"Okay."

The waiter quickly sent two packing boxes.

If you want to talk about the service attitude, it is still the attitude of these ordinary shops and restaurants that are warm and thoughtful. The service attitude of banks and luxury stores is more double-standard, and if you have money, you can enjoy VIP service, and if you don't have money, you will be treated coldly.

"I'm talking to Du Leng about getting married this year, and you're all going to come and drink my wedding wine when the time comes!"

Ma Xiaolan put some crayfish, mutton skewers, and leeks into the box.

At the same time, a shocking news was announced to them.

When she fell in love with Du Leng, I am afraid that few people are optimistic.

Zhou Can even felt that Du Leng was just just playing, and the two would break up soon. I really didn't expect that the two had reached the point of talking about marriage.

"Xiaolan gets married, I will definitely go. I'm just a little afraid that I won't be able to take time off when the time comes. ”

Qiao Yu was the first to speak.

"Boss, getting married is a great event, and it only comes once in a lifetime. You'll have to give everyone a leave. ”

Ma Xiaolan immediately looked at Zhou Can.

"I'm sure I'm not stuck here, it's just that doctors and nurses are special professions, and it's really not possible for everyone to take vacations at the same time. If it's a wedding in the city, I arrange two or three hours off, and it's not a big problem. ”

Zhou Can didn't dare to agree indiscriminately.

Healthcare workers are the least likely profession to take time off. Because patients can't afford to wait, they have to be treated in time when they arrive at the hospital.

Nurses in hospitals are often very tight, and many clinical nurses do the work of two people alone. The hospital not only refused to let them take leave, but also wanted to let them work overtime day and night.

This phenomenon is extremely common especially in large hospitals.

In the event of a flu outbreak, the medication in the treatment room can be placed from the end of the cabinet. Each patient's medication needs to be checked at least twice, prepared in advance, and then administered to the patient within the required time.

Even if it only takes one minute to dispense medicine to a patient, it takes two to ten minutes to inject the medicine, and after the injection, the waste bottle is recycled, the needle is pulled out or the indwelling needle is disposed of for about a minute.

It takes at least five to ten minutes, if not longer, to complete the treatment of a patient.

Even if the working hours of nurses are extended to 12 hours a day, when there are too many patients, it is still far from enough.

After there are more patients, there is also a terrible phenomenon, which is prone to serious patients and accidents.

This can lead to a significant overcrowding of multiple nurse resources.

As a result, it is difficult for nurses to take time off.

Doctors are more special than nurses, and each doctor specializes in different fields. The more senior the doctor, the lower the substitutability in the department.

When a chief physician is resting, that department may not be able to admit that type of patient.

Ordinary doctors are very replaceable, but they do a lot of work!

The more low-level doctors are interns and trainees, the more work they do. It is really too much to think that interns can hold two hands to watch the operation of senior doctors and learn slowly.

Taking Zhou Can's emergency department as an example, when a patient is rescued, the intern has to be there when the senior doctor is not present.

Ma Xiaolan got married, and it was almost impossible for the surgical team to take a group vacation for a day.

It is easier to get approval by taking two or three hours of temporary leave from the department.

Everyone was happily eating food, and Zhou Can's mobile phone rang.

When I took it out, it was a call from the emergency department of the hospital.

Put through.

"Doctor Zhou, please hurry back to the emergency department of the hospital, and a patient with a heart attack has been sent in, and the situation is very dangerous."

"Good! I'll be there right away! ”

Zhou Can stood up and hurriedly said to everyone, "There's no way to accompany you, there is a rescue patient in the emergency department, I have to rush over immediately." What kind of food and ingredients do you like to eat, just be open, and ask me for reimbursement tomorrow. ”

After speaking, Zhou Can quickly left.

Fortunately, the small alley where he had supper was very close to Tuya Hospital, and he trotted briskly back to the hospital's emergency department.

By the time he arrived, the patient had already been pushed into the emergency room.

Patients with myocardial infarction must be rescued in time, otherwise they will die soon.

"Xiao Zhou, come and see this patient's situation!"

Director Lou sweated in his head.

It seems that he has led the nurses and doctors in the emergency department to carry out a round of resuscitation of patients.

I haven't seen a doctor from the Department of Cardiothoracic Surgery or Cardiovascular Medicine for a consultation.

Both departments have the capacity to treat patients with myocardial infarction.

The emergency department currently does not have the capacity to treat it, and simple vascular thrombolysis and cardiopulmonary resuscitation are no problem.

Zhou Can walked quickly to the rescue bed, and when he saw the patient's face, he couldn't help but be stunned.

