Back in 2002 as a doctor

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Zhou Congwen cut open under the xiphoid process, stretched his fingers in and touched the position of the patient's heart, then inserted the head of the sternum saw into it and pulled it upward to prepare to saw the sternum.

"Professor Zhou, don't worry, she's talking nonsense." Seeing that Zhou Congwen was silent, the anesthesiologist knew that he might be angry, so he tried to persuade him as a peacemaker.

"Oh." Zhou Congwen sighed deeply.

The equipment nurse was only angry for a while, and she couldn't fight with the patient's family, using Zhou Congwen as a blowing bucket.

Seeing that Zhou Congwen was depressed, she also knew that she was wrong, and said quickly, "Professor Zhou, I just said it casually, don't mind, what is going on."

"The heart is broken." Zhou Congwen said.

"..."

"..."

The equipment nurse and the anesthetist were startled, and it took a full 2 ​​seconds before they realized that Zhou Congwen was talking about surgery.

"Don't talk nonsense, open it and look. If your heart breaks, I will help you get dressed."

"You don't need to wear it, it's okay for you to wait for Professor Zhou to undress." The anesthesiologist laughed.

Chapter 0913 good teacher Zhou Congwen

"Don't make trouble." Zhou Congwen began to saw the sternum.

The driving speed in the operating room was very fast, but Zhou Congwen didn't dare to talk nonsense because he had just been swept in.

Now whenever there is a problem, the logical chain of being swept into the imperial capital, and then the boss fishes me out, hates me for not living up to expectations, and then chases me with a broom is established, and it is impossible to argue.

When the three of them become tigers, even if they know the truth, they will dismiss it and believe in more entertaining guesses.

The sternum saw buzzed, and blood foam and bone stubble flew up, which was blocked by Yuan Qingyao with dry gauze.

Then bone wax was applied to stop the bleeding.

"Professor Zhou, tell the truth, what exactly is the disease." The equipment nurse said, "When I saw the patient, I thought there was something wrong with your diagnosis, and I probably needed to open the chest for exploration. But seeing that you are doing surgery, you are really going to do a bypass, and you even split the sternum." ……real or fake."

"real."

"I don't believe it." The equipment nurse said, "If it's true, I'll have my sternum sawed."

"Don't mind." Zhou Congwen said, "This thing is too hard, you have to do gastrointestinal surgery after eating, what a trouble."

"It's as if the heart must have burst." The equipment nurse cheered herself up.

But she probably already knew that there was nothing wrong with the diagnosis, because Zhou Congwen was really splitting the breastbone.

"In vitro preparation, immediately... Forget it, wait a minute." Zhou Congwen said after sawing off the sternum.

"What are you waiting for, Brother Zhou?" Yuan Qingyao asked standing opposite Zhou Congwen.

"Wait for Director Vine."

"She will have surgery?"

"Let Director Teng see the anatomy of the heart with the milking blood flow under direct vision." Zhou Congwen said, "This opportunity is not many, so take a second look to deepen the impression. Wait until the next time Director Teng sees the milking blood flow again." , she definitely knew it was a broken heart."

"Professor Zhou, you are driving too fast." The anesthesiologist said with a smile, "Milk."

"Don't think about medical terminology." Zhou Congwen said with a smile, "What you're talking about is... Forget it, I'll talk about it after Director Teng comes in, or I'll have to say the same thing twice."

"Sister Zhao, go and call Director Teng, you will see the heart immediately." Zhou Congwen and the itinerant nurse said.

The itinerant nurse glanced at the operation area and saw that Zhou Congwen was still doing work such as stopping the bleeding of the sternum and applying bone wax, "Professor Zhou, I'm really confident."

"That is."

The itinerant nurse shook her head and chuckled, then turned and went out.

The sternum was opened, and a dark red hematoma was seen in the free wall of the patient's left ventricle.

"Here, this is where the heart ruptured." Zhou Congwen pointed at the location and said to the equipment nurse.

"It's really broken?"

The situation in front of her was completely different from what the equipment nurse had imagined. She looked at the dark red area in amazement and muttered to herself.

