"Thank you, doctor, thank you!" the woman hurriedly thanked.

"No thanks. Ruan Bin waved his hand.

"Let's go, let's go!" Huang Hongwen shouted in the emergency department hall.

Towards noon, the emergency department was still overcrowded.

Ruan Bin looked at the sound and saw Huang Hongwen and a nurse pushing a flat cart towards this side. It was followed by the families of two middle-aged couples.

"Vomit~" At this moment, the old man in his 60s who was lying on the flat car was flushed, took off the oxygen mask with his hand, and spit a mouthful of blood on the ground with his head tilted.

"Dad, are you okay?" the family member who followed behind hurriedly asked when he saw this.

"No, it's okay, it's better to spit it out, but now I just feel chest pain and can't breathe. The old man lay back on the flat car and said weakly.

Seeing this, Ruan Bin hurriedly stepped forward: "Lao Huang, what's the patient's condition?"

"The patient was jogging in the park an hour ago, suddenly felt chest pain, difficulty breathing, family members randomly called 120, we had already vomited blood twice when we arrived, plus now it is the third time, each time more than the other. Oh yes, the patient has a history of high blood pressure!" Huang Hongwen hurriedly said.

It looks serious!

If the patient has cardiovascular and cerebrovascular diseases, and now it is dyspnea and hemoptysis, it is likely to cause myocardial infarction and cerebral hemorrhage.

When the time comes, it will only be for the rescue!

Nowadays, people who are generally old basically have cardiovascular and cerebrovascular diseases.

It's just a matter of weight.

"General Diagnostics!"

Ruan Bin doesn't care about 3721, he will first throw a general diagnosis in the past.

In the face of such a patient whose condition will worsen at any time, the first thing to do is to quickly diagnose the condition and send it for treatment immediately. If there is a lot of time spent diagnosing the disease, the disease will get worse and worse. It's not a cold or fever, you can wait for hours.

Patient: Sun Wuhong

Age: 65 years old

Medical records: hypertension, hyperlipidemia, varicose veins, pulmonary artery thromboembolism.

"Pulmonary artery thromboembolism, varicose veins?" Ruan Bin suddenly understood after reading it.

Thromboembolism in the pulmonary arteries can cause chest pain, difficulty breathing, and hemoptysis. And this varicose vein can cause this pulmonary embolism!

Yes, more than one disease!

As for high blood pressure or something, he directly ignored it, who hasn't had high blood pressure these years? Life is too good.

"Give him a chest X-ray, electrocardiogram, pulmonary angiography!" Ruan Bin said to Huang Hongwen.

Huang Hongwen nodded.

"I hope I don't need surgery!" Ruan Bin said secretly in his heart after watching Huang Hongwen and a few others leave.

Generally, if you have this kind of pulmonary artery thromboembolism, if you have not yet been in shock, you will generally take conservative drug treatment first, that is, use drugs to relieve the pulmonary artery thrombus in the pulmonary artery, quickly reduce the pulmonary artery pressure, improve the right heart function, reduce or eliminate the impact on the left ventricular diastolic function, improve the left heart function and cardiogenic shock, improve pulmonary perfusion, prevent chronic pulmonary hypertension and long-term prognosis, dissolve deep vein thrombosis, and prevent repeated embolism.

Once the dissolution effect is obvious, the patient can be transferred to vascular surgery. Because varicose veins also have to be treated, this is the job of vascular surgery.

If dyspnea continues to worsen, and cyanosis and hypoxemia occur, and cardiac ultrasound indicates pulmonary hypertension, then life is in danger at any time, and surgery is necessary immediately!

The reason why Ruan Bin didn't want surgery was that this thing had to be operated by interventional surgery.

Today, Director Qian is on a rotational break, and Lao Liu will lie down for half a month, and it is estimated that only Jiang Yurong will have this kind of interventional surgery. He didn't know if the other three attending doctors at the hospital would!

"Doctor Ruan, come and help, car accident, foreign body insertion in the leg, ruptured major artery in the thigh, need your resuscitation aortic endovascular balloon occlusion!" Zhang Haoyu shouted to Ruan Bin from afar.

"It's coming!"

Another twenty minutes passed.

Huang Hongwen took the diagnosis report and found Ruan Bin.

"Ruan Bin, the results are out, pulmonary artery thromboembolism!" Huang Hongwen said breathlessly.

"Then show me what to do, the treatment of the treatment, direct conservative treatment with medication, and prescribe intravenous infusion of urokinase, streptokinase and tissue plasminogen kinase. If his condition improves, he will be sent to vascular surgery immediately. By the way, I suspect that the pulmonary aortic thromboembolism he got may be caused by varicose veins, so you can give him a deep vein patency test to see if he has varicose veins!"

Huang Hongwen: ......

In fact, he came to ask Ruan Bin mainly because he didn't have a lot of decisions in his heart, whether he should be treated conservatively or surgically. Although he has been here for more than two months to study, he is still a rookie, how can he be like you Ruan Binya's airplane level has skyrocketed!

"Okay. Huang Hongwen nodded. In fact, this kind of learning experience is a kind of growth.

After another half an hour of busyness, it was finally time to eat.

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