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Chapter 946: Upgrade in place

The next day, Yang Ping went to the CCU to make rounds to check Karen's postoperative condition.

Professor Yang's ward rounds were destined to be watched by many onlookers, so Yang Ping had just stood by the bedside, and Karen's ward was already surrounded by doctors on the inside and outside of the three floors, whether it was a senior chief physician and deputy chief physician, or a young doctor, master's degree, regular trainee, or intern, Yang Ping was surrounded by water.

Xia Shu reported on Karen's condition after CCU surgery, and his vital signs are currently stable without the support of ECMO, and stable vital signs are maintained by Karen's own heart, which is very rare for Mr. Karen.

Prior to this, in order to reduce the load on the heart and preserve the only cardiac function, Cullen had been relying on ECMO to sustain her life, even when she was transported to China by medical plane, Cullen still did not get out of ECMO support.

Now that the surgery has been completed, the tattered heart has been repaired and rebuilt, and it has normal functions to support Karen's life.

After listening to Xia Shu's return, Yang Ping took the tablet computer handed over by Xia Shu, and began to flip through Karen's latest examination results, the patient's electronic medical record data update is always faster than paper data, all the examination results come out, the first thing is to upload the electronic platform of the intranet, and the paper report to the doctor also needs a cumbersome process: the paper report is issued, the department is delivered by a special person, and the doctor in charge of the bed or the intern doctor puts the report into the medical record, this process sometimes takes several days, so the doctor is more willing to look at the information on the computer, which is more timely.

In the intensive care unit of CCU, there are many kinds of examinations every day, and often one day's examination can exceed the examination of the entire hospitalization period of the ordinary ward.

Blood routine, biochemistry, liver and kidney function, myocardial enzyme spectrum, procalcitonin, etc., all have been re-examined after surgery, from the examination results, the infection has been completely controlled, this kind of infection with local lesions, the effect of surgery is immediate, after removing the infection focus, the general infection can be quickly controlled, and some residual infections are quickly eliminated under the blow of antibiotics and human immunity.

The most common infection with lesions is a variety of abscesses, surgical incision and drainage of pus or removal of abscesses, the infection is quickly controlled, without surgical intervention, relying solely on medical treatment, no matter how high-grade antibiotics are difficult to obtain good results.

Karen's bacterial endocarditis, infected valves, abscesses and vegetations formed, these are all infectious lesions, these lesions cannot be removed, the infection cannot be controlled at all, and now the surgery has completely cleared these lesions, and then replaced with a new valve, the infection is controlled, as long as the heart function returns to normal, Karen's condition will recover quickly.

The Swedish doctor who followed him kept recording something, and the doctor made the notes very meticulously in the form of drawings and words, and he even drew Karen's bed in the CCU, the various equipment in the room, the various monitoring data on the instruments, and so on.

Song Zimo glanced at it, the entire notes of the Swedish doctor were like villain books, probably in order to pursue the speed of recording, those villains were like the recently popular stickman paintings, very concise.

After reading the electronic medical record, Yang Ping was going to do a bedside echocardiogram, which is a postoperative examination that needs to be repeated repeatedly.

Echocardiography can qualitatively diagnose some heart diseases, and can also quantitatively analyze heart structure, valve morphology, ventricular wall motion and hemodynamic status, and evaluate heart morphology and structure, including heart chamber size, ventricular wall thickness, valve opening and closing, and myocardial movement.

Therefore, color ultrasound is the most commonly used examination in cardiac surgery in many cases, and it is an indispensable diagnostic and evaluation tool in the perioperative period of cardiac surgery, that is, before, during and after surgery.

In China, echocardiography is generally done by sonographers, whether it is cardiology or cardiac surgeons, few have mastered the principles and operations of echocardiography, and most doctors are laymen.

Unlike in China, cardiologists and surgeons in Europe and the United States must do echocardiography by themselves, and they begin to receive comprehensive learning and practice in this area from the time of residency training, so cardiac ultrasound is a necessary skill for every cardiologist and must be proficient.

Dr. Filgenbaum in the United States, the founder of echocardiography, was not a sonographer, but a cardiologist. Cardiac surgeons or internists have clinical experience, how to master the principle and use of color ultrasound by themselves, and can perfectly combine clinical and imaging.

However, a doctor in the ultrasound department will not go to the heart surgery for a lifetime, lacks clinical experience in heart diseases, and only has imaging knowledge, and the combination of clinical and imaging is more conducive to the progress of cardiac color ultrasound.

