"And what you said is wrong." Zheng Rendao: "Bradley A. Gross and others conducted a systematic review and combination of the current literature on vascular interventional treatment of moyamoya disease and moyamoya syndrome. The study was published in neurosurg rev."
"He only summarized 28 cases of vascular interventional treatment, including 11 cases of endovascular stents and 17 cases of angioplasty. There were only 7 successful operations."
"Twenty-five percent." Su Yun said.
"First of all, Dr. Bradley A. Gross is biased against interventional surgery, which is beyond doubt. He said at the end of the article that the results clearly do not support the use of vascular intervention to treat moyamoya disease and moyamoya syndrome, and they need to do more in the future. research to collect more data to prove this point."
Su Yun pouted and looked at his phone. Di's car was already very close.
"I think that as long as all research work fails to adhere to an objective and fair attitude, the conclusions will be questionable." Zheng Rendao.
"Whatever you say, interventional surgical treatment of moyamoya disease... I'll ask Sanbo or Tiantan to see if they have carried out it. I think about it, not many people know neurosurgery. Does anyone know the neurosurgery in Huashan? ?”
Su Yun was chattering, and a car rolled out of the way.
After getting in the car, Su Yun held up his mobile phone and contacted things, while Zheng Ren recalled the connection between moyamoya disease and coronary artery surgery.
It is self-evident what kind of risks you will face if you have emergency surgery.
But Zheng Ren was not afraid.
Be prepared first, and then wait until you see the patient and go to the system operating room 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" it.
I have used surgical training time twice in the past two days to think about my condition.
One time, eating animal thyroid gland caused hyperthyroidism and thyroid storm. Another time, it was a complete waste because I peeled the garlic myself.
This matter must be blamed on Chang Yue, Zheng Ren thought to himself.
Soon we arrived at 912. It was not that far away and we could reach it just by running, but Su Yun called a taxi out of habit and it didn't matter.
Zhao Yunlong was in EICU, so the two of them went directly to EICU without hesitation.
The EICU of 912 is a U-shaped building. Each patient is isolated individually. There are small tables set up 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. 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 working without sleep for 40 consecutive hours, the trainee doctor showed no signs of fatigue and fell into a morbid state of excitement.
Zheng Ren shook his head. If the emergency department is not popular, critical care departments such as ICU and EICU are definitely not popular.
The ICU at Haicheng City No. 1 Hospital is pretty good, and there are relatively few critically ill patients there. But the EICU of 912 is a different world, with 40 hospital beds always operating at full capacity.
If there were no living beings like training doctors, the operation of 912 would directly face collapse.
Not only this, but also Zheng Ren's community hospital is the same. At present, community hospitals have sufficient nursing capacity, but doctors are basically training doctors.
Zheng Ren didn't have time to lament these things. He quickly followed Su Yun into an isolation room.
Zhao Yunlong stood solemnly in front of the hospital bed, staring at the patient's ECG monitor.
"Old Zhao, what's going on?" Su Yun asked.
"Tachous ventricular arrhythmias have occurred three times after the operation, and they were corrected by electric defibrillation. The situation is not optimistic. Come and 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 also walking in. Then he turned around and said, "Mr. Zheng, you are here too."
"For Mr. Zheng, call me boss." Su Yun said, squatting down and looking at the breast bottles on both sides.
The amount of drainage is not very large, so the surgery should be fine. It is estimated that the patient's own physical condition led to the occurrence of tachyarrhythmia after bypass surgery.
"The patient had a hidden disease before the operation." Zhao Yunlong ignored Su Yun's nagging. He seemed to be used to it and reported his condition directly.
Zheng Ren's eyebrows suddenly wrinkled.
Insidious disease? This... Zheng Ren found it interesting.
The so-called insidious disease is when the patient does not have any symptoms, but by chance, he is found to be seriously ill and must be treated.
Broadly speaking, all tumors in their early stages are considered insidious. However, it is not accurate to say that the disease is not serious when the tumor occurs in the early stage.
What is really troublesome is the kind of illness that is extremely serious, but the body does not respond, at least the patient himself is not aware of it.
This situation is rare, I didn't expect to encounter it today.
The patient had a myocardial infarction, and the disease was still hidden... Zheng Ren was 80% sure this time that the moyamoya disease in the patient's brain might be a key factor that caused the patient not to notice the pain in the precordium.
Of course, this is just a guess.
"The patient had chest tightness and shortness of breath for three months, which worsened for three days. He came to the respiratory department of our hospital for treatment. Chest CT showed severe aortic calcification and enlarged heart, so he went to the circulatory department for hospitalization. Cardiac angiography showed three-vessel lesions and 90% obstruction of the anterior descending artery. , the right crown is 95% blocked, and the circumference is 95% blocked.”
Such severe coronary heart disease, Zheng Ren could already guess what the patient had gone through.
Sure enough, Zhao Yunlong later confirmed Zheng Ren's guess.
"While hospitalized in the circulation department, the patient's family refused to undergo interventional cardiac surgery. After the angiography, while the family was still discussing, the patient suddenly developed cardiac arrest after rapid ventricular arrhythmia." Zhao Yunlong said: "Emergency cardiopulmonary resuscitation, cardiac arrest Stenting.”
In Zheng Ren's mind, he pictured the kind of emergency rescue that caused excessive secretion of hormones that the Department of Circulation Medicine and the Department of Cardiothoracic Surgery performed this afternoon.
In case of cardiac arrest, the patient was pressed and sent to the circulatory catheterization laboratory.
This process sounds simple, but it is estimated that the doctors in the circulatory department have not yet calmed down.
"During the stent removal process, the patient suffered two sudden ventricular arrhythmias." Zhao Yunlong said: "As soon as the balloon was opened, the heart stopped as soon as it was stimulated. Later, we had to perform emergency thoracotomy and coronary artery bypass surgery."
It’s pretty much what Zheng Ren thought, it’s basically this process.
"After the operation, the patient did not have much bilateral chest bottle drainage, nor much pericardial drainage, but frequent ventricular arrhythmia, and he has been defibrillated three times." Zhao Yunlong said, "I'm going to do iabp, but the patient's family has not responded yet. "
IABP, also known as intra-aortic balloon counterpulsation, is one of the mechanical assisted circulation methods. It uses physical effects to increase diastolic pressure in the aorta, increase coronary blood supply and improve myocardial function.