Chapter 1631 Correction of Echocardiography

Zheng Ren didn't have any mood swings, he didn't notice the rudeness of the other party at all, he inserted the film into the film reader.

The same as the films seen in the system space, two standing X-ray films and a CT 3D reconstruction.

The bullet entered about 1/3 of the medial side of the right clavicle. Chest X-ray showed that the bullet was in the shadow of the heart at the lower border of the heart, and there was no hemothorax or pneumothorax.

The position of the clavicle fracture has been externally fixed, which is very clear.

The CT 3D reconstruction did not find the exact location of the bullet.

Zheng Ren glanced at the film and began to read the medical records.

According to the injured person's own account, when he was injured, he had a movement of leaning forward. The rest of the other medical history, there is no reference.

Looking at the surgical records of the Affiliated Hospital of Medical University, it still doesn't make any sense.

Zheng Ren was a little confused.

On the upright plain film, the bullet is under the shadow of the heart, but the CT 3D reconstruction is not. This is not a matter of technical level. I did the reconstruction in my mind, and I didn't see the image of the bullet.

Cardiac ultrasound, conventional four-chamber ultrasound, still did not see where the bullet was, only mild tricuspid regurgitation.

Zheng Ren hesitated for a while, and judged logically that the bullet was missing.

But two X-rays showed that the bullet did not change position.

The patient was hemodynamically stable with a heart rate of 96 bpm, a blood pressure of 110/70 mmHg, and a respiratory rate of 17 breaths per minute. Blood parameters such as electrocardiogram and troponin T were normal.

Is it in the heart? Zheng Ren suddenly had this idea.

Ordinary echocardiography does not see bullets, so try to correct it.

M-mode echocardiography is prone to distorted detection results due to the misalignment of the ultrasound beam.

There are special studies on the azimuth error of echocardiography and the search for a simple and effective method to correct the error, but it is rarely used in clinical practice.

The measurement of cardiac structural parameters must follow the quadrature rule. According to the mathematical principle of the geometric pattern of the left ventricle, it is proved that there is a functional relationship between the error value and the true value of the deviation from the azimuth angle cosθ.

Thus, the mathematical expression of the relative correction error is established, and a convenient method for measuring the deviation angle and correcting the error with the cosθ function is provided.

Seeing Zheng Ren watching the film silently, Director Tian curled his lips and said coldly, "Director Ma, Gu Lao won't come, we can go. What do you mean by bringing a little doctor?"

"Director Tian, ​​you are enough!" Director Ma said angrily, "This is Dr. Zheng Renzheng, a candidate for this year's Nobel Prize, not a little doctor."

"Nobel Prize?" Director Tian was stunned for a moment, but he was still disdainful, "Is it the one from the Interventional Department? Nonsense, clinical procedures can't win the Nobel Prize. This is just like..."

Saying that, he sneered twice.

"Just like that group bought an award at the American Music Awards, they showed their faces and lip-synched," said the professor who led the group next to Director Tian.

Director Ma really couldn't sit still.

He thought that this was a high probability thing, but you said it like this, and you are still in front of the person involved. Isn't this a slap in the face?

What does it have to do with you whether people are willing to sing the little apple or eat the little apple?

If 912 is willing to play these, let others play. If you want to do it, if you have the ability to do it, do it yourself! Does it make sense to stand here and directly tear off the emperor's new clothes?

If this matter is not handled well, the two principals will definitely come forward in the end.

When things get to that point, the trouble will finally come to the Ministry...

Director Ma no longer dared to think about it.

There have been two or three incidents of this kind of torment in the past 20 years, and every time it happened, it shook the entire medical community.

It's great to stand on the sidelines and watch the fun, but when it comes to yourself, it's definitely not a pleasant thing.

"Director Ma, what do you mean?" Linger said gloomily, "Comrade Zheng Ren is a member of the health care team with a very high level. He just went to Nanyang to complete his mission and returned to China. Hezhe, your Medical University Affiliated Hospital is not looking for a consultation. You just couldn't find the problem, and asked our 912 people to vent their anger?"

"..." Director Ma was helpless.

This is so special, if you look for a chance, you must die to suppress the cardiothoracic surgery and make them so arrogant.

"CT looks fine, but it's caused by overlapping images on imaging. After correction, it can be determined that the bullet is in the heart." Zheng Ren said suddenly and lightly.

Ringer was a little hesitant at first. If Boss Zheng couldn't find out where the bullet was, it would be useless no matter how fierce he was.

But Boss Zheng found the bullet and took the commanding heights, so he couldn't kill them!

As for what Boss Zheng said, Ringo didn't care. According to his "rich" clinical experience, Boss Zheng is never wrong!

Zheng Ren still didn't care what other people were doing. After he found the problem in the 3D reconstruction, he came to the system space, clicked to buy surgery, and entered the system operating room.

Surgery training begins!

The chest was opened, the sternum split, and the buzzing sound of the sternum saw echoed in the system operating room.

Zheng Ren felt a little dangerous while doing it, and the danger might come from Su Yun.

Such a big operation, or the removal of bullets into the heart, if you don't call him, will he turn his face against himself? !

Regardless of that, it has to be anatomically determined that the bullet is in the heart.

After opening the mediastinum, Zheng Ren fixed the heart with an octopus and cut open the right ventricle.

A yellow-orange-orange bullet appeared in the field of vision.

Not an imagined shotgun, but a standard bullet.

The bullet was in the diaphragm of the right ventricle, and the heart was sutured after taking it out. No active bleeding was found, and the operation was declared over.

The operation was not difficult for Zheng Ren.

The moment after the operation, another thought suddenly appeared in Zheng Ren's mind.

In this position, it seems that the bullet can be removed through interventional surgery without opening the chest.

The unimaginable thought shocked Zheng Ren himself.

The original "simple" operation has become extremely complicated.

Want to try it?

But when this thought rose from the bottom of his heart, Zheng Ren could no longer restrain his desire for this strange technique.

try?

Just try it.

Calm down, Zheng Ren recalled the location of the bullet and the possibility of taking it out.

It's still possible.

Fortunately, the patient was not injured by a gunshot wound. But Zheng Ren still wants to make the harm to those working overseas a little bit smaller, and a little bit smaller.

Shouldn't it be better to spend some time experimenting with new surgical methods on your own?

It should, and it is necessary.

Zheng Ren himself has full respect for these state-owned enterprise employees who are traveling overseas. Although it seems a bit "wasted", because surgery can solve the problem.

But he still wanted to try.

The procedure was different from the previous procedure. Zheng Ren used a 16-Fr E sheath to puncture the right femoral vein under the guidance of echocardiography while the subject was awake and sedated.

The guide wire and catheter are introduced into the femoral vein, then into the inferior vena cava, and finally into the right ventricle.