Since 1981 Health School Chapter 600

  Chapter 600 This is a sky-high price bracket

  The patient's heart rate and blood pressure continue to drop, and cardiac arrest may occur at any time, and time waits for no one.

  Chen Qi quickly ran to the General Affairs Department and asked them to set up a tent in the backyard as quickly as possible.

  Ask, why not do surgery in the operating room? The answer is: the radiation of interventional surgery is too large, which is easy to cause damage to the precision instruments in the operating room.

   There is no problem with this reason, because whether it is X-ray or CTMR, a dedicated room is required for radiation isolation. If you really want to damage a few microcomputers, there will be nowhere to cry.

  Chen Qi directed the logistics staff to lift out a small X-ray machine from a warehouse, about the size of a desk.

  Question: When did the People's Hospital have such a small X-ray machine? The answer is: employees don't ask about leadership matters.

  In short, Chen Qi was quite low-key when he was going to perform this interventional operation. Not only did the medical staff in the emergency department be required to keep it secret, but even the doctors in Xijing Hospital were not allowed to watch.

  Why don't you give me a bystander?

  They are professionals, and all of them are professors and associate professors. They are old people, and they are not as easy to fool as young people like Yi Zewen, Chen Li, etc., so they are determined not to show them.

  Of course, the excuse on the surface is: the radiation of interventional surgery is too large, which will have a great impact on health. For the safety of friends, please do not stand by.

  Professor Tong was still not convinced at first, thinking that it doesn't matter if he eats some radiation when he is old.

  But when Chen Qi said that the amount of radiation in one hour is equivalent to that of 1000 X-rays, the old man was immediately taken away by his disciples.

  The tent operating room was set up very quickly, and it can be used after one pass of disinfection.

Cardiac interventional surgery does not require a sterile environment, because this kind of surgery does not require disembowelment, and only needs to make a pinhole on the wrist or the inner side of the leg. This is why Chen Qi dared to rest assured in such a temporary tent. The reason for the surgery.

  When Yi Zewen and Chen Li came in, they looked around curiously.

  Both of them had fought with Chen Qi in Africa for 2 years, and they were no strangers to the tents in the field hospital, and they immediately felt like they were here.

   "Dean, we are back to the way we were in Africa, performing surgery in a tent."

   "The conditions are better than those in Africa. The land in Africa is all muddy land, but we have concrete land here."

  Chen Qi struggled to take out some lead clothes from the box:

   "Come on, this operation is special, and the radiation will be more serious. For your health, put on lead clothes."

  Yi Zewen and Chen Li casually grabbed the lead jacket with one hand, but suddenly one of them lost their grip and the lead jacket fell to the ground.

  Yi Zewen picked it up in surprise and thought about it: "Dean, this lead coat is not light, is it more than 20 catties?"

  Chen Qi also laughed out loud when he saw two subordinates make a fool of himself:

   "A piece of clothing weighs 30 pounds. It is specially made. Don't take it off when you wear it, otherwise don't blame me if you can't have a baby in the future."

  It doesn't matter that Yi Zewen is married and has children, but Chen Li is a little scared as an unmarried girl.

   Moreover, she tried it, and she couldn't last long with a 30-jin lead suit on her body, so she was so anxious that she was sweating profusely.

  Chen Qi feels sorry for his two subordinates. He wants to be majestic, but he has to implicate the entire team. Even if he is the dean, he is somewhat embarrassed.

   "How about this, Lao Yi will operate with me in a while, Chen Li, you can leave after you have prepared all the surgical instruments, it is too much for the little girl to wear lead clothes."

  Chen Li is 160cm tall and weighs only 45kg. A 15kg lead suit is too much for a little girl.

  But Chen Li still gritted her teeth: "No, Dean, let's start the operation."

   Chen Qi looked at the strong little girl and nodded slightly, thinking that when she grew up a few more years, she would definitely be promoted to be the head nurse.

  Yi Zewen is the first contact with "cardiac interventional surgery", so he knows nothing about the operation.

   "Let's not perform surgery first, but first do an angiography to check where the heart vessel is blocked and narrowed, and then we can put a stent. Push the patient in."

  Cui Tongzhi felt that he was about to die. It turned out that it was just abdominal pain, but now his chest is tight, and he felt a sense of dying.

   "Dean Chen, save me!"

   At this time, Cui Tongzhi's heartbeat had dropped to 40 beats per minute, and his consciousness began to be a little blurred. The situation was already very critical.

  Chen Qi nodded heavily: "Don't talk, relax, everything depends on me, I can't die!"

  Cui Tongzhi's tears came out after rinsing, who wants to die since ancient times!

  Chen Qi looked at Yi Zewen and Chen Li: "Are you all ready?"

"Ready!"

  Chen Qi yelled out of the tent again: "The X-ray machine will be turned on soon, everyone should stay away from it by more than 20 meters, and you are not allowed to approach it. The people in the security department are in charge of vigilance."

  Subsequently, Chen Qi directly turned on the switch of the angiography X-ray machine. This kind of thing from the black technology of later generations is digitally controlled throughout and does not require too much operation by the operator.

  After Yi Zewen fully disinfected the patient's wrist joint and performed local anesthesia, Chen Qi directly took out a blood vessel puncture needle, felt the patient's radial artery and pierced it in. After the piercing was in place, he began to place the guide wire inside.

  Yi Zewen is a little curious:

   "Dean Chen, is this guide wire made of metal? If you accidentally poke it into the blood vessel, will it cause accidental injury to the blood vessel?"

