I Can See Health

  Chapter 420 Missing Inspection Items

  The First Affiliated Hospital of Kyoto University, Cardiology Catheterization Laboratory.

   This is Lu Chen's second time here.

   He will be in the cath lab for the next month.

   As long as Lu Chen has participated in electrophysiological operations, all of them will be recorded in detail, including the degree of completion, difficulty and number of operations.

   "Lu Chen, you were actually sent to our catheterization lab?!"

   There happened to be a coronary intervention today. After Fang Ruzhang came to the catheterization room, he happened to see Lu Chen.

   "Yes." Lu Chen just changed into his surgical gown and was following his teacher, Xiao Shikang, the chief surgeon during the first stage of the assessment.

   "That's great. If you have any questions after that, I'll ask you." Fang Ruzhang had seen Lu Chen's level and admired it very much.

   The premature ablation of the epicardium in that hand is something that most people really can’t learn.

   "Are you here for coronary intervention?" Lu Chen watched Fang Ruzhang push the patient to the opposite coronary catheterization lab.

   "Yes, a patient in my hospital bed." Fang Ruzhang smiled, "But it wasn't me who did it, it was Director Wan who did it. This is a leader in the city, so Director Wan started it himself."

   "Director Wan does it himself?" Lu Chen smiled, "I guess Director Wan rarely has surgery now."

  Fang Ruzhang spread his hands, "There is no way, the leader asks, we can't do anything about it."

   Actually, professors at the level of Director Wan rarely perform surgery in person, and most of their energy is devoted to scientific research or administration.

   It is better to let some deputy directors of the department or senior attending doctors do it, and the effect of the operation may be better.

   After all, these doctors have been working in the front line for a long time and have developed their skills.

  Lu Chen and Fang Ruzhang chatted for a while, saw Director Wan Jingshui coming to the catheterization room, said hello and left.

  …

   At present, there are eight operating rooms in the catheterization laboratory, including six coronary intervention rooms and two electrophysiological intervention rooms.

   This is after the price reduction of cardiac stents, and an electrophysiological intervention room was temporarily added (the price of electrophysiological equipment has not been reduced yet).

  With the price reduction of domestic stents, the popularity of coronary intervention is also gradually waning.

  Many new scholars of cardiology intervention are between coronary artery and electrophysiology from time to time, and most of them chose coronary intervention in the past.

   But now, more and more people are learning about electrophysiological intervention.

   This is also the result of profit-driven.

  The doctor is also a normal person, and he must be going to places with more money.

   Therefore, high-risk departments, such as emergency department, pediatrics, have a large number of gaps every year.

  …

  Lu Chen's current job is very simple, waiting for electrophysiological surgery.

   As long as there is an electrophysiological operation, he will have the opportunity to take the stage as an assistant.

  When there is no surgery, he studies in the catheterization lab.

  Electrophysiological surgeries are mostly routine surgeries, except for a few surgeries that require the installation of a temporary pacemaker.

"Lu Chen, there is no surgery today, but two are scheduled for tomorrow. One is for a patient in the third area of ​​the heart, and one of them seems to have a pacemaker. , you can evaluate it later." Xiao Shikang came to Lu Chen's side and brought him a medical record folder.

   Any patient undergoing surgery needs to be well prepared before surgery.

   The most important point is to determine whether there is an indication for surgery. In short, it depends on whether the patient needs surgery.

   "Oh, good." Lu Chen nodded, took the medical record folder and read it carefully.

  A pacemaker, as the name suggests, is a machine that helps the heart beat.

When the heart is diseased and beating slowly, there is a problem with the heart pumping blood, and the blood cannot enter other organs in the body, such as the liver, kidney, brain, etc., ischemia and hypoxia in various organs, resulting in multiple organs failure, and even lead to sudden death.

   At this time, you need the help of the outside world. A device is placed in the heart to help it beat and maintain the normal blood supply of various organs. This is called a pacemaker.

  There are many reasons for bradycardia, the common ones are coronary heart disease, electrical conduction system disorder, endocrine disease, intracranial hypertension, in addition, there are some drug-induced bradycardia.

   "Mr. Xiao, I'll go to the third district in my heart to see this patient." Lu Chen looked through the medical records, but there was not much useful information.

   "Okay, let's go, you need to see the patient in person." Xiao Shikang nodded slightly.

  Lu Chen changed out of his surgical gown, put on a brand new white coat, and put a shoe cover on his sneakers, so he took the elevator to the third area in his heart.

