In the emergency department, although the direction of the investigation is not much different when facing the emergency patient, all kinds of examinations and investigations are also based on the experience and judgment of the attending doctor.

That is to say, the experience of the attending doctor accounts for a large proportion of rescue and first aid, guessing what the patient's possible situation is, first do a certain aspect of investigation and examination, and then gradually screen.

Experienced doctors often make accurate judgments, so the cause of the disease can be found quickly in the process of screening and screening, and abnormalities can be found, while inexperienced doctors may delay some time.

The reason why Fang Han initially let him do a full rib CT scan was precisely because it was based on his own judgment.

With Fang Han's grandmaster-level observation and grandmaster-level palpation, coupled with advanced touching methods, Fang Han definitely has an advantage over all the doctors in the emergency department of Yanjing Hospital in terms of preliminary diagnosis, even Qian Xiaolin is not as good as Fang Han in this regard.

When Fang Han was diagnosing the pulse just now, he felt that Long Yaxin's pulse was a little abnormal, but it was not very obvious, and Fang Han did not have an accurate judgment for a while, so he suggested that he do a cardiac ultrasound, and sure enough, it ........ Something went wrong.

On the side, Director Guan and Director Wang were also looking at the CT scan of the head and brain and other examinations.

"There was no intracranial hemorrhage, no cerebral obstruction, and the result should have been a simple closed chest injury, multiple rib fractures on the left side......"

"Hmm. "

Director Wang nodded and asked, "Didn't you say that you did a cardiac ultrasound, but what was the result?"

Fang Han handed over the cardiac ultrasound in his hand, and Director Wang was shocked when he saw it: "This situation is rare." ”

"What's the situation?"

Director Guan asked.

From the standpoint of Director Guan and Director Wang, they only looked at Long Yaxin from the doctor's point of view, and Director Guan and Director Wang didn't know Fang Han.

"Judging from the ultrasound results, it should be the mitral valve chordae rupture......."

Director Wang pointed to the ultrasound above and said, "Look here, and here, you can do an auxiliary examination to further confirm." ”

Saying that, Director Wang opened a few more lists of auxiliary examinations.

"Xiao Fang, is this mitral tendon cord rupture serious?" Yang Jianying stepped forward and asked Fang Han softly.

When talking about the condition, Fang Han and several doctors were on the other side of the curtain, and at this time, Zhang Xiaoquan was talking with Long Yaxin on the side of the bed, but Yang Jianying was standing on the side and heard the words of the two directors just now.

Before Fang Han could speak, Director Wang spoke up: "Who recommended this cardiac ultrasound, it's very important to do it." ”

Generally speaking, similar to Long Yaxin's situation, cardiac ultrasound is not a mandatory item, and basically no doctor will consider it in the early investigation.

However, this rupture of the mitral valve tendinae tendinae is a big problem, and this problem may not be dangerous in a short period of time, but once the condition is aggravated, it is more passive to deal with it.

Correspondingly, it is relatively rare for trauma to cause valve tendinae rupture, coronary artery injury, and pericardial tamponade in clinical practice.

"It was Dr. Fang who suggested a cardiac ultrasound. Wang Haobo hurriedly said.

Director Wang then looked at Fang Han, what a young doctor.

When he entered the emergency room just now, Director Wang really didn't pay much attention to Fang Han, Fang Han's face is indeed easy to be ignored in a place like the hospital, he is too young, at Fang Han's age, which hospital he puts in gives people the feeling that he is a rookie doctor.

Director Wang and Director Guan just regarded Fang Han as a little doctor just now, and they didn't care, they always thought that it was Wang Haobo, the inpatient director of the emergency department, who was in charge of the rescue here.

As soon as Fang Haobo said about our Doctor Fang, Director Wang knew that this young doctor was definitely not an ordinary doctor, otherwise there would be no need to say so in the emergency department.

Wang Haobo has been the general inpatient for more than half a year, and Director Wang and Director Guan still know each other.

"Dr. Fang came to our hospital for further study from Jiangzhong Hospital, and the level of liver resection is very high. Wang Haobo hurriedly introduced.

As soon as Wang Haobo said this, Director Guan and Director Wang knew who it was, although they had never seen Fang Han, they had heard more or less in the past few days that a young doctor who had done a very good liver resection came to the emergency department.

"No wonder, it turned out to be Xiao Fang. ”

Director Wang smiled and said: "Ordinary people don't think about doing this cardiac ultrasound at this time, Xiaofang, your suggestion is very good, this cardiac ultrasound is very timely." ”

Fang Han was expressionless, but asked: "Director Wang, how should this mitral chordae tendinae rupture be treated, what treatment methods are available, and are there any sequelae and complications after treatment?"

Fang Han naturally knew what it meant when the mitral chordae tendinae ruptured, but he was not clear about the current treatment of Western medicine.

Perhaps for Director Wang, this cardiac ultrasound was done in a timely and critical manner, and the patient's condition was discovered in a timely manner, but for Fang Han, he was not glad to find this problem, but even heavier.

