Tuesday was also a busy day for Yu Zhiming.

As soon as he arrived at the Zhizhen Building of the hospital, Yu Zhiming did a key examination of the whole body and heart of a five-year-old girl introduced by Yao Hui, a bank colleague introduced by Yao Hui, the director of the community business committee.

I have to say that this little girl's heart malformation is the most serious that Yu Zhiming has ever examined.

Affected by the heart malformation, the little girl's cardiac ejection index was 30%, far below the lower limit of normal of 55%.

Yu Zhiming also found that the little girl's lungs, kidneys and other organs had been damaged due to insufficient heart pumping function.

If this development continues, even if effective adjuvant treatment is obtained, as long as the heart malformation is not cured, it can be supported for more than a year at most.

In view of the severity of the little girl's heart malformation, Yu Zhiming was quite vague about the little girl's parents, and whether there was a chance of surgery could only be determined after careful research......

Yu Zhiming spent more than two hours drawing the perspective of the little girl's heart, and then took pictures of the drawings and sent them to Dr. Luo Yu of the PLA General Hospital.

Then, he went to the soundproofed examination room next door.

On the experimental table in the center of the room, there is a one-to-one scale bust model of a pregnant woman in labor.

This is a biomimetic prop used to train medical staff to deliver babies and caesarean sections.

Nowadays, the medical teaching mannequin is quite realistic, high-end, almost fake, and almost real, which makes up for the lack of teachers to a large extent.

In the corner of the console, there is also a cage with three shivering little white rabbits.

Yu Zhiming looked at Duan Yi and Zhou Mo on the side, and ordered, "Let's start." ”

Duan Yi, who heard the order, reached into the cage with one hand, grabbed a rabbit's back, pulled it out, and pressed it on the experimental table.

At the same time, she grabbed the anesthetic needle with her other hand and pierced it directly into the shoulder of the little white rabbit.

The anesthetic is pushed in.

Duan Yi's movements are smooth, and he knows similar things at a glance, and he has done them before.

Zhou Mo looked at it a little twitching, and couldn't help but say, "Doctor Duan, you are gentle, rabbits also know that it hurts." ”

Duan Yi grinned and said: "We used rabbits to do experiments, and after the experiments, the last step was to inject the rabbits with air injections and carry out euthanization treatment. ”

Zhou Mo snorted: "These three are the best-looking rabbits that I carefully selected in the laboratory animal center." ”

"Dr. Yu has already said that after the experiment, I can take them home and raise them."

"Doctor Duan, don't hurt them."

Yu Zhiming added: "The premise is that my surgical trials go well and they survive. ”

As he spoke, Yu Zhiming had already lifted the soft silicone belly of the pregnant woman, followed by the uterus, and took out the fetal model curled up.

Then, he took the anesthetized unconscious rabbit from Duan Yi and stuffed it into the womb.

Then, Yu Zhiming adjusted the position of the little rabbit again, so that its chest was facing up, and it was not covered by the rabbit's legs.

In a real intrauterine intervention, the fetus is in the correct and appropriate position, which is a prerequisite for the smooth start of the operation.

Fetal position adjustment, this is not too simple for Yu Zhiming.

Covering the uterus and closing the belly of the pregnant woman model, Yu Zhiming pressed his hands on the belly of the model to simulate the first part of the operation to confirm the exact position of the fetal position and fetal heartbeat.

Then, Yu Zhiming stretched out his hand.

Duan Yi, who had been prepared for a long time on the side, put a seventeen-centimeter-long slender puncture needle on his hand.

Duan Yi picked up the interventional guidewire and dilation balloon that would be used next, and looked at Yu Zhiming again.

At this time, Yu Zhiming was holding a puncture needle in his hand, and he had not yet made the next move, but the feeling that the whole person gave Duan Yi was no longer as casual as just now.

Duan Yi believes that Yu Zhiming at this time is like a warrior, who is preparing for the upcoming duel, which is awe-inspiring.

Duan Yi also unconsciously relaxed his breathing, and his eyes did not dare to blink, lest it affect Yu Zhiming's performance.

In the next moment, Yu Zhiming moved.

I saw that the needle in his hand fell, and the puncture needle did not enter, piercing the model's belly.

Because there was no ultrasound imaging equipment, Duan Yi could not see whether the puncture needle had penetrated in the exact position.

Yu Zhiming could feel it very clearly that the puncture needle pierced the belly and uterus of the pregnant woman.

Immediately afterwards, the needle passed through the intercostal space of the fetus, the wall of the right ventricle of the fetus, and successfully reached and passed through the pulmonary stenosis.

At this point, the important puncture step is complete.

Yu Zhiming took the interventional guidewire from Duan Yi without any delay, and there was also an expansion balloon with a diameter of only 3.5 mm, which was sent into the pulmonary artery through the middle channel of the puncture needle.

When the balloon was straddling the pulmonary valve in the center, Yu Zhiming used the pressure valve to compress and expand the balloon, and after rapidly expanding it twice, he quickly withdrew the balloon.

This is followed by the withdrawal of the guidewire, and the puncture needle.

At this point, the intrauterine intervention is completed.

From the beginning of the puncture needle to the withdrawal and withdrawal of the puncture needle, the entire interventional operation process did not exceed eight seconds.

Yu Zhiming, who had completed the operation, stood in front of the experimental table, without further movements, and closed his eyes slightly and began to retrace the surgical process just now.

