I Can See Health

   Chapter 424 Lu Chen, don't be left behind!

  Xiao Shikang also understood the seriousness of the matter, and immediately contacted the CT room, and then communicated with the patient's family about the condition.

   "Our family is here to perform atrial fibrillation ablation surgery. Why did so many problems suddenly disappear?"

   The patient's family is a middle-aged woman. She listened to Xiao Shikang's words in a foggy manner.

   "It doesn't mean that there are so many problems after the operation." Xiao Shikang explained patiently, "We considered that the patient had so many problems before the operation, but during the operation, we happened to find it!"

   "Then what to do next?" The middle-aged woman frowned.

   "Go out for an examination immediately. Only after the diagnosis can be made, the next step of diagnosis and treatment can be done." Xiao Shikang said.

   "Do you have no suspected diagnosis now?"

   "Considering the rupture and hemorrhage of liver mass, we still don't know the cause of pericardial effusion." Xiao Shikang paused.

   "Liver occupying space, liver cancer?" The middle-aged woman was stunned. She knew some medicine, but it was only a little bit of skin.

   "Not sure yet." Xiao Shikang shook his head.

   "Well, then, let's go out for an examination." The middle-aged woman compromised.

  …

   With the consent of the patient's family, Xiao Shikang immediately sent a doctor out to accompany the examination.

   While Lu Chen stayed in the catheterization room, he continued to read the patient's medical records.

  The patient's current information is not perfect, only the recent medical history, as for the past history, it is very vague.

   "That's right! The patient should have been taking anticoagulant drugs!" A light flashed in Lu Chen's mind.

   The patient is now undergoing ablation of atrial fibrillation.

  Patients with atrial fibrillation need long-term anticoagulants, warfarin or Xarelto.

   The side effect of anticoagulants is bleeding!

   Is it because of long-term anticoagulation that the patient has bleeding in each serous cavity?

   Just after Lu Chen thought about it, the CT room sent back news that the patient's abdominal CT was done.

  Xiao Shikang immediately found an idle computer, turned on the computer imaging system, and called up the abdominal CT image.

CT results showed that the patient had two cystic low-density shadows in the left lobe of the liver, small foci of hemorrhage, and thin-wall enhancement. In the arterial phase, there was obvious intramural enhancement of small nodules, and in the portal venous phase and delayed phase, support enhancement was equal to that of the liver parenchyma. There was no enhancement of the cyst contents, and the adjacent gastric cavity was compressed.

  The diagnosis given by the doctor in the CT room showed that the liver cyst was complicated with hemorrhage, but tumor metastasis was not excluded!

   Seeing this, Lu Chen already had an idea in his heart.

  The diagnosis made by the doctor in the CT room is simply by looking at the abdominal CT.

   But the real clinical diagnosis is not just relying on a CT film.

  Xiao Shikang frowned after reading the patient's image: "It seems that a liver cyst ruptures and bleeds!"

However, Lu Chen shook his head, "I think it looks like a tumor metastasized liver cancer splitting and bleeding. The tumor not only metastasized to the liver, but also metastasized to the pericardium, otherwise the source of the pericardial effusion cannot be explained. In addition, the patient's oral anticoagulant, may also be involved in the development of the disease."

After listening to Lu Chen's explanation, Xiao Shikang was also stunned.

   Such an explanation is not unreasonable!

   However, what surprised Xiao Shikang most was Lu Chen's clinical thinking mode.

   In addition to his excellent interventional surgery ability, I did not expect his clinical diagnosis and treatment ability to be equally excellent!

   "Well, it also makes sense. However, the first task at present is to stop the bleeding!" Xiao Shikang said.

  Lu Chen nodded slightly.

   Now it doesn't matter what causes the liver rupture and hemorrhage.

   Although the patient's current symptoms are not severe, they may develop further at any time.

   The trend of the two minus signs on his head just confirms this state.

  …

   The patient did not return to the cath lab of the Cardiology Department, but was directly sent to the surgical operating room.

