Zhou Litao still had questions to ask, but when he saw the eyes of the patient's family, he couldn't help but continue.

When I came to the CT room, I waited for a while, and the CT doctor explained the situation to the patients behind me and added the emergency patients.

The other patients also understood, and when they saw that the patient was lying on a flat car, and there were three doctors and a nurse by his side, everyone who saw it felt that this patient was going to die.

There are also people who are unreasonable and do not think about other people, but it is not common.

It's just that in front of this window in the emergency department, there is a lot of contact, and it becomes the norm.

The patient was sent to the CT room, and several people came to the operation.

Zheng Ren didn't get started either. It's always overstepping, after all, it's not good. He stood quietly behind the doctor in the CT room, watching the film.

"Boss Zheng, the patient has no bloody stool, and I think that if the diagnosis is isolated superior mesenteric artery dissection, it is better to treat it conservatively. At this time, there was no family member of the patient, so Zhou Litao immediately expressed his thoughts.

Su Yun's eyebrows were raised, and just as he wanted to go back, Zheng Ren gently touched him with his elbow and said with a smile: "If there is no blood clot in the cavity, there is no problem with being conservative." After all, the dissection pressure of the superior mesenteric artery is relatively low, which cannot be compared with the aorta. ”

Zhou Litao was also a little puzzled, didn't Boss Zheng say that surgery was recommended just now? Why did he change his mind so quickly?

"It's just a possibility, Cui Lao asked, and I said it. Zheng Ren smiled: "Each has its own benefits, and the operation can avoid undetectable, large intestinal necrosis of the patient and the possibility of other complications." If it is conservative, it can reduce the damage of surgery and save costs for patients and their families. ”

What he said was so sleek, Zhou Litao didn't know how to answer.

"Let's look at the diagnosis first, and what to do is still up to the patient's family. Zheng Rendao.

The 64-slice CT scan took a long time, and the patient's abdominal pain and agitation were obvious, so it took half an hour to push the patient out.

Then Zheng Ren said: "Mr. Zhou, you push the patient back first, and I will see the results of the reconstruction." ”

Seeing Zhou Litao leaving, Su Yun asked puzzledly: "Boss, this thing is talking too much." ”

Zheng Ren felt that Su Yun just said the opposite, not that Zhou Litao talked a lot, but that he talked a lot. He smiled and said, "What people say is true." ”

"Cut. Su Yun disdainfully, "The pain of the mezzanine is not something that ordinary people can bear." I met a patient who asked him after surgery, and he said that it hurt like a knife was stirring in his chest, and he didn't want to live at that time. If you can die directly, it is better to die. ”

"Well, if you can do surgery, you still have to do it, and I don't agree with conservative treatment. Zheng Rendao.

"Then why don't you slap him. Su Yun expressed disdain for the attitude of a good old man like Zheng Ren.

"It's meaningless, this kind of patient can't be accepted by our department, it should be more experienced. Zheng Ren said: "If we need to come to power, we will do it." If not, the vascular department can do it. In the CT room, the general inpatient of the emergency department, are you idle. ”

"You're a man with your tail between your legs. Su Yun looked at Zheng Ren with a smile and said, "Do you need to be so low-key?"

"It's low-key and substantial. And didn't you say you didn't want to go to the emergency department, why are you so arrogant?" Zheng Ren asked rhetorically.

"......" Su Yun was speechless.

This is really a dilemma, he thought about it carefully, what Zheng Ren said made sense, but he didn't agree.

It's really breathtaking.

"There are two views in academia, surgical and conservative. But I still prefer surgery, and the specific situation is analyzed. If treated conservatively, there is a risk of recurrence. Zheng Ren said: "This point can only be determined after the 64-row vascular CTA comes out." ”

Su Yun nodded, quietly watching the doctor in the CT room do an examination, and the black hair on his forehead was floating weakly.

Because it was an emergency department, the 64-slice CT three-position reconstruction was done quickly.

The superior mesenteric artery can see a true and false double lumen, there is no thrombus in the true lumen, and thrombosis can be seen in the false lumen.

The false lumen is not large enough to compress the blood vessels, resulting in occlusion of the superior mesenteric artery.

The superior mesenteric artery supplies all of the small intestine and two-thirds of the large intestine with blood, and once ischemia, it can cause ischemic pain in the small intestine.

In Haicheng Zhengren, a patient with intestinal bleeding embolized part of the superior mesenteric artery, and took the initiative to let the small intestine die and resect it, which is the reason.

However, patients who once wanted intestinal necrosis and found a bleeding point to be removed. Now the patient is avoiding this.

The patient's condition is judged by whether to have surgery or not.

If he was in the emergency department of Haicheng First Hospital, Zheng Ren would definitely not hesitate to explain to his family and go to the stage for surgery. But here is 912, ambiguous things, Zheng Ren only gives opinions, not responsible for making decisions.

Sending the film back, Zhou Litao had already sent the patient to the general surgery department, and he was not there. Cui Lao inserted the film into the reader, put on glasses, and watched carefully frame by frame.

After more than ten minutes, Cui Lao said, "Xiao Zheng, what do you think?" ”

"You can be conservative, you can be ......"

"I'm asking for your opinion, not for you to kick the ball. Cui Lao was displeased and glanced at Zheng Ren.

His hair is like snow, and his eyes are like knives.

"I recommend surgery. Zheng Ren immediately returned, "On the way, I observed that the patient's pain threshold was relatively low, and the blood pressure was not well controlled. Although there is no thrombus in the true lumen of the superior mesenteric artery in such patients, the likelihood of recovery will be further reduced with conservative treatment. ”

Cui Lao didn't speak, sat down, and looked at Zheng Ren quietly.

"The surgery is also relatively simple, and the next stent will do. Superior mesenteric arteriography + PTA + stenting. If the patient's family is financially fine, he can be discharged from the hospital after three days of postoperative observation. ”

"Well, that's right. Cui Lao said: "Young people, be vigorous, don't pretend to be old-fashioned." ”

"......" Zheng Ren is the first time I have heard someone say this about himself.

Cui Lao, it's really different.

However, the difficulty of practicing medicine in his time cannot be compared with that now. The contradiction between doctors and patients has become more and more acute as medical treatment is introduced to the market.

"The patient has a history of smoking, high blood pressure, and poor blood pressure control. In my experience, patients with a history of smoking are basically not saved. Now that low molecular weight heparin is given for anticoagulation, alprostadil dilates blood vessels, and papaverine for antispasmodic, you go to general surgery and prepare for surgery. Cui Lao said.

He not only gave a diagnosis, but also determined the next treatment.

There is a history of smoking, and it is difficult to keep the sentence of success, which is worth ten thousand gold for Zheng Ren. It's not like a doctor saying that.

But Cui Lao said so.

This is a summary of experience, and although this sentence is not rigorous, it cannot appear in journal articles because of this.

This is just a summary of Cui Lao's lifelong experience, and you can't learn it anywhere else.

Zheng Ren's heart sank, nodded, and bowed deeply.