This doctor has a system

Chapter 271 260. What have you been doing so long ago?

Soon, Cui Shengmei's husband brought over the results of previous examinations. Last year, she had a cranial magnetic resonance examination and several cranial CT scans.

Because of his high-level reading skills, Gao Feng reviewed the imaging examination first.

The results left him somewhat disappointed, as there were no valuable discoveries at all.

Asked about the medical history again, it was found that Cui Shengmei suffered from recurring hemispheric head pain, also known as migraine. This disease is more common in young and middle-aged people and women.

The characteristics of the disease include severe pulsating headache on one or both sides, which mostly occurs on one side of the head. It may be combined with symptoms such as nausea, vomiting, and fear of sound and light stimulation.

The cause of migraine is complex, and genetic factors, nerve cell excitability disorders, endocrine and metabolic factors can all contribute to its occurrence.

"Sister Cui, are there any triggering factors when you usually have headaches? For example, when your elder brother makes you angry." Gao Feng asked.

"How could I make her angry?" Cui Shengmei's husband exclaimed, "Everything in the house that can breathe must be obeyed by her."

It can be seen that the eldest brother's family status is not very high.

"Don't listen to his nonsense!" Cui Shengmei retorted, "I usually worry about the small things and listen to him about the big things."

"So what is a small thing and what is a big thing?" Dong Qianqian asked.

"I have the final say whether it's a small matter or a big deal." Cui Shengmei said.

No wonder you have a headache, everyone thought.

"Teacher Gao, here is a cardiac color ultrasound." Li Xun handed over a report sheet, "It says patent ductus arteriosus."

"Patent ductus arteriosus?"

The ductus arteriosus was originally the normal blood flow channel between the pulmonary artery and the aorta in the fetal period. Due to pulmonary respiratory dysfunction at this time, the pulmonary artery blood from the right ventricle enters the descending aorta through the ductus, while the blood from the left ventricle enters the ascending aorta. The ductus arteriosus is necessary for the special circulation pattern during the embryonic period.

After birth, the lungs expand and assume the gas exchange function, and the pulmonary circulation and systemic circulation perform their respective duties. Soon the duct closes on its own due to disuse.

It's the same as with people. If you don't use him or pay attention to him for a long time, he will become autistic over time.

But some people have a stronger heart. They are not autistic, and no one can do anything to them.
This is the case with patent ductus arteriosus, hey, I just don’t close it, I just play!

In this state, it is best to perform surgery to interrupt the blood flow.As a common congenital cardiovascular malformation, it accounts for 12% to 15% of the total number of congenital heart diseases, and is about twice as common in women as in men.

"At that time, the doctor said that her condition was relatively mild, so she did not perform surgery." Cui Shengmei's husband explained.

The clinical manifestations of patent ductus arteriosus mainly depend on the amount of blood flow from the aorta to the pulmonary artery, as well as whether secondary pulmonary hypertension occurs and its degree.In mild cases, there may be no obvious symptoms, while in severe cases, heart failure may occur.

Cui Shengmei's blood volume from the aorta to the pulmonary artery was relatively small.

"That's wrong!" Gao Feng said.

"What's wrong?" The patient and family members suddenly became nervous.

"The anatomical structure of the interatrial septum and the blood flow shunting in the heart are not right. There should be other problems combined."

"By the way, it's not a patent foramen ovale, right?" Gao Feng suddenly felt blessed. "Sissi, do another cardiac ultrasound examination on her. I suspect that the patient has patent ductus arteriosus + patent foramen ovale."

The foramen ovale is a physiological passage between the interatrial septum of the heart during the embryonic period. Under normal circumstances, the baby fuses around 2 months after birth. If it fails to fuse after one year of age, it will form a patent foramen ovale (PFO).

Most people may not pay attention to this disease, but you may be suffering from this disease while lying in bed reading a novel.

That's right!

As one of the most common congenital heart anomalies in adults.It is estimated that 4 in 1 adults is diagnosed with this disease.

Guys, are you in a hurry?But I advise you not to rush yet.

Because theoretically speaking, even if the foramen ovale is patent, under physiological conditions, it will generally not cause abnormal blood shunting or small shunting volume, and the patient will not develop symptoms.

However, when the patient's right atrium pressure exceeds the left atrium due to various reasons (such as strenuous exercise, coughing, diving, etc.), patent foramen ovale can cause obvious right-to-left abnormal shunting of blood flow in the heart, or it may be temporary, or continued.

