This Doctor is Great

bed number 29,

A large group of doctors, like melon eaters, surrounded the 29 beds.

In front of him is Director Niu, and next to him is doctor Zhou Mo.

Other doctors continue to go out in the order of deputy director, attending doctor, hospitalization, and further training.

As for Huang Yiming, it's on the outside.

Huang Yiming was a little happy, because he was afraid that he would be asked. Now that he is outside, he should be able to get through it.

"Tell me about the patient's condition..."

Director Niu looked at Zhou Mo with the thought of taking the school exam in his heart.

Last night, Chen Bing, his student, called him on purpose, specifically talking about Zhou Mo, which made Director Niu interested.

Perhaps because he is about to retire, he is more willing to give young people opportunities and be more tolerant.

Zhou Mo nodded: "Yes..."

Then she began to describe the medical records of Grandma on the 29th hospital bed.

"29 beds, Wang Zhaodi, was admitted to the hospital at 3 pm the day before yesterday, the patient's chief complaint was ten years of refractory hypertension, and the pressure was measured at 150/90..."

"The patient's condition has the following characteristics: first, the patient's blood pressure has been changed several times, but the blood pressure has not been well controlled. Second, the patient has long-term headache symptoms."

"During the ward round yesterday, the patient was found to be in low spirits and asked about poor sleep at night, so he considered whether he had sleep apnea syndrome... So I started using the sleep apnea monitor at 9 o'clock last night, and the final result was... AHI value It is 25 times/hour, and the minimum blood oxygen saturation at night is 80%…”

"Considering that the patient has refractory hypertension for 10 years and the blood pressure is not well controlled, I have reason to suspect that one of the causes or the main cause of the patient is - nocturnal sleep apnea syndrome!"

"At present, consider trying to use a non-invasive ventilator at night to improve sleep at night, and at the same time carry a 24-hour ambulatory blood pressure monitor to see if the ventilator improves the condition of high blood pressure and headache..."

"I'm done."

Zhou Mo said everything very fluently.

Director Niu was a little surprised.

This medical student is somewhat of a level.

However, he didn't show it on the surface, but started the real exam.

"How much is her nocturnal urine?"

"It was 1800ml last night..."

"What about last night?"

"1500ml..."

Of course, Zhou Mo is very clear about the data, so he doesn't need to think about it at all.

Generally, this sleep apnea syndrome is accompanied by the clinical manifestations of hyperhidrosis and polyuria.

"Does the patient have a family history of apnea?" Director Niu continued to ask.

This kind of problem is generally easier to ignore, especially for newcomers.

Director Niu is testing Zhou Mo's care and understanding of sleep apnea syndrome.

It was still difficult for Zhou Mo.

Zhou Mo replied fluently: "I asked, there is no genetic family history..."

Director Niu was satisfied.

At this level, among the new medical students, it can be regarded as a good performance.

Then,

Director Niu asked a few more questions in a row, all of which were deeper knowledge points, just to test the school, and then Zhou Mo answered them clearly and quickly, showing his profound knowledge.

Director Niu was obviously very happy, and his interest suddenly increased a lot.

When I got interested, I started to teach my experience, and I talked about some strange hypertensive patients I encountered before...

For example, after a patient with a deviated nasal septum underwent corrective surgery, it was found that the high blood pressure that had accompanied many years disappeared suddenly...

These clinical experiences are undoubtedly invaluable.

"Ding... You listened carefully to the experience imparted by a cardiovascular specialist..."

The system sound rang.

"By the way, who is the other medical student?"

Suddenly, Director Niu, who was in high spirits, found that another medical student had not seen him.

Huang Yiming, who was happily paddling at the back of the crowd: "..."

The body froze violently!

Oops!

My pills!

She raised her hand tremblingly: "I'm here..."

Director Niu looked at Huang Yiming with kind eyes, and immediately saw Huang Yiming's guilty conscience, and suddenly lost the mind of taking the exam.

"Okay, 29 beds, just follow Zhou Mo's plan for the time being. If the blood pressure improves, gradually reduce other medicines..."

"Yes, Director!"

Huang Yiming was relieved to see that Director Niu didn't ask him a series of life-threatening questions.

But soon became a little dejected.

Don't ask yourself, this is obviously because of his poor performance, and the director directly ignores him.

For him, who has always been a scholar, this obviously makes him very disappointed.

…

After finishing the 29th bed, I didn't go to the 28th bed, because the most crucial coronary angiography was not done in the 28th bed...

Then go to other wards for rounds...

…

10 O'Clock,

The ward round brigade picked and picked and checked the 9 more important patients.

End the ward round.

All the doctors in the five groups dispersed in a hurry.

Zhou Mo returned to the 28th bed. The patients and family members of the 28th bed are no longer there. It is estimated that coronary angiography has already been done.

It took half an hour for the coronary angiography to get the results. Zhou Mo was not in a hurry and returned to the duty room to find a computer to change his medical records and doctor's orders.

As a result, looking around,

The computer has been occupied by others!

Use the computer peak!

I'm late!

Terrible!

Although there are already a lot of computers in the department, there are still not enough computers. Every time the peak period, they have to grab computers.

Zhou Mo could only take out his mobile phone and start reading.

After thinking about it for a while, Zhou Mo picked out a book titled "Famous Doctors Explain: Rehabilitation after Coronary Stenting" and read it.

Mainly to correspond to 28-bed patients.

…

…

After half an hour,

Soon, the 28-bed patient came back.

Zhou Mo glanced at the duty room, just as a senior brother left his seat.

Zhou Mo ran over and grabbed the computer.

Sit down, first open the medical record system of the 28 beds, and haven't seen the results of coronary angiography.

Then he opened the medical records of the 29-bed grandmother, began to modify the medical records, added the results of nighttime sleep apnea, adjusted the doctor's orders, and added non-invasive ventilators and blood pressure monitoring at night...

It will be changed soon.

Then open the medical record system of the 28 beds again.

The results of coronary angiography are out!

Zhou Mo took a look.

Surprised.

This coronary angiography found two problems.

Question 1: One of the coronary arteries is partially narrowed due to atherosclerosis, and the blood flow is insufficient, which should be the cause of angina pectoris and myocardial infarction this time.

Question 2: It is found that the position of the coronary stent, and the distal blood vessel, appear large and small, the blood vessel is relatively narrow, and does not match the diameter of the arterial stent.

Since Zhou Mo didn't have much knowledge of interventional surgery, he realized that this patient might have to undergo cardiac stent intervention.

And it takes two brackets... no, it's three brackets!

The first stent: The stenotic blood vessel that is the culprit of angina pectoris this time needs to be placed with a stent to open the stenotic blood vessel and restore normal blood flow. Or use another method: use a balloon to expand that section of blood vessel and replace the stent, but the effective time of this method is much shorter than that of the stent.

The second and third brackets: It is the place where there is a problem with the original bracket, there are two parts at the beginning and the end, one bracket on each side...

One heart, four stents?

sizzle~~~

Then, wouldn't this heart become a match heart?

.