Gou is practicing medicine in the clinic

Chapter 272 God-like prediction, ultra-difficult interventional surgery
Li Jingsheng went to see Dr. Xu with the trophy and certificate of honor.

After some inquiring, I asked.

Dr. Xu treats patients in the emergency department.

He was not familiar with other parts of Qiaobang Hospital, but he was familiar with the emergency department.

I came here twice last time to help Dr. Shao Bing diagnose a difficult case.

When I came to the reception hall of the emergency department, I didn't see Dr. Xu.

Just as I was about to ask a nurse girl, a young doctor came towards me, holding medicines in his hand.

When he saw Li Jingsheng, he stared at him twice, and then a familiar smile appeared on his face.

"Is that Dr. Li?"

"Yes, may I ask who you are?"

Li Jingsheng confirmed three times and found that he did not recognize the young doctor.

Although he is said to be young, he should actually be about the same age as Li Jingsheng.

The youngest interns at Qiaobang Hospital are estimated to be 27 or [-] years old. For such a top tertiary hospital, the minimum academic requirements are at the master's level.

Even better departments recruit doctors, who are basically PhDs or above.

"I am Mao Dazhi, a physician in the emergency department. I had the honor to see you diagnose the little girl with Lyme disease last time, so I am particularly impressed by you."

Doctors are all highly educated people. They only admire two types of people: superior doctors or leaders who dare to take responsibility, and doctors with excellent medical skills.

Precisely because we are all professionals, we have a clearer understanding of where the other party is strong.

That little girl with Lyme disease was very difficult to diagnose.

Moreover, the family members were extremely resistant to the doctor at that time and refused to cooperate with many examinations.

In that very unfavorable situation, after Li Jingsheng took action, he not only changed the attitude of the family members, but also quickly made a major breakthrough, and finally found out the real cause of the disease.

These abilities left a very deep impression on Mao Dazhi.

"Haha, that's it! I feel honored to be remembered by you." Li Jingsheng said with a smile. "By the way, Doctor Mao, do you know where a patient named Xu Jiacheng is being treated? I asked about sending him to the emergency center, but your place is very big and it's really hard to find him."

"Is he the doctor who participated in the competition and was knocked out on stage?"

Good things don't go out, bad things pass thousands of miles.

The news that Dr. Xu was so angry has probably spread.

"Correct!"

Li Jingsheng's face twitched.

The mentor was so angry that he almost caused Professor Wei to be scrapped, which was considered a bad breath.

"He should still be in the emergency room. Who is he to you?"

Mao Dazhi asked.

"It's my teacher."

"Ah... I just made some mistakes and offended you, please forgive me. I'll take you there. Ordinary people can't enter the emergency room."

After learning that Dr. Xu was Li Jingsheng's teacher, Mao Dazhi realized that he had made a mistake.

As a remedy, he took Li Jingsheng into the emergency room.

A doctor from the undergraduate department called the door and it was opened immediately.

Li Jingsheng was able to successfully enter the rescue room.

There are many hospital beds here, and the monitoring equipment keeps making various rhythmic sounds.

Some patients even need to be put on a ventilator to stay alive.

People, what they are most afraid of is getting sick.

Here, no matter how prominent your status is or how rich you are, you still need to suffer the ruthless torture of illness.

"Sister Xiu, where is the doctor who participated in the competition?"

"Here, bed 7!"

The older nurse pointed to one of the emergency beds.

Dr. Xu had already put on a ventilator, his face looked extremely pale, and his eyes were slightly squinted weakly.

There is a finger oxygen clip on the finger.

My heart rate is pretty normal and my blood pressure is a little low.

Mainly respiratory diseases.Li Jingsheng's diagnosis of endometriosis was quite advanced, but he knew almost nothing about Dr. Xu's disease.

If you can show him the examination report, symptoms, medical history and other information, he may be able to discover something, but not necessarily.

"Teacher! I'm here to see you."

When Li Jingsheng saw Dr. Xu's miserable state, his heart was filled with panic and his nose was a little sore.

Dr. Xu's eyes opened slightly.

