Emergency Department of Jiangzhong Hospital.

Except for Fang Haoyang, all the expert doctors gathered in the consultation room for preoperative consultation.

Today's patient is one of the most difficult emergency patients that Jiangzhong Hospital has encountered so far.

Not only Jiangzhong Hospital, but also for the entire Jiangzhou Province and even the whole country, today's patient is quite difficult.

"The patient was an obstetric patient transferred from Shangjiang Central Hospital, 28 weeks gestation, and aortic dissection aneurysm ........"

Li Wenjun introduced the patient's situation to everyone.

"Heart aortic dissection aneurysm itself is a high-risk disease, the onset is rapid, the mortality rate is quite high, the patient is also pregnant and pregnant, the risk of surgery is increased geometrically, with the level of our Jiang Intermediate Hospital, it is impossible to complete such an operation. ”

As he spoke, Li Wenjun looked at Fang Han: "Xiao Fang, what do you think now?"

The patient's condition is very complex, the aneurysm may rupture at any time, and once the dissected aneurysm ruptures, it takes only 60 seconds from rupture to death.

The aortic wall of the human body is divided into three layers: the inner wall, the elastic interlayer and the adventitia, and the aneurysm dissection is the blood in the aortic lumen from the aortic intima tear or lesion into the aortic media, so that the aortic intima is separated, and the aortic wall expands along the long axis of the aorta to form a true and false chamber separation state of the aortic wall.

In this case, the wall of the aorta becomes quite thin, and often a violent breath or sneeze can cause the aorta to rupture.

Aortic dissection is a rare clinical condition, with an incidence of 1 in 100,000 or even 1 in 200,000 per year.

The probability of happening to pregnant women is very, very low, but when it happens, it is a very serious condition.

The patient was 28 weeks pregnant, the dragon and phoenix fetus, and was close to giving birth, and now the aortic dissection of the heart was found, which means that the relationship is now one corpse and three lives.

"With the patient's current condition, the risk of continuing to transfer is very high. ”

Fang Han said: "In terms of medical level, our Jiangzhou Province is a relatively high medical standard among the surrounding provinces, if our Jiangzhou Province can't get this disease, then the best choice for patients is to transfer to Shanghai or Yanjing, once the dissection is ruptured on the road, the consequences are almost predictable." ”

The people were silent.

What Fang Han said was the truth.

The patient was transferred from Shangjiang City to Jiangzhong Hospital, and took a lot of risks along the way, Shangjiang City is not too far from Jiangzhong, two hours by car, but if you transfer to Shanghai or Yanjing.

In the state of the patient, it is not possible to take an airplane, and the turbulence and weightlessness at high altitude can easily cause aortic dissection to rupture, and once ruptured, it means death.

The risk of transfer is very high.

It is said that there is no cardiac surgery in Jiangzhong Hospital, and the patient should not choose Jiangzhong Hospital in this situation, but the last operation of Solis and Fang Han was also observed by doctors from Shangjiang Central Hospital, and this time the patient came to Jiangzhong Hospital at the suggestion of the director of cardiac surgery of Shangjiang Central Hospital, to put it more bluntly, it was for Fang Han.

However, as Li Wenjun said, Jiang Zhongyuan could not handle such a complicated operation.

"Xiao Fang, do you mean let's do it?" Li Wenjun asked.

"Doctor Fang, I suggest being cautious. ”

Vice President Tan Wangxue said loudly: "Such a complicated operation, our hospital can't do it at all, as far as the heart is concerned, you are alone, this kind of operation is not something that can be taken down by one person." ”

"Yes, Xiaofang, it's better to be cautious. Qin Weihua also spoke out to dissuade him.

The risk of surgery is too great, and the consequences are quite serious, one corpse and three lives, if something goes wrong, the negative impact of Jiang Zhongyuan is small, and Fang Han's own future is big.

With the current situation of Jiang Zhong Hospital, it is not too much to push the patient out, after all, Jiang Zhong Hospital does not have an extracardiac field, although Fang Han can do heart surgery, he can rely on Fang Han alone, and such an operation cannot be taken.

Since it can't be taken, it is better to let the patient transfer to the hospital, even if it is to transfer to Jiangzhou Provincial Hospital or the Affiliated Hospital of Jiaotong University, than in Jiangzhong Hospital.

Fang Han said: "Since our Jiangzhong Hospital can't take it, I suggest that we immediately contact several other hospitals to participate in the operation." ”

"Participate in the operation together?" Tan Wangxue was stunned.

Fang Han nodded: "The patient's condition is complicated, not only to have a cestomy surgery, but also to have a heart aortic vascular replacement surgery, the risk is very large, such an operation is a very high-risk operation for any hospital, since one hospital can't take it, I suggest that several hospitals participate in the operation." ”

From Fang Han's point of view, he naturally would not push the patient out easily.

It's not about being strong, it's about being responsible for the patient.

With such a risky operation, not only could they not take it from Jiangzhong Hospital, but also from the provincial hospital and the medical affiliated hospital, and even Shanghai Hospital and Yanjing Hospital did not dare to say that they could handle it.

One corpse, three lives.