   In the developing stage of liver rupture and bleeding, stop it in time!

  Otherwise, once the bleeding is severe and shock is caused, the operation will be too late.

   This little episode in the catheterization lab did not affect the normal operation of other operations.

   However, Lu Chen did not have a single operation all day.

  Today is the second day he came to the catheterization lab.

   The number of surgeries is still zero!

  Although there are many electrophysiological surgeries, these are the only surgeries arranged for Lu Chen.

   In the next time, Lu Chen followed Xiao Shikang and observed several other surgeries.

   "Don't worry, there will be another operation tomorrow." Xiao Shikang smiled, "You can start tomorrow."

   "Yeah." Lu Chen nodded, but he was not in a hurry. For things like surgery, high quality is the main thing.

  Otherwise, even ten ordinary operations may not be worth one difficult operation.

  …

Four p.m.

   News came from the operating room.

   The patient's bleeding has stopped, and the initial diagnosis is tumor metastasis!

   This result makes Xiao Shikang a little scared!

   Preoperative abdominal CT examination only reported a suspicious liver cyst.

  Liver cysts are benign, as long as the size does not compress the surrounding tissue and the location is not dangerous, they can generally be left untreated.

   Even the abdominal CT of the intraoperative abdominal examination was considered to be a benign liver cyst rupture and hemorrhage.

   However, what surprised everyone was that a quick pathological section turned out to be a malignant tumor!

   "Lu Chen, thanks to you for discovering the abnormality." Xiao Shikang said with lingering fears, "If the patient underwent an ablation operation in such a confused manner, the follow-up would be even more troublesome."

  Atrial fibrillation does not affect the patient's lifespan.

   But after surgery, the risk of bleeding is increased, and the patient's rupture may progress faster!

  Lu Chen was also a little fortunate. Fortunately, when he was looking at the angiography image, he saw this small-medium amount of pericardial effusion.

   If we just let it go in such a confused way, then the current situation will be different!

  …

   At half past five in the afternoon, I finally got off work.

  Lu Chen rejected Yao Jie's request to share a meal and returned to his hotel.

   It's been a long time since he went to the clinic, and suddenly he came to the catheterization room. Lu Chen was really not used to it.

   But after today's somewhat thrilling diagnosis and treatment process, Lu Chen felt a surge of excitement.

   This kind of long-lost enthusiasm is incomparable to simple surgery!

   Surgery, of course, depends on the technical ability of the doctor.

   However, in the process of diagnosing and treating patients, it emphasizes the rigorous thinking of "detective style", inferring from every suspicious point in the medical record, and finally discovering the final diagnosis of the patient, and treating the patient in time to cure the patient.

   Just as Lu Chen was thinking about it, Min Xiaobo called.

   "Hey, Lu Chen, how many surgeries have you had in the past two days?"

  Min Xiaobo is straight to the point.

   "Cough cough." Lu Chen coughed slightly embarrassedly, "Not one."

"Ah?" Min Xiaobo was surprised, "Why don't you have one? We are in the second stage of the assessment. The number of operations is also an important indicator. I asked others, and it seems that they have done at least two. Surgery."

  Lu Chen smiled helplessly, he didn't explain too much.

   Originally, he also had two surgeries, but due to his own reasons, both surgeries were cancelled.

   "I've already made four, you have to hurry up!"

   "No rush, no rush, there will be opportunities later." Lu Chen said.

"Hey, there are thirteen of us. If half of them pass the second-stage assessment and get a certificate of completion, that's not bad." Min Xiaobo said, "Everyone is working hard, Lu Chen, don't be left behind. what!"

   "Well, thank you Bo Ge for reminding me." Lu Chen smiled.

   "Then let's do this first, hang up."

   hung up the phone, Lu Chen breathed a sigh of relief.

   In less than a month, he really has to work hard.

   Then, with a thought, he entered the virtual space of the system again to perform a simulated operation of electrophysiological intervention.

   (end of this chapter)