qin Feng said.
Mr. He nodded, and when the patient's condition was almost the same, Qin Feng went out to find the family members to sign the consent form for the operation, and then came back in for the operation.
"Supine position, general anesthesia."
The anesthesiologist and Qin Feng opened their bows left and right, and put the patient's body into the corresponding position.
Because of the positioning, Qin Feng can't really let Mr. He go up to do it. Mr. He said he was an assistant, but Qin Feng didn't plan to use Mr. He as an assistant, more like an instructor.
Next, Qin Feng began to puncture the left radial artery, put a 5F radial artery sheath into it, and guide the catheter into the aorta with a guide wire.
"Intravenously push heparin 1mg/kg." Qin Feng said.
Mr. He quickly pushed the prepared heparin into the patient's body, and Qin Feng continued the operation to place the peritoneal stent into the patient's body.
(End of this chapter)