Chapter 2612 A Little Bit of Clinical Experience

"You may not know about ophthalmology, the gallbladder must have been removed." Su Yun stared at the ECG monitor, moved a footstool to the patient's left side, and chatted with Mr. Yu without saying a word.

"Uh, reflex?" Yu Zong asked.

"Yeah, what are you most afraid of when you cut the gallbladder? Cutting the common bile duct is very serious, but it is not as serious as the gallbladder reflex. Like the oculocardiac reflex, the gallbladder is involved in the operation of the biliary tract, or the heart rate slows down when the biliary tract is explored. In severe cases, reflex coronary artery spasm can lead to myocardial ischemia, arrhythmia, and even cardiac arrest.”

"Especially when rescuing patients with hemorrhagic shock, the probability goes up and down."

Mr. Yu is fine, after all, he is the hospital director of 912. But Gu Xiaoran's heart was pounding while listening.

He has already started related operations in the hospital in his hometown.

The hospital on the other side of the house is relatively small, and the departments are not so detailed. The director has contact with Zhou Chunyong, so Gu Xiaoran seized an opportunity that no one wanted to come to the imperial capital.

Coming to the imperial capital to study this time has really brought about a huge change in Gu Xiaoran's life, and he has new changes every day. Let's say... today.

When he thought about what he had explained to the patient's family before the cholecystectomy, he didn't have a gallbladder reflex at all, and he didn't even know what a gallbladder reflex was.

Not to mention Gu Xiaoran, even their director should not know. The probability of this kind of situation happening is extremely low, even if you do 1,000 surgeries, you may not encounter one case, let alone a rookie like Gu Xiaoran.

"Brother Yun, what should we do after we show up?" Gu Xiaoran asked in a low voice.

"Rescue, can you still just watch the patient die?" Su Yun said contemptuously: "If you are not sure, call the big bull in your hospital, whoever is the most powerful can be called. Of course, as long as you It’s fine if you don’t cry on the operating table. If you pollute the operating area, it’s not enough to cause trouble.”

Su Yun finally laughed at Gu Xiaoran.

"Hey." Gu Xiaoran smiled, but his smile was stiffer than Mr. Yu's.

"Xiao Ran, isn't it." Mr. Yu said, "The gallbladder reflex is really rare, and urinary retention in the bladder stretches the vagus nerve is even rarer. Otherwise, why does Boss Zheng always feel that there is something wrong before the operation, but can't remember it? what is it then."

Gu Xiaoran glanced at Boss Zheng, and saw him sitting in the corner of the operating room, his eyes seemed to be staring at the ECG monitor just like Brother Yun.

Boss Zheng was still worried about the patient, and Gu Xiaoran felt a slight strangeness in his heart. I always hear Boss Zheng talk about rich clinical experience... What is rich clinical experience? This is it.

Although Boss Zheng didn't find out at the earliest time, he stepped forward at the first time, presided over the successful rescue, and the patient should be fine.

Thinking of this, Gu Xiaoran took another look at the patient.

He opened his eyes in a daze, as if he just fell asleep and didn't know what happened.

"The probability is different. The heart-eye reflex in ophthalmic surgery has a 90% probability of occurrence, but the probability of the bladder-induced heart reflex is too low." Su Yun said.

"Uh... I remembered, one time I had an operation, and I saw the patient's appendix after the laparotomy." Mr. Yu had already done the fistula, and by the way told the circuit nurse to drain the urine in the bladder in 2-3 times, " When I pulled the hook, as long as I exerted force, the patient's heart rate would change, which was fun at the time."

"It's caused by a reflex, and the vagus nerve reflex in the gastrointestinal tract is also very rare, and after it happens, I don't know what happened." Su Yun stood on the footstool, raised a bit higher, and said with a bird's-eye view of the ECG monitor.

"Basically, I had no experience at that time. Brother Yun, it should be fine this time."

"It should be fine." Su Yun glanced at his boss and saw him sitting firmly on the stool. Although he didn't say a word, even if he sat there, he gave people a feeling of being at ease.

As long as this thing is there, nothing will happen, Su Yun gradually accepted this reality in his heart.

Really rich clinical experience? Or is this guy born with a keen sense of smell, just like Heizi?

Su Yun glanced at his boss, thinking about it.

Before this accident, he didn't seem to know what was going to happen. Just at the moment of cardiac arrest, he began to preside over the rescue. Alas, why is the boss so willing to steal the limelight? Su Yun sighed deeply.

"It's not uncommon for a full bladder to cause cardiac arrest." Zheng Ren said suddenly.

"Um?"

"However, generally speaking, it is not thought that it is caused by a full bladder." Zheng Ren continued: "When you wake up in the morning and hold your urine, you suddenly empty it, and you collapse in the bathroom. Such examples are often seen, but they are usually sent to the toilet. Went to the circulatory department for treatment."

"..." Mr. Yu was taken aback for a moment.

"When hollow organs receive expansion stimulation, they can pass through the afferent center of the celiac plexus or vagus nerve, and the excitement is transmitted to the lower parasympathetic center in the medulla oblongata, the dorsal nucleus of the vagus nerve, and the impulse is released to reach the heart through the parasympathetic fibers in the left vagus nerve." Zheng Ren said, "It's a very clear reflex arc."

"Uh..." Gu Xiaoran suddenly made a surprised voice, and then said: "Boss Zheng, our old director once had an operation, and he suffered a heart attack while doing it! Now that I think about it, it might be because of urinating. "

"Huh? Then?"

"Heart attack."

"Have you been rescued?" Zheng Ren asked.

"Oh, after all, it is in the operating room, and it was rescued." Gu Xiaoran said, "While dissolving the thrombosis, I contacted the municipal hospital, and the 120 ambulance sent the stent down."

"You can't even get off the bracket?" Su Yun asked.

"Yeah." Gu Xiaoran nodded, "I went with me, and the doctor in the city said it was close. Fortunately, I fell ill in the operating room. I thought it was lucky at the time, but now I think it might be because I was holding my urine. .”

"Boss, do you think this is a work-related injury?"

"Have you heard of work-related injuries in the hospital?" Zheng Ren asked in a rare way.

Seeing that he didn't finish his sentence, Gu Xiaoran changed the topic again, and asked quickly: "Boss Zheng, the vagus nerve is excited, and then what?"

"The result of vagus nerve excitation is-coronary vasospasm, decreased sinus node excitability, slowed conduction velocity of specific conduction system, weakened myocardial contractility, decreased cardiac output, decreased blood pressure, and even cardiac arrest." Zheng Zheng. benevolence.

"It's amazing." Gu Xiaoran said in a low voice.

"It's not great. I never thought about it before." Zheng Ren sighed, and said, "This time I have experience, and I'll be fine in the future. Su Yun, you're right."

"Is what I said right?" Su Yun glanced at Zheng Ren and asked.

"Clinical experience is accumulated little by little. That Korean professor is playing hooligan." Zheng Ren said seriously.