“Calculation of the inferior vena cava’s inhalation collapse: （Max D-Min D）/Max D× 100%。”Zheng Ren explained when he saw principal Zhang’s blank expression.
“Place the probe under the sword to the right, and the scan plane is parallel to the inferior vena cava. The image shows the right atrium, inferior vena cava, and hepatic vein.
Under normal circumstances, the inferior vena cava would obviously collapse with deep inhalation. The diameter of the inferior vena cava was less than 2.1 cm, and the rate of inhalation collapse was& gt, 50%, which was 3 mmhcg.
When the right atrial pressure is high, the diameter can be& gt, 2.1 cm, and the rate of inhalation collapse is <50%, which is 15 mmhcg. “
Zheng Ren was like a machine gun, speaking in one breath, not giving the others time to think.””The diameter of the inferior vena cava is 2.4 cm, and the rate of caving in after inhalation is <50%. This can clearly prove that it’s a pulmonary embolism.”
“The fifth point is that the speed of the triserpupate reflux has increased, according to the simplified Bernoulli equation …” As he spoke, Zheng Ren paused. When he saw principal Zhang’s blank expression, he immediately sighed.
“You’re not in the medical field, so you might not understand. You only need to know that it’s calculated according to the Bernouli equation. From the perspective of tristepupate reflux, there’s a thrombosis, and it’s very serious. “
Principal Zhang almost cursed.
What do you mean I’m not a doctor? You’re the principal of the medical University, how can you be so sarcastic?
But he didn’t dare to say it out loud. Principal Zhang did not expect boss Zheng, who was well – versed in anatomy, to be so good at explaining theories.
He was unconvinced and looked up at Sun Chao, trying to find mysterious help.
How good would it be if director Sun Chao could also say something to dispel boss Zheng’s arrogance?
However, what principal Zhang saw was … Director Sun Chao, who had a dumbfounded look on his face.
Sun Chao had some understanding of ultrasound, but it was definitely not this deep. “What formula? what equation? are these things you should say when you look at an ultrasound scan?”
Sun Chao knew that principal Zhang was looking at him, but he … Didn’t understand a single word!
He could only pretend that he did not see Principal Zhang’s gaze. His eyes were dull as he looked straight at Zheng Ren.
A few days ago, was director Tian of the cardiothoracic Department as embarrassed as he was? How could they fight if they couldn’t understand what the other party was saying?
This was not a battle at all, but a one – sided slaughter!
“The sixth point is that there is an incision in the middle of the pulmonary artery’s blood flow spectrum contraction. At the same time, it is accompanied by an obvious decrease in blood flow speed, a shortening of the time it takes for blood flow to accelerate, the early stage of right ventricle ejection, which is commonly known as the shortening of the RPG stage, and a decrease in the ratio of action to right ventricle ejection time. These are the standard signs for our diagnosis, which are ‘finger – fist signs’.”
It wasn’t over yet …
After one, two, three, four, five, there was still six!
Everyone was numb.
There was no expert in ultrasound at the scene, so everyone felt that boss Zheng’s words were right but not right. However, even if he wanted to argue, he could not produce any strong evidence.
Really F * cking hell!
Director Sun Chao was bitter.
However, it was not over yet.
“Seventh, thrombosis is the most typical characteristic of thrombosis in the lungs.
Thrombosis in the right atrium or right ventricle had different forms. When it was in the pulmonary artery, it was often a large thrombosis that extended from the main trunk to one or two pulmonary arteries.
The right pulmonary artery was easy to show, but the left pulmonary artery was relatively short, so it was difficult to show. In addition, pay attention to distinguish between thrombosis and tumor of the right heart system!”
“This patient’s right pulmonary artery has thrombosis in the main trunk due to gas interference, so I can’t see it very clearly. However, we can roughly estimate that it’s at least 10 cm long. “
Zheng Ren said quickly in a deep voice.
“You can see that a part of the thrombosis is in the trunk of the right pulmonary artery, and a small part is in the right ventricle.”
At this point, he raised his head and glanced at principal Zhang.”We won’t talk about the differential diagnosis of thrombosis and heart tumor here because we don’t have much time.”
Principal Zhang felt great contempt.
He felt that boss Zheng was trying to tell him that even if he said it, he wouldn’t understand it, so he didn’t say it. It’s meaningless to talk so much to you bunch of useless people. It’s completely meaningless.
As for Sun Chao, he was directly ignored by Zheng Ren as a piece of mosaic.
It’s … It’s really F * cking amazing!
Sun Chao cursed in his heart again.
“Eighth, the atrial septal defect has abnormal movement …”
“Ninth, reopen the Oval hole …”
However, boss Zheng’s words were not over yet.
After he finished talking about thrombosis, Zheng Ren went on to the eighth and ninth points.
After he finished speaking, he put the list on the desk and tapped his finger on the film reader, making a banging sound.
“The diagnosis is quite clear. There’s a pulmonary embolism, and a blood clot has blocked the main right pulmonary artery. From the ultrasound scan, the blood clot was very long, at least 10 cm. This is one of the taboos in interventional untypical surgery!”
“Besides, the patient’s condition is urgent. If I have time, I can successfully remove the plug in two hours. “But now … I estimate that the patient’s survival time is only about an hour. If we remove the plug or do other tests, the patient will definitely die. “
“Principal Zhang, please sign!” Zheng Ren frowned and said in a commanding tone.
Time was of the essence. What peaceful weather? what respect for the old comrades? all of that was bullshit.
Principal Zhang was stunned.
Was this a forced abdication? Was the time really so tight?
“Boss, the patient’s blood oxygen saturation level is 75%! I’ll send him to the operating room first, the surgery is ready to start. ” Su Yun pushed the patient and ran all the way. When she passed the office, she shouted.
“Go on.” Zheng Ren took out a piece of white A4 paper and placed it in front of principal Zhang.””Principal Zhang, there’s no time. The surgery is extremely risky, and there’s at least a 40% chance that the patient won’t be able to get off the operating table.”
“…” Principal Zhang shivered.
He was not the only one. All the chief physicians of vascular surgery from all over the country who came to watch the show shivered.
However, the two’ shivers ‘had different meanings.
Principal Zhang felt that there was a 40% chance that the student would be put in a difficult position, but the other directors were shocked that this young man had a 60% chance of completing the surgery!
This was a highly difficult surgery. According to him, the patient would die within an hour.
Can cardiopulmonary bypass be established in one hour?
He actually said that he was 60% confident?
“A 10 – centimeter pulmonary embolism, cut out the heart, cut out the pulmonary artery, and remove the thrombosis …
Impossible, that was absolutely impossible!
Subconsciously, many chief physicians did not question the patient’s diagnosis. Instead, they placed all their distrust into the success rate of the surgery.
It couldn’t be that high!
“I agree to the surgery. Please sign here. There’s no time for other pre – Operation instructions.” “I’ll write this after the surgery,”Zheng Ren said.
“If you can’t make up your mind …” Zheng Ren said as he looked at Lin Ge.
“Boss Zheng, don’t worry. What the medical Affairs department needs to do is to escort the clinical team. Even if principal Zhang couldn’t make up his mind, the hospital administration Department still approved the surgery!” Lin Ge understood what he meant and said without hesitation.
