In the ultrasound room, Zhou Can personally stood next to the sonographer.

Echocardiography often refers to the use of ultrasound short-wave ranging principle pulse ultrasound through the chest wall, soft tissues to measure the periodic activities of the underlying heart wall, ventricles and valves, etc., which are displayed on the monitor as the corresponding activity and time relationship curves of each structure, and these curves are recorded into images with a recorder.

It is a good assessment of the size of the heart, the function of the valves, and the left ventricular ejection fraction.

What Zhou Can wants to check now is the left ventricular ejection fraction.

"LVEF, down EF by 39%."

The superborn doctor reported the number to Zhou Can.

"It's about the same as the left ventricular ejection fraction examined by other hospitals." Zhou Can nodded, and then said to the patient. "Here, try to hook your feet, use some strength."

The patient does as told.

"What is the left ventricular ejection fraction now?"

“52%。”

The sonographer's face was incredulous.

The ejection fraction is only 39%, which is a low level. It's not particularly serious, but it's not light.

Normal ejection fraction is between 50% and 70%.

The patient's left ventricular ejection fraction went from 39% to 52%, which is really incredible.

If this state can be maintained all the time, the patient will basically be able to return to normal.

"Nice, relax, relax!"

Zhou Can had more confidence in the judgment in his heart and instructed the patient to relax.

"Bend your calves!"

Again, instruct the patient to do what he asks.

"What's the score this time?"

“46%。”

"Not bad." At this point in the test, Zhou Can already basically knew where the cause of the patient was. "I'm going to squeeze your calves, bear with it."

After signaling the patient to straighten and relax his legs again, Zhou Can tried to squeeze the gastrocnemius muscle in the patient's legs.

"How much?"

“43%，42%。

This is the result of squeezing the left and right legs separately.

"Alright, thank you! Type out the report, and it's time to call it a day. ”

Zhou Can said to the sonographer.

"Dr. Zhou, is the cause of my illness really in my legs?"

"That's right, it's in the legs. I'll talk to you when I get back to the ward! ”

It cannot always occupy the resources of the ultrasound department.

Now that it's past the end of work, the doctors in the ultrasound department are forced to work overtime.

Unlike clinical departments, medical technology departments work very punctually. They can get to and from work on time and have a day off on Saturdays and Sundays. However, ultrasound and CT departments will have a job loss mechanism because of the very large business demand.

In addition, in a large hospital like Tuya, the ultrasound department of the two departments of obstetrics and gynecology and cardiothoracic surgery is not under the management of the general department of medical technology, but belongs to the department of obstetrics and gynecology and cardiothoracic surgery.

If you want to become a sonographer, the ultrasound department in these two departments is recognized as the most promising.

The doctors in the ordinary ultrasound department have no way to break the barriers, and they have basically been mixed in the small circle of the medical technology department. Upper middle income, but there will be no significant improvement.

Unlike doctors in clinical departments, although they are a little tired from work, after work or on vacation, they are called back by the hospital to work overtime.

And even after work, I have to worry about the patients in my care, and pray that something will happen to those patients.

In the event that the patient dies or something like that, he must be held responsible.

This responsibility does not mean that it will lose money to the family, or even revoke the practice license, but that there will be an evaluation mechanism, which will have a great impact on the doctor.

If a certain doctor manages a patient and two deaths in three days, the senior doctor will scold the mother at the same time, he will also focus on preventing this doctor and marginalize this doctor in the future. Clinically, he will no longer be given weight.

To put it bluntly, it is no longer useful to speak, and the medical instructions must be read by the senior doctor before they can be implemented, and some clinical treatment measures also need to be consulted by the senior doctor, or directly let him listen to the command of other doctors at the same level.

Not to mention the disqualification of the awards.

Zhou Can's weight in the emergency department is very high, and even the deputy chief physician has to listen to his command during clinical rescue.

……

At the side of the makeshift bed in the corridor, Zhou Can was holding an echocardiogram and explaining the cause of his heart failure to the patient. Director Xueyan had already rushed over when she heard the news.

"I've really found out the cause! Terrible! ”

Director Xueyan's face was full of smiles.

Every time such a difficult case is successfully diagnosed or cured and discharged from the hospital, she feels very happy.

