"Shallow and light pulse, tachycardia, dyspnea, hypoxia, chest pain, radiating to the back and abdomen, the condition is more severe, with a history of hypertension and coronary heart disease. Liu Ya looked at Fang Ruohua. "What is the blood pressure?"

"One hundred and fifty, one hundred and eighty millimeters of mercury, relatively high. Fang Ruohua wiped her sweat, and when she saw the painful expression of the old man on the sofa, she was also a little scared.

"Uncle Jiang, have you given any medicine?" Liu Ya asked again.

"I gave a compound nitroglycerin and pressed it under my tongue. Uncle Jiang stood aside and said unhurriedly. He has seen a lot of this kind of thing, anyway, the doctor has already come, and it is useless to be anxious, and the most important thing is to wait patiently for the doctor's treatment and decision.

"Do you have a medical history before, but you haven't done any treatment?" asked Liu Ya again.

Generally speaking, many times of severe angina pectoris, all of which are caused by severe coronary heart disease, myocardial ischemia, causing severe pain. The next stage of angina pectoris is often ischemia and mass death of heart muscle cells, that is, myocardial infarction.

In this case, coronary intervention or heart bypass surgery is definitely needed to completely solve the myocardial insufficiency caused by cardiovascular atherosclerosis.

The so-called coronary intervention is what ordinary people call a stent inside the heart blood vessels. From the arterial blood vessels at the wrist as the approach, the flexible tube and needle are penetrated from the arterial blood vessels to the root of the aorta, and through the delivery of iodine or other contrast agents, combined with CT or X-ray imaging, the blood flow of the coronary arteries in the heart can be directly observed, so as to judge the blockage of the arteries and the specific location of the blockage.

At the same time as coronary angiography, the dilator that can open the blood vessel can be left directly in the blocked position, and the dilator can be opened at the same time as the hose is withdrawn, and the originally blocked or hardened blood vessel can be opened.

However, coronary intervention is not a complete treatment, if the patient's coronary arteriosclerosis is severe, or even calcification, then the intervention may directly puncture the blood vessels, causing very terrible consequences.

Moreover, if the patient has more coronary artery blockage in the heart, it is also impossible to solve the problem through interventional treatment, after all, it is not a good thing to do too much stent.

In such cases, heart bypass surgery is often necessary. Heart bypass, as the name suggests, is to bypass the originally blocked blood vessels on the heart and create a new pathway, so that the blood can go from the newly built "bridge" and dredge the blood.

The specific method is to take out a blood vessel from the patient's lower limb at the same time as the thoracotomy, divide it into several segments, and then suture it on the heart, and the blood vessel that has been blocked will not be left alone, as long as the blood can reach the heart muscle from the new pathway, provide nutrients to the muscle, and maintain the normal operation of the heart.

However, the operation is to open the chest, the trauma is large, and the preoperative recuperation is required, and the various physical indicators are up to the standard before the operation can be performed, otherwise the risk of the patient on the operating table will increase indefinitely.

The patient experienced two angina hospitalizations and did not receive any treatment, which Uncle Jiang must have known. The patient's current situation is not very effective in interventional surgery, and the thoracotomy bypass surgery is not strong enough, so he is afraid that he will not be able to get off the operating table, so he can only choose conservative treatment.

Uncle Jiang nodded at Liu Ya, a little helpless, "The stent is useless, the physical condition is too poor, this is the third time, I'm afraid it's not a small danger." ”。

Liu Ya didn't say anything, and there were some things in his heart that were still difficult to say. In this case, multiple angina pectoris is a manifestation of multiple myocardial infarctions, the number of healthy cells in the heart muscle is shrinking, conservative thrombolysis and vasodilation therapy cannot fundamentally solve the problem, and the physical condition is definitely getting worse.

"Take out the medicine in your mouth, five milligrams of nitroglycerin intravenously, five milligrams of diazepam intravenously, oxygen inhalation after getting in the car, ECG monitoring, and an electrocardiogram, which can only be said when you go to the hospital. Liu Ya said.

Although Fang Ruohua was nervous, he still completed the doctor's order very quickly.

Wang Ge and Liu Ya carefully placed the patient on the cart and glanced at Uncle Jiang.

