Huang Dazhi's doubts about the surgery did not lie in the diagnosis, but in the technique.
Regarding the technique, Zheng Renneng can demonstrate it. How it should be used during the operation depends on each person's understanding.
Even if Zheng Ren didn't hide his secrets, most people wouldn't be able to understand.
After Professor Huang asked for advice on the two more difficult super-selection and thrombectomy techniques, Mr. Xie Yi finished the handover and walked out.
He knew that this was not a good time to chat, so he took Zheng Ren and others to the interventional department with a smile.
On the way, Professor Huang didn't say anything more because Zheng Ren and Su Yun both fell asleep while walking. He was just careful not to let the two of them fall asleep, fall or get injured while walking.
After entering the ward, Professor Huang came to the door of the director's office and said with a smile: "The director specially left the door open for you and said that you can come and have a rest at any time if you need it."
"Thank you." Zheng Ren said vaguely.
Suddenly, there was a rush of footsteps in the corridor, and the sound of wheels scraping against the ground was loud.
Subconsciously, Zheng Ren opened his eyes. In a trance, he thought he was in Haicheng City No. 1 Hospital.
"What's wrong?" Zheng Ren asked in a daze.
"Boss, it seems to be a rescue operation." Su Yun was also in a dazed state and guessed when he saw the nurse running to a ward pushing a trolley.
"Go take a look." Zheng Ren also saw the situation clearly and immediately became more energetic.
Xie Yiren wanted to say something, but hesitated and finally let Zheng Ren go.
She originally wanted to take a look at where Zheng Ren was sleeping, and then drive around to see if she could buy something to eat.
Unexpectedly, as soon as I came down, I encountered the rescue team in the ward again.
Zheng Ren strode into the ward and saw a patient whose hands and feet were slightly twitching. He wanted to dance but couldn't. What he said in his mouth was vague and unclear.
Nurses, doctors, and volunteers acting as caregivers are rescuing the patient in front of the bed. No one can be seen, and the system panel has not given a diagnosis for the time being.
"Boss, this person is probably a programmer. He talks about codes in his sleep. He is really dedicated." Su Yun whispered.
"programmer?"
"Listening to his delirium, it should be like this." Su Yundao said.
"Isn't this a postoperative patient? What happened?" Professor Huang was a little surprised and asked quickly.
"Teacher Huang, after the stent surgery, the patient had blood transfusion and blood pressure reduction, and developed symptoms such as ataxia and blurred vision. Then he began to experience delirium, dizziness, headache, nausea and vomiting, and the vomited gastric contents were gastric contents." The doctor reported.
"Stent?" Zheng Ren was stunned for a moment.
Today's patients are basically patients with hemorrhagic shock. Blood transfusion is enough, and there is generally no need to lower blood pressure.
Coupled with the stent, Zheng Ren immediately thought that he had diagnosed a patient with abdominal aortic dissection when he first arrived.
That patient had a stent, and Zheng Ren was sure there would be no problems with the stent surgery. My own surgical experience and the degree of completion of the surgery given by Big Pig Trotters can all prove it.
What's going on here
He took a step forward and saw the patient while the volunteer was getting something.
The diagnosis given by the system panel on the upper right side of the field of view is pelvic fracture after interventional embolization, abdominal aortic dissection and aneurysm stent surgery, and thiocyanate poisoning.
Already sleepy and confused, Zheng Ren got the wrong diagnosis.
The first reaction was cyanide poisoning!
This is such a big deal, could someone poison me
Zheng Ren was so frightened that he woke up.
Then he saw clearly that it was thiocyanate poisoning, and he recalled it quickly in his mind, and his expression moved slightly.
Seeing that something was wrong with Zheng Ren, Su Yun squeezed up and asked, "What's wrong, boss?"
"It's okay." Zheng Ren shook his head, but he couldn't tell Su Yun about the cyanide poisoning. If he did, he could talk about it until next year.
"Is he the patient who underwent surgery for abdominal aortic dissection aneurysm?" Zheng Ren asked.
"Teacher Zheng, yes." Professor Huang felt the strong aura of the superior doctor and subconsciously called the teacher.
"What are you using to lower your blood pressure?" Zheng Ren asked.
After aortic dissection and aneurysm surgery, blood pressure must be kept stable until the peritoneal scaffold completely blocks the breach. Generally, antihypertensive drugs are given for 1-2 days, and then they can be stopped. It's nothing special, it's all routine treatment.
"Sodium nitroprusside, pump in with a micropump, the dose is 8 μg/kg/min." The young doctor immediately reported the dosage.
Zheng Ren then knew what happened.
He said in a deep voice: "Stop the sodium nitroprusside, contact the nephrology department immediately, and go for dialysis immediately."
Professor Huang was stunned for a moment, what kind of operation is this? Acute renal insufficiency? Renal insufficiency usually manifests itself in urine output, but this patient's urine output was normal.
Although hemorrhagic shock causes oliguria, it is not to the level of renal insufficiency, which is less than 50ml per hour.
There were doubts, but after hearing Zheng Ren's words, he immediately subconsciously stopped the micropump and infused sodium nitroprusside.
"You don't need to give too much treatment, just be careful not to aspirate the vomitus and cause suffocation." Zheng Rendao.
"..." Professor Huang was puzzled. He arranged for the young doctor to contact the Nephrology Department immediately. He came to Zheng Ren and asked, "Mr. Zheng, is it acute renal failure?"
"That's right." Zheng Ren replied.
Sweat... sweat profusely...
So, what kind of answer is this.
For the first time, Professor Huang felt that Zheng Ren was a bit unreliable, but this idea was nipped in the bud as soon as it surfaced.
The other party is a Nobel Prize candidate, and his identity can prove many problems.
Not to mention, I also saw the surgery with my own eyes, and it was definitely the most awesome one I have ever seen. Generally, this kind of doctor has quite a lot of clinical experience.
My own doubts only proved that I had little clinical experience and my diagnosis was wrong.
Professor Huang looked at Zheng Ren with questioning eyes, waiting for his explanation.
"It's thiocyanate poisoning," Zheng Ren said.
Uh... Sodium nitroprusside is commonly used clinically. Many patients with high blood pressure need to use sodium nitroprusside to control it. Over the years, Professor Huang has rarely heard the diagnosis of thiocyanate poisoning.
Not very few, but basically none.
Thiocyanate poisoning sounded so strange to him.
"Is it a problem with the metabolism of sodium nitroprusside?" Su Yun immediately thought of some possibilities and asked.
"Yes." Zheng Ren said, "Sodium nitroprusside is a nitrohydrocyanate, a strong dilator that directly acts on the arteriovenous vascular bed.
Sodium nitroprusside is continuously pumped and is first converted into cyanide by red blood cells, and then converted into the terminal metabolite thiocyanate by rhodanese in the liver.
Thiocyanate is excreted by the kidneys, and its half-life in patients with normal renal function is 4 to 7 days. There is accumulation in patients with renal failure. If the dose is too high, the metabolite thiocyanate in the blood may be too high and poisoning may occur. "
"But the patient has no abnormal renal function." Professor Huang said, trying to recall the patient's test results.
"It didn't happen before, but now it does."