Chapter 419: Lu Chen, Don’t Fall Behind!

Remember【New】 in one second!     Xiao Shikang also understood the seriousness of the matter, and immediately contacted the CT room, and then communicated with the patient's family about the condition.

"We are here for atrial fibrillation ablation surgery, why are there so many problems suddenly?"

The patient's family is a middle-aged woman. She was confused by what Xiao Shikang said, and she didn't understand most of it. She could only understand one sentence. The patient's condition suddenly became very complicated!

"It's not that so many problems appeared after the operation." Xiao Shikang explained patiently, "We consider that the patient had so many problems before the operation, but we just happened to find them during the operation!"

"What should we do next?" The middle-aged woman frowned.

"Go out for examination immediately. Only after the diagnosis can we do the next step of diagnosis and treatment." Xiao Shikang said.

"Don't you have any doubts about the diagnosis now?"

"Consider the rupture and bleeding of the liver mass. As for the cause of pericardial effusion, we are not clear yet." Xiao Shikang paused and said.

"Liver mass, liver cancer?" The middle-aged woman was stunned. She knew some medicine, but only some fur.

"It's not certain yet." Xiao Shikang shook his head.

"Well, then, let's go out for the examination."

...

After getting the consent of the patient's family, Xiao Shikang immediately sent a doctor to accompany the examination.

And Lu Chen stayed in the catheter room, continuing to look through the patient's medical records.

The patient's current information is not very complete, only the recent medical history, as for the past history, it is very vague.

"By the way! The patient should have been taking anticoagulants!" A gleam of light flashed through Lu Chen's mind.

The patient is now undergoing atrial fibrillation ablation.

Patients with atrial fibrillation need long-term anticoagulants, warfarin or Xarelto.

The side effect of anticoagulants is bleeding!

Could it be that the patient's bleeding in various serous cavities was caused by long-term anticoagulation?

Just as Lu Chen was thinking, the CT room sent back a message that the patient's abdominal CT was completed.

Xiao Shikang immediately found an idle computer, turned on the computer imaging system, and called up the abdominal CT image.

CT showed: the patient had two cystic low-density shadows in the left lobe of the liver, with small hemorrhage foci and thin-wall enhancement. The larger one had intramural nodule enhancement in the delayed phase (hemorrhage was not excluded), and the smaller one had obvious intramural nodule enhancement in the arterial phase, and the portal and delayed phases supported enhancement, the degree of which was equal to the liver parenchyma, the cyst contents were not enhanced, and the adjacent gastric cavity was compressed.

The diagnosis given by the doctor in the CT room was liver cyst with bleeding, but tumor metastasis was not excluded!

Seeing this, Lu Chen already had an idea in his mind.

The diagnosis of the doctor in the CT room was simply based on abdominal CT.

But the real clinical diagnosis is not just based on a CT film.

After reading the patient's imaging, Xiao Shikang frowned and said, "It seems that it is still a liver cyst rupture and bleeding!"

Lu Chen shook his head, "I think it is a liver cancer splitting and bleeding due to tumor metastasis. The tumor has not only metastasized to the liver, but also to the pericardium. Otherwise, the source of pericardial effusion cannot be explained."

After listening to Lu Chen's explanation, Xiao Shikang was also stunned.

Such an explanation is not unreasonable!

However, what surprised Xiao Shikang the most was Lu Chen's clinical thinking mode.

In addition to his excellent interventional surgery skills, he did not expect that his clinical diagnosis and treatment skills were also excellent!

"Well, that makes sense. However, the current priority is to stop the bleeding!" Xiao Shikang said.

Lu Chen nodded slightly.

It is no longer important what caused the liver rupture and bleeding.

Although the patient's current symptoms are not serious, they may develop further at any time.

The two minus signs on his life value just confirm this state.

...

The patient did not return to the catheter room of the cardiology department, but was sent directly to the surgical operating room.

While the liver rupture and bleeding are still in the development stage, stop it in time!

Otherwise, once the bleeding is severe and shock occurs, the operation will be too late.

This episode in the catheter room did not affect the normal progress of other operations.

But Lu Chen did not perform a single operation all day.

Although there are many electrophysiological operations, there are only these two operations arranged for Lu Chen.

In the following time, Lu Chen followed Xiao Shikang and observed several other operations.

"Don't worry, there will be another operation tomorrow." Xiao Shikang smiled, "We can start tomorrow."

"Yeah." Lu Chen nodded. He was not in a hurry. For something like surgery, high quality should be the priority.

Otherwise, even if ten ordinary operations were performed, it might not be as good as one difficult operation.

...

Four o'clock in the afternoon.

News came from the operating room.

The patient's bleeding has stopped, and the preliminary diagnosis is tumor metastasis!

This result made Xiao Shikang a little scared!

The preoperative abdominal CT examination only reported a suspicious liver cyst.

Liver cysts are benign. As long as the size does not compress the surrounding tissues and the location is not dangerous, they can generally be left untreated.

Even the abdominal CT during the operation considered a benign liver cyst rupture and bleeding.

However, what surprised everyone was that the rapid pathological section turned out to be a malignant tumor!

"Lu Chen, thanks to you for discovering the abnormality." Xiao Shikang said with lingering fear, "If the patient was given an ablation operation in such a muddleheaded way, the follow-up would be even more troublesome."

Atrial fibrillation does not affect the patient's life span.

However, after the operation, the risk of bleeding is increased, and the patient's rupture bleeding may progress faster!

Lu Chen was also somewhat fortunate that he saw this small-to-moderate amount of pericardial effusion when he was looking at the angiography image.

If he had just let it go, the current situation would be different!

...

At 5:30 in the afternoon, it was finally time to get off work.

Lu Chen rejected Yao Jie's request for dinner and returned to his hotel.

It has been a long time since I went to the clinic, and I was a little uncomfortable to suddenly come to the catheterization room.

However, after experiencing today's somewhat thrilling diagnosis and treatment process, Lu Chen felt his heart surge.

This long-lost enthusiasm is incomparable to a simple operation!

Surgery, of course, requires the doctor's technical ability.

However, the process of diagnosing and treating patients requires "detective-style" rigorous thinking, inferring from every suspicious point in the medical record, and finally finding the patient's final diagnosis, and treating and curing the patient in time.

While Lu Chen was thinking, Min Xiaobo called.

"Hello, Lu Chen, how many surgeries have you performed in the past two days?"

Min Xiaobo got straight to the point.

"Ahem." Lu Chen coughed awkwardly, "None."

"Huh?" Min Xiaobo was surprised, "Why don't you have one? We are in the second stage of the assessment. The number of surgeries is also an important indicator. I asked other people, and it seems that at least two surgeries have been performed."

Lu Chen smiled helplessly, and he did not explain too much.

Originally, he also had two surgeries, but because of his own reasons, both surgeries were cancelled.

"You have to hurry up too!"

"Don't worry, there will be a chance later." Lu Chen said.

"Hey, among the thirteen of us, it would be great if half of us could pass the second stage assessment and get the completion certificate." Min Xiaobo said, "Everyone has worked hard, Lu Chen, don't fall behind!"

"Well, thank you for your reminder, Brother Bo." Lu Chen smiled.

"That's it for now, I'm hanging up."

After hanging up the phone, Lu Chen breathed a sigh of relief.

In the next less than a month, he really had to work hard.

Afterwards, he moved his mind and entered the system virtual space again to perform a simulated electrophysiological intervention surgery.