As the head of the department, I naturally hope that the department will get better and better.

The accumulation of fame and reputation of a department has a certain role in treating ordinary cases, but it is limited. The most impactful cases have to be difficult cases.

"I still don't understand, why is my heart failure related to my legs?"

Patients are curious about this.

The Brother Wei invited by his family was standing next to the hospital bed, his face full of incredulity.

I thought that Zhou Can was talking nonsense, but I didn't expect that after the examination, the leg was really related to heart failure.

"There are several powerful muscles in the legs called the gastrocnemius muscles. Ordinary people may not know what it does, but in the eyes of our doctors, it is called the second heart of the body. Ever since our human ancestors learned to walk upright, there has been a major defect in our human bodies. The heart becomes farther away from the ground, which makes it extremely difficult for blood from our lower limbs to flow back to the heart. ”

"At the same time, it is difficult for the blood pumped by the heart to reach the ends of the lower limbs. At this time, the human body has evolved over countless years, and the gastrocnemius muscle in the leg has evolved the role of the paraheart. Every time it exercises, it squeezes the blood from its legs and allows it to return to its heart smoothly. Then, when relaxed, it forms a natural suction force that draws the blood over. In this way, it forms a pumping function similar to that of the heart. ”

Zhou Can explained to the patient the connection between the legs and the heart.

Listening to the patient's knowledge and Brother Wei's knowledge.

As for Director Xueyan, the nurses, and the other doctors, they all looked at Zhou Can with admiring eyes. Everyone has learned the knowledge in books, some have forgotten it, and some have not forgotten it, but they cannot be used flexibly in clinical practice.

Zhou Can is able to learn and apply it at his fingertips.

His clinical diagnostic thinking made every medical staff present feel envious.

"It turns out that our human legs are the second heart, it's amazing! But there is nothing wrong with my legs, how can it cause heart failure? ”

The patient is currently in his second year of high school, and because he is very studious, he must have learned a lot of knowledge.

But after listening to Zhou Can's explanation, he still felt extremely amazing and his eyes were opened.

"That's going to talk about you, you usually read and study, sit all day, and rarely exercise. And you are in the stage of physical growth, and there is a severe lack of exercise and exercise in the lower limbs, which causes your lower limb muscles to relax and atrophy quite severely. This requires you to exercise every day in the future to gradually return to normal levels. At that point, your second heart will basically be back in function. ”

"Don't underestimate the role of the second heart, if it can work normally, it can reduce the pressure of the heart and promote blood circulation throughout the body. On the contrary, when it has serious problems, the heart does the work of two people alone, and after a long time, the heart cannot bear it. Severe strain and weakness. In this case, it is unable to do the work of two people anymore, and the left ventricular ejection fraction is lower than normal. ”

"Then because it was not corrected in time, the real cause was never found, and the heart has been in this abnormal working state. After a long time, it leads to total heart failure. ”

Zhou Can sometimes treats patients like children who are not angry.

Both distressed and annoyed.

Declining their misfortune and being angry are the true mentality of the vast majority of doctors in their work.

Seeing a patient sick or even dying, the doctor's heart is sad. However, some patients just don't care when they are healthy. Tell him to smoke less, drink less, and stay up late, so he doesn't bother to listen!

All the doctors are alarmist.

Then, when I fell ill, I realized that the doctor was giving advice. It's a pity that it's too late by this time, and there is no chance.

"That'...... Can I be cured of this disease? ”

Patients have regarded Zhou Can as a miracle doctor, and their trust in Zhou Can has risen to an unprecedented height. The true cause was found, and he also saw hope for a cure.

At least we finally know the reason for this strange disease.

"Negi! I'll develop a treatment plan for you, which will focus on your exercises. If you can't keep exercising, and once you learn to leave your health behind again, there's nothing I can do. It's a good thing to study hard, but you must pay attention to the combination of work and rest. While studying, you must also take care of your health, you know? ”

Zhou Can felt that it was not difficult to treat this disease.

The only difficulty is that the patient himself is not cooperative and refuses to insist on exercising.

"Don't worry, I'll listen to you this time. After this illness, my studies were also delayed, which made me deeply aware that if you want to hurry, you can't achieve it. I will deeply learn this lesson, and I will always keep this lesson in mind in the future, even if I join the work after graduation. ”

The patient expressed his position to Zhou Can.