In the case of mitral valve retrieval rupture, Fang Han himself is completely unable to intervene, as for how to treat it and the postoperative situation, Fang Han's eyes are even darker, but he knows the seriousness of this situation.

Director Wang frowned at the moment, what's the matter with this young man, he has an opinion about himself?

Wang Haobo hurriedly said, "Director Wang, Director Guan, the patient is Dr. Fang's girlfriend. ”

As soon as Wang Haobo explained this, Director Wang and Director Guan instantly understood.

From the doctor's point of view, they can discuss, or even relax, this examination is done well, what is avoided, etc., but as a relative of the patient, the mood is definitely not relaxed.

Knowing that the patient was Fang Han's girlfriend, Director Wang also understood why Fang Han was expressionless at this time, and said directly: "In response to the patient's situation, there are currently two treatment methods, one is mitral valve repair and the other is mitral valve replacement. ”

"Mitral valvuloplasty is the repair of a diseased valve to restore valve and heart function, and mitral valve replacement is done in patients whose heart valve cannot be repaired. There are two types of prosthetic valves, mechanical and bioprosthetic. Mechanical valves are durable, but require lifelong anticoagulation. Inadequate anticoagulation can lead to thromboembolism, valve failure, and excessive anticoagulation can lead to bleeding. Bioprosthetic valves do not require lifelong anticoagulation, but their durability is poor, and most young patients still require reoperation to replace the valve. If the mitral valve can be successfully repaired, the patient's life span and quality of life can return to normal. If the mitral valve is replaced, whether a biological valve or a mechanical valve is used, the patient's life span and quality of life will be different from that of a normal person. ”

"In other words, the plasty technique is the best?" Fang Han asked.

Director Wang nodded and said: "It is good if you can do plasty, compared with artificial mechanical valve replacement, valvuloplasty does not require anticoagulation, and avoids complications caused by taking warfarin and other anticoagulant drugs; ”

Fang Han naturally knows this point, repair depends on the situation, it can be repaired only if it can be repaired, and if it can't be repaired, it can only be replaced......

......

"Announce the time of death!"

Chen Peizhong walked off the operating table dejectedly, and Qian Xiaolin on the side also had a bad face.

The patient still did not last until the end of the operation, and the patient stopped beating halfway through the liver resection operation, and was not resuscitated.

"The amount of bleeding is too much, if Fang Han is here, maybe he can save it......"

Chen Peizhong's level of Fang Han is very clear, not to mention Fang Han's liver resection, just saying that Fang Han's hemostasis is something he can't compare.

"Xiao Fang is still taking care of his little girlfriend now, not to mention what the situation is over there, even if Xiao Fang is willing, I don't worry about letting Xiao Fang have surgery today. ”

Qian Xiaolin shook his head, Chen Peizhong was already the highest-level doctor in Yanjing Hospital, and he was definitely trying his best to do this, as for Fang Han.

In today's state, Qian Xiaolin is really not at ease with Fang Han.

If Fang Han was a few years older, maybe Qian Xiaolin would be more at ease, but Fang Han was really too young, if something like this happened, he dared to let Fang Han undergo such a big operation?

"yes, I'm not worried either. Chen Peizhong nodded.

"I'll go out and have a look, and there are two other patients. ”

As he spoke, Qian Xiaolin hurriedly walked out of the operating room, and when he got out of the operating room, Qian Xiaolin did not completely leave the operating room, but directly entered another operating room through the internal passage of the operating area.

In the operating room, Zhou Guojun is rescuing another patient.

"How's the situation?" Qian Xiaolin entered the operating room, walked to the side and asked softly.

"The spleen was ruptured, the ribs were fractured, the rescue was timely, the operation was smooth, and there should be no mistakes. ”

"That's good. Qian Xiaolin nodded.

"What about the other side?" asked Liu Guojun.

"Let's go......" Qian Xiaolin whispered two words.

"Tsk!"

Liu Guojun smashed his mouth and continued to rescue, without saying more, the situation over there is indeed more serious than here, otherwise it would not be Chen Peizhong himself.

Qian Xiaolin stood on the side and watched for a while, and found that the patient's vital signs were stable and the operation went smoothly, so he didn't look any further, and then went out of the operating room and came to the rescue room.

Director Wang was looking at the follow-up auxiliary examination results in the rescue room, and Qian Xiaolin came in.

"How's it going, have you made any new discoveries?"

Wang Haobo stepped forward and hurriedly whispered a few words in Qian Xiaolin's ear, and Qian Xiaolin was silent, this is not a good thing to have a new discovery, especially since the person concerned is still Fang Han's girlfriend.

"Judging from the results of various examinations, it can be confirmed that the mitral valve tendinae tendinae are ruptured, and it is very difficult for the patient's condition to repair the chordae tendinae. ”

"So it can be done?" Fang Han asked.

"It can be done, but it is very difficult, and the risk is also high, and the safest solution is direct valve replacement. Director Wang said.

"Which director of our hospital does the best in valve repair and replacement?" Fang Han asked.