The next day, the night shift.

Although Ruan Bin now has a huge sum of 15 million, he is not in a hurry to buy a house or a car, he plans to see where the house is suitable for him first.

Anyway, I'll find time to find out in a few days!

The surgeons in the emergency department for tonight's night shift are mainly Ruan Bin and Wei Haiyang, as well as two resident doctors and several interns.

Not long after the shift was handed over, the front desk received a call from the front desk.

Ruan Bin took the lead in going out of the emergency room.

The patient was a drunk who had fainted, and there was also a drunken man who used a wine bottle to say in public that he wanted to practice iron head skills, although he did not practice himself into a real iron head skill, but smashed his head and broke the blood flow.

Ruan Bin lost a general diagnosis that was a slight concussion and epidermal hemorrhage, and there was no major problem.

Pull these two back to the hospital and hand them over to two resident doctors to deal with.

They can handle this little problem!

As soon as he returned to the hospital, Ruan Bin saw Wei Haiyang with two interns checking on a patient's condition. Ruan Bin, who had nothing to do now, leaned over and asked, "What's the matter?"

"Tingling pain in the right side of the chest! The abdomen also started tingling, and it has been hurting for more than an hour. Wei Haiyang replied.

"I've done a non-contrast CT scan on him, and I'm waiting for the results. Also, he had a very high D-dimer, and I first suspected pancreatitis, and the second was aortic dissection. Lao Ruan, what do you think?" Wei Haiyang said.

At this time, the man in his fifties lying on the hospital bed sat up in pain, clutched his chest and said, "Doctor, I am in pain...... What to do?"

He couldn't speak clearly, and he looked very weak.

Next to him, his wife Liu Caili was already nervous.

"Give him a painkiller first. Ruan Bin glanced at it and said.

Then I lost a general diagnostic.

Patient: Wang Youcai

Age: 53 years old

Medical records: hypertension, Aortic dissection.

Seeing this diagnosis, Ruan Bin's brows immediately furrowed.

A aortic dissection is very dangerous!

The aorta is a large blood vessel that runs throughout the body and is responsible for supplying blood and nutrients to various vital organs. The aortic vessel wall is composed of three membranes: inner, medial, and outer. Normally, these three membranes are tightly bonded together to form a wall, which together withstand the impact pressure of blood flow in the blood vessels.

However, if there is a tear or ulcer in the membrane (intima near the blood flow), the tear in the intima will further tear and expand under the impact of the blood flow, causing the separation of the three membranes and forming a false lumen next to the true lumen of the blood vessel, and some of the blood flows or stases into a hematoma in the false lumen, and a dissection is formed.

After the formation of vascular dissection, only the adventitia of the dissection is left to bear the pressure of blood flow alone, and if not treated in time, this situation can lead to the rupture of the blood vessel at any time, which can be fatal in minutes.

In particular, the mortality rate of type A aortic dissection can reach 50% within 48 hours, and if it is delayed, the mortality rate can be as high as 90% within one month, which is almost a lifetime of death.

If this disease occurs, you have to operate immediately, the sooner the better, no one knows when its blood vessels will rupture, once it ruptures, it will not be saved!

Ruan Bin didn't answer Wei Haiyang's words immediately, but said to the nurse on the side, "Have you measured your blood pressure in your lower limbs?"

Zhao Yaxue was stunned for a moment, "I'm preparing to measure." ”

"Measure it and see. ”

Listening to Ruan Bin's words, Wei Haiyang was surprised: "Do you suspect that it is an aortic dissection?"

"Well, but let's look at the blood pressure in the lower limbs first. ”

Soon, Zhao Yaxue measured it.

"Abnormal blood pressure in the lower limbs, 150 on the left and 80 on the right!" Zhao Yaxue reported.

Abnormal blood pressure in the lower limbs!

Wei Haiyang and Ruan Bin looked at each other, and if this situation occurs, it is very likely that it is an aortic dissection!

"Measure again!"

"Good. ”

"160 on the left, 90 on the right!"

"It's not the same twice!" Wei Haiyang's face changed.

I know the big deal!

It is impossible for a person's blood pressure to change so quickly in just one or two minutes, and the only problem is that there must be a problem with the aortic blood vessels, resulting in abnormal instability in blood pressure!

"Old Wei, don't do plain CT, just do enhanced CT!" Ruan Bin said in a deep voice.

"Good. Wei Haiyang nodded.

He knew that noncontrast CT would not be able to detect aortic dissection!

When the contrast-enhanced CT results came out, it was indeed an aortic dissection!

"You're the patient's family, aren't you?" asked Ruan Bin as she turned to Liu Caili.

"Yes, yes, I'm his wife. ”

"Your husband's condition is very complicated now, it is an aortic dissection, and he has to be operated on immediately!" Ruan Bin said.

"What is aortic dissection?" Liu Caili, who only has a Chinese beginning and is fifty years old, does not understand this term at all.

"It's that the wall of the blood vessel in the middle of the big blood vessel is broken, and the blood rushes into the blood wall to stretch the blood vessel wall open. Once the blood vessels ruptured to a certain extent, the blood could not be stopped, and he died immediately. Ruan Bin patiently explained.

"This can only be treated surgically, so you should consider whether you want to treat it or not. ”

"My husband is fine, how can this happen?" Liu Caili panicked.

"Does your husband have a history of high blood pressure?

"Yes...... But he eats occasionally, sometimes not. ”

Looking at the other party's dodging gaze, Ruan Bin sighed and said: "If you have high blood pressure, you should take medicine on time! If you can't take it today, you won't eat if your blood pressure is not so high! You can only eat less, you can't stop eating! Your husband's situation is caused by high blood pressure!"

Among them, a large proportion of patients with aortic dissection are still not well controlled after taking drugs, which leaves a hidden danger to the occurrence of aortic dissection.

Like this, Wang Youcai must have caused this situation because of abnormal blood pressure medication!

"How much does it cost to do this surgery?" asked Liu Caili nervously.

The little people are afraid of going to the hospital!

Now, when you hear that you are going to have surgery, you have to ask how much it costs before you can make a decision!

"About 300,000!" Ruan Bin began.

"What? 300,000!" Liu Caili's tone suddenly brought a crying tone.

300,000!

In an ordinary family, it is definitely a huge amount of money!

Ruan Bin was also very helpless when he saw this, if your husband took blood pressure medication on time and controlled his high blood pressure well, maybe there would not be this kind of aortic vascular dissection rupture!

But it's too late to say anything.

"Doctor, then, how sure is the success of the operation?" asked Liu Caili again.

Ruan Bin was about to speak, but Wei Haiyang answered: "No one dares to say that this kind of high-risk surgery is certain! If you do it, there is still a glimmer of hope, if you don't do it, there will definitely be no hope!"

"Well, talk to your other family members and make a decision as soon as possible. Ruan Bin also nodded.