This young man is a man of perseverance and perseverance, and he will definitely be able to do it when he says it.

Zhou Can also nodded with satisfaction, and went back to the office with Director Xueyan to discuss the treatment plan for this young man.

The treatment plan was formulated overnight, and the use of drugs was minimized, and the physical assistance was the main way. However, because the patient's heart failure is quite severe, there is definitely no shortage of drugs that should be used.

You can only wait until the patient slowly recovers, and gradually reduce the use of drugs.

It is a three-part poison of medicine, especially Western medicine, many of which contain hormones. Their side effects on the body are very large and the effects are extremely far-reaching.

It is easy to develop a body's dependence on medications.

In addition, after the same medicine has been used for a long time, drug resistance will also form. This can lead to poor absorption of the drug by the body, and the effectiveness of the drug will be greatly reduced.

……

The next day, Zhou Can finished checking the emergency department early in the morning, and specially rushed to the cardiothoracic surgery department to check the young man's treatment.

A specific electric compression tool is temporarily used for the gastrocnemius muscles in both legs to assist the patient's lower limb gastrocnemius muscles to contract and relax. It is equivalent to massaging the calves.

You can see a significant improvement in the patient's complexion, and breathing is no longer so rapid and laborious.

These are all good things.

Even without the need for examination, Zhou Can could feel that the patient's heart failure symptoms had been greatly alleviated.

"You can get out of bed and walk downstairs in a while, and let that Brother Wei accompany you. Where is he? ”

Zhou Can has been here for so long, and he hasn't seen that Brother Wei.

If you don't stay by your employer's side for a long time, is that guy constipated? Squatting on the toilet?

"Hmm...... Brother Wei asked for leave with me and lined up for an examination. ”

The patient hesitated for a few seconds, but finally did not lie to Zhou Can and told the truth.

"Wasn't you still a good person yesterday? Why did you get sick all of a sudden? ”

Zhou Can's brows furrowed slightly, this patient has no one to accompany him, that's not good.

"Well, didn't you tell him the day before yesterday that it was best for him to go for a liver test? At that time, he may have thought that you were too young and did not have a high level of medical skills, so he did not pay attention to it. Yesterday I saw that you had successfully found the cause of my illness, and he had already begun to believe in your medical skills. Worried about his physical condition, he bought me breakfast this morning and took care of me after washing, and then he rushed to the hepatobiliary department to line up to see a doctor. ”

Patients may also feel that talking about these things of the bodyguards is a bit inauthentic.

But he couldn't lie to Zhou Can, so he seemed a little awkward when he spoke.

"I see, then you don't leave here alone without any escort. You can walk around the bed and move your legs to increase the muscle strength of the gastrocnemius muscles. ”

After Zhou Can listened, he smiled dumbly.

That Brother Wei is really interesting, the day before yesterday he asked him to check his liver, but he didn't listen.

Now it's early in the morning, so I'm queuing up to register.

This person is so realistic.

"Okay! Dr. Zhou, do you think Brother Wei's liver really has a problem? How did you tell he had a liver problem? I was purely curious, I just thought medicine was amazing. Your medical skills, in particular, were truly eye-opening. ”

The patient asked.

"There's nothing unusual about this. The first time I saw him, I noticed that he had some degree of palmar symptoms on his palms, and then I saw red spider nevi on his neck, and there were more than one, so I concluded that there was probably something wrong with his liver. ”

Zhou Can didn't think he had much ability.

"There are a lot of medical skills that seem amazing to you ordinary people, but they are just the accumulation of medical experience. Because we come into contact with a large number of patients every day, and through the experience of generations of doctors, we have the ability to detect whether the other person has a clear disease at a glance. ”

"Got it! Thank you for your patience. This visit to Tuya Hospital for treatment should be another right choice I have made, I have gained a lot of knowledge, and most importantly, I finally have hope of curing my disease. ”

The patient is sincerely grateful to Zhou Can.

"You said that if I really had a heart transplant, would it still not be curable?"

This question is actually not easy to answer, after all, it is necessary to take care of the face of those experts in the imperial capital. Those experts were really out of the question, so they considered heart transplantation.

(End of chapter)