  Chen Qi gently placed the guide wire while looking at the X-ray display screen:

   "It will not damage blood vessels. This guide wire is made of special materials, and it will become slippery and soft when it encounters liquid."

  Chen Li also asked curiously on the side: "The guide wire is inside the blood vessel, will the patient feel pain?"

   "It doesn't hurt, because there are no nerves in the blood vessels, so the patients don't feel it. This is one of the reasons why we didn't do general anesthesia."

  Under the guidance of the X-ray monitor, the position of the guide wire reached the root of the aorta and did not penetrate into the heart.

  Chen Qi replaced an angiographic catheter at this time, using the guide wire as a track, and the contrast agent catheter was placed retrogradely along the artery in the coronary sinus, aligning with the coronary artery opening.

  Chen Qi reminded at this time:

   "Okay, now that the catheter is in place, I'm going to inject a contrast agent. You can see which blood vessel is blocked in a while. Remember that position. We'll have to put the stent in later."

  Yi Zewen nodded again and again, looking at the screen without blinking.

   At this time, it can be seen on the display screen that the blood vessels of the heart are like different branched branches, which appear from time to time as the heart pumps blood.

  Where the blood vessels are suddenly interrupted or become smaller, it means which part of the blood vessels is blocked or infarcted, and it is clear at a glance.

  Suddenly Yi Zewen shouted excitedly: "I saw it, is it here that the right coronary artery is occluded after the proximal segment."

  Chen Qi glanced at Yi Zewen in relief.

Although this is Yi Zewen's first contact with interventional surgery and the first time he has seen this kind of two-dimensional blood vessel image, but he can quickly prepare to tell the location of vascular occlusion, which shows that Yi Zewen's anatomical foundation is very solid and he is indeed a useful patient. talent.

"Okay, now that we have found the occlusion, the next clinical idea is very simple. Since you are blocked here, I will install a stent for you to open up your occlusion, and the blood vessel will be closed. If it is unblocked, the myocardial infarction will be cured, right?"

  Yi Zewen nodded excitedly,

   "I understand. It turns out that this is the mystery of interventional surgery. It is simple and the effect is immediate. Then how to put this stent in?"

  Chen Qi took out the liquid metal bracket for one person from a delicate small box, and was quite emotional.

  In his previous life, there was just such a bracket, worth about 28,000, an absolute high-tech product.

  But this kind of good thing has been ruined by a few unscrupulous doctors, because this thing has a big kickback.

  A bracket costs 10,000 to 30,000 RMB, and the rebate may range from 1,000 to 5,000 RMB. What consequences will this lead to?

   It means that there is only one narrow or occluded place, and the problem can be solved by installing only one stent, but the doctor artificially exaggerates that there is a problem and there is trouble, and if it is not done properly, people will die?

then what should we do? Put more brackets on.

  The family members nodded obediently and went home to borrow money to save their lives, but the doctor got a lot of kickbacks.

  Although there are a small number of such doctors, it is these few black doctors who spoil the whole pot of porridge like a mouse, causing the public and public opinion to be black all the way when they encounter doctors.

  Later, the higher-ups also knew about this disadvantage, so they began to restrict imported stents, either restricting your bidding or restricting your medical insurance reimbursement, and wanted everyone to use domestic stents.

  There is definitely a difference between the quality of domestic brackets and imported brackets, but the difference is not big, after all, it is more than half cheaper.

  But sometimes it is good intentions to do bad things, why do you say that?

   Imported brackets cost tens of thousands of yuan each, and they are not used.

  Okay, if you use a domestic bracket, a few thousand yuan is acceptable, but the relevant department forced the price to a few hundred yuan.

  The purpose is to benefit patients and reduce the burden, and the starting point is absolutely good.

   But medical equipment is what you pay for, and the cheaper the better.

  If you lower the price so low, the profit of the manufacturer will be gone, so how can they still use the best materials for you? It will definitely cut corners, just like reducing the configuration of a car.

  In the end, it is the patient who suffers the most, because the stent is used by the patient to save his life, and he wants to live for a few more years.

  If the quality of the stent is not up to standard, the disease will still occur after a few years, and may die directly.

   Or not die, the stent needs to be replaced, which will cost a lot of money, do you think the patient saves money or not?

   To paraphrase a sentence on the Internet:

   Expensive things, the moment you give money is distressing, every day is happy when you use it, it feels very worth it!

   Cheap things are only happy at the moment you buy them, and there is no happy day when you use them.

  So the domestic medical market is really chaotic and dead when it is released, which makes people extremely helpless.

  Yi Zewen and Chen Qi took a closer look and were shocked:

   "Dean, such a small and light thing actually costs tens of thousands of dollars? This, isn't this too expensive?"

  Chen Qi smiled slightly: "It's tens of thousands of dollars. This thing is also the most advanced medical device in Europe and the United States, and ordinary people simply can't afford it."

  In fact, Chen Qi thought to himself that the stent in his hand is much more advanced than the current first-generation stent. Unfortunately, he is a doctor and not a medical scientist.

   "How can such a small stent be placed in the coronary artery of the patient's heart?"

   "Actually, the principle is similar to that of radiography. See, this catheter is called a coronary balloon catheter. I just need to install the stent on it, and then send it through the radial artery along the guide wire."

   After speaking, Chen Qi has already started to operate.

  In the monitor, the coronary balloon catheter has reached the blood vessel blocked by the heart, and then Chen Qi began to rotate the operating handle in his hand, in order to make the balloon expand like a balloon.

  As the balloon is stretched, the stent covering the outside of the balloon expands as the balloon expