Chapter 504: Difficult Aortic Dissection, Revelation
Zhou Can was busy until 12:43, when he finally finished handling the emergency surgeries and the patients awaiting surgery who were admitted yesterday.
Some traumatic and acute patients in the emergency room need to be treated immediately.
There is no way to accumulate this.
Whenever such patients are seen, they are usually examined as soon as possible. After finding out the cause of the disease, the doctor will simply determine whether it can be treated in the emergency room. If it cannot be treated, either call the corresponding specialist department to take the patient away.
In most cases, even if the condition cannot be treated, some preliminary rescue work needs to be done on the patient.
For example, helping patients stop bleeding, defibrillation, opening airways, etc.
As for patients who can be directly operated on in the emergency room, that goes without saying. Those patients will line up like an assembly line to enter the emergency operating room for surgery.
Zhou Can has recently begun to consciously reduce the number of first and second level common surgeries, allowing other doctors in the operating room to handle them.
He mainly deals with patients who require difficult surgeries.
The number of level 3 surgeries has increased from about two to three or even four.
In the first and second level surgeries, the more difficult cases were handled by other doctors if they were confident. Those that they were not confident about were all thrown to Zhou Can and Dr. Xu.
This arrangement is beneficial to Zhou Can and other doctors in the emergency department's operating room.
Zhou Can has almost become a new trump card in the emergency department's operating room. He only performs simple and minor surgeries, which is not conducive to his growth. The department leaders naturally hope that he can become as strong as possible.
As a leader, if you are too weak, how can you lead the emergency department into battle?
Giving simpler minor surgeries to other doctors can also allow them to get better training.
Doctors who have trained their surgical skills can then take on more difficult operations.
Eventually, a virtuous circle will gradually be formed.
When I walked out of the operating room, I looked up and saw a middle-aged man in his forties sitting on a bench across the corridor. He had short hair, was well-dressed, had a calm look in his eyes, and was in a bad mental state.
"Excuse me, is this Doctor Zhou?"
Seeing Zhou Can walk out of the operating room, the man stood up and asked.
"It's me!"
Zhou Can walked straight towards the other party.
"Are you the patient who came to see me specifically?"
"Yes, yes, that's me!"
The man nodded repeatedly, and just after saying a few words, he covered his chest and started coughing. There was a faint cracking sound when he coughed, and the man's face showed a rather painful expression.
"Where do you feel uncomfortable? Come, sit down and talk slowly. There's no rush."
Zhou Can is a dozen years younger than the other man, but he cares about him like an elder.
"It's okay! I had a heart surgery and have been coughing since then. Lately I've been feeling anxious and short of breath, and occasionally I've had stabbing pains in my upper abdomen. I checked at several major hospitals and they all said it was aortic dissection, and it was very serious."
As he spoke, the man picked up the information bag on the chair.
He handed Zhou Can the film he shot in the theater.
After taking it and looking at it, Zhou Can's expression suddenly changed slightly.
"Oh, this is really serious. This whole avenue is full of dissections. To be honest, this is the first time I've seen such a large dissection. And this blood vessel is the aorta. If it ruptures, I'm afraid it will be too late to rescue . I suggest you deal with it as soon as possible and don't delay."
Zhou Can has performed quite a few major surgeries under the guidance of Director Hu Kan.
He has dealt with some very dangerous aortic dissections.
But I have never seen such a serious dissection as the one in front of me. The main reason is that the dissection band where the blood vessel wall is torn is too long.
The blood spurting out from the dissection forms a long, water-bag-like dark shadow band in the chest and abdominal cavity.
With such a large and long dissection, the risk of rupture is very high.
Even in a hospital as large as Tuya, if a patient is diagnosed with aortic dissection, the patient will be immediately issued a critical illness notice, even if he or she does not experience angina pectoris.
Only doctors understand how dangerous aortic dissection is.
"I asked several large hospitals, and they all told me that I had to undergo a cardiovascular aortic artificial vascular replacement to replace the entire diseased blood vessel. The incision would be from the chest to the thigh. There were also many surgical risks, including paraplegia, death during the operation, etc."
The man spoke clearly and logically, and he knew the entire operation and its risks.
This means that you have learned about the entire surgery in detail from other doctors.
It is almost impossible to place a stent for such a long aortic dissection.
