I Can See Health

   Chapter 459 He is the main sword!

  Lu Chen got the patient's medical records, this is a 24-year-old female patient.

   "Lu Chen, this patient is a nurse in our hospital's orthopaedic department." Fan Zhiping said.

  Lu Chen nodded and continued to read.

   The patient has repeatedly experienced heart palpitations in the past month.

   Especially at night, it was the most serious. After admission, an electrocardiogram was performed, which showed frequent early morning sickness.

"We did a 24-hour dynamic electrocardiogram for the patient." Fan Zhiping, "it shows that her ventricular tachycardia, in 24 hours, has a total of more than 30,000! And it is a multi-source ventricular tachycardia, occasionally with short burst ventricular tachycardia. attack."

  Lu Chen raised his brows slightly, "So you did radiofrequency ablation for the patient?"

"Yeah." Fan Zhiping nodded, then sighed, "Our department performed radiofrequency ablation on her, but during the operation, we found that the origin of her abscess was very strange. I ablated her for three hours, and still The origin of VT has not been found..."

   After hearing Fan Zhiping's description, Lu Chen almost understood the patient's medical history.

   For patients with such a large number of premature ventricular contractions, which also affects their daily life, they must have attempted ablation surgery.

   What's more, the patient is not very old, and if he continues to have ventricular tachycardia, in the long run, it may lead to heart failure or even cardiomyopathy.

   And the difficulty of this patient's operation is to find the "origin point" of VT!

  Lu Chen looked at the patient's electrocardiogram.

   After studying it carefully for a while, I found out that this electrocardiogram is different.

   "Brother Fan, how did you diagnose this electrocardiogram?" Lu Chen asked.

   Fan Zhiping wondered: "Isn't this ventricular tachycardia originating from the left ventricular outflow tract?"

   "Nothing else?"

  Fan Zhiping frowned, "It's gone."

  Lu Chen didn't say much after hearing this.

   This electrocardiogram is extremely complicated. On the surface, it is indeed just a multi-source frequent ventricular tachycardia, but as long as you look deeper, more origins are still to come!

  …

   At this moment, Li Yao made a sound.

   "Director Yin, prepare for surgery!"

   "Okay." Yin Chao's face was quite solemn.

   They have done three or four hours of surgery, but they haven't been able to find the origin.

  Although Professor Li Yao's electrophysiological skills are superb, Yin Chao still feels that he needs to plan for at least two hours.

   Soon, the patient was pushed into the operating room.

  Li Yao took Lu Chen into the operating room.

   Beside, Yin Chao sighed slightly, Professor Li Yao still let his students be assistants!

  …

   Intervenes indoors.

  Wash hands, disinfection, anesthesia...

   These routine operations are all done by Lu Chen.

  Yin Chao couldn't help thinking, maybe Lu Chen just performed these ordinary operations, and when it was time for puncture and ablation, he would leave the intervention room.

   But as the operation continued, Yin Chao knew he was wrong.

   After anesthesia, Lu Chen started electrophysiological examinations, including mapping and ablation.

   "This... ah..." Yin Chao is now completely giving up.

  …

   At this time, Lu Chen held the electrophysiological examination catheter in his hand and slowly entered the punctured catheter.

  The 20-year-old young woman had a good vascular condition, so Lu Chen's puncture operation went very smoothly.

   This stunned everyone involved in the outside.

   This technique and speed should definitely not come from a student!

  This technology, in Fengm County, absolutely cannot find a second person!

   "Fan Zhiping, haven't you stayed in the eighth district of the Cardiology Department of the Second Jinghua Hospital?" Yin Chao asked subconsciously, "This Doctor Lu Chen, is his electrophysiological intervention ability so strong?"

   Unexpectedly, Fan Zhiping also had a surprised look on his face at this time. He slowly shook his head: "Director, when I was in the eighth area of ​​my heart, Dr. Lu Chen hadn't started to learn electrophysiological intervention..."

   "Ah?" Yin Chao was stunned for a moment, then turned to look at Fan Zhiping, "He, he didn't know anything before? In this year's time, his surgical ability has become so strong?"

   "Yes." Fan Zhiping nodded slightly.

   But Yin Chao still thinks it's a bit incredible. Fan Zhiping must have misremembered. He doesn't think that someone can improve the ability of interventional surgery to this level within a year!

  …

   At this moment, Li Yao came out of the intervention room.