The father of echocardiography in China is Professor Wang Xinfang of the Department of Ultrasound of Wuhan Union Medical College Hospital, who has made great contributions to the ultrasound profession and is recognized as the first person in the world to monitor fetal heart rate ultrasound.

In the 60s of the last century, obstetricians in China could only understand the situation of the fetus in the womb by hearing and touching, and could not hear the fetal heartbeat. In 1963, during an ultrasound examination of a pregnant woman, Professor Wang found that the wave on the ultrasound machine jumped a little, and it was speculated that this should be the movement of the fetus's limbs. He immediately thought: since he can understand the movement of the limbs, can he use it to monitor the fetal heartbeat? So, Professor Wang began to try and used two ultrasound probes, one connected to the mother's heart and the other connected to the fetal heart, to obtain two wavelength bands with different speeds. After several observations, he discovered the fetal heartbeat reflex. In that year, Professor Wang published an article in a domestic medical journal and drew the world's first fetal heartbeat fluctuation frequency curve. In 2002, according to this article, the world's ultrasound community finally confirmed that China was the first to discover the fetal heart echo reflex.

In fact, when Xia Shu was in Fuwai Hospital, he was not very familiar with echocardiography, whether it was the principle or the practical operation, he rarely came into contact with it, and usually relied on the help of an ultrasonographer to complete the echocardiogram examination. After coming to the Institute of Surgery of Sanbo Hospital, Xia Shu began to learn to do echocardiography by himself and make his own diagnosis, and now Xia Shu has mastered the principle and operation of ultrasound, and the operation is very proficient.

Yang Ping watched from the side, Xia Shu operated, and the color ultrasound probe began to examine Karen's heart, and conducted a comprehensive evaluation of the size of the heart chamber, the thickness of the ventricular wall, the opening and closing of the valve, the movement of the myocardium, etc., without missing any detail, especially the condition of the valve, which must be carefully evaluated to find some subtle potential risks.

The surrounding doctors quietly watched Yang Ping and Xia Shu do cardiac color ultrasound, no one made a sound, and they were all very focused.

The Swedish doctor, on the other hand, continued to draw his "stickman" while watching, because he had to reconstruct the respective positions and postures of the doctor and the patient during this kind of examination, so that some things that he did not understand could be analyzed slowly later, and many things could not be depicted in detail and accurately by relying on words.

From the color ultrasound examination, no problems were found, indicating that Karen's surgery was very successful, and the cardiac color ultrasound showed that all parameters of the heart, whether static or dynamic, were normal, the implanted valve was of appropriate size, the opening and closing functions were normal, and there was no closure or incomplete opening.

Karen's surgery involves thousands of stitches to the heart, as long as these stitches can stop the healing period, the stitches are only temporary and ultimately need to heal the tissues in the heart.

The healing time of the incision on the heart is very short, because the heart itself has a very rich blood supply, the richer the blood supply, the stronger the healing ability, and the worse the blood supply, the worse the healing ability.

For example, diabetic patients have a long wound healing time, and even are prone to non-union, because diabetes can cause peripheral blood vascularity changes, resulting in poor blood vascularity, so wound healing is slow or non-healing.

"Extubate him today!" Yang Ping felt that Karen was in good condition and could be extubated.

Secretary Xia told Yang Ping's words, and after the ward round, he would pull out the tracheal intubation that was placed before yesterday's operation for Karen to let Karen breathe normally.

The Swedish doctor was amazed at Karen's recovery, he participated in Karen's entire perioperative treatment, observed the entire operation up close, let him see what the world's strongest cardiac surgery is like, his small notebook recorded the entire treatment process of Mr. Karen, and after asking permission, he copied Karen's operation, which is undoubtedly valuable to Swedish doctors.

After checking the room, Yang Ping had to rush back to the Institute of Surgery, and there were still many surgeries waiting for him.

Outside the door of the CCU, Ning Qi and Karen's family members have been waiting for a long time, Mr. Karen was introduced by Ning Qi, and his family's accommodation and life in China are arranged by Ning Qi, so Ning Qi often comes to Yang Ping to understand his condition.

Most of Karen's family members speak Swedish, Yang Ping briefly introduced Karen's condition with the help of a translator brought by Ning Qi, and heard that the operation was very stable, and now he can be extubated, and he can be transferred back to the general ward in a few days, and then slowly get out of bed and move, Karen's family is excited, and his wife and several children keep saying thanks.

"Thank you!" Ning Qi also looked at Yang Ping gratefully.

Yang Ping smiled and said, "I'm a doctor, it's just my duty." ”

"When you are free, I will invite you to dinner, don't say that you are busy - not to invite one, but also to invite Xiao Su and my godson, you set the time, go to my house, I will cook by myself." Ning Qi said in a gentle voice.