"Well, it's just that it was discovered earlier, and it's just right to deal with it now."

"Not a contusion of the heart."

"The patient has no history of trauma. Where did the contusion come from? Don't forget to eat the sternum saw. If you find it unpalatable, I will serve you some salad."

"cut!"

A few minutes later, footsteps were heard outside.

Teng Fei walked back silently, holding the preoperative signature book in her hand.

"Director Teng, this is what you saw during the operation." Zhou Congwen tapped the hematoma on the free wall of the left ventricle with a hemostat. "The image during the operation is called milking-like blood flow, also called milking phenomenon."

"Uh..." Teng Fei was a little confused.

Open the sternum and look directly at the patient's heart, which is much clearer than when she was undergoing surgery.

"Professor Zhou, wait a minute, I'm going to move a footstool." Teng Fei felt that her vision was not good enough, and she cherished the opportunity to witness the operation with her own eyes, so she hurriedly said to Zhou Congwen.

She moved a footstool over, condescendingly looked at the anatomical structure, but was thinking about what Zhou Congwen said.

Cardiac surgeons are natural circulatory interventional doctors, and they should do pci surgery most.

Because they can see the heart every day, they are familiar with the anatomical structure of the heart to the bone.

It's a pity that there are not so many ifs in reality, and we will not do this because of what is most suitable.

So Teng Fei cherishes this opportunity to look directly at her heart.

"The typical transient systolic stenosis we see in the angiography can be linear, bead-like stenosis or unclear development, or even no development at all, while the diameter of the diastolic period is normal and the development is clear. This phenomenon is called 'crowding'. Milking effect', also known as milking blood flow, milking phenomenon."

"It's better to open your chest to see clearly." Teng Fei murmured.

In her mind, she compared the knot after knot of blood flow during the radiography, and Zhou Congwen's description, and immediately had a deep understanding of the so-called milking-like blood flow.

"When this happens, there should be some symptomatic treatment to buy time for surgical intervention."

Zhou Congwen began to dissect the heart structure.

"Beta-receptor blockers are the first-choice drugs. Commonly used drugs include betaloc and bisoprolol, which slow down the heart rate and reduce systolic compression.

Then there are non-dihydropyridine calcium antagonists, which are used when beta receptor blockers are contraindicated, or when they are combined with coronary artery spasm.Commonly used drugs are Verapamil, Hexinshuang, etc., which can also slow down the heart rate. "

"Oh oh oh."

Medication is Tengfei's specialty. After hearing several drug names, she immediately knew what Zhou Congwen meant.

Once this happens, the heart rate needs to be slowed down to create time and opportunity for surgical intervention.

Zhou Congwen started to talk about pathophysiology, and performed surgery while talking.

Establish extracorporeal circulation, and open the heart after deep hypothermia.

The patient's anterior descending artery oozes blood and has clearly been torn.But the breach wasn't that big, so what I saw just now was a hematoma instead of the tragic scene after a heart burst.

In addition, Zhou Congwen established extracorporeal circulation in advance, all of which have made full preparations for the treatment.

The equipment nurse also understood what was going on when he saw this.

Why not use a small incision, because extracorporeal circulation should be established to minimize intraoperative bleeding.

If it was really a small incision... Although I don't know if Professor Zhou Congwen Zhou can do it, but extracorporeal circulation will definitely not be established, and it is not certain how much blood will flow after the heart is opened.

Professor Zhou's diagnosis level is high, and the operation is well done, and these equipment nurses all admit it.

But he was just too nagging, he talked about the rupture of the heart while performing the operation, as if an old professor in a medical school was teaching students about local anatomy in front of a general teacher.

Thinking of this, the equipment nurse looked up at Teng Fei.

Ordinarily, Teng Fei, the chief director of Circulatory Internal Medicine, might dislike Zhou Congwen's way of being a good teacher.

But Teng Fei was not bored, her brows and eyes were full of dignity.

Following Zhou Congwen's narration, she kept nodding her head, asked directly if she didn't understand something, and even accepted the status of student frankly.

Alas, Zhou Congwen is too young, just kidding, why did he let himself have a sternum saw.

