"Did you say anything?"

"No, but I listened to the head nurse's tone, it should be a more urgent matter, saying that you should call Director Zheng back."

Emergency?

Could it be that there is a patient in the heart who is critically ill?

However, I haven't heard of a patient in a dangerous condition in the heart recently!

Zhou Qihua couldn't think of the reason for a while, so he had to take out his mobile phone and nodded to the nurse: "Okay, I know, you can go back and get busy first." ”

After speaking, Zhou Qihua had already dialed the phone number of Director Zheng of the Department of Cardiology.

Director Zheng may have been busy, and it took a while before he answered the phone.

But after the phone was connected, Director Zheng's anxious voice came: "Lao Zhou, haven't you left yet?" ”

"No, isn't it time for the shift yet?"

"It's okay if you don't go, it's okay if you don't go."

Hearing this, Director Zheng's spirit was a little highly concentrated at the moment, and at the same time, he was relieved to know that Zhou Qihua hadn't gone back yet.

But it didn't take long for him to say in a solemn tone: "If you don't leave, you can come to your heart, I'm in a bit of a hurry to find you." ”

"Now?"

"I'm having a meeting, and I also know in the past two days that after a group of interns came to our emergency department, there were various conditions every day last week, and it was not okay not to do it without two instructions, if you really want to do this, something will definitely happen this week." Zhou Qihua explained.

"Let's put aside the matter of the meeting, and you come over first."

"No, Lao Zheng, what's the matter, so anxious?" Zhou Qihua was a little puzzled.

"You don't have a treat for more serious patients in your heart, why do you have to let me go?"

"Even if you want to go over, you have to explain the situation to me first, otherwise I won't be able to explain to the emergency department, and I can't leave everyone else here."

Director Zheng had no choice but to say: "We just received a patient in our hearts, and the situation is a little dangerous, so we need Lao Zhou's cooperation, let's diagnose and treat it together, and think about whether there is a good way." ”

"Just received?"

"Hmm."

Hearing that a patient in critical condition was admitted to his heart, Zhou Qihua's expression suddenly became solemn: "Okay, I'll go over immediately." ”

"Okay, I'll wait for you."

"It's in the special needs ward of the heart."

Zhou Qihua ended the call with Lao Zheng, and said directly to Lao Li and the others: "I received a patient in a more critical situation in my heart, I will go over for a consultation, and you will take over the shift according to the normal situation, especially those interns, you must be optimistic, don't do things for me again." ”

After speaking, Zhou Qihua turned around and hurried towards the special needs ward of the Department of Cardiology.

The emergency department is still a little far from the inpatient building, but Zhou Qihua also knows that the situation is dangerous, otherwise Lao Zheng would not be in such a hurry to let himself go, walking all the way with the wind, and it didn't take long to come to the cardiology inpatient department.

Before entering the ward, Zhou Qihua had already seen that the door of the special needs ward in the heart was full of people, and he immediately knew that the patient who was admitted to the special needs ward was not ordinary, and his feet were much faster.

At this moment, the nurse at the door of the special needs ward had sharp eyes and saw Zhou Qihua coming out of the elevator, and immediately greeted him: "Director Zhou, Director Zheng is waiting for you in the consultation room over there." ”

Zhou Qihua nodded, changed his direction directly, and walked towards the consultation room.

When he arrived at the door of the consultation room, Zhou Qihua knocked on the door, and then pushed the door in, and saw that it was already full of people, several directors of the city's first hospital, both inside and outside, and several directors of other departments were also there.

It's not the first time Zhou Qihua has seen such a big battle, but this kind of thing rarely happens in the first courtyard of the city.

"Lao Zhou, you're here just in time."

Zhou Qihua, who pushed the door in, attracted everyone's attention, and Director Zheng, who was standing there talking about the patient's condition, immediately stopped talking when he saw that it was Zhou Qihua, and gestured: "Come, Lao Zhou, you sit here, we have just started to discuss, today's situation, it is really not possible without you." ”

"Who is critically ill, such a big battle?"

"There were a lot of people at the door of the special needs ward just now, and when I came to you, good guys, there are more people, and the director of our hospital who has something to do with the heart has been brought by you, right?"

Zhou Qihua smacked his tongue.

"More than that."

Director Zheng smiled bitterly: "I also called a few people who were on vacation at home, and the dean was also on his way, and it may take about ten minutes to arrive." ”

Even the dean was alarmed?

