These words directly scratched Xie Baoshu's itch. He immediately went through all of Wang Zhang's diagnosis and treatment ideas from head to toe, and he nodded again and again.

"Xiao Xie, your basic skills are very solid, and your clinical intuition is also very sharp." Wang Zhang approvingly: "Your Yunshi First Courtyard is really full of talents." ”

"It's okay." Xie Baoshu's heart bloomed with a smile, and he couldn't hide it on his face: "Actually, my ability is more than that, if you give me the opportunity to have surgery, I promise that I will not disappoint you." ”

"Then you can rest assured, there will definitely be no shortage of opportunities, and it can't just be a hook - it will depend on your performance when the time comes." Wang Zhang said with a smile.

"Director, just put a hundred hearts!" Xie Baoshu is full of confidence.

At this time, the patient came back and the test results were all back.

The good news is that none of the tests are abnormal.

The bad news is that the symptoms of the patient.

After a while, his chest pain intensified again, and his face turned pale.

This can't be faked. What is it that causes such pain for patients?

"When did you start having chest pain?" Wang Zhang thought for a while and asked.

"Since this morning, the trip that was supposed to be canceled has also been cancelled." The patient's friend said: "After lunch, I saw that he couldn't hold on, so I persuaded him to come to the hospital." ”

"Let's do another enhanced CT." Wang Zhang made a decision.

Only contrast-enhanced CT is the gold standard for determining aortic dissection, but this kind of CT requires a contrast agent, and he does not want to give it to the patient if it is not necessary.

But now that the patient's condition has become so serious, he has to think carefully about the possibility of atypical aortic dissection.

Xie Baoshu looked at the patient's paroxysmal pain, and actually had another judgment in his heart.

At the Vocational Skills Enhancement Center, he has encountered similar patients, and the symptoms of pain are just like this.

However, Director Wang's current approach is understandable.

Aortic dissection, the full name is aortic dissection aneurysm. At the onset of the disease, the artery will rupture immediately, causing massive bleeding, and it is very difficult to rescue people in the hospital, so no matter how careful you are.

The effect of CT-enhanced CT was also transmitted immediately. Not aortic dissection and no pulmonary embolism.

Wang Zhang breathed a deep sigh of relief, and doubts followed.

The patient's pain is still unrelieved, clutching his chest in pain – what could be the problem?

"Pull another ECG." Wang Zhang said.

His orders were carried out flawlessly. Xie Baoshu took the results and looked at them and said, "Director, it's a normal ECG." ”

Wang Zhang took it and took a look at it noncommittally, and when he saw that this was the case, his evaluation of Xie Baoshu in his heart couldn't help but increase a few points again.

"You can also read an electrocardiogram?" He asked.

"yes." Xie Baoshu doesn't know the word modesty: "My ability to read pictures is very strong now, so I won't tell you."

"Alright." Wang Zhang said angrily: "Tell me your opinion, what other possibilities are there for this patient's chest pain?" ”

Xie Baoshu had been waiting for him to say this, and immediately said when he heard it: "Pericarditis." I suspect pericarditis. ”

"Pericarditis?" Wang Zhang shook his head: "It's unlikely. I just listened to the heart sounds and didn't hear a pericardial friction rub. ”

"And, come over and see the results of the ultrasound." Wang Zhang called him over: "There is no pericardial effusion and oozing at all. ”

Xie Baoshu had actually seen the results of color ultrasound just now, but he still insisted: "In the case of a new occurrence, the exudate at the pericardium may be very small, which cannot be seen in color ultrasound, and may not be audible on auscultation." ”

When Wang Zhang heard this, he was a little moved. I can't find any other reason left and right, and it's not easy to use medicine at will, but if you treat it in this direction, although it is relatively conservative, it is not easy to have a fork.

He thought about it for a while, and asked the patient again: "Have you really not had any surgery on your heart recently, nor have you had any external injuries?" ”

"No external injuries." The patient shook his head painfully, suddenly remembered something, and said, "But I underwent a radiofrequency ablation last week because of my premature heartbeat"

Radiofrequency ablation is an interventional technique in which an electrode catheter is sent through a blood vessel into a specific part of the heart chamber to release a radiofrequency current and block the abnormal conduction tract and origin point of tachyarrhythmia.

Intraoperative currents may injure normal myocardial tissue, causing pericarditis and even delayed pericardial effusion.

Wang Zhang slapped his thigh: "I did this operation, why didn't you say it just now?" ”

The patient's face was innocent: "What you asked is, did you do surgery, but didn't you say internal medicine?" ”

"You're too real." Wang Zhang said helplessly, and immediately turned his head to look at Xie Baoshu.

The latter secretly rejoiced in his heart because the patient's words confirmed his judgment, and Wang Zhang looked at him squarely.

"Okay, you guessed it." Wang Zhang said: "Let's talk about it, how to treat it, right? ”

"The patient had a radiofrequency ablation done last week and developed pericardial inflammation. However, if it is not serious for the time being, a non-steroidal anti-inflammatory drug, such as ibuprofen, may be considered to relieve chest pain. Xie Baoshu replied:

"At the same time, we should pay close attention to changes in the effusion in the pericardial space, and if necessary, pericardiocentesis and surgery can be used."

"Good." Wang Zhang was extremely satisfied with his performance, and on the one hand, he prescribed ibuprofen to the patient and arranged for him to stay in the hospital bed to rest.

By the time he left work, the patient's condition had improved greatly, and the pain in his chest was basically gone.

Xie Baoshu arranged for him to do another heart ultrasound and listen to the heart sound again.

Sure enough, just as he had judged at the beginning, this time, there was a very small amount of fluid in the pericardium, and there was a "sand-rustle-rustle" rub sound in the heart during auscultation.

"This is a typical pericardial friction fric." Director Wang rushed over to listen to it, and then summoned all the residents in the department to come over to listen and learn, and by the way, in front of everyone, he praised Xie Baoshu well.

"Brother Xie, tell me, we all learned together, how can you be so good?" Dorjee asked Xie Baoshu quietly.

"Do you need to ask? Brother Xie, I'm a genius—of course it can't be. Xie Baoshu said with a smile: "It's actually the result of practicing with VR glasses. ”

"It's not Brother Xie, I also went in and learned the pulse control and hemostasis technique. But the rest, just a hundred microsquare source energy, before you learn anything, it's gone. Dorjee said regretfully.

Xie Baoshu's heart suddenly moved, and he said mysteriously: "I seem to have discovered a small secret technique that can brush source energy, do you want to give it a try?"

"The secret technique of farming source energy?" A voice came from behind them: "What's that, tell me about it!" ”

The two looked back and saw that the person who spoke was Gan Yi, who had just entered the observation area.

Not only him, but under Wang Zhang's arrangement, the doctors who listened to the pericardial friction on the patient with a stethoscope one by one, one by one, all of them erected their ears long, waiting to listen attentively.

Xie Baoshu became inexplicably nervous: "I admit it, because of good luck, I got a lot of source energy. But I can't guarantee whether it will work for you. ”

"Hurry up, don't hide your secrets." Wang Zhang also turned around and said, "Whether it's useful or not, we'll know after we try it!" ”