Zheng Ren didn't have any mood swings and didn't notice the other party's rudeness at all. He inserted the film into the reader.
The same as the films seen in the system space, two standing X-ray films and one CT three-dimensional reconstruction.
The bullet entered about 1/3 of the inner side of the right clavicle. Chest X-ray showed that the bullet was in the shadow of the heart at the lower edge of the heart, and there was no hemothorax or pneumothorax.
The location of the clavicle fracture has been externally fixed, which is clearly visible.
However, the CT three-dimensional reconstruction did not find the specific location of the bullet.
Zheng Ren took a look at the film and started flipping through the medical records.
According to the injured person's own words, when he was injured, he made a forward body movement. The rest of the medical history is of no reference.
Looking through the surgical records of the Medical University Affiliated Hospital, it still makes no sense.
Zheng Ren was a little confused.
In the standing plain film, the bullet was under the shadow of the heart, but in the three-dimensional CT reconstruction it was not. This is not a matter of technical level. I reconstructed it in my mind and did not see the image of the bullet.
Cardiac color ultrasound, conventional four-chamber color ultrasound, still did not see the bullet, only mild tricuspid regurgitation.
Zheng Ren hesitated for a moment and judged logically that the bullet was missing.
But two X-rays showed the bullet had not changed position.
The patient was hemodynamically stable with a heart rate of 96 bpm, blood pressure of 110/70 mmHg, and respiratory rate of 17 breaths/min. Blood indicators such as electrocardiogram and troponin T were normal.
Could it be said that it is in the heart? Zheng Ren suddenly had this idea.
If you don't see the bullet in ordinary echocardiography, try to correct it.
M-mode echocardiography is prone to distortion of detection results due to incorrect incident orientation of the ultrasound beam.
Regarding the issue of echocardiographic azimuth error, and looking for simple and effective methods to correct the error, there have been specialized studies, but they are rarely used clinically.
Measuring cardiac structural parameters must follow the orthogonal law. According to the mathematical principle of the left ventricular geometric pattern, it is proved that there is a functional relationship between the error value and the true value that deviates from the azimuth angle cosθ.
Thus, the mathematical expression of the relevant correction error is created, and a simple method for measuring the deviation angle and correcting the error using the cosθ function is provided.
Seeing Zheng Ren watching the film in silence, Director Tian curled his lips and said coldly: "Director Ma, if Mr. Gu doesn't come, we can go. What do you mean by bringing a little doctor?"
"Director Tian, that's enough!" Director Ma said angrily: "This is Dr. Zheng Renzheng, a candidate for this year's Nobel Prize. He is not a little doctor."
"Nobel Prize?" Director Tian was startled for a moment, but still disdainful, "The one from the interventional department? Nonsense, clinical procedures cannot win Nobel Prizes. This is the same as..."
As he spoke, he sneered twice.
"It's like that group buying prizes at the American Music Awards. They go up and show their faces, lip-sync and dance." said the team leader next to Director Tian.
Director Ma really couldn't sit still.
He thought this was a high probability thing, but if you said it like that in front of the person involved, wouldn't it be a slap in the face
What does it have to do with you whether people are willing to sing about Little Apple or eat Little Apple
If 912 is willing to play with these things, let them play with them. If you want to do it and have the ability to do it, do it yourself! Does it make sense to stand here and undress the emperor's new clothes
If this matter is not handled well, the two deans will definitely have to come forward in the end.
Once the matter reaches that point, it will eventually escalate into the ministry...
Director Ma no longer dared to think any more.
This kind of quarrel has happened two or three times in the past 20 years, and each time it happened, it shocked the entire medical community.
It's great to stand aside and watch the excitement, but it's definitely not a pleasant thing when it comes to yourself.
"Director Ma, what do you mean?" Lin Ge said gloomily, "Comrade Zheng Ren is a member of the health care team and has just returned from a mission in Nanyang. He Zhe, your affiliated hospital of the Medical University, either wants to consult, but he can't find one. The problem is, are we 912 people here to vent your anger?"
"..." Director Ma was helpless.
Damn it, if you find an opportunity, you will definitely suppress the cardiothoracic surgery department to death, making them so arrogant.
"The CT looks fine, but it's caused by overlapping images on the imaging. After correction, it can be confirmed that the bullet is in the heart." Zheng Ren suddenly said calmly.
Lin Ge was a little hesitant at first. If Boss Zheng couldn't find where the bullet was, it would be useless no matter how fierce he was.
But Boss Zheng discovered the bullet and took the commanding heights. He couldn't kill them by himself!
As for what Boss Zheng said, Lin Ge didn't care. According to his "rich" clinical experience, Boss Zheng is never wrong!
Zheng Ren still didn't care what others were doing. After he discovered the problem during the three-dimensional reconstruction, he came to the system space, clicked to purchase the surgery, and entered the system operating room.
Surgery training begins!
The chest was opened, the sternum was split, and the buzzing sound of the sternum saw echoed in the system operating room.
Zheng Ren felt a little dangerous while doing it, maybe the danger came from Su Yun.
Such a major operation, or an operation to remove the bullet that had wandered into the heart, if I didn't call him, would he fall out with me? !
Regardless of this, we have to confirm from the anatomy that the bullet is inside the heart.
After opening the mediastinum, Zheng Ren fixed the heart with an eight-claw device and cut the right ventricle.
A yellow-orange bullet appeared in the field of vision.
Not the imaginary shotguns, but standard bullets.
The bullet was located in the septum of the right ventricle. After taking it out, the heart was sutured and there was no active bleeding. The operation was declared over.
The surgery was not difficult for Zheng Ren.
The moment he finished the operation, another thought suddenly appeared in Zheng Ren's mind.
At this location, it seems that the bullet can be removed through interventional surgery without opening the chest.
The incredible thought shocked Zheng Ren himself.
What was originally a "simple" surgery became extremely complicated.
Do you want to try it
But with this thought rising from the bottom of his heart, Zheng Ren could no longer contain his desire for this weird technique.
Try it
Just try it.
Calmly, Zheng Ren thought about the location of the bullet and the possibility of removing it.
It's still possible.
The patient suffered a gunshot wound, but fortunately there was no major injury. This is incredible luck. But Zheng Ren still wants to make those working overseas less harmed.
Isn’t it time for you to take some time to experiment with new surgical methods
It should, and it is necessary.
Zheng Ren himself has full respect for these state-owned enterprise employees who travel overseas. Although it seems a bit "wasteful", because surgery can solve the problem.
But he still wanted to try.
The surgical procedure was different from previous surgical procedures. Zheng Ren used a 16-Fr E sheath to puncture the right femoral vein using echocardiographic guidance while the subject was awake and sedated.
The guidewire and catheter enter the femoral vein, then the inferior vena cava, and finally the right ventricle.