Zhou Qihua immediately realized the seriousness of the matter, the person who was admitted to the special needs ward at this moment was afraid that his status was not low, and it was very likely that he was still in the system, and it was impossible for ordinary people to let the dean rush over.

The president of the first court of the city has an administrative level that is not low.

Even the dean had to come over in person, as you can imagine.

Thinking of this, Zhou Qihua asked with a solemn expression: "The one who is admitted to the special needs ward is ......?"

"In the city, the one in charge of our hygiene." Director Zheng smiled bitterly.

Hiss~

Zhou Qihua gasped, his expression instantly became extremely solemn, there was no trace of curiosity on his face, but full of seriousness, at this moment he completely understood why Lao Zheng was so nervous.

Moreover, the reason why the dean will come is also known.

If it was that one, it wouldn't be surprising.

That is the first mate in charge of the entire health system in Yongcheng, and he was sent to the first hospital of the city to rescue, which is the trust of the first hospital of the city, who dares to drop the chain at this time?

If they hadn't been rescued, they would have to walk around without food.

At this time, not to mention that the dean is just not in the hospital, even if it is a meeting in other provinces and cities, it has to be rushed back, this rescue, although Lao Zheng is the main hand, but the dean is also considered to have come out of the heart, although it has been some years since the patient has been treated, but some major cardiology surgeries, the dean will still participate, and even play an important role in it.

The first court of the city, the president is still very authoritative in his heart.

At this time, he will rush back, as expected.

Moreover, even if he is not an expert in his heart, he must rush back at this time.

Thinking of this, Zhou Qihua quickly sat down in his position.

Waiting for Zhou Qihua to sit down, Director Zheng said directly: "I won't introduce too much about who the patient is, this mission is different from the past." ”

What's different, Director Zheng didn't say.

The one who can sit in this consultation room is at least at the level of the deputy chief physician, and he is also the kind with extremely strong ability, he doesn't even shout if he has no ability, and it's useless to shout, these people won't know what it means to rescue the one in the special needs ward.

It's not just a medical mission anymore.

Hearing this, everyone nodded.

Director Zheng continued: "The person who had an electrocardiogram examination in the Eastern Hospital before and was diagnosed with coronary heart disease for more than a month. During the period, I took a break for a while, but I didn't listen to the persuasion, and recently I worked overtime every day, and I was still reading the report and giving instructions in the early morning.

According to the secretary's account, angina pectoris attack in the afternoon, containing nitroglycerin tablets, which can be relieved for half an hour, did not care at the time, his secretary had persuaded him, but it was useless, and the one did not care at all. At about 16 o'clock, the colic recurred, and the nitroglycerin-containing tablets were ineffective, and they were finally sent to our hospital for rescue.

Before you came, I also used a containing agent and isoamyl nitrite to absorb people, but it still didn't work.

I also want to hear your opinions, what should I do in this situation? How is the medication used? What kind of medicine is used?

On the way here, the dean had already talked to me on the phone before, and he would save people at all costs, but the medicine was not used indiscriminately, and the medicine was too old and too powerful, once something happened, no one could bear this responsibility. ”

"Lao Zheng, I heard you say this, that person should have an acute heart attack!" Zhou Qihua interjected.

Director Zheng nodded: "Well, coronary heart disease angina attack." ”

"I also used the medicine I just used, if it doesn't work, it will be difficult to do, and once this disease attacks, it is easy to kill people." Zhou Qihua said with a solemn face.

Acute myocardial infarction is myocardial necrosis caused by acute, persistent ischemia and hypoxia of the coronary arteries.

Clinically, there are often severe and persistent retrosternal pain, which cannot be completely relieved by rest and nitrates, accompanied by increased serum cardiac enzyme activity and progressive ECG changes, which can be complicated by arrhythmia, shock or heart failure, which can often be life-threatening.

And in addition, the person is old, and the situation is more serious than that, one is not good, and the person may be gone in less than an hour.

The key thing is that the best time for rescue is within half an hour, which has passed a lot of time, and no other treatment will be given, and the consequences will be too serious.

"That's why you have to race against the clock!"

"Lao Zheng, we have understood the situation, let's go to the scene to have a look, and it is best to invite Chinese medicine to come and see, in this case, maybe Chinese medicine will have a way, the city hospital is not far from us, let them come and have a look, maybe there is any good way, otherwise it will not work if it continues like this." Zhou Qihua thought about it and put forward his own opinions.