How could it be him?

The patient on the rescue bed was Zhang Qilian, the director of the Third Hospital, who had seen him twice.

At the moment, his face is pale, his eyes are indifferent, his breath is short, and his heart rate is extremely unstable.

"Have you done an imaging?"

"Not yet. The patient was transferred from the Third Hospital, and the results of biochemical examination showed that the patient's cardiac enzymes were severely elevated. After checking the electrocardiogram, the diagnosis of myocardial infarction can be basically confirmed. ”

Director Lou showed the patient's examination data to Zhou Can for review.

"Looking at his blood pressure and heart rate, as well as his face, as well as the ST-T dynamic changes in the electrocardiogram, the area of the myocardial infarction should be not small. It would have been nice if it had been sent earlier, but now I am afraid that I need to be sent to the cardiac catheterization laboratory immediately for interventional treatment. ”

After seeing the patient's condition, Zhou Can quickly gave rescue suggestions.

This is the difference between a high level and a normal level.

Even though Director Lou and others knew that the patient had a myocardial infarction, they could only do some routine rescue and stabilize the patient's life first.

After Zhou Can read it, he could directly give a specific rescue plan.

"Contact the cardiac catheterization lab immediately and send the patient over. I went to talk to the family. ”

Director Lou is also decisive and abnormal.

……

After nearly two hours of rescue, Zhang Qilian's life was saved, but because the ischemia time was too long, there would definitely be serious sequelae.

Heart failure, arrhythmias, and ventricular aneurysms, among others.

The main manifestation is heart failure.

In the future, he will feel out of breath when he takes two random steps, and his quality of life will be seriously reduced.

The only solution is to replace the artificial heart or have a heart transplant.

Myocardial infarction and cerebral infarction are irreversible damages.

In fact, long-term ischemia of any tissue in the body may cause irreversible damage.

However, some parts are more special, even if the large blood vessels are blocked, there are still arterial blood vessels that can supply blood. In this case, the body will have severe symptoms, and as long as it is treated promptly, most of them will not leave sequelae.

Zhang Qilian's interventional thrombectomy was carried out very difficult.

His blood vessels are very special.

Interventional doctors have not been able to intervene in the femoral artery, radial artery, or percutaneous coronary artery intervention.

Later, it was Zhou Can who took action, and with the help of six-level injection and six-level implantation, the problem was finally discovered.

It turned out that there were two more serious arterial plaques in Zhang Qilian's path from the femoral artery to the coronary artery. As a result, the two blood vessels are abnormally narrowed, especially at a bend, and the blockage is quite severe.

It also greatly increases the difficulty of the guidewire passing through the blood vessels.

If it is only the femoral artery approach that is blocked, the interventional surgeon is still not afraid. Access from the radial artery is also possible.

The radial approach is used more in clinical emergencies.

Unfortunately, the access between Zhang Qilian's radial artery and coronary artery was more severely blocked, and the blood vessels were severely deformed. This condition is very rare in clinical practice.

At least it was the first time that Zhou Can had seen a patient with such a severe vascular malformation.

Even when he performed coronary angiography, he found that the patient's coronary arteries were severely deformed.

This made him wonder if the arteries and blood vessels of the patient's whole body had this kind of lesion? Or is it a special constitution that you were born like this?

What exactly is the reason, we can only wait for later.

Zhang Qilian's vascular condition is so special, no wonder the Japanese cardiologist from the Third Hospital is helpless.

Through this treatment, Zhou Can has stronger confidence in his interventional treatment level.

Before you know it, his level of intervention has surpassed that of many 'experts'.

When he walked out of the cardiac catheterization laboratory, he had roughly deduced the entire onset of Zhang Qilian's illness - the treatment process in his mind.

It is likely that in court, Zhou Can came to a Jedi counterattack, which made Zhang Qilian feel very difficult to accept.

Coupled with the fact that there are serious lesions in the arteries and blood vessels of the whole body, after being severely stimulated, blood pressure soars, aggravates the blockage of blood vessels, and finally forms a myocardial infarction.

Some people will be curious, when the blood pressure rises, the blood circulation in the body should be accelerated, and the blood circulation should be smoother, how can a heart attack occur?

The pathogenic mechanism should be analyzed from multiple perspectives.

First, high blood pressure promotes the progression of atherosclerosis, which directly leads to narrowing of the arteries.

Zhang Qilian's arterial vascular lesions throughout his body are so serious, it is likely that he has been in a state of hypertension for a long time.

Secondly, poor blood pressure control for a long time can easily cause damage to the target organ and enlargement of the left ventricle.