Because this aorta has multiple branches, it supplies blood to multiple organs in the thoracic and abdominal cavities.
Although placing a stent can block the gap of the vascular dissection, it will also block other branches of this blood vessel. This will cause multiple organs to lose blood supply. At that time, it will not be saving lives, but killing people.
Replacing the entire aorta is difficult, but as long as you have strong surgical skills, you can still try to challenge it.
As long as Zhou Can improves his ligation skills to level six, he will be fully capable of challenging this type of surgery.
"The trauma is great, the risk is high, and the risks during and after the operation are unpredictable. There are indeed many problems. However, your aortic dissection is already so serious. If you don't treat it, it will be more dangerous than having a time bomb tied to your body."
The patient's condition can no longer be delayed.
Any excessive emotion or uncontrolled blood pressure may lead to dissection rupture.
At that time, blood will rush into the chest and abdominal cavities like an uncontrolled flood.
Basically any rescue measures were too late.
The mortality rate of aortic rupture is much higher than that of carotid artery rupture.
The prognosis is extremely poor, with a mortality rate approaching 100%.
Having your neck or throat cut and bleeding is horrific, but most people can be saved as long as they are sent to the hospital in time.
The heart's aorta is in the chest and abdominal cavity. Once it ruptures, it is impossible to stop the bleeding without opening the chest.
And even if the chest is opened, it will most likely be useless.
Ligating the aorta or clamping it with a hemostatic forceps is equivalent to cutting off the blood supply to most organs and tissues in the body. If the limbs of the body are ischemic for more than half an hour, there is a risk of necrosis.
The internal organs are more delicate, and some will gradually become necrotic after only three minutes of lack of blood.
You should know that necrosis of organs in the body is mostly irreversible.
"Doctor Zhou, I came to you this time to ask you to help me think of a solution. See if you can help me solve this aortic dissection without replacing the entire blood vessel. I also heard from one of my subordinates that he watched an online surgery live broadcast yesterday. You successfully cured a patient with cardiovascular disease that the Imperial Capital Renhe Hospital and Japanese cardiac surgeons were unable to cure."
The fact that this person came all the way to find Zhou Can in such a short time is enough to show that he has considerable power.
Because the accent doesn't sound like a local accent.
"Where are you from?"
"Oh, I'm from Shanghai, and my family runs a small business. After learning about your deeds last night, I thought about it and rushed over from Shanghai this morning."
"Thank you for your trust. I am actually an ordinary doctor in Tuya Hospital. The success of the operation yesterday was partly due to luck. I am not as good as you think."
Zhou Can didn't believe that this person was doing some small business.
He usually comes into contact with many wealthy people and bigwigs.
From this person, one can sense a kind of faint majesty and an indescribable self-confidence. If I guessed correctly, this person is not only very financially powerful, but he probably also has considerable power in the official circles.
Such people are either the second generation of top families or the second generation of officials.
If he kills someone, Zhou Can doesn't want to become the second Xu Yida to die.
He saw deeply the misery of Dr. Xu.
So, try to shirk it if you can.
Doctors must learn to protect themselves so that they have the opportunity to save more people.
"How about this, you go eat first. I can wait until you have time and then have a good chat with you. I can feel that there is a trace of fear of me in the depths of your eyes. Don't worry, I am definitely not the kind of person who is unreasonable. I am not an ungrateful person either."
The man was really amazing. He could even clearly observe the trace of fear that Zhou Can inadvertently revealed in his eyes.
During the conversation, it was revealed that Zhou Can was already a wealthy man with a net worth of over 100 million yuan.
But he was crushed by this man throughout the whole process. The other party's aura was very terrifying.
Generally speaking, a person's aura comes from comprehensive strength in all aspects, including his or her own wealth, knowledge, ability, connections, as well as the strength of his or her family and the resources that can be mobilized.
Those who can easily mobilize large amounts of resources come first as officials, and second as wealthy businessmen.
This has been the case throughout the ages.
However, with the evolution of modern civilization, capital has gradually become all-encompassing.
The man told Zhou Can that he was not an ungrateful person, which meant that as long as Zhou Can cured his illness, he would be his lifesaver.
There will definitely be a long-term relationship in the future.
This person never revealed his true identity from beginning to end, but he used his identity as a trump card.
"Have you eaten yet? If not, I can treat you to a hospital meal if you don't mind."
People come from far away to see him for medical treatment.
Now that he's sick, I haven't treated him yet. It's not too much to treat him to a working meal.
"I've already eaten. Go ahead and eat! When do you think you're free? I'll come find you then."
The man said.
"There are still many surgeries to be performed this afternoon, so I'm afraid we'll have to wait until the evening. It's not easy for you to come all the way here, so how about this, give me the information, and I'll take a closer look while we eat, and then I'll give you a definite answer."
Zhou Can's words were equivalent to telling the other party that if the disease really cannot be cured, then sorry, you have to seek help from someone else.
When communicating with such "second generation", attitude is very important.
If you show enough sincerity, you won't be upset even if people reject you.
"Here! Please!"
The man handed him the information bag.
"You're welcome. This is what we doctors are supposed to do."
After taking the information bag, Zhou Can quickly went to the cafeteria to eat.
Qiao Yu had already prepared food for him.
Watching Zhou Can eating and reading the film, she couldn't help but ask curiously, "This patient doesn't look like an ordinary person. What's wrong with him?"
"Aortic dissection, it's quite serious."
"It seems that your live broadcast yesterday has made you famous. In the future, more people will come to you for medical treatment."
Qiao Yu said with a smile.
"Alas, people are afraid of being famous, just like pigs are afraid of being fat. When pigs get fat, they have to be shaved. When people become famous, troubles will follow. I really hope that some ordinary patients will come, so that I can have enough time to grow. It would be better if these big guys and young masters came less often."
Zhou Can sighed.
Other doctors want to become famous.
However, he was troubled by the fact that after becoming famous, the patients he came to see were difficult to treat.
After all, the strength is not strong enough.
Just like money, it never seems to be enough.
Even though he is now worth over 100 million yuan, there are very few things he can do.
You may not have enough money to buy a house in a super first-tier city.
The same goes for the level of medical skills, which never seem strong enough. Compared to before, his strength is already very strong.
However, he is still a long way from reaching the pinnacle of medicine.
"If the patient's identity is too sensitive, it's safer to just turn it down. If a person of some status gets a serious illness like this, they will definitely look for the best doctor in the world to treat them. If other top experts can't cure a disease, you'd better not challenge it. The risk is too great."
Qiao Yu was very smart and she knew immediately that the person who came to Zhou Can for treatment was not an ordinary person.
"Sister Qiao Yu is right. If you need to turn it down, you must do so without hesitation. If you find it inconvenient, I'll go and get it back for you later."
Ma Xiaolan's mouth and personality have always been like a hot pepper.
There is one good thing about her: she is only mean to others, but she is very caring towards her team members and people close to her.
Whether Zhou Can encounters a difficult patient or other medical staff are in trouble, she will lend a hand.
Sometimes when Zhou Can saw her arguing with patients and arguing with their family members, he admired her even more.
Everyone has shortcomings, and Ma Xiaolan has a lot of them. However, as they continued to interact, Zhou Can never thought of driving her away again.
"No, I've already given the patient a heads-up. If his treatment is beyond my capabilities, I can only ask him to go home. He flew all the way from Shanghai, so it would be unreasonable for me to not do my best."
Zhou Can always does things in accordance with his conscience.
After reading the patient's films and biochemical test reports, Zhou Can fell into deep thought.
The man, named Chen Zhongzhi, is 42 years old and has no other illnesses.
The main one is aortic dissection.
Replacing the entire aorta is risky and traumatic, and placing a stent will hinder the blood supply to other branches.
This operation is really tricky!
Until the end of the meal, Zhou Can still couldn't think of a solution that didn't require aortic replacement.
Holding the information bag, he was about to tell the patient to find another doctor.
After searching for a while, the man named Chen Zhongzhi seemed to have left the emergency department.
There was no other choice, Zhou Can could only leave the information bag temporarily in the office and go into the operating room for surgery.
I guess this person will come over when I get off work.
One patient after another, the lesions were eliminated under the treatment of Zhou Can and his team members.
Most of them can leave after being treated, and just take some medicine and go home to recuperate.
Severe cases may require hospitalization for a period of time.
"Oh my, oh my..."
A groaning patient was wheeled in.
A patient who is in such pain must not have any minor illness.