The safety of pregnant women is not only related to the pregnant women themselves, but also to the affected children.

Babies at 28 weeks of gestation have a high birth risk rate and a low survival rate, coupled with the aortic dissection aneurysm of the heart in pregnant women........

When the hospital was doing the examination and analysis just now, Fang Han had already carefully weighed the pros and cons.

The reason why Li Wenjun and others feel that Jiang Zhongyuan can't handle this operation is not because he doubts Fang Han's level, but because Jiangzhong Hospital does not have a team in the field of extracardiac surgery at present.

Except for Fang Han, other doctors have not participated in heart surgery at all, and nurses have hardly participated in such a high-risk operation, except for Fang Han, who are all novices, how to do this operation?

Therefore, Fang Han suggested asking for foreign aid.

"Last time, Dr. Solis performed several surgeries in our hospital were coordinated by the team of doctors from the provincial hospital and the affiliated hospital, and this time we can also invite doctors from the provincial hospital and several other hospitals to participate together, and I will be the chief surgeon. ”

Li Wenjun groaned slightly and looked at Tan Wangxue.

This is also Fang Han's current and unusual, not only is his status in Jiangzhong Hospital unusual, but he has also had liver surgery and heart surgery, and everyone knows Fang Han's level very well.

Today's Fang Han, although he is still young, can be in the Jiang Middle Court, in some circles that are familiar with Fang Han, his words are taken seriously by others.

If this had been changed two years ago, Fang Han dared to say this, and someone would have been scared a long time ago.

The authority of the doctor is established in the treatment after treatment.

The superb surgical level and the recovery of patients with incurable diseases one by one have allowed Fang Han to establish absolute authority in Jiangzhong Hospital.

"Okay, I think Xiao Fang's proposal is still feasible, as doctors, we must also be responsible for the patient, Xiao Fang's proposal is indeed the best way at present, so I will contact several other hospitals. ”

"Director Jiang, is there a problem with our obstetrics department?" Fang Han asked Xiang Jiang Yue'e again.

This operation can be said to be two surgeries, caesarean section + cardiac aortic vascular replacement, first caesarean section, and then immediately cardiac aortic vascular replacement, both operations are faster.

Don't have a caesarean section, you have to save as much time as possible, which is quite demanding on the obstetric side.

"No problem. ”

Jiang Yue'e said: "The Department of Obstetrics and Gynecology of our Jiangzhong Hospital is not a simple Chinese medicine department, but also has an elite surgical treatment team. ”

"Okay, then do it, the obstetrics department will go to prepare immediately, and when the doctors from other hospitals are in place, the obstetrics department is the first stick, and it is also the first pass of this operation." ”

"Fang Han, caesarean section must be done first, can't heart surgery be done first?" asked Zhuo Haihua, deputy director of the obstetrics department.

"Of course not!"

Before Fang Han could speak, Kuang Mingzhuo said: "Cardiac surgery is to establish cardiopulmonary bypass, and at that time, physical cooling and other means will be taken, if heart surgery is done first, the danger to the child is very great." ”

The doctors in the obstetrics and gynecology department went to make preoperative preparations first, while Fang Han and Chen Yuan walked out of the consultation room.

In the corridor outside the emergency room, the patient's family is waiting anxiously.

The patient's parents, parents-in-law, husband, and a large family of children are haggard and sad.

"Doctor!"

Seeing Fang Han and Chen Yuan discharged from the hospital, the patient's family members hurriedly came up like a swarm, and the patient's husband hurriedly said before Fang Han could speak: "Doctor, it's really not good, we protect the adult, protect the adult, please save my daughter-in-law, please." ”

"Don't worry!"

Chen Yuan hurriedly said: "Now it's not a question of protecting adults or children. ”

"Doctor, you mean, both can be saved?"

The patient's family didn't understand this, they only knew that the operation was very dangerous, after all, the patient was transferred from Shangjiang City, and they knew some of the conditions.

"The fetus is already 28 weeks, in this case we have to have a caesarean section first, and then we can do heart surgery, not as simple as protecting adults or children. ”

Chen Yuan patiently explained to the patient's family.

Fang Han didn't say a word, looking at the family in front of him.

Dragon and phoenix fetus, 28 weeks, originally for this family, they should be full of joy waiting for the arrival of a new life, but who would have thought that the child has not yet been born, but ushered in such a sudden change.

The patient's aortic dissection is caused by the third trimester of pregnancy, which is relatively very, very low, but such a low probability event happened to the patient.

Caesarean section and arterial dissection, the risk of surgery is almost exponentially increased.

Fang Han originally planned to say something to the patient's family, but looking at the family's expectant eyes and worried looks, he couldn't say a word.

Even if there is a system in the body, Fang Han is not too sure about this operation, and if the artery ruptures during the caesarean section, the props of the system are actually not very useful.

In this operation, the doctor is only one aspect, and the patient's willpower and luck are also crucial.

: Said good last night, the result was not written, let everyone down, this paragraph I was repeatedly considered, repeatedly revised, and strive to write well, to put it very seriously, the reason why the update is slow, is to ensure the quality, the number of words in Chinese medicine is a lot, I don't want to write to the back of the collapse.....