Chapter 306: : Blindly piercing the pericardium!

After seeing several directors, Chen Cang came quickly: "Director, you are here."
Li Baoshan nodded, and said solemnly, "How is it now?"
Chen Cang swallowed: "It's fairly stable. I'm going to do the relevant inspection now, and I'll be back soon."
Oh, Li Baoshan.
At this time, the two directors, Tao Yan, director of cardiac surgery, and Xu Tianfu, director of cardiology, came over.
Tao Yan frowned and asked, "Xiao Chen? What about the patient?"
Chen Cang explained: "The patient's current test results have not yet come out, I guess it may be pericardial tamponade caused by traumatic blood pericardium!"
A few words came out of the pericardial stuffing, and the directors' faces suddenly changed!
Pericardial stuffing, this is a terrible disease!
Inspection can not be done casually, at least someone must stare!
Thinking of this, Li Baoshan hurriedly asked, "What inspection went?"
At this time, Chang Lina, who was taking the patient for an examination, pushed the car and the doctor on duty with the radiology department came over.
The doctor of the radiology department took out the nuclear magnetic film in his hand: "Director, look, this is a chest radiograph, this is nuclear magnetic."
After hearing this, Tao Yan's face suddenly changed: "Why NMR?"
This sentence made everyone silly!
The doctor of the radiology department stunned: "In order to clarify the blood in the pericardial cavity ..."
This question confuses the doctor of the radiology department, isn't it ... what am I doing wrong?
But watching the three directors stare at each other with a serious look, the doctor of the radiology department suddenly shrank his head. Am I really wrong?
Li Baoshan quickly asked: "Is the patient stable now?"
Chang Lina sent for an examination and nodded: "Stable! Blood pressure is 90/70, heart rate is 70 beats per minute ... The patient's vital signs are stable."
With this remark, the directors around were relieved!
Xu Tianfu said slowly: "It is not to prevent you from doing magnetic resonance, but to do it if the patient's condition is stable.
indeed!
Xu Tianfu is not joking.
Heart disease patients who die in the CT room and MRI room every year are no longer a minority.
Therefore, many domestic hospitals do not recommend MRI and CT for patients with possible MI, HF, etc., and wait until it stabilizes.
The radiology doctor smiled awkwardly, "Director, it was stable when it was delivered."
Three people together!
Pericardial tamponade caused by blood pericardium ... how stable is it without treatment?
At this time, Xu Tianfu holding the nuclear magnetic film suddenly stumbled: "No ... why there is no blood accumulation?"
Even Tao Yan, who was aside, was dumbfounded, and after a careful comparison ... I looked at the echocardiogram and was curious.
"No, you see, the second rib on the left, the third rib ... there are obvious blunt injuries."
"But the ultrasonic fluid level ..."
At this time, Old Liu hurried in and rushed in: "Doctor Chen, I took the blood that you asked me to get just now."
At this time, everyone looked up at Chen Cang.
Li Baoshan's eyes widened suddenly: "What kind of blood is this?"
Chen Cang said, "After the driver and I arrived at the scene, the patient was in a very poor condition, the pericardial tamponade was very serious, the blood pressure was only 60 / 30mmHg, and the triad of pericardial tamponade was very obvious. The patient who was enrolled had a very weak heartbeat at that time. I was worried that there was a problem on the way to the hospital. I immediately chose an outdoor pericardial puncture. "
This word comes out!
Suddenly the three directors changed their faces again.
They all know the serious consequences of pericardial tamponade.
But how do you do a pericardial puncture outdoors?
There is no B-ultrasound positioning, and there is no guardian watching
Pericardial puncture can only be done blindly.
Do it blindly ... even if you are not careful, it will cause problems.
After all, the pericardium is not the thoracic cavity, and there is a lot of operating space, and his operating space is very small.
Tao Yan thought about it, hesitated, and asked, "You ..." blindly? "
Chen Cang nodded: "It was a last resort. The situation was special and the patient was very urgent. It was imminent. If I didn't do it, I would do it."
The three looked at each other, couldn't help but swallowed the saliva ... I could think of the danger.
But the more so, the more feared all three were.
Well, patients can't come to the hospital.
Li Baoshan sighed, "You are too risky."
Tao Yan shook his head: "A must!"
Speaking of which, the eyes of Chen Cang of the three have changed.
After all, dozens of people in the Department of Cardiology and Cardiac Surgery of the Second Hospital of the Provincial People's Hospital can blindly penetrate the pericardium.
Even Tao Yan is not sure if they dare!
Maybe ... in that case, would you do it yourself?
Tao Yan wondered inwardly, but ... can it really succeed?
Thinking of this, Tao Yan's look at Chen Cang was really full of appreciation.
Be courageous!
It is really a capability to be able to determine the pericardial tamponade decisively and perform the puncture on the spot decisively.
Sometimes people really have to serve the old.
Watching the excellent young people grow up from generation to generation, several directors are also grateful and sorry.
Fortunately, someone has succeeded.
Unfortunately, I'm old ...
However, I learned that the patient's vital signs were stable after the pericardial puncture had been performed, and everyone was relieved. There was indeed some blood in the pericardial cavity of the patient at this time.
But there is no large-scale bleeding, and it should not be damage to large blood vessels.
Nor is it a sharp rupture of the heart.
The only consideration now is pericardial damage, which causes pericardial vascular damage.
At this time, various test results came back.
The index is basically normal ~ EbookFREE.me ~ The hemoglobin is low but it does not reach the indication of blood transfusion. The white blood cells are slightly higher, but it is normal.
After reading various inspection reports, Tao Yan said: "Now we need to open the chest to investigate whether there is any damage to the heart or blood vessels. We should find out the blood source and treat it in a timely manner."
"And ... you see in the film, here, there is pericardial hemorrhage and blood clots, so you should cut out the pericardium, clear the pericardial blood, identify the source of the bleeding and repair the damage to the heart blood vessels!"
Xu Tianfu also nodded: "Fortunately, there is no puncture wound in the heart, otherwise it is not so simple. Look at this broken rib, it should have damaged the blood vessels of the pericardial tissue, and did not cause damage to the heart. I estimate this It should be the main cause of blood pericardium and tamponade! "
I have to say that Sun Sheng is more fortunate because the fractured ribs did not cause damage to the heart. Otherwise ... this is not the case now.
After discussing with several directors, they made a decision to improve the operation as soon as possible.
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