Lao Zheng said: "I have already mentioned it to the dean, he has contacted the director of the city hospital, and the person should be almost there at this time." ”

"But you're right, there's no reason to discuss it here, go to the scene and have a look, maybe there can be other ways, and now Lao Ye is rescuing over there."

"Then let's go, don't delay the best time for treatment."

Everyone got up one after another and walked towards the special needs ward.

When Zhou Qihua and others arrived, several chief Chinese medicine physicians from the Municipal Hospital of Traditional Chinese Medicine also rushed to the scene.

Not only a few people from the city hospital, but even those who have been sitting in the Liannan Traditional Chinese Medicine Association also came.

Huang Beishan, Ye Haishen, and Zhang Jingcai were all present.

At this time, these people came, and Director Zheng also gave a brief introduction to the situation.

And Zhang Jiwei, the president of the First Municipal Hospital, hurriedly walked in when everyone was discussing how to save people: "How is the situation?" ”

Everyone looked at each other and shook their heads: "The situation is not optimistic, we have used all the medicines that can be used, but none of them have a good effect." ”

"What about rapid sublingual nitroglycerin?"

Nitroglycerin is rapidly administered under the tongue to rapidly circulate nitrates to the diseased blood vessels, dilatating the diseased blood vessels and relieving symptoms.

Zhang Jiwei was born in the heart, and he has often participated in the first aid in the heart over the years, so he naturally knows these drugs very well, and he also understands the effects of them, so he mentioned nitroglycerin as soon as he came.

"It's useless, it's already used."

Director Zheng, as the attending doctor, shook his head and stood up and said: ""This person prepared this medicine when he was diagnosed with coronary heart disease angina pectoris, and he used it himself when he had angina pectoris in the afternoon, and it was relieved a little at that time.

But because this person has been working overtime recently, and he hasn't had much rest, nitroglycerin only had a little effect, but soon angina appeared, and he was sent to us the second time, and nitroglycerin was also used, but this time it didn't work. ”

After speaking, Director Zheng was also helpless.

"What about dual antiplatelet aggregation, plaque stabilization, myocardial oxygen consumption, vasodilation and other treatments?" Zhang Jiwei's brows furrowed deeply, if nitroglycerin had no effect, it proved that this person's situation was really serious.

"I used it too, but it hasn't worked yet."

Zhang Jiwei took a breath and immediately decided: "Then you can only perform emergency coronary angiography stent implantation." ”

"Isn't this too risky?" Director Zheng hesitated.

Coronary artery stent implantation is a mechanical interventional treatment, stent implantation is the most effective means to deal with acute vascular occlusion of PTCA, it is to permanently place a metal stent at the coronary artery lesion, through balloon dilatation or self-expansion to support the blood vessel wall, to keep the coronary artery lumen open, reduce the mortality of acute myocardial infarction.

Aspirin and clopidogrel should be taken before stent placement to prevent thrombosis. Patients with diabetes should monitor blood sugar in time, relieve the patient's tension and anxiety, ensure good sleep, and eliminate mental tension; It is also necessary to prepare the skin before the procedure.

After coronary angiography, percutaneous coronary endovascular angioplasty is performed to puncture the femoral or radial arteries percutaneously, and then a special catheter is used to deliver a stent to the coronary artery stenosis and dilate it, thereby recanalizing the occluded vessel or minimizing the residual stenosis of the vessel.

Because stents can treat acute occlusion caused by balloon dilation, the safety of interventional therapy can be improved, and it can be used to treat complex lesions with more satisfactory results than balloon dilation, and at the same time, it can reduce the restenosis rate of balloon dilation and improve the long-term effect of treatment.

However, during coronary artery stent implantation, when the blood vessel is punctured, it is easy to cause femoral artery pseudoaneurysm, retroperitoneal hematoma, dissection, thrombosis, embolism, arteriovenous fistula and so on.

When entering the coronary artery for operation, it is easy to cause coronary spasm, coronary dissection, various arrhythmias, severe ventricular arrhythmia, acute occlusion of blood vessels, stent thrombosis after stent implantation, no reflow, coronary perforation, coronary ventricular fistula, cardiac tamponade, acute pulmonary embolism.

There may also be other complications, such as sudden hypotension, stroke, cardiac impairment, and allergic reactions to nephropathy with contrast agents.

This person is no longer young, and no one can guarantee that there will be serious sequelae during the operation.

(End of chapter)