Brother Chuan watched Xu Jiu Yanle bloom, but his heart was in a mess, Guan Zheng didn't know what he looked like now, and he had to do these things only by himself, and of course this was what Guan Zheng meant.

Shi Jinyu's heart really can't stand the toss, Guan Zheng's condition is repeated, which makes people unbearable, how many times do you really want to fall to the ground and then take a good rest.

The doctor came out of the ward and said, "The patient really has difficulty recovering, and it is impossible to survive if the knife is inserted into the heart, but he has been in good condition before, which is fortunate, but now the patient's wound is inflamed and there are many complications, and it is difficult for us to guarantee that he will be able to get better, even if he recovers, I am afraid that he will not be able to run and jump in the future." ”

Shi Jinyu said: "But you know, he is a policeman. ”

The doctor nodded and said, "I know that he is a police officer, and because I know that he is a police officer, we are all working very hard to hope that he can recover as before, if not as before, at least let him continue to work as a criminal policeman." We are always working towards this goal, so as long as the patient has strong willpower and determination to overcome this hurdle, then we will do our best. ”

Shi Jinyu didn't speak, just looked at Guan Zheng who was still smiling at him in the ward, obviously the wound was so painful, obviously the body was so uncomfortable, and obviously the mood was so bad, but why did he still smile? Why don't you cry and vent your grievances? Why not complain about the unfairness of the world?

To tell the truth, Guan Zheng gave the place in the task force to Xu Jiuyan, maybe Xu Jiuyan will be very happy, but Guan Zheng will definitely not be happy. He has been guarding a case for ten years, and now he will give up when he says he will give up, and you can imagine how much suffering and sadness there is in it.

Shi Jinyu walked into the ward, and Guan Zheng said, "Why did you stand at the door just now?" ”

Shi Jinyu said: "It's okay, think about something." ”

Guan Zheng took Shi Jinyu's hand, but instead comforted him, saying, "I'm really fine, I'll get better." ”

"Do you know how you're doing?" Shi Jinyu asked.

Guan Zheng nodded and said: "Clinically, repeated short-term use of antibiotics, fever often recurs, especially in patients with valve murmurs, echocardiography, progressive anemia causes general weakness, weakness and shortness of breath, patients with a long course of disease often have systemic pain, which may be caused by toxemia or embolism of various parts of the body, joint pain, low back pain and myalgia are more common at the onset, mainly involving the gastrocnemius muscle and femoral muscles, ankles, wrists and other joints.

Murmurs of pre-existing heart disease or original normal heart murmurs can be heard, petechiae of the skin and mucous membranes, linear hemorrhage under the nail bed, petechiae are toxins acting on the capillaries to increase fragility and rupture bleeding or due to embolism, the spleen is often mild to moderately enlarged, soft and tender, in patients with recurrent episodes of pneumonia, followed by hepatomegaly, mild jaundice and finally progressive renal failure.

On the affected endocardium, especially fungal infections, large, brittle vegetations may be attached, exfoliated emboli can cause multiple embolism and metastatic abscesses, including myocardial abscesses, brain abscesses, and purulent meningitis, pneumonia, pulmonary embolism, and single or multiple lung abscesses if the embolus is from the infected right heart chamber, and the skin may have polymorphic ecchymosis and purpuric hemorrhagic lesions.

Most patients with subacute infective endocarditis have a slow onset with only nonspecific occult symptoms, such as malaise, tiredness, low-grade fever, and weight loss, and a few begin in the form of complications of the disease, such as embolism, unexplained stroke, and progressive exacerbation of valvular heart disease. Like me. ”

Shi Jinyu listened lightly and said, "Then what? ”

Guan Zheng said: "Low cardiac output syndrome. Unsatisfactory correction of cardiac malformations is an important cause of postoperative low cardiac output. During intracardiac operation, it is necessary to block cardiac circulation, and ischemia and hypoxia can cause damage to the myocardium, resulting in myocardial insufficiency; If there is insufficient oxygen exchange after surgery, hypoxia or acidemia can aggravate myocardial insufficiency; Tachycardia or bradycardia affecting atrioventricular diastolic insufficiency, arrhythmias such as third-degree block caused by hypoxia or surgical trauma are often the cause of low postoperative discharge, and I think I just have tachycardia, a minor problem.

Patients with large left-to-right cardiac shunt are prone to pulmonary hypertension, and patients with severe pulmonary hypertension have pulmonary arteriolar wall hardening and thickening of the wall and luminal stenosis, often accompanied by thickening of the tissue between the alveoli and capillaries, interstitial edema, which increases the pulmonary vascular resistance and enlarges the hypertrophy of the right ventricle.

Low cardiac output syndrome is the final result of the imbalance between myocardial energy supply and demand during the cryogenic cardiopulmonary bypass, and the metabolism changes from aerobic metabolism to anaerobic metabolism after aortic blockade, and energy production is sharply reduced, making it difficult to maintain the normal metabolism of cells. The function of the cell membrane sodium pump is impaired, and a large number of sodium ions are retained in the cells, causing myocardial edema. Cardiomyocytes are damaged by increased lactate, an anaerobic metabolic end product, resulting in intracellular acidosis. The left ventricular submyocardial hypoxia is most severe during ischemia and hypoxia, with local metabolites accumulating and subendocardial microvascular dilation. Poorly protected myocardium, during the ischemic period, more serious myocardial structure damage can occur, the permeability of the cell membrane increases, the capillary integrity is destroyed, a large amount of water and electrolytes can enter the cells in a short time after reperfusion, aggravating myocardial edema, increasing the subendocardial vascular resistance, reducing blood flow, further aggravating the imbalance between supply and demand of submetrial oxygen, and finally subintimal hemorrhage necrosis.

During the cardiopulmonary bypass, the active use of various effective myocardial protection methods can prolong the tolerance time of myocardial ischemia, reduce the degree of myocardial edema and necrosis, and continuously perfuse with oxygenated blood at room temperature can continuously supply oxygen to the myocardium, so that the myocardium can change from anaerobic metabolism to aerobic metabolism during the blockade cycle, which can avoid the negative balance of myocardial energy metabolism and is conducive to the recovery of postoperative myocardial function. ”

Shi Jinyu smiled and asked, "Are you so clear?" ”

Guan Zheng smiled and said, "I have studied biology for six years, specializing in anthropology, which is not difficult for me. ”

Shi Jinyu nodded and said, "Then you have to actively cooperate with the doctor and get better as soon as possible." ”

Guan Zheng smiled and said, "Of course, I have to go back and continue to investigate the case." ”

Shi Jinyu touched the three scars on Guan Zheng's wrists, as if saying to himself: "When will this scar heal?" ”

Guan Zheng replied, "It's almost there." ”