Clinically, diffusion MRI of the liver is rarely performed. Or not very little, but almost none.
Director Luo must have read the article in the New England Journal and knew how to determine the puncture location through nuclear magnetic diffusion.
But he was still not sure, so he had to listen to Zheng Ren himself to believe it.
"Thank you for your help, Director Luo." Zheng Ren said: "After the examination today, if there are no contraindications for surgery, the surgery can be performed tomorrow."
Because MRI diffusion is not a routine examination, patients generally do not bring relevant films to 912 for treatment, so a film needs to be taken before deciding on surgery.
In the past, patients admitted to the interventional department were treated in the outpatient department and were not admitted to the hospital first. The patients were allowed to undergo MRI diffusion in the outpatient department. Whoever finished the procedure first would be admitted first. In this way, the hospitalization period can be shortened as much as possible.
Director Luo raised his head, glanced at Zheng Ren, and asked, "You are familiar with Lao Chu, right?"
"We met when we first came to the Imperial Capital. Director Chu took good care of me." Zheng Ren said.
"Then you go to Lao Chu and take the patient to have the MRI done today. Remember to tell me about the surgery tomorrow and I'll go see Boss Zheng's skills." Director Luo said.
"Okay." Zheng Ren nodded.
He was not polite, nor did he have any inappropriate reaction because Director Luo asked him to take the patient for examination.
Director Luo has already talked about it this far. If Zheng Ren is still not satisfied, that would be too much.
"Go find Mr. Liu and show you the patient." Director Luo said.
Zheng Ren and Director Luo exchanged mobile phone numbers and WeChat messages before leaving the director's office.
Mr. Liu? The resident in the Department of Gastroenterology is named Liu.
Zheng Ren thought, came to the door of the doctor's office, and knocked on the door.
"Is Mr. Liu here?" Zheng Ren asked with a kind face.
"I am, what do you want?" A short, fat female doctor in her thirties looked up at Zheng Ren and asked.
"Hello, I am Zheng Ren from the interventional department. Director Luo asked me to come to you to see a patient with late-stage liver cirrhosis and portal hypertension who was admitted yesterday." Zheng Ren said.
"Oh, you are Boss Zheng." Mr. Liu said enthusiastically: "Please come in, please come in."
Zheng Ren walked in, smiling and acting extremely gentle.
"The patient is a 60-year-old woman with a history of liver cirrhosis for more than 30 years. Now her liver has shrunk very badly, but her liver function is not bad. Here are the indicators. Boss Zheng, please take a look." Mr. Liu found the medical record and handed it to Zheng Ren .
According to the test sheet, this is indeed the case. The patient's liver function is worse than normal, but it will not affect the operation.
"How much ascites?"
"Here is a CT scan of the abdomen. Take a look." The chubby Mr. Liu said.
Zheng Ren inserted the film into the reader and started reading.
With the reconstructed passive skill, Zheng Ren himself could determine the puncture point with a simple abdominal CT scan.
But if it is not systematic and has a strong personal style.
In other words, others cannot follow Zheng Ren's method to determine the puncture point of tip surgery, which is unrepeatable.
If it is not repeatable, it cannot be promoted.
The film showed that the patient's liver had shrunk by about 1/4 of its volume, the spleen was enlarged, and images of gastric varices could be seen.
The amount of ascites was not large for this degree of cirrhosis, and the patient controlled it well.
"A month ago, the patient went to a local hospital for vomiting blood and received emergency treatment. After his condition stabilized, the patient's family came to our hospital for treatment." Mr. Liu began to introduce the patient's medical history.
Zheng Ren just listened and carefully analyzed the patient's condition.
In fact, for simple cases of advanced liver cirrhosis and portal hypertension, Zheng Ren can completely stop doing it himself and leave this kind of work to others, and he can only be responsible for the surgery.
But the situation has just begun. Zheng Ren doesn't want to leave Director Luo with an arrogant impression.
And the most important thing is that Zheng Ren is not at ease.
Having been a doctor for a long time, Zheng Ren is the kind of person who can't hold two ounces of sesame oil in his belly. As long as the patient has some problems that are not solved, he may not be able to sleep well at night.
