Huang Dazhi's doubts about surgery do not lie in diagnosis, but in technique.

Zheng Ren can demonstrate this kind of problem, and it depends on everyone's understanding when it comes to how to use it in surgery.

Even if Zheng Ren doesn't hide his selfishness, the vast majority of people can't understand it.

After Professor Huang consulted two more difficult methods of overselection and thrombectomy, Shay walked out after completing the handover.

He knew the height of his eyebrows and eyes, and understood that this was not a good time to chat, so he smiled and took Zheng Ren and the others to the interventional department.

On the way, Professor Huang didn't say anything more, because Zheng Ren and Su Yun were about to fall asleep while walking. He was just careful not to let the two of them fall asleep while walking, fall or bruise.

After entering the ward, Professor Huang came to the door of the director's office and said with a smile: "The director specially left the door for you, saying that as long as you need it, you can come and rest at any time." ”

"Thank you. Zheng Ren said vaguely.

Suddenly, there was a rush of footsteps in the hallway, and the sound of wheels scraping against the ground was loud.

Subconsciously, Zheng Ren opened his eyes. He was in a trance, thinking that he was in the first courtyard of Haicheng.

"What's wrong?" asked Zheng Ren in a daze.

"Boss, it seems to be a rescue. Su Yun was also in a state of confusion, and saw the nurse pushing a flat cart to a ward, and guessed.

"Take a look. Zheng Ren also saw the situation clearly, and immediately became more energetic.

Shay wanted to say something, but hesitated for a moment, and finally let Zheng Ren go.

She wanted to see where Jung in was sleeping, and then she went to drive around to see what she could buy.

Unexpectedly, just after coming down, I was rescued by the ward again.

Zheng Ren strode into the ward and saw a patient with slightly twitching hands and feet, wanting to dance but couldn't. What is said in the mouth is vague, and it is not clear.

Nurses and doctors, as well as volunteers acting as nurses, are resuscitating at the bedside, no one can be seen, and the system panel does not give a diagnosis for the time being.

"Boss, this person is probably a programmer, and all he talks about in his dreams is code, and he is really dedicated. Su Yun whispered.

"Programmer?"

"Listen to his delirium, it should be so. Su Yun said.

"Isn't this a postoperative patient, what's wrong?" Professor Huang was a little surprised, and he quickly asked.

"Mr. Huang, the patient had blood transfusion after stent surgery, lowered blood pressure, developed symptoms such as motor incoordination, blurred vision, and then began to have delirium, dizziness, headache, accompanied by nausea and vomiting, and the vomit was stomach contents. The doctor reported.

"Bracket?" Zheng Ren was stunned for a moment.

Today's patients are basically patients with hemorrhagic shock, and blood transfusion is sufficient, and there is generally no blood pressure lowering.

Coupled with the stent, Zheng Ren immediately remembered that he had diagnosed a patient with abdominal aortic dissection when he first arrived.

The patient had a stent, and Zheng Ren was sure that there would be no problems with the stenting. His own surgical experience and the degree of completion of the operation given by the big pig's trotters can be corroborated.

What's going on?

He took a step forward and saw the patient while the volunteers went to pick up their things.

The diagnosis given by the system panel in the upper right of the visual field is - after interventional embolization of pelvic fracture, after abdominal aortic dissection aneurysm stenting, thiocyanate poisoning.

Already sleepy and confused, Zheng Ren misdiagnosed it.

The first reaction is cyanide poisoning!

This is a big deal, is someone poisoning?

Zheng Ren was so frightened that he woke up.

Immediately, it became clear that it was thiocyanate poisoning, and he quickly recalled it in his mind, and his expression moved slightly.

Su Yun saw that Zheng Ren's situation was not right, so he squeezed up and asked, "What's wrong, boss?"

"It's fine. Zheng Ren shook his head, he couldn't tell Su Yun about cyanide poisoning, if he did, he would be able to talk about it next year.

"I guess I did the post-operative patient with the abdominal aortic dissection aneurysm. Zheng Ren asked.

"Teacher Zheng, yes. Professor Huang felt the strong aura of the senior doctor, and subconsciously called the teacher.

"What do you use to lower blood pressure? Zheng Ren asked.

It is also necessary to maintain stable blood pressure after aortic dissection aneurysm, and wait for the peritoneal frame to completely block the rupture. Generally, antihypertensive drugs should be given for 1-2 days, and then they can be stopped. It's nothing special, it's all routine treatment.

"Nitroprusside, pumped in a micropump, at a dose of 8 μg/kg/. The little doctor immediately reported the dosage of the medication.

Jung in then knew what was going on.

He said in a deep voice: "Stop nitroprusside, contact the nephrology department immediately, and go for dialysis immediately." ”

Professor Huang was stunned for a moment, what kind of operation is this? Acute renal insufficiency? Renal insufficiency is usually manifested in urine output, and this patient's urine output is normal.

Although hemorrhagic shock causes oligouria, it is not enough to achieve renal insufficiency below 50 liters an hour.

There are doubts and doubts, but after he heard Zheng Ren's words, he immediately subconsciously stopped the micropump to pump sodium nitroprusside.

"You don't have to deal with it too much, just be careful not to let the vomit aspirate and cause suffocation. Zheng Rendao.

"......" Professor Huang was puzzled, he arranged for the little doctor to contact the nephrology department immediately, came to Zheng Ren's side and asked, "Teacher Zheng, is it acute renal failure?"

"Sort of. Jung Ren replied.

Sweat...... Sweat......

Sort of, what is the answer.

For the first time, Professor Huang felt that Zheng Ren was a little unreliable, but this idea was nipped in the bud as soon as it emerged.

As a Nobel Prize candidate, the other party's identity can prove many problems.

That's not all, I have seen the operation myself, it is definitely the most awesome one I have ever seen, and generally this kind of doctor has a lot of clinical experience.

In the end, my own suspicion can only prove that I have little clinical experience and the diagnosis is wrong.

Professor Huang looked at Zheng Ren with an inquiring gaze, waiting for his explanation.

"It's thiocyanate poisoning. Zheng Rendao.

Belch...... Sodium nitroprusside is used clinically, which is commonplace. Many patients have high blood pressure, which is controlled with nitroprusside. For so many years, Professor Huang has rarely heard of the diagnosis of thiocyanate poisoning.

Not very little, but basically nothing.

thiocyanate poisoning, he sounds so strange.

"It's a problem with nitroprusside metabolism. Su Yun immediately thought of some possibilities and asked.

"Hmm. Zheng Ren said, "Sodium nitropusside is a nitrohydrocyanate that acts directly on the strong dilator of the arteriovenous vascular bed.

Nitroprusside is continuously pumped from red blood cells to cyanide, and then from thiocyanase in the liver to thiocyanate, a terminal metabolite.

thiocyanic acid is excreted by the kidneys, and the half-life of people with normal kidney function is 4~7 days. Patients with renal failure are accumulative. If the dose is too large, the metabolite thiocyanate in the blood is too high and poisoning is likely to occur. ”

"But the patient has no abnormal kidney function. Professor Huang struggled to recall the patient's lab returns.

"Not before, but now there is. ”