"Do you cook yourself?"

This eldest lady usually manages everything every day, and she cooks by herself?

Ning Qi said with a slight annoyance: "I can cook when I am ten years old, my cooking skills are very good, don't look down on people, cookies are just the first time people make them." ”

"I'll ask Xiao Su to make an appointment with you." Yang Ping replied.

Ning Qi straightened the hair in front of his forehead and nodded: "Okay, I'll make an appointment with Xiao Su." ”

Yang Ping was busy, and there were many surgeries, and it was not good to talk to Ning Qi for too long, so he said goodbye and immediately rushed to the operating room, and heard Song Zimo say on the way that Bao Junhao had been sentenced, and his father Bao Yulou had set up a charity fund in a low-key manner, which was dedicated to the education of teenagers. This incident is also a wake-up call for Yang Ping himself, and he must pay attention to his own safety.

Dean Xia called and said that he wanted to talk to Yang Ping, and Yang Ping said, "I'll go to your office." ”

Dean Xia hurriedly said: "No, no, no, I'll go to the locker room of your operating room, let's talk a few words in the locker room, don't waste your time, now I'm in the locker room, why didn't I see you." ”

Yang Ping immediately explained: "I just went to the CCU to make rounds, and I'm only going back now, you wait a while." ”

In the locker room of the operating room of the Institute of Surgery, Yang Ping saw Dean Xia, who had been waiting for a long time, his tall body was particularly conspicuous, so that the bench in the locker room seemed too small and thin, and when he saw Yang Ping come in, Dean Xia got up and said: "Let's talk a few words here, don't delay your time, you are very busy now, and you are about to have surgery." ”

"I just thought you'd be in the operating room, so I found a gown to put on."

Dean Xia doesn't need to go to the operating room to find someone now, so he takes off his visiting clothes, which are too small for him, and it feels like an adult wearing a child's clothes and about to burst immediately.

The two sat on the bench in the dressing room and chatted, Dean Xia said: "Our hospital is about to be restructured, no longer managed by the provincial department, and will be directly managed by the imperial capital in the future, but the management and staff of the entire hospital remain unchanged, no reduction, no increase, no replacement, what should I do or what to do, I originally thought it would be acquired by the imperial capital 301, but now it seems that this is bigger, you see how much our country attaches importance to talents, this is all for you, you like the southern city, like in Sanbo Hospital, so Sanbo Hospital is upgraded on the spot, I also followed the light, and I was promoted together, so that I have been upgraded, and the administrative level of my dean has also been upgraded a few levels, and the pension will definitely be higher in the future. ”

Yang Ping had heard about the acquisition of 301, turning Sanbo Hospital into the southern clinical center of 301, which was the original plan, and now it seems that this plan has also been denied, and it has been replaced by the in-situ upgrade of Sanbo Hospital.

"It's all for you, in order to maintain the environment and vitality of the hospital is not affected, so upgrade in situ, this is what I'm talking about today, in addition to a higher status in the future, more resources, the rest will remain the same, in the future, your scientific research funds will be more sufficient, not only allow you to raise funds personally, but also the state will strongly support it, so in the future you can rest assured to engage in your research, money is not a problem, the superior leader said, in principle, there is no upper limit, the superior leader also said, don't have psychological pressure, there will be no indicators or anything like that, Everything you plan and develop freely. ”

Dean Xia knew that the superior leaders fully respected Yang Ping's choice, and in order to provide Yang Ping with a good platform, the superior leaders spent a lot of thought.

"There's nothing else, it's just this thing, you can put forward any ideas and requests you have." ”

Dean Xia was afraid that Yang Ping would have any other requirements.

"There's nothing to ask for, it's business as usual anyway."

Yang Ping and Dean Xia chatted for a while, Dean Xia still has a lot of things, Yang Ping also has a lot of surgeries, Dean Xia left and said: "I think you have a good place, if you have anything to do in the future, you will be in this place, and it will not delay your time, it is better than the office." ”

"Don't, don't come here too often, if you run here often, we doctors won't dare to change clothes here."

Yang Ping reminded Dean Xia.

Dean Xia thought about it, too, this is the place where other doctors change clothes, how can it be used to talk about work, he looked around the locker room and said, "Why didn't you see anyone coming in to change clothes?" ”

"Seeing you here, everyone hid in the duty room to change clothes." Yang Ping said truthfully.

Dean Xia looked very distressed: "I'm so unpopular? So detached from the masses? ”