Looking at Li Jingsheng, he nodded slightly.

Unable to speak.

You can see there is still dried blood on the corner of his mouth.

"Teacher, you won the bronze medal, No. 3. I got the No. 1, and Dr. Jiang Yue got the No. 2. During the treatment of the patient, Wei Xianxian took risks and almost had a major accident, so he was treated coldly. ”

Li Jingsheng told Dr. Xu the great news.

After listening, Dr. Xu's blood pressure suddenly began to rise.

This is over excitement.

The monitoring equipment immediately sounded an alarm.

The older nurse immediately ran over after hearing this. After checking, she said fiercely to Li Jingsheng, "What did you say to the patient? His condition has just stabilized and he cannot be overly emotional."

Some patients have weak physical endurance, and great sadness or joy is not a good thing.

I wanted to cheer up Dr. Xu and relieve the knot in Dr. Xu’s chest.

I didn't expect such serious consequences.

"sorry Sorry."

Li Jingsheng apologized repeatedly.

"You have already visited, go and wait outside! The patient cannot receive any more stimulation."

The nurse rushed him out coldly.

Li Jingsheng glanced at the screen of the eye monitoring device and then at Dr. Xu. His nervous expression immediately became much more relaxed.

"Actually, I am also a doctor. Although my teacher's excitement caused his blood pressure to rise, it soon stabilized. His condition should improve quickly."

Li Jingsheng said confidently.

When the nurse heard this, she naturally scoffed at first.

A frivolous and ignorant boy appeared out of nowhere and said that the patient's condition was improving rapidly.

Almost as soon as Li Jingsheng finished speaking, the ventilator started alarming.

The nurse's face showed panic and she quickly checked.

"Doctor Luo, Doctor Luo, the ventilator in bed 7 is alarming. Come and take a look."

A 37-year-old male doctor walked over quickly, made some adjustments to the ventilator parameters after checking, and cleared the alarm.

"The patient's condition has improved significantly. If the improvement can continue, there should be hope that the ventilator will be removed soon."

Dr. Luo said with a hint of joy.

Doctors basically have the same expression when they see the patient's condition improving.

Just two words, happy.

"Just now...what you said was actually true." The nurse looked at Li Jingsheng with a look of disbelief on her face.

"I never tell a lie."

If Li Jingsheng doesn't even have this bit of judgment, wouldn't it be a waste of time?

"Can you not drive me away now?"

"As long as your behavior does not harm the patient, I will naturally not drive you away." The nurse's attitude towards him changed somewhat, her tone was no longer so cold, and her eyes no longer showed contempt.

"Thank you!"

Li Jingsheng stayed with the hospital bed and wanted to observe Dr. Xu's condition more to see what kind of disease it was.

When Dr. Luo heard that Li Jingsheng had predicted in advance that Dr. Xu's condition would improve, he also looked at him highly.

"Which hospital are you doctors from?"

"The second hospital!"

"Oh, I've heard that your hospital is famous for its bone-setting techniques. I have something to do over there, so I'll go ahead and stop saying irritating words to the patients."

When Dr. Luo heard that he was a doctor at the Second Hospital, most of his enthusiasm immediately disappeared.

He said hello and went straight to work.

Li Jingsheng stayed by the bedside and carefully observed Dr. Xu's condition.

Dr. Xu seemed to use a lot of effort when breathing.

There is obvious collapse of the chest.

Could it be that the tension in the alveoli is not good?

This is really hard to say.

Chronic respiratory failure is also possible.

However, respiratory failure generally does not cause vomiting or coughing up blood.

After observing for a while, he could not tell what kind of disease the teacher had.Finally had to try to find a nurse.Dr. Xu also needs more rest.

Knowing that Li Jingsheng won No.1 was enough to make him feel gratified.

Something happened to Wei Xianxian in the competition, and he didn't even rank. This made Dr. Xu extremely happy, and he let out a bad breath that had been pent up for many years.

It's just that no matter how great the good news is, it can't directly cure his disease.

Maintaining a good mood and sleeping well are indeed the best medicines, but to truly cure the disease, you have to rely on drugs and surgery.

