Chapter 1786 Hidden Disease

"And what you said is wrong." Zheng Rendao: "Bradley A. Gross et al. systematically reviewed and combined the current literature on vascular intervention for moyamoya disease and moyamoya syndrome, and the study was published in Neurosurg Rev."

"He only summarized 28 patients with vascular intervention, 11 with endovascular stents, and 17 with angioplasty. There were only 7 successful procedures."

"Twenty-five percent." Su Yun said.

"First of all, there is no doubt that Dr. Bradley A. Gross is biased against interventional procedures. He concludes the article that the results clearly do not support the use of vascular interventions for moyamoya disease and moyamoya syndrome, and they will need to do more in the future. research to gather more data to prove this point.”

Su Yun pouted and looked at his phone, Di's car was very close.

"I think that all research work, as long as it cannot adhere to an objective and fair attitude, the conclusions are questionable." Zheng Rendao.

"Whatever you say, interventional surgery for moyamoya disease... I'll ask Sanbo or the Temple of Heaven to see if they have done it. I think, not many people know about neurosurgery. Does anyone know about Huashan's neurosurgery? Woolen cloth?"

Su Yun babbled, and a car came over with a double dodge.

Getting in the car, Su Yun was in touch with his mobile phone, while Zheng Ren recalled the connection between moyamoya disease and coronary surgery.

It is self-evident what kind of risks will be faced if emergency surgery is performed.

But Zheng Ren was not afraid.

Be prepared first, and the others will wait until you see the patient and go to the operating room of the system for surgery to confirm your point of view.

Although there is still some time for surgical training, Zheng Ren habitually does not want to "waste".

In the past two days, I have used surgical training time twice to think about my condition.

One time, eating the thyroid gland of animals led to hyperthyroidism and thyroid storm. Another time, it was a complete waste, because I cooked garlic myself.

This matter must be counted on Chang Yue's head, Zheng Ren thought to himself.

Soon I came to 912. The distance was not too far away, so I was there by running, but Su Yun habitually called a car, and it didn't matter.

Zhao Yunlong was in the EICU, and the two did not hesitate to go directly to the EICU.

The EICU of 912 is a U-shaped building. Each patient is isolated separately. There are small table boards in the corridor. This is a place for medical staff to lie down and sleep for a while when they are tired.

Medical staff have no time to rest in the duty room at all. EICU is such a strange existence.

It was almost ten o'clock in the evening. After the two entered the EICU, the first thing they saw was the busy workstation.

The four trainees on duty, including the one on the night shift last night, are still busy. After 40 hours without sleep, the training doctor could not see fatigue, and he fell into a morbid state of excitement.

Zheng Ren shook his head. If the emergency department is not welcoming, the intensive care units such as the ICU and EICU are certainly not welcome.

The ICU of Haicheng No. 1 Hospital is fairly easy to say, and there are fewer critical illnesses on that side. The EICU of 912 is a different world, with 40 beds always running at full capacity.

If there is no such creature as a doctor of training, the operation of 912 will directly collapse.

Not only this, but also Zheng Ren's community hospital. At present, the nursing force of community hospitals is sufficient, but the doctors are basically advanced doctors.

Zheng Ren didn't have time to sigh about these things. He quickly followed Su Yun and walked into an isolation room.

Zhao Yunlong stood in front of the hospital bed very seriously, staring at the patient's ECG monitoring.

"Old Zhao, what's the situation?" Su Yun asked.

"Three times of rapid ventricular arrhythmia have occurred after the operation, which was corrected by electrical defibrillation. The situation is not optimistic, you can take a look." Zhao Yunlong did not look back, but said in a loud voice.

"Tell me from the beginning." Zheng Ren said.

Zhao Yunlong turned around and saw Zheng Ren walking in with him, so he turned around, "Mr. Zheng, you're here too."

"It's also Boss Zheng's, it's called the boss." Su Yun said while squatting down to look at the chest bottles on both sides.

The drainage volume is not much, and the operation should be fine. It is estimated that the patient's own physical condition caused the rapid ventricular arrhythmia after bypass surgery.

"The patient had a hidden disease before surgery." Zhao Yunlong ignored Su Yun's nagging, it seemed that he was used to it, and reported his condition directly.

Zheng Ren's eyebrows suddenly wrinkled.

Hidden disease? This... Zheng Ren finds it interesting.

The so-called hidden onset is that the patient does not have any symptoms, but it is discovered by chance that the condition is very serious and must be treated.

In a big way, all tumors in the early stage are considered as insidious onset. However, it is not accurate to say that the early onset of the tumor is not serious.

The real trouble is that the disease is very serious, but the body does not respond, at least the patient himself is not aware of the disease.

This kind of situation is rare, and I didn't expect to encounter it today.

All the patients had a myocardial infarction, and the disease was still hidden... Zheng Ren was 80% sure that the moyamoya disease in the patient's brain might be a key factor, causing the patient to not notice the pain in the precordial area.

Of course, this is just a guess.

"The patient suffered from chest tightness and shortness of breath for three months, which worsened for three days and came to the respiratory department of our hospital for treatment. Chest CT showed severe calcification of the aorta and enlarged heart, so he went to the circulatory department for hospitalization. Cardiac angiography showed three-vessel lesions, and 90% of the anterior descending artery was blocked. , the right crown is blocked by 95%, and the circumflex is blocked by 95%.”

Very serious coronary heart disease, Zheng Ren can already guess what the patient experienced.

Sure enough, Zhao Yunlong then confirmed Zheng Ren's guess.

"During the hospitalization in the Department of Circulation, the patient's family refused to undergo cardiac interventional surgery. After the angiography, while the family was still discussing, the patient suddenly became ill, and the cardiac arrest occurred after the rapid ventricular arrhythmia." Zhao Yunlong said: "Emergency CPR, cardiac surgery is performed. Stenting."

Zheng Ren outlined in his mind the kind of emergency rescue that caused the excessive secretion of hormones that was carried out by the Department of Cardiothoracic Medicine and Cardiothoracic Surgery this afternoon.

Cardiac arrest, a compression, while sent to the circulatory catheterization room.

This process is simple to say, and it is estimated that the doctors in the circulatory department have not slowed down.

"During the stent placement, the patient suffered two rapid ventricular arrhythmias." Zhao Yunlong said: "The balloon is opened, as long as the stimulation is performed, the heart stops. Later, only emergency thoracotomy was performed and coronary artery bypass surgery was performed."

Similar to what Zheng Ren thought, it was basically such a process.

"After the operation, the patient's bilateral chest bottle drainage was not much, and the pericardial drainage was not much, but the rapid ventricular arrhythmia occurred frequently, and he had been defibrillated three times." Zhao Yunlong said, "I am going to do IABP, but the patient's family has not responded. "

IABP, also known as intra-aortic balloon counterpulsation, is one of the methods of mechanical auxiliary circulation. It is a means of increasing intra-aortic diastolic pressure, increasing coronary blood supply and improving myocardial function through physical action.