  …

   Three areas in the heart.

   Yao Jie is sitting in the office, writing down the course records for the patients she manages.

"Junior sister, I have already taken the patient for you just now, you don't have to go." Wu Lang smiled and walked to Yao Jie's side, "This is a patient with bradycardia, it seems that he is here for a permanent pacemaker. I have contacted the teacher in the cath lab. You will talk to the patient and family about the risks of surgery."

   "Okay, thank you Brother Wu." Yao Jie said.

   Ever since Wu Lang knew that Yao Jie had a boyfriend, he was depressed for a few days, but then he thought about it, her boyfriend is from Beijing, and the long-distance relationship will not last long.

   He is now by Yao Jie's side every day, and there will be a chance one day.

  After all, the moon is the first to get a building near the water.

   At this time, Lu Chen came to the doctor's office in the third district of the heart.

   "Excuse me, for the patients with twenty-three beds, who is the doctor in charge of the beds?"

   Yao Jie heard this familiar voice and looked back in surprise. It was Lu Chen.

   "Senior brother, you...why are you here?"

  Wu Lang was stunned for a moment, then looked back, Nima, what happened to Lu Chen?

   He quickly moved away from Yao Jie.

  Lu Chen smiled and said, "I've been in the catheterization room of your hospital recently, the twenty-three beds..."

   "Oh, the twenty-three beds are new patients, and I am in charge of the beds." Yao Jie hurriedly glanced at the inpatient interface.

   "Well, this seems to be a permanent pacemaker. I'll go see him." Lu Chen said.

   "I'll go with you." Yao Jie stood up immediately.

  …

   Come to bed number 23.

  Lu Chen glanced at the patient, who was a 65-year-old mother-in-law.

   Her electrocardiogram was a sinus bradycardia, and when she was inactive, her heart rate was only 30-40 beats per minute.

   "Do you usually feel dizzy or faint?" Lu Chen asked.

  The old woman paused and said, "I didn't faint, but I often get dizzy, and sometimes my eyes get dark, and it's fine in a few seconds."

  Lu Chen nodded slightly. This symptom of dizziness was caused by the slow heartbeat, low blood pumping and insufficient blood supply to the brain.

   "There are obvious symptoms. At first glance, a pacemaker is needed." Lu Chen said to Yao Jie.

   "Well, brother, I will talk to the patient about the risks of surgery." Yao Jie nodded slightly.

   "Don't worry." Lu Chen waved his hand, "We need to complete the preoperative examination first..."

   Before Lu Chen finished speaking, the mother-in-law on the hospital bed said, "Doctor, I have already done it in the hospital below, so there is no need to check the blood again."

   "Did it in a tertiary hospital?" Lu Chen wondered.

   "Well, it's a tertiary hospital." The mother-in-law nodded, then took out a stack of test sheets from the bag she was carrying.

  Lu Chen took the test sheet, and the name of the hospital on it was indeed a tertiary hospital.

   At this time, Yao Jie also said: "Senior brother, the superior teacher said that he has been checked in other hospitals, and we don't need to check it here."

  Lu Chen nodded and didn't answer, but carefully read the patient's test sheet.

   for a long time.

  Lu Chen still shook his head and said to his mother-in-law on the hospital bed, "No, we still need to check blood! These laboratory tests are not perfect, we need to check a few more tubes of blood."

   Hearing this, my mother-in-law immediately became unhappy, "I'm here for surgery, why are you checking my blood? Wait, my son has gone out to park, and I'll call him to come over."

  Lu Chen smiled helplessly, it was useless to ask someone to come over!

   "Okay, your son is here, let him go to the office to find me." Lu Chen said, and then left the ward with Yao Jie.

   "Senior brother, didn't you say that this patient has proof of surgery?" Yao Jie asked in a low voice, "She has already done all these tests, why do you still need to do it?"

  Lu Chen paused and frowned, "What I said is, at first glance, a pacemaker is needed, but we need to rule out some other diseases. Didn't you read the test sheet that the patient brought?"

   "No..." Yao Jie whispered.

   "Let's not say anything else, there is one very important test missing." Lu Chen handed Yao Jie the test sheet that the patient brought, "Do you know what it is?"

   Yao Jie took the laboratory test sheet, flipped through a few sheets, and asked, "What's missing?"

  Lu Chen's eyes narrowed and he said, "thyroid function."

   (end of this chapter)