After raising a cat, the goddess doctor became popular in the interstellar

These words directly scratched Xie Baoshu's itch.He immediately went through Wang Zhang's diagnosis and treatment ideas from head to toe, and he nodded repeatedly.

"Xiao Xie, your basic skills are very solid, and your clinical intuition is also very keen." Wang Zhang praised: "Your first hospital in Yunshi is really full of talents."

"It's okay." Xie Baoshu's heart burst into laughter, and he couldn't hide it on his face: "Actually, my ability is more than that. If you give me a chance to have an operation, I promise you won't be disappointed."

"Then don't worry, there must be opportunities, and you can't just pull the hook - then it will depend on your performance." Wang Zhang said with a smile.

"Director, just rest assured!" Xie Baoshu was full of confidence.

At this time, the patient came back, and the test results were sent back.

The good news is that all inspection results were normal.

The bad news, however, is the patient's symptoms.

After such a short time, his chest pain intensified again, and his face became pale.

It can't be faked.What is the cause of the patient's pain?

"Since when did you have chest pain?" Wang Zhang asked after thinking about it.

"Since this morning, the planned trip has been cancelled." The patient's friend said, "After lunch, I saw that he couldn't hold on any longer, so I persuaded him to come to the hospital."

"Let's do another enhanced CT." Wang Zhang made a decision.

Only enhanced CT is the gold standard for judging aortic dissection, but this kind of CT needs to create a contrast agent, and he doesn't want to do it for patients if it is not necessary.

But now the patient's condition has become so serious that he has to seriously consider the possibility of aortic dissection with atypical symptoms.

Xie Baoshu looked at the patient's appearance of paroxysmal pain, and actually had a different judgment in his mind.

In the Vocational Skills Improvement Center, he has encountered similar patients, and the symptoms of pain are just like this.

However, what Director Wang is doing now is understandable.

Aortic dissection, the full name is aortic dissection aneurysm.When the disease occurs, the artery will burst immediately, causing massive bleeding. Even if a person is rescued in the hospital, it will be very difficult, so you can't be too careful.

The effect of enhanced CT was also sent back immediately.Not aortic dissection, and no pulmonary embolism.

Wang Zhang took a deep breath, and doubts followed.

The patient's pain still has not been relieved, and he is holding his chest in pain-what is the problem?

"Take another electrocardiogram." Wang Zhang said.

His orders were perfectly carried out.Xie Baoshu glanced at the result and said, "Director, it's a normal electrocardiogram."

Wang Zhang took it over and took a look noncommittally. Seeing that it was indeed the case, he couldn't help but improve his evaluation of Xie Baoshu in his heart.

"Can you read an EKG?" he asked.

"Yes." Xie Baoshu didn't know the word modesty: "My ability to read pictures is very strong now, to tell you the truth."

"Okay." Wang Zhang said angrily: "Tell me your opinion. Regarding this patient's chest pain, what other possibilities are there?"

Xie Baoshu had been waiting for his words, and immediately said: "Pericarditis. I suspect it is pericarditis."

"Pericarditis?" Wang Zhang shook his head: "It's unlikely. I auscultated the heart sounds just now, but I didn't hear a pericardial friction rub."

"Also, come here to see the results of the cardiac ultrasound." Wang Zhang called him over: "There is no pericardial effusion or exudation at all."

Xie Baoshu had actually seen the color Doppler ultrasound results just now, but he still insisted: "In the case of a new occurrence, there may be very little exudate in the pericardium, which cannot be seen on the color Doppler ultrasound, and may not be heard on auscultation. "

When Wang Zhang heard the words, he was a little moved.There is no other reason to be found, so it is not easy to use medicines at will, but if the treatment is carried out in this direction, although it is relatively conservative, it is not easy to cause problems.

After thinking for a while, he asked the patient again: "Recently, have you not had any surgery on your heart, and have you not suffered any trauma?"

"No trauma." The patient shook his head in pain, and suddenly remembered something, and said, "But because of premature heartbeat, I underwent radiofrequency ablation last week."

Radiofrequency ablation is an interventional technique that sends an electrode catheter into a specific part of the heart chamber through blood vessels, releases radiofrequency current, and blocks the abnormal conduction beam and origin of tachyarrhythmia.

The electric current in the operation may damage the normal myocardial tissue, cause pericarditis, and even cause delayed pericardial effusion.

Wang Zhang slapped his thigh: "After this operation, why didn't you just say it?"

The patient looked innocent: "You asked if you had surgery, but you didn't talk about internal medicine?"

"You are too real." Wang Zhang said helplessly, then turned to look at Xie Baoshu.

The latter was secretly pleased because the patient's words confirmed his judgment, so Wang Zhang took a serious look.

"Okay, you guessed it right." Wang Zhang said: "Tell me, how to cure it?"

"The patient underwent radiofrequency ablation last week, and pericardial inflammation occurred. But it is not serious for the time being. You can consider using non-steroidal anti-inflammatory drugs, such as ibuprofen, to relieve chest pain." Xie Baoshu answered clearly:

"At the same time, we should pay close attention to the changes in the fluid in the pericardial cavity, and use pericardiocentesis and surgery if necessary."

"Very good." Wang Zhang was extremely satisfied with his performance. He prescribed ibuprofen for the patient and arranged for him to stay in the observation bed to rest.

By the time I got off work, the patient's condition had greatly improved, and the pain in the chest was basically gone.

Xie Baoshu arranged for him to have another heart ultrasound and listen to the heart sound again.

Sure enough, just as he judged at the beginning, this time, there was a very small amount of effusion in the pericardium, and there was a friction sound of "sha-sha-sha" in the heart during auscultation.

"This is a typical pericardial fricative sound." Director Wang rushed over to listen to it for a while, and then called all the residents in the department to listen to the sound and study. By the way, he praised Xie Baoshu in front of everyone.

"Brother Xie, tell me, we all learned together, how can you be so good?" Duoji asked Xie Baoshu quietly.

"Do you need to ask? Brother Xie, I'm a genius—of course it's impossible." Xie Baoshu said with a smile: "It's actually the result of practicing with VR glasses."

"It's not brother Xie, I also went in and learned the technique of controlling pulse to stop bleeding. But the others, just a hundred micro-fangs of energy, are gone before I understand anything." Duoji said regretfully.

Xie Baoshu's heart suddenly moved, and he said mysteriously: "I seem to have discovered a little secret technique that can generate energy, do you want to try it?"

"The secret skill of generating energy?" A voice came from behind them: "What is that, tell me!"

The two turned their heads and saw that the person who spoke was Gan Yi who had just entered the observation area.

It wasn't just him. Under Wang Zhang's arrangement, the doctors who were using stethoscopes to listen to the pericardial friction sound on the patients one by one, one by one, all of them pricked up their ears and waited intently to listen.

Xie Baoshu became inexplicably nervous: "I admit, I got a lot of energy because of good luck. But I can't guarantee whether this method will work for you."

"Speak quickly, don't hide your secrets." Wang Zhang also turned around and said, "If it works, we'll know if we try it!"