While wiping the blood on the sternum saw, the equipment nurse thought to herself.

Chapter 0914 Hormone secretion after expectations fail

Zhou Congwen's operation was clear and simple, and looked unpleasant, but when he finished the coronary artery bypass surgery and was about to withdraw from extracorporeal circulation, less than two hours had passed.

This also includes time to prepare for surgery.

Both the equipment nurse and the anesthesiologist clicked their tongues again and again.

"Probably so." Zhou Congwen said happily to Tengfei even though the system task completion notification sound did not sound after the operation.

"Professor Zhou, I know this time." Teng Fei was also very relieved, but then sighed.

"What's the matter, Director Teng?" Zhou Congwen asked, and then he smiled, "Is there a problem with the patient's family?"

"Yes, hypocritical." Teng Fei said helplessly, "Before the operation, I explained to them that the heart ruptured, and I even carefully explained how it happened. But once something happens, the face of the patient's family is really ugly."

"Let's sign it." Zhou Congwen was also a little uncertain. He believed in Teng Fei's communication, and because emergency surgery didn't wait for anyone, he opened his chest first.

If the operation is completed but there is no pre-operation signature...it is not unsolvable, after all, it is an emergency operation.

But if that was the case, he would have to explain it to Han Chu and seek help from the medical office, Zhou Congwen found it troublesome.

"I signed it, but my family is very indifferent, and I'm a little unhappy." Teng Fei said.

"Normal, don't take it to heart." Zhou Congwen said flatly.

"I've been working for a long time, and I'm used to it." Teng Fei said, "Our medical industry belongs to the window industry, and we have seen too many people, so we don't take it seriously."

"Director Teng, have you ever been abroad?" Zhou Congwen suddenly asked an impossible question.

"Going abroad...been to Thailand and South Korea."

"Oh, there are very close exchanges between England and France. A year ago, there was a research group in psychology to study the problems that appeared among tourists..."

"..."

This topic flew straight to the sky.

Can there be problems with tourists' psychology, and it is an old capitalist country like Britain and France, where they have fallen in love and killed each other for hundreds of years.

"Because everyone found that the satisfaction of French tourists going to the UK is relatively high, while the satisfaction of British tourists going to France is relatively low." Zhou Congwen gossips while undergoing surgery.

It's just that his gossip is very serious, and if he doesn't drive, everyone has no interest.

"Why?" Teng Fei was taken aback, "I've been there a lot, and I think that's the way it is in the city of romance?"

"No." Zhou Congwen smiled while performing the operation, "It's not because of social culture, nor because of differences in economic development, but because of a strange reason—fishing boats."

"!!!"

"Take a fishing boat? Shouldn't it be a passenger boat? Their economy should be strong." The equipment nurse interrupted.

"Hehe, after research, it is found that most of the residents in the coastal areas of France make a living by fishing, so fishing boats often gather at the pier, causing the pier to be blocked.

Therefore, when British tourists come to the pier by boat, they can't get to the shore while looking at the pier that is close at hand.

What can be met but not sought, has caused the so-called aggressiveness to increase significantly.This is an objective fact that psychologists have just figured out. "

There was silence in the operating room.

It's normal to have an operation, drive, etc., but Zhou Congwen opened his mouth to gossip and even talked about psychological experiments, which is a bit too professional.

But it sounds like it makes a little sense.

"Through psychological research, experts put forward a theory - the frustration-attack theory, also known as the theory of blocked goals.

When we are about to reach the goal, the brain will generate satisfactory expectations in advance. Once the goal is reached, it will buffer the excitement of the brain and make people regain their sanity immediately.

On the contrary, if the perpetrator encounters obstacles in the process of action, the brain will generate strong anger, which will stimulate the body to secrete a large amount of hormones, and some may even lead to emotional loss. "

Teng Fei was speechless.

When Zhou Congwen said this, she finally understood what Zhou Congwen meant.

The family members of the patient hope that the patient will be safe, and have extremely strong expectations for this. Therefore, once the expectations are hindered, the brains of the family members of the patients will have strong anger, and the body will also secrete hormones accordingly.

This……