As the left ventricle becomes larger, the ability to eject blood decreases.

It's like a house, originally there was a family of three, and it was very warm. One day, the house was expanded and much larger, but it was still three people, and it would look empty if you lived in it.

The same is true for the ventricles.

The ventricles are enlarged, and there is still so much blood entering the ventricle, and its ability to eject blood is naturally weakened.

At the same time, enlarged ventricles can cause the heart muscle to become weak, which is also an important reason for the weakening of the ability to eject blood.

If the left ventricle is enlarged and left unattended, it will affect the blood supply to the heart muscle in the long run. At this time, the risk of coronary spasm is severely increased.

With these conditions, the patient will be stimulated by a sudden increase in blood pressure, and the unstable atherosclerotic plaque will fall off directly. At this time, the blood clot is formed, which eventually causes the coronary artery to be blocked.

Therefore, when communicating with those who have heart disease, it is important to pay attention to the way you speak.

Excessive stimulation can cause the patient's blood pressure to rise, which is dangerous.

If the popularity dies, there is a chance that a lawsuit will be filed.

Zhang Qilian lost the battle in the court, his blood pressure increased, and he eventually suffered a heart attack.

His own hospital focuses on cardiac surgery, so he naturally prefers to be treated in his own hospital. It's just that he never expected that the high-paid Japanese extracardiologist in the hospital would be so rubbish.

At the critical moment, the chain fell again.

In the end, after many efforts, he was still unable to help him remove the blood clot and unblock the blocked arterial cardiovascular system.

There's no way around it at this point.

After discussing with Vice President Zhang and others, the family chose to believe in Tuya's medical technology and pulled the person directly to Tuya for rescue.

As it turned out, they made the right decision.

After more than two hours of hard work, Zhou Can placed two stents in the path from the patient's femoral artery to the coronary artery, and after the severely narrowed blood vessel was opened, the guidewire was able to pass through smoothly.

In the end, the thrombectomy was successfully completed.

If Zhou Can's criteria are used, he feels that at least hundreds of vascular stents need to be placed in the patient's body.

Even so, I am afraid that it will not be able to solve the problem completely.

Zhang Qilian is still at risk of clogged arteries.

Regardless, he managed to bring people back, which would surely make his fame rise again.

After coming out of the intervention room, family members gathered around.

"Doctor, how is my husband?"

Zhang Qilian's wife looks very young, very well maintained, and wears exquisite makeup.

If it weren't for her nasolabial folds and slight crow's feet at the corners of her eyes, as well as her eyes that didn't match her youthful appearance, Zhou Canzhen would have thought that this woman would be in her twenties.

The skin is not only fair, but also very shiny.

The figure is also maintained very well.

The temperament is gentle, the kind in the show of wisdom.

Zhang Qilian acted ruthlessly, viciously, and not handsome, but he married such a beautiful wife. This reminded Zhou Can of another sentence, flowers love to grow on cow dung.

"The patient was temporarily out of danger of his life. However, his systemic arterial vascular disease is very serious, and he needs to be extra careful in the later stage, and he must not get angry again. And because it is sent too late and the best rescue time is missed, the patient may have heart failure after recovery, and cannot do heavy work or strenuous exercise. ”

Zhou Can and Zhang Qilian are enemies.

But whether in the rescue process or now, he has embodied the sacredness and nobility of the doctor's profession.

Always in the spirit of the patient's sake.

"Su Qing らしい!"

When she heard this, she clasped her hands together and smiled happily on her face.

It can be seen that she cares about Zhang Qilian very much.

The love between the two should be sweet.

She was speaking Japanese just now, and it was an instinctive reaction. This made Zhou Can understand that this woman was likely from Japan.

Subconsciously glanced down at her legs.

Sure enough, the standard looped legs.

"Thank you, thank you!"

She thanked Zhou Can again and again.

"You're welcome! You'll be able to see the patient later. You may need to stay in the hospital for about three to seven days. ”

Zhou Can nodded to her and left directly.

……

The next day, Zhou Can checked the ward of the emergency department in the morning and went to see Zhang Qilian's recovery.

As soon as I arrived at the inpatient ward of the cardiovascular department, I saw a familiar figure.

Vice President Zhang, who was taken away by the security guards last time, stood outside the ward and talked on the phone.

As the vice president, now that the dean is down, his work will definitely be busy.

Seeing Zhou Can coming over, Zhang Xingxing's face showed subtle changes.

It's more embarrassing.

"Dean Zhang, it's morning!"

Zhou Can was very generous and greeted him with a smile.

(End of chapter)