   "Li Yao, you are..." Yin Chao was stunned, the operation is still going on, why did the chief surgeon come out?

   "I'll make room for you!" Li Yao glanced at Yin Chao, "If you don't make room, how will the doctors in your department study?"

   "This..." Yin Chao was stunned for a moment, and then said, "Professor Li, aren't you the chief knife?"

   "I didn't say I was!" Li Yao pointed to Lu Chen who was intervening in the room, "He is."

   "But..." Yin Chaochao intervened in the room and looked at it, "Your student hasn't graduated yet... This is a bit out of line, isn't it? The most important thing is that he doesn't have a certificate or an intervention certificate, so he can't take the lead!"

   Hearing this, Li Yao smiled.

  Perhaps, Lu Chen lacks other things, but the certificate is the thing he lacks the most!

   "He has the certificate!" Li Yao smiled, "The intervention certificate issued by the Chinese Society of Electrophysiology."

   "Huh?" Yin Chao swallowed and glanced at Lu Chen who was intervening in the room.

   Does this student have a certificate?

   And it was issued by the Chinese Society of Electrophysiology. This is the most valuable electrophysiological intervention certificate!

  If the person in front of him is not Professor Li Yao, Yin Chao really doubts that others are entertaining him.

  …

   But that's all for now, Yin Chao stopped grumbling, and gave Fan Zhiping a wink.

  Fan Zhiping understood, immediately put on the surgical gown and lead gown, and walked into the intervention room.

   Intervenes indoors.

  Lu Chen is in the process of ECG mapping and ablation.

   This is also the most difficult and most important part of the entire electrophysiological surgery!

  Fan Zhiping came to Lu Chen's side.

  Lu Chen also noticed him.

   "Lu Chen, come here to be your assistant." Fan Zhiping said slowly, and there was still disbelief in his voice.

   He watched Lu Chen's operations up close, and he could see that kind of skilled skills.

   However, skill is secondary now.

   Being able to find the origin of VT is the most important thing!

  Otherwise, no matter how skillful you are, it will be futile.

  …

   Right at this moment, Fan Zhiping noticed that there seemed to be something wrong with the place where Lu Chen had melted!

   "Lu Chen, why are you melting here?" Fan Zhiping said slowly.

  Lu Chen glanced at Fan Zhiping, then withdrew his gaze. As he spoke, the movements of his hands did not stop at all.

   "Brother Fan, look carefully at the patient's electrocardiogram. The chest lead in the picture shows the transition of the chest lead in sinus rhythm above the transition of the chest lead in sinus rhythm, indicating that the premature ventricle may come from the left ventricular outflow tract."

"Another point, the R wave duration/QRS wave duration of V1 is greater than 50%, and the R wave amplitude/S wave amplitude of V1 is greater than 30%, which is a coincidence, and it also suggests that it may come from the left ventricular outflow tract; I lead is a negative wave, It shows that the starting vector of the frontal vector starts from the left to the right, and it may come from the left coronary sinus ostium."

   "Of course, it may also be at the junction of the left ventricular outflow tract or the left and right sinus orifices or at the AMC or the epicardial epicardium of the great cardiac vein at the top of the ventricle, and the inferior wall is also high R, but the shape of the chest conduction does not conform to the transition."

  …

  Fan Zhiping didn't realize it.

  Lu Chen can see so many things from an electrocardiogram!

   Lu Chen's current state made Fan Zhiping think of the scene where he used to interpret ECGs in the WeChat group.

   Really deserves to be "Professor Lu"!

Lu Chen finally said: "Individual consideration, the origin of this patient's ventricular tachycardia, left ventricular outflow tract (left coronary sinus ostium) ventricular premature > right ventricular outflow tract partial anterior septum > pulmonary artery trunk premature, left ventricular outflow Ventricular anemia at the junction of the left and right sinuses or at the AMC or the great cardiac vein."

   "I wonder if you included these parts in the three hours of your surgery?"

  Fan Zhiping touched the back of his head a little embarrassedly, "I really don't..."

  …

   Intervenes outdoors.

   Lu Chen's words clearly reached everyone's ears.

  Yin Chao had a shocked expression on his face.

  Lu Chen's analysis can be said to explain the profound things in simple language, and even surpassed his understanding.

   Is this an electrophysiological intervention ability that a student can have?

   (end of this chapter)