Li Jingsheng came to the nurse, who was observing the patient's urination.

Some rescue patients require prompt intubation and catheterization after delivery.

Observing urine volume and urine color, and recording them in a timely manner will help doctors understand the patient's condition in a timely manner.

For example, hematuria or proteinuria are serious conditions.

"Beautiful teacher, do you know the cause of the patient in bed 7?"

"This is being investigated. Currently, it is only symptomatic treatment."

Hearing the nurse's answer, Li Jingsheng had no choice but to give up.

I originally wanted to check Dr. Xu's examination report, but I guess I can only wait until tomorrow.

Because Dr. Xu was here only a short time ago, he must not have done many examinations.

After coming out of the emergency room, he breathed a sigh of relief.

The teacher's physical condition is stable and his life is not in danger for the time being.But I feel that the cause of this disease is not simple, it is probably very complicated.

Maybe we can ask Lian Tao to help with the diagnosis at that time.

When Li Jingsheng returned to the game, the cardiovascular disease competition reached a critical stage.

What you can see on the screen is a guide wire traveling through the blood vessel.

This is the specialty of cardiovascular medicine. Looking at this situation, he should be preparing to deal with blocked heart blood vessels.

Due to cardiovascular sclerosis, plaque, and blood stasis, myocardial cells will soon die in large numbers.And the longer the blockage lasts, the worse the risk of myocardial infarction will be.

This is irreversible.

Many patients with myocardial infarction, even if they are rescued in time, will still have some sequelae after they are cured.

For example, obvious physical weakness, palpitation, shortness of breath and other symptoms may occur.

The projection that appears on the big screen should be the development on the screen in the interventional room.

The tiny guidewire makes its way slowly through the blood vessel.

You can see that there are many narrow areas on the inner wall of the blood vessels, and plaques must be present in these places.Hardening of the arteries is the main culprit in the appearance of plaque.

With Li Jingsheng's cardiovascular medicine diagnosis level and experience in diagnosis and treatment, it can be seen at a glance that this patient's cardiovascular disease has become extremely serious.

The segment of blood vessel that the guidewire wanted to unblock was completely blocked.

Time passed by minute by minute.

All the doctors in the room looked anxious.

But everyone knows that it is easier to see things than to do them.

If you want to clear the blocked blood vessel segment, you must first ensure that the guide wire can pass through smoothly.

Sometimes the guide wire will be blocked when it encounters a large plaque. Fortunately, the doctor who operates it is highly skilled.Although the guide wire was difficult to move forward, it was still moving forward little by little, passing through obstacles one after another.

At this time, the whole place became quiet.

Li Jingsheng's heart was also tightened.It can be seen that the guide wire finally reached the blocked blood vessel segment after a difficult "long journey".

Now as long as you can pass through it, insert a balloon, and expand and unblock the blood vessels, you can restore the smoothness of the cardiovascular system.

The guide wire worked hard to move forward, but the blockage was too serious.

Never been able to pass.

Judging from the exposed length of the guidewire, the approach should be from the femoral artery.

This is also a commonly used approach.

After many attempts, the surgeon failed to get the guide wire to pass through the blocked blood vessel segment, and finally had no choice but to give up.

This contestant had a very high level of placement and still failed.

Everyone could not help but lament the patient's eventual death.

There are many times when doctors are unable to do anything.

There are too many diseases that humans have not yet conquered.

Sometimes we can only watch as the patient's condition worsens and worsens, and eventually complications and death occur one after another.

"Unfortunately, none of the contestants from the People's Hospital and Qiaobang Hospital were able to get through this blockage of cardiovascular disease. At present, there is only the last contestant left, Professor Luo Binggang. He is a cardiovascular expert from Huairen Medical College in the Imperial Capital , he has successfully treated more than 4000 cardiovascular patients through interventional surgeries.”

As soon as the host finished speaking, the screen changed and a new blood vessel puncture point appeared.

It seems that the access chosen this time is no longer the femoral artery, but may be the radial artery.

What is he trying to do?
Li Jingsheng soon discovered that the access point was not the radial artery, but a small artery at the clavicle of the neck.