"Uncle Jiang, this situation must be notified to the family......" Wang Ge said.

"I know, I have his son's contact information here. I've packed up my ID card, bank card, and medical insurance card, let's go. "Uncle Jiang knows the routine very well, he prepared everything long before Liu Ya was here, and he patted his pocket.

"I say, you'll like Uncle Jiang. Wang Ge smiled at Fang Ruohua.

The group entered the elevator, and Wang Ge found no trace of death in the patient's home or in the elevator, and even after getting into the ambulance again, he did not see the Grim Reaper chasing them.

However, the patient's condition was already critical, as if neither nitroglycerin nor diazepam had any effect, the pain continued, and there was no improvement after receiving oxygen.

What's going on?

Wang Ge didn't dare to take it lightly, the Grim Reaper would definitely be waiting for him somewhere, since the ambulance left the community quickly, the King Pigeon was very nervous to look at the situation around the road, to prevent the Grim Reaper from appearing inadvertently.

After reporting to the city's medical emergency command and dispatch center, the vehicle began to accelerate.

"Xiao Liu, in this case, is the operation really impossible?" Uncle Jiang had been in a very low mood since he got into the car, and he looked at Liu Ya and asked in a low voice.

"Since the doctor did not provide any treatment when he was admitted to the hospital, it may be that the family did not agree. However, when the family disagreed, it was often due to the degree of risk of the surgical treatment, and the attending doctor at that time must have informed the patient's family or the patient himself in detail of the huge risks that the operation might take. "However, this is now the third time in this situation, and if you don't have surgery and continue conservative treatment, there will be a more serious risk to your life, even more serious than the previous two times, and if you have surgery, then you will also have to take risks." This ......"

"It depends on how his family chooses, right?" Uncle Jiang asked.

Liu Ya didn't speak, just nodded.

"Okay, I got it. Uncle Jiang put on reading glasses and took out his mobile phone. As he gets older, he is slower to accept new things, and the smartphone in his hand is older, but he still has to think about his next move for a long time with every click.

Wang Ge watched all this from the rearview mirror, and felt distressed and uncomfortable for a while.

However, fortunately, the old people's mutual aid association established by Uncle Jiang found out about the patient's situation in time, if there was no Uncle Jiang, the patient would have angina pectoris at home and myocardial infarction, maybe there would not even be a chance to dial 120, and the person would be gone.

Because the distance was too close, the vehicle arrived at the hospital within nine minutes, and at this time Uncle Jiang had already called the patient's son, but he had no choice but to be in the field, and it would be at least the next day to rush back, so he had to ask the local relatives to come first.

After Wang Ge helped send the patient to the emergency room, he first parked the car back to the parking lot, and then returned to the emergency hall, Uncle Jiang was really still here, he sat next to Uncle Jiang, and the metal bench under his buttocks was very uncomfortable.

From beginning to end, the Grim Reaper never appeared, but the king pigeon always felt that things were not so simple. He wanted to come here to see if the Grim Reaper appeared, and he might use the special ability of the Soul Calming Card to buy this patient a little more time.

Uncle Jiang's mood was very low, and he looked at the payment slip he had just taken out on the chair, of course, Wang Ge knew that he was not worried about money.

"Uncle, it's okay. The king pigeon sat down and said.

"What are you doing here, busy with your going, I'm fine here. Uncle Jiang took off his reading glasses and glanced at the king pigeon.

"Anyway, there's nothing to do here, come and accompany you, and see if there's anything to help." Whether it's someone else or yourself, it's a VIP customer on our side. The king pigeon replied.

"Boy, flamboy!" Uncle Jiang finally rejoiced, "I don't say that I want to run to you five or six times a year, especially in winter, and it's thanks to my illness this year, otherwise I'm not at home, and I really can't take care of the other old guys in the community." ”

Wang Ge didn't speak, just quietly listened to Uncle Jiang talk about him.

"Xiao Wang, even though you are engaged in medical work, you probably can't experience this feeling, looking at the old guys around you, walking one by one, there are fewer and fewer people in the mutual aid association. In the past, everyone's health was fine, so how good it was to get together to choose a dance, sing a play, and rehearse a chorus. But it didn't take long to find that Lao Zhangtou was gone, Lao Sun Tou was gone, Aunt Li had a cold, high blood pressure was uncomfortable, she couldn't stand steadily, and she couldn't participate in any activities. There are fewer and fewer people, and this year, hey, I can't even play poker and play royalist. ”

"I feel uncomfortable, watching others go one by one. Wang Ge said.