For example, for those difficult and complicated diseases, the patient may appear to be suffering from one disease, but it is actually another disease. If you want to perform surgery, you should first analyze it yourself and then compare it with the system template to try to be as foolproof as possible.
After listening to Mr. Liu's report, she took Zheng Ren to the ward to see the patients.
As soon as he entered the ward, Zheng Ren heard an elderly woman say: "Son, our family doesn't have much money. Seeing a doctor in the imperial capital is very valuable."
It was a gray-haired old man who looked on the phone, who looked at least ten years older than his actual age.
"Why don't we go back? I'll take some Chinese medicine and I'll get better soon."
The old lady said tremblingly.
As soon as she finished speaking, a roaring voice came from the phone next to her ear.
Zheng Ren didn't hear clearly what was said.
But the old lady was obviously timid. She was not that kind of tough person. She just listened to her son's words silently, her head slightly lowered, her gray hair scattered, and the sunlight filtered through, making black and white clear, like withered weeds.
Doctors generally don't care about this kind of housework unless they encounter extremely special circumstances.
Zheng Ren kept a gentle smile and stood at the bedside with Mr. Liu. He waited for the old lady to hang up the phone before starting the consultation.
At first, Zheng Ren did not ask directly, but chatted with the old lady about common things. For example, where is my hometown and how many people are there
The old lady's mood quickly calmed down, as if she had found someone to talk to, and she chatted a lot with Zheng Ren.
Mr. Liu was a little anxious. There was still a lot of work to be done over there. Once he was delayed here for half an hour, all the work would be postponed.
Zheng Ren felt Mr. Liu's mood and said with a smile: "Mr. Liu, you go and do your work first. I'll chat with Auntie for a while."
"Yeah." Mr. Liu nodded repeatedly, "I'm sorry, Boss Zheng, I have too much work."
"You go and do your work. After I finish asking what tests are needed, I'll go find you."
Mr. Liu apologized and quickly left.
Zheng Ren had nothing to do, so he continued to communicate with the patient.
When I was in Haicheng, this kind of job was always for Chang Yue. But when first dealing with the 912 Department of Gastroenterology, Zheng Ren still did it himself.
Soon, Zheng Ren learned about the patient's condition.
Her lover died early, and she raised a child by herself. The child is also not good at studying. He has been in society very early and often caused trouble.
When she first found out she had hepatitis B, she didn't go to the hospital for treatment. She just ate from separate bowls with her children to avoid infecting her son.
More than ten years later, symptoms of liver cirrhosis began. Due to family constraints, she was still not given treatment, but only took intermittent oral medications to control the activity of the hepatitis B virus.
She didn't know how the disease was progressing. When I had ascites, I thought it was because I was fat and had a big belly.
It wasn't until a month ago that I suddenly vomited blood one day, so I was hospitalized for rescue and a set of examinations were done.
The patient was diagnosed with advanced liver cirrhosis, portal hypertension and large amounts of ascites.
After a period of treatment, the ascites was much better. Her son began to look for medical advice everywhere, and finally found the 912 hospital.
I waited in line for a bed for nearly a month before I moved in.
Seeing Zheng Ren's kindness, the old lady took his hand and said, "My son, my son is not married yet. I don't make much money, but I have some savings, but hospitalization is too expensive..."
"Auntie, it's okay. You can get some reimbursement when you go back. The specifics depend on the local medical insurance policy." Zheng Ren comforted her.
"I'm fine, doctor. Please tell my son later that I'm fine. Just let me go back." When it came to money, the old lady began to wipe her tears again.
"Uh..." Zheng Ren couldn't help it. This was a systemic social project. What could he do
Maybe the surgery can be live-streamed to save the old lady some money
Give it a try, but many people can't accept the live broadcast of surgery.
Lu Xun once said, when I see short sleeves, I immediately think of white arms, immediately think of whole bodies, immediately think of ###, immediately think of ##, immediately think of hybridization, immediately think of illegitimate children. Only at this level can the imagination of the Chinese people make such a leap.
This is what the old man said about cheongsam. Even though a hundred years have passed since the Republic of China, it still seems to be timeless.
People will still think so about the live broadcast of surgery.
"Mom, I'm here." Zheng Ren was thinking about it when a rough voice came. Zheng Ren looked back, and the golden light almost blinded Zheng Ren.