Under normal circumstances, larger arteries are generally chosen as the approach for catheter-based interventional surgery.

Professor Luo Binggang chose to approach through the small arteries in the patient's neck, which was the opposite.

Li Jingsheng's eyes were fixed on the screen without blinking. This kind of learning opportunity was very rare.

There were bursts of discussion in the venue.

Everyone is discussing why Professor Luo from the Imperial Capital chose a small artery as the approach?
Isn't this blocking yourself?
Although the distance from the femoral artery is long, the diameter of the blood vessel is large and there are almost no bends along the way, so it is often the preferred location for interventional surgery.

Why no one chooses the small arterial approach?
For example, this blocked cardiovascular artery seems to have entered from a small artery in the neck, very close to the blockage point.

But there are many detours and side roads.

If you are not careful, you will get lost in the plexus of blood vessels.

As you can imagine, any large blood vessel spreads out little by little like a tree root.

The large blood vessels branch off into secondary blood vessels, and then branch off from the secondary blood vessels into smaller tertiary blood vessels.

Just spread out layer by layer.

Director Luo chose to approach from level [-] or level [-] blood vessels. You can imagine how difficult it is to successfully reach the blockage point of the large blood vessels.

What is the purpose of this kind of thinking of giving up the easy and choosing the difficult?
It's definitely not a show off.

After Li Jingsheng thought about it carefully, he immediately thought of a possibility, because the lower end of the blockage point had already been tried.No matter whether it was accessed from the femoral artery or the radial artery, it could not be opened successfully.

Now choose the approach from the carotid artery, because I want to try it from the upper end of the blocked blood vessel segment.

If you change the direction, you might have a chance of success.

Sometimes, a blood vessel blockage is more like a tapered plug.

Entering from the lower end and trying to open it up, the further you push forward, the tighter it will become.

If you change the direction, you might be able to pass through the blocked blood vessel smoothly.

"Wow, so strong!"

This was the first time for Li Jingsheng to see a master of interventional surgery in the Imperial Capital.

The tiny guide wire is manipulated to advance rapidly through the patient's blood vessels, just like driving a navigation system, accurately bypassing curves and forks one after another.It doesn't matter if you make the right choice once or twice.

Being able to choose the right one every time shows that Luo Binggang is extremely familiar with the anatomy of this vascular plexus.

This is the real gangster.

You can probably tell the direction of every tiny blood vessel with your eyes closed.

I saw the guide wire cutting through obstacles all the way, and unexpectedly quickly reached the blocked blood vessel segment.

There was a burst of exclamation from the whole audience.

The guidewire advanced a little above the blood vessel, and when it passed through the middle blockage, it got stuck again.

It would be great if this patient could undergo interventional surgery before the blockage was completely blocked!

Now the difficulty of treatment has increased many times.

Li Jingsheng looked anxious for a while, only a little bit.

But just this little bit stymied the patient's hope of survival.

At this time, Li Jingsheng suddenly stood up and walked quickly towards a staff member.

"Take me to the intervention room. I might be able to give this contestant one last shot."

Li Jingsheng's massage techniques have advanced to a level of proficiency, and he has understood the secret of 'pulling tendons'.I can’t say it will definitely work, but at least give it a try.

If the experiment is successful, it may even become an innovation in interventional surgery in the future.

By combining massage and catheter intervention, it is possible to open up important blood vessels that are blocked.

"This……"

The staff hesitated.

It's obviously against the rules, and an accident happened not long ago, so safety control must be tightened.

"Stop doing this and that, take me there quickly! The patient's rescue is running against time. It's been so long. If we fail this time, I'm afraid there will be no chance for further treatment."

"Please wait a moment, let me ask the leader for instructions!"

After the staff asked the leader for instructions, the other party agreed.

However, several safety requirements are proposed.

Li Jingsheng is not allowed to operate guide wires or other operations that would cause catastrophic consequences to the patient.

Li Jingsheng hurried to the intervention room.

　I'm working overtime, the second update needs to be made up later, sorry everyone!bow!

　　
　
(End of this chapter)