This causes related clinical syndromes such as unexplained stroke, migraine, decompression sickness, recumbent breathing-orthostatic hypoxemia, etc., and corresponding symptoms begin to appear, including unexplained headache, dizziness, dyspnea, or limb weakness.

Therefore, if you have symptoms such as unexplained headache, dizziness, difficulty breathing or limb weakness, you should go to the hospital in time to consider the possibility of patent foramen ovale and conduct relevant examinations.

Soon, Cui Shengmei's cardiac color ultrasound showed that the patent ductus arteriosus was about 2.5mm, and she also had a patent foramen ovale.

"About 1/4 of the population has headaches, 9.3% of which are migraines. Multiple domestic and foreign studies have shown that 46% of migraines can be completely cured after percutaneous closure of migraine complicated by patent foramen ovale (PFO) , 83% of migraine symptoms can be significantly relieved. Therefore, some headaches may be caused by our heart defects." Gao Feng explained to the patient.

"In your current situation, I suggest you perform patent foramen ovale closure."

Cui Shengmei and her husband were both a little excited, "Doctor, are you sure?!"

"Annoying headache: You helped Cui Shengmei find the real culprit who has troubled her for nearly 20 years. Your outstanding performance is shocking! You received 10 skill points."

"I'm 90% sure." Gao Feng, who was endorsed by the system, gave Cui Shengmei a relatively definite answer.

He didn't dare to say 100%. Medicine is a complicated thing. If the patent foramen ovale sealing operation goes wrong, the patient would just bring trouble to himself if he used this as an argument.

"Then when can I have the surgery?" Cui Shengmei was very anxious, "Will you do it for me or go somewhere?"

"Don't worry, we need to wait until the lung infection is under control." Dong Qianqian said, "We can contact the cardiology department in advance and ask the doctor there to come over and formulate a surgical plan."

Gao Feng made a call to Director Xin Guoyu of the Department of Cardiology. He was not in the hospital at the moment and asked Qu Mengqi to come over and see the patient.

"We can do a percutaneous puncture for patent foramen ovale closure + patent ductus arteriosus closure." Director Qu communicated with the patient, "It's not urgent. I'll wait until the condition of your lungs gets better before transferring." Bar."

It was an elective surgery anyway, so there was no rush. Qu Mengqi was very relaxed.

After he took care of the patient, he chatted with Gao Feng for a while, "You don't know, Lao Xin has been shaking recently."

"He often went to other places to throw knives and so on. The surrounding counties and cities were visited by him."

"Good guy, your career will be rejuvenated immediately!"

"Is it that exaggerated?" Gao Feng laughed.

"That's it. The main reason is that everyone is still not familiar with this catheter-based aortic valve catheterization, so they all want to ask him to teach." Qu Mengqi explained, "There are hospitals in several surrounding provinces that have contacted him."

I think so too, and he feels envious in his heart.

Hu Jiaran just got out of the taxi. Today he came to his boss to report on the progress of the project and to inquire about his new ideas.

Li Youliang was waiting for him at the gate of the community. As he walked over, the latter greeted him.

"No, you came empty-handed?" "Ah?" Hu Jiaran was stunned for a moment. He always came empty-handed before, okay?Have you changed the rules now?
"The boss's wife is pregnant and now likes to eat durian." Li Youliang said, "The last time I went to their house, I saw that the boss's mother-in-law said that eating too much is bad for your health."

"Then buy some!" Hu Jiaran pulled him away.

As we all know, there are three major types of legal gambling in modern times: hair perming, marriage, and buying durian.

Hu Jiaran and Li Youliang chose three items at once, and finally chose three items uncertainly, "Boss, is there a discount if we buy three items?"

"Well, I can give you 5 yuan cheaper." The boss said calmly.

"Five yuan? Who are you looking down on? You still sell it so expensively!" Hu Jiaran was unhappy, "Well, I'll give you a number and you can see if it works."

"What do you say."

"20?"

"Okay." The boss turned around and went to get the thick bag.

Fortunately, I have money now, otherwise I will die of pain, Hu Jiaran thought to himself.

The scariest thing about shopping is that you nervously say a price, and then the boss agrees without even being embarrassed.
"If he pretends to be embarrassed, I might feel better." Hu Jiaran said to Li Youliang, "This boss's professionalism is not very good."

"Stop talking, the last one I bought was more expensive than you, and it's not cheaper for me yet." Li Youliang said.

Gao Feng was very happy to see Hu Jiaran coming, "I was talking about going to your place. How far is our project? Now I have another good idea!"

"I'll tell you."

