When Xu Qiu appeared at the door of the conference room and calmly sat in the corner, Director Zheng suddenly had a bad feeling. The protagonist of this meeting is about to change... Sure enough, as Xu Qiu sat down, the main seat of the conference room naturally became the corner where he sat. "Everyone is here, let's start." Director Zheng calmed down and cleared his throat. Then, Niuniu's medical records and various examination results were presented to everyone. Director Zheng knocked on the table and said, "Although the patient's regurgitation is only moderate, she has left ventricular systolic dysfunction, and LVEDD is greater than 70mm. In this case, surgery must be corrected." The doctor in the imaging department nodded, "The surgery should be done as soon as possible. The key now is whether to repair the mitral valve or replace it!" Clinically, both methods can deal with mitral valve prolapse. However, there is no clear clinical evidence-based data on the advantages and disadvantages of these two methods internationally, and it is hard to say which one is better in terms of efficacy and safety. In Meiguo, a country with great authority in cardiothoracic surgery, they have conducted clinical research and concluded that:
There is no significant difference in the left ventricular end-systolic volume index, the main efficacy indicator of patients, after repair and replacement. However, the recurrence rate one year after surgery was about 30% in the repair group, while it was only in the replacement! Director Zheng also took this into consideration and suggested: "If there is no financial pressure, I would recommend mitral valve replacement." Many doctors in the emergency department shook their heads. Director Zheng raised his eyebrows: "Is it difficult?" He Hai touched his chin and said: "If the valve is replaced, the patient may not be able to afford it. Even if it is mechanical, replacing both valves, the cost of the operation alone may be close to 100,000." Director Zheng was also a little embarrassed and said: "How many people who come to the hospital are not short of money? Let them make up for it?" He Hai smiled bitterly and said: "Their conditions are more difficult than you think. A few days ago, it was the first time this child had ice cream in so many summers." The conference room fell into a brief silence. I don't know who sighed. Seeking medical treatment without illness is painful not only for the patient, but also for the doctor. Who can bear to see a desperate patient dying in front of him? Director Zheng read the examination report in his hand again and again, and finally said in a deep voice: "From the patient's condition, it is likely that a valve replacement is needed. To repair, the chest needs to be opened and then evaluated..." The discussion of the plan has reached a deadlock. At this time, a lot of eyes subconsciously glanced at Xu Qiu. Even Director Zheng put down the information in his hand and asked: "Xu Qiu, what do you think?" Valve replacement is easy for both patients and doctors. If you want to repair, I'm afraid you need both luck and skills. It's like a broken engine.
Replace with a new one, dismantle the old one, and then put the new one back in place and it can be used. But repair... is not a job that everyone can do. "Doctor Xu, what do you think?" "If the valve is replaced, the patient can only choose a mechanical valve, and after the operation, he will have to take warfarin for life... For a child, it is too cruel." "Yes, although the biological valve only needs to take anticoagulants for three months, it will have to be replaced again in about ten to twenty years, which will be a heavy burden at that time." "Everyone wants to do a repair, but it's not that easy. Without surgery, we don't know whether the valve can be repaired!" Everyone has different opinions. After Xu Qiu and others calmed down, he thought for a long time and said lightly: "The patient's symptoms are not serious, and the patient's physical development has not been seriously affected. The valve damage should not develop to the point where a valve replacement is necessary...Do a valve repair." Director Zheng's face was solemn. No surgery has been performed yet, and ordinary doctors dare not make such a clinical judgment... If it were someone else, the people present might still argue for a long time. But Xu Qiu had already conquered all the doctors in the cardiac surgery department with Kong Huixia's heart repair surgery. Even a stabbed heart can be repaired, Whether the valve can be repaired, others are not sure, but they believe Xu Qiu has the ability! "Okay, then prepare for the mitral valve repair first. The mechanical valve should be prepared in the operating room first." After Director Zheng finished speaking, he sat next to Xu Qiu and asked, "Are you still the main surgeon?" "Yes." "That's great... I'll be the assistant?" "Yes." Director Zheng smiled. Dr. Xu is still so frugal with words... ... Niuniu's surgery was finally scheduled for ten o'clock in the morning on the third day. Surgery on the heart, no matter how simple, is extremely dangerous. If you are not careful, if something goes wrong with the heart, there is basically no chance to make up for it. For example, this mitral valve repair surgery must be performed under extracorporeal circulation. That is, the heart stops beating, the body temperature drops to 25~26 degrees, and then the extracorporeal circulation machine is used to replace the heart to maintain blood supply throughout the body.
The longer the operation is delayed, the higher the risk and the worse the prognosis. In the past few days, Niu Niu also began to adjust her body. She started taking antibiotics that day to prevent infection. She took potassium chloride orally to overcome potassium deficiency. She corrected heart failure... She also gave her intravenous drips of glucose, insulin, potassium chloride solution, etc. to protect her heart muscle... The night before the operation. Liu Susu went to the ward as usual to prepare for a routine checkup before the operation for Niu Niu. At this time, a man with a limp leg and a painful face limped into the emergency department and shouted: "Doctor, help me, my leg hurts!" Liu Susu paused and took him to Fan Lei's clinic, which was on duty that day. "Why don't you send it to Zhou Hua?" Fan Lei was checking his cell phone and looked unhappy when he saw Liu Susu bringing someone here. "Zhou Hua has gone to deal with a patient with a foreign body in the rectum. You are the only one who is free." "Okay, okay, sit down. What's going on?" The patient's face was covered in sweat. He gritted his teeth and shook his head: "My feet hurt. It hurts so much. I can't touch it with water. It feels like I'm in pain when I walk on the ground!" After that, the patient takes off his shoes and shows his wounds. Fan Lei frowned immediately: "Don't take off your shoes yet, what do you do?" "I work part-time in a furniture factory." "Has that foot been injured?" "Yes, he was pierced by a nail!" Fan Lei nodded, without even looking at it, and said: "The laboratory department is off work. You probably have tetanus. I will give you symptomatic treatment first. You will go to the ward to stay. You will be admitted to the hospital during the day tomorrow, and then further examination will be done." ” The patient wanted to say something else, but seeing Fan Lei's impatient expression, he didn't dare to pester him and limped away. When there were only two people left in the consulting room, Liu Susu couldn't help it anymore and said, "Doctor Fan, you should check me out." Fan Lei didn't take Liu Susu seriously at all and said, "It's so obvious that you still need to check for tetanus?" "you……" "You are a doctor and I am a doctor? Do you want you to teach me how to treat a doctor?" Liu Susu was furious and said, "If you treat a doctor like this, something will happen sooner or later." Fan Lei almost laughed out loud. He waved his hand and drove Liu Susu out of the consulting room. Liu Susu was still a little worried, so she ran over and took a look at the patient's wound. There was indeed a gash overflowing with pus. It was so deep that even the injured toe was a little gray.
"It does seem to be tetanus..." Liu Susu muttered, and then told the patient: "Hurry up and call a family member to come over and stay with the bed, preferably three." "Nurse, three, three?! Why do we need three people to accompany us?" The patient couldn't understand.