Uncle Jiang raised his head and let out a sigh, "Yes, they are all old neighbors for more than ten years, and they have been friends for more than ten years. ”

"Uncle Jiang, you can't talk nonsense. You have a long life!" Wang Ge quickly interrupted Uncle Jiang. He wasn't lying at all.

Last time, Uncle Jiang was critically ill, although there was a god of death chasing him, but the god of death behind him was surprisingly slow, as if he had no intention of taking away Uncle Jiang's soul at all, and the appearance was just a routine, which meant nothing.

If this Uncle Jiang doesn't live long, he won't believe it if he kills the king pigeon.

"You don't have to comfort me, sooner or later people will die. You can't escape. I'm either afraid of death, or I'm afraid that after I die, what will happen to these old guys in the community. Uncle Jiang patted the hand of the king pigeon and sighed.

Although Uncle Jiang is a little pessimistic, this situation will appear sooner or later, and it seems that it is not too much to take precautions.

"To put it mildly, Uncle Jiang, if you are gone, I dare not say that every day, the old people in your community, I will definitely go to see it once a week, and deal with it quickly if there is something." Wang Ge thought for a moment, now he only has eight hours a day, and it is not too much pressure for him to spend a few hours after work every Sunday to go around there.

Uncle Jiang shook his head, "That's not the case, can you make sure that this thing that is sick can be found in time? can you ensure that the phone is answered 24 hours a day?"

"This ......" the king pigeon was silent, he really can't do it, he also has a job.

"Forget it, it's not that simple. If I can live for a day, I can watch these old guys for a day. If I'm gone, someone will come forward. Uncle Jiang smiled.

Wang Ge was just about to say something more, when he suddenly saw a figure holding a long-handled umbrella at the door of the emergency hall.

If it doesn't rain outside, and you don't need the sun in winter, it's definitely death. But this Grim Reaper is not necessarily for the elderly patient with angina, Wang Ge is very cautious, and is still ready to take the Soul Suppression Card out of his chest and stuff it into his mouth.

But the next action of the Grim Reaper made the king pigeon completely cold. He pulled out a blue booklet from behind his back, which was very familiar to the king pigeon, the book of life and death.

The Grim Reaper looked at the clock hanging in the emergency hall, and then at the information in the book of life and death, and rushed straight in the direction of the king pigeon with an umbrella.

Sure enough, the patient was in critical condition, and the Grim Reaper did not appear at the patient's home and on the way to the hospital, not because he was late, but because there was no need to be early.

Yang Shou is over, it is necessary to take out the soul of the deceased according to time, it doesn't matter if the time is a little later, but it must not be early.

Moreover, in the case of the end of Yang's life, the dispel and deception functions used by the king pigeon through the soul suppression card are useless.

The time of death is written in the book of life and death, and even if the god of death is deceived into believing that the patient's physical condition has improved, he must act according to the time specified in the book of life and death.

Moreover, the dispel function can only last for a short ten minutes, and even if the Grim Reaper waits for these ten minutes, it will still take away the soul.

The pigeon's hand on his chest slowly lowered, and he no longer looked at the Grim Reaper.

At this time, the Grim Reaper, who was relatively close to the king pigeon, seemed to feel the breath of death and the enforcer from the king pigeon, but seeing that the king pigeon didn't seem to find him, he didn't think much about it, put away the book of life and death, and entered the emergency room with an umbrella.

This patient's life must not be saved, Wang Ge was distressed for a while, and looked at Uncle Jiang and didn't know what to say.

"I don't think he can make it. Uncle Jiang was the first to speak. "In the past two or three years, I've sent away a lot of old guys. Go ahead, don't worry about me. I've thought about it for a long time. ”

Wang Ge nodded, stood up, turned around and just took a step, and clearly heard Uncle Jiang behind him, that heavy sigh.

"Alas. ”

This sigh, I don't know how much Uncle Jiang's heart has condensed.