Although I didn’t understand it, I was shocked!Hu Jiaran said finally.

"It's just that we don't have enough manpower. If we start from both ends rashly, maybe," he said euphemistically.

"Then let's wait until this project is completed." Gao Feng followed the good advice.

Great, this trip was not in vain, the painter was very happy.

"When I get back, I'll speed up and try to get the finished product by the end of this month!"

Hu Jiaran suddenly felt like a thunderbolt. According to estimates, the finished product should not be released until next month. A month ahead of schedule?

Concubines can't do it!

"Is there a problem?" Gao Feng asked with concern.

"No!" Hu Jiaran showed an expression that was impossible, "I will lead everyone to work overtime when I get back!"

"Yes." Gao Feng was very satisfied. He was now more and more satisfied with Hu Jiaran.

"By the way, Qi Huiren from Xinhua Pharmaceutical brought me a gift last time. I don't need it here, so I'll give it to you." He handed Hu Jiaran a small box, "I see you still need a watch. "

"Jiaran, this watch is over 10,000!" Li Youliang smiled after leaving Gao Feng's house, "Why don't you look happy?"

"When I get back, I have to ask Manager Zhao to recruit new people quickly. I'm really afraid that my subordinates will die suddenly if we keep up with the progress." Hu Jiaran said with a bitter smile, "I'm under too much pressure!"

"Then you didn't say it just now?"

"I don't dare." Hu Jiaran said, "Brother Youliang, how about you?"

"roll!"

One week later, Dong Qianqian re-examined Cui Shengmei's chest CT. The absorption was very good, and the patient could not wait any longer.

Gao Feng had never seen patent foramen ovale closure + patent ductus arteriosus closure, so he was ready to learn more when he had time, which was greatly welcomed by Qu Mengqi.

"This is still a bit difficult. The arterial catheter with a diameter of 2.5mm is indeed too thin, and is similar in diameter to the guide catheter we use during surgery." Director Qu introduced.

"Then what are you going to do?" Gao Feng asked, "Does this require precise guidance from esophageal ultrasound?"

"What?" Qu Mengqi was stunned for a moment.

"Did I say something wrong?" Gao Feng spent a full 8 skill points on the documents he read in the system space last night, and he felt that he understood the principles and operations of this surgery.

"We mainly use radiation and contrast agents." Qu Mengqi explained, "Ultrasound is sometimes used during the operation." He hesitated.

"Have you ever seen someone do it simply under ultrasound guidance?"

"I've seen it before." Gao Feng replied. He had really seen it in the system space.

Seeing how crisply he answered, Qu Mengqi felt a little unconfident, so he quickly made a call to an expert.

He is a real expert, not a fool.

"Professor Shan? I'm Xiaoqu, yes, yes, yes, I have a question for you. It's like this."

"No rays, just ultrasound guidance. That's right! Or is it a conventional surgery? Yes, OK, I understand. Thank you, Professor Shan."

After hanging up the phone, Qu Mengqi fell into deep thought. Professor Shan said that he had never heard of any hospital in China that only used ultrasound guidance when doing this.The other party is very authoritative in this area and can teach on it during the National Heart Annual Conference.

"Do you want me to tell you in detail?" Gao Feng said.

"Is this okay?" Qu Mengqi suddenly felt a little excited.

This technology has not yet been developed in China. If I...
Oh my god, I don’t dare think about it!
Thinking about Lao Xin who was throwing knives everywhere now, Director Qu couldn't help but cheer up, "Professor Gao, just teach me step by step! I will be your apprentice from now on!"

The effect of surgery under pure ultrasound guidance is not necessarily better than that under X-ray, but it has a huge advantage, that is, it can avoid taking radiation.

Patients can avoid taking rays, and surgeons can also avoid taking rays. The former is actually not important, because taking rays once in a while will cause little damage to the body, but it is different for the latter.

If the cath lab doctor who has been exposed to X-rays for a long time knew that this kind of technology existed, he would probably jump up on the spot and say, "Why did you go there earlier!"

"What have you been doing so long ago?"

Director Tang of the Department of Cardiology is currently in this state. He is bald and looks very funny with his big, beady eyes.

"I will retire in two years, and now you are telling me that ultrasound guidance alone is enough?!"

"It's so hurtful!"

"This is Director Tang Quanan of our department. The first patent foramen ovale closure in the hospital was performed by Director Tang." Qu Mengqi introduced to Gao Feng.

　Brother, please remind me if there are typos. I found that someone’s name was written wrong in front of me.
　　
　
(End of this chapter)