Zhou Mo on the side looked a little stunned.

She pulled Duan Yi away from Yu Zhiming a few steps, and asked in a low voice, "Is the operation over?" ”

"So fast?"

Duan Yi also explained in a low voice: "The requirement of this operation is to be fast and quick to solve. ”

"The fetus does not remain faithfully motionless in the womb of a pregnant woman, especially when stimulated."

"If the fetus suddenly alarms, the consequences are unimaginable."

"Also, this is an operation in the delicate heart of the fetus, and the balloon has to block the pulmonary artery when it expands, so in order to avoid triggering an overreaction of the heart and reduce the stimulation as much as possible, it must also be fast."

Zhou Mo sighed half-understandingly, glanced at Yu Zhiming, who didn't know what he was thinking, and said, "In just a few seconds, Doctor Yu seems to have completed it quite easily." ”

Duan Yi glanced at the ignorant and fearless guy.

"Pretty easy to watch?"

"Let me tell you, there will be no more than five teams in the country that can do this intrauterine interventional surgery."

"I also told you that even if an international mature team does this intrauterine intervention, 50% of cases will have various fetal complications."

"10-20% of them are intrauterine deaths......"

Duan Yi still wanted to raise the data, but saw Yu Zhiming open his eyes and hurriedly ran over.

"Dr. Yu, continue?"

Yu Zhiming shook his head and said, "No need, one test is enough, I have already obtained the data I want." ”

"You don't have to let the little rabbit suffer anymore."

These words made Zhou Mo smile, pointed to the belly of the pregnant woman model, and asked, "The one inside?" ”

Yu Zhiming replied: "It's okay. ”

As he spoke, he took out the rabbit from the model's belly and handed it to Zhou Mo.

"When its anesthetic effect passes, it will still be a lively little white rabbit."

Zhou Mo held the motionless rabbit in his arms and asked, "Doctor Yu, after this operation, the fetus has recovered and is fine, right?" ”

Yu Zhiming smiled and said, "How can it be so simple and easy, this is not a radical surgery. ”

"After this intrauterine dilation and intervention, it is hoped that the fetus will be able to compensate for the correction of the right ventricle, which is severely stenotized by the pulmonary artery and resulting in dysplasia, in the subsequent development."

After a pause, Yu Zhiming added: "If the correction of the heart is not in place, after the fetus is born, it will also need to be corrected for heart malformations." ”

Zhou Mo snorted lightly and said, "Taking such a big risk to do this intrauterine operation, the result is still uncertain." ”

"Hey, what is the final effect of this surgery?"

Yu Zhiming replied: "According to the current statistics, the success rate of intervention is about 60%. ”

Zhou Mo was a little puzzled and asked: "Taking such a big risk, it is only half of the success rate of intervention, why don't you just wait for the child to be born and do heart malformation correction surgery at the same time?" ”

Yu Zhiming rolled his eyelids and ignored this guy.

Duan Yi patiently explained: "Zhou Mo, if you don't do this intrauterine intervention, a large part of the fetus will lose the opportunity to operate after birth. ”

"Even if surgery is possible, it is extremely risky and the cost of treatment is staggering."

Yu Zhiming spoke again: "Just like the little girl with a heart malformation in the morning, if it can be detected when the fetus is born, it will be actively intervened in utero......"

"As long as there is some effect, it will not be so risky to do heart malformation correction surgery now, resulting in no cardiac surgeon daring to perform surgery."

Zhou Mo understood what he said.

"In other words, the fetus's heart malformations can be intervened in utero?"

"And is it easier to perform surgical intervention in utero than to perform corrective surgery after birth?"

Yu Zhiming explained: "Not all, it can only be said that most of the heart malformations can be intervened in utero. ”

"The advantage of intrauterine intervention is that it can induce the fetal heart to be corrected by development."

Zhou Mo thought of a little and said with great interest: "Doctor Yu, if you have completed this operation, does it mean that the fetal heart is malformed, and you can do intrauterine intervention?" ”

"It's like cancer, in the early stage, you can deal with it, and in the advanced stage, there is a way."

"This heart development malformation, late stage, you can cooperate with Luo Yu and other experts, and early fetus, you can also."

Yu Zhiming smiled and sighed lightly.

"In this so-called early stage, given the high risk of intrauterine intervention and the success rate of intervention, I personally think the best decision is to terminate the pregnancy."

These words made Zhou Mo hesitate and struggle for a moment, and finally opened his mouth and said, "Is it true that the doctor will become a little cold-blooded after a long time?" ”

"Dr. Yu, how do I feel that your decision to terminate a pregnancy is so frivolous?"

"After six or seven months of development, he can respond to his mother in the belly, and he is already a flesh and blood baby."

Yu Zhiming didn't want to deal with Zhou Mo anymore.

Duan Yi explained again: "In China, if a fetus is not born, it does not belong to a complete natural person. ”

After a pause, she said again: "Zhou Mo, have you ever seen someone who gave up treatment just because of a mere medical fee of 20,000 or 30,000 yuan?" ”

"I've seen it, more than once."

"This intrauterine interventional operation costs one or two hundred thousand yuan before and after. Postnatal heart malformation correction surgeries are generally hundreds of thousands, or even millions. ”

"Zhou Mo, can my country come up with one percent of the families who have come up with so much money?"

"Even if the corrective surgery is successful, many children's heart function will have some deficiencies, which will have a great impact on their future growth and development......

PS.

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