When doctors have a simulated operating room

After hearing what Tian Ming said, Zhang Yi and Lu Jing looked at each other.

So there is this meaning?

Coronary atherosclerosis, referred to as coronary heart disease.

The arteries and veins connected to the four ventricles and atria of the heart flow to the whole body and are blood vessels that supply blood circulation to the entire human body.

The coronary artery is a small blood vessel that specifically supplies blood to the heart and wraps around the heart.

It is distributed on the periphery of the heart and fits tightly to the heart wall like a net.

Once a thrombus appears in the coronary artery and blocks the blood vessel, the myocardium will be ischemic.

Once ischemic, the entire myocardium is prone to obstruction and necrosis.

So this is why coronary heart disease is prone to myocardial infarction.

There is a very typical symptom for the precursor of myocardial infarction.

That is, angina pectoris will occur before the infarction develops.

If found, seek medical attention immediately.

The coronary artery is not as large as other blood vessels in diameter, it is very small.

Under contrast imaging, the black blood vessels are about the same thickness as toothpicks, and even the end blood vessels are thinner than toothpicks.

The formation of blockage is usually caused by chronic diseases such as heredity, hypertension, hyperlipidemia, and hyperglycemia.

In general, interventional thrombolysis is used for coronary heart disease.

Within six hours.

Clearing the blood flow of the coronary artery and restoring myocardial blood supply can ensure most myocardial function.

If it is like the veteran mentioned by Tian Ming just now.

In addition to infarction, he also has ventricular aneurysm.

Then the surgical plan has to be changed to open chest.

Perform bypass surgery and remove the myoma.

Ventricular aneurysm is a necrotic myocardial cell that is gradually replaced by fibrous connective tissue after myocardial infarction and gradually protrudes outward.

This necrotic tissue will fall off by itself after a long time.

Once it falls off, it is easy to cause blockage of other large blood vessels.

So this small ventricular aneurysm should never be underestimated.

The problem now is.

This old man is old, and the elasticity of his blood vessels and his body resistance are weakened.

If he undergoes open-chest surgery, the failure rate is extremely high.

It is very likely that all the blood vessels will be broken with one cut.

Or the body cannot withstand such a large operation as opening the sternum, and the recovery is extremely poor, etc.

The doctors at Ping An Hospital want to make the operation safer.

And also to allow the old man to participate in the military parade.

So they want to take this opportunity to invite Professor Jin to take a look.

After Tian Ming said this, Zhang Yi was actually very curious about the old man's situation.

Zhang Yi had previously drawn a coronary artery bypass surgery.

He even drew a cardiology interventional therapy.

It's just that there has been no opportunity to practice the technology recently.

Zhang Yi thought for a while and said:

"Director Tian, ​​can you take me to see this old man later?"

Tian Ming turned his head and looked at Zhang Yi in surprise.

Only one thought came to his mind!

That is, Dr. Zhang would not want to say that the surgery of this 93-year-old veteran...

Can he do it?

No way!

He admitted that Dr. Zhang was very good at general surgery and appendectomy.

He admired him very much.

But...

This veteran is in cardiac surgery.

It's impossible that he can also do cardiac surgery, right?

Tian Ming shook his head and thought:

Impossible!

It's impossible for such a young doctor to perform cardiac surgery!

But, it shouldn't be a big deal to just take a look.

After thinking about it, Tian Ming agreed:

"Okay, I'll take you to see the patient's condition first. However, the old soldier is of a special status, so we have to respect him."

Zhang Yi nodded: "I understand."

Lv Jing listened to the conversation between the two quietly.

Thinking: This is good, Zhang Yi is going to start his pretentious journey in Ping An Hospital again.

Director Tian probably doesn't know this.

Zhang Yi...

He can even do cardiac surgery!

One and a half hours later.

Tian Ming looked at the watch on his hand and said to Zhang Yi:

"Let's go, Doctor Zhang, let's go see the old soldier patient first."

Zhang Yi nodded, said something to Lu Jing next to him, and followed Tian Ming.

Inpatient Building No. 1, 8th Floor.

Tian Ming had no problems with facial recognition all the way.

Although Zhang Yi looked unfamiliar, no one dared to say anything following Tian Ming.

In large hospitals, the positions of directors and deputy directors are very high.

Walking to the door of a VIP ward, Tian Ming reached out and knocked on the door.

The nurse who was taking care of the elderly opened the door.

"

"Doctor, you are here." The nurse said politely.

Tian Ming nodded.

In the ward.

In addition to the old man.

There was only a middle-aged woman in her fifties and a nurse in her early forties.

"Doctor, how is the situation? Will Professor Jin come to operate on my father?"

The woman in her fifties asked hurriedly.

Tian Ming nodded:

"Don't worry, Professor Jin will come soon."

At this time, Zhang Yi had already walked to the bed of the old soldier.

At the age of 93, the old soldier's entire facial skin has become sunken and old and dull.

However, after a thrombolysis and the drug treatment in the past few days.

The old man is in good spirits.

Seeing a doctor coming in, he also knew who it was.

He also opened his mouth and gently called out: "Hello, Doctor. "

The old man didn't wear dentures, so he could only speak with his mouth open.

But Zhang Yi still understood.

He said, Hello, doctor.

Zhang Yi smiled at him and replied, "Comrade Qin, hello to you too. ”

This old man is well taken care of.

His physical condition is also good, and he doesn’t have Alzheimer’s disease.

Although he has many chronic diseases.

The most serious problem that threatens his life is coronary heart disease.

Zhang Yi observed carefully.

The blockage of the old man’s coronary artery branch is caused by blood clots and fat thickening of the blood vessel wall.

Now the blood clots have been melted.

But it is not enough, the problem of thickening of the blood vessel wall has not been solved.

There is still a possibility of blockage again in the future.

If at this time, a stent is added to open the blocked blood vessel, then the operation is completed.

But the problem is not that simple.

The elasticity of the blood vessels around the old man’s heart disappears and blockage occurs again.

After adding the stent, if the small blood vessels cannot withstand the pressure and rupture, the problem will be even bigger.

So only bypass surgery can be considered.

That is, looking for the whole body A section of intact blood vessel for transplantation.

Graft this intact blood vessel to the coronary artery.

Ignore the blocked blood vessel and directly build another pathway for blood.

In this way, the myocardium will regain blood to maintain nutrition and power.

But now the problem is here.

To do a bypass, you have to open your chest.

And at the same time, you have to remove the ventricular aneurysm.

Opening your chest is very risky for this old man.

You have to consider recovery, infection, grafted blood vessels, etc.

It is even unknown whether the removal of ventricular aneurysm will have an impact on the old man's heart.

The doctors at Ping An Hospital sincerely hope that the old man can get better.

So they took this opportunity to invite authoritative experts in this field to take a look.

The old man asked the nurse to put on his dentures, and then looked at Zhang Yi and Tian Ming and said:

"Doctor, when can I have surgery?

I'm in good health. I just had chest pain before. My third daughter-in-law was so nervous that she had to send me to the hospital.

I have been in the hospital for so many days. You see, I am much better now. I can have the operation now. "

Tian Ming shook his head:

"Don't worry, old man. We have to think of a foolproof way to operate on you."

The old man nodded and said:

"Yes, yes, I will still listen to what you doctors say, but I hope I can have the operation and be discharged as soon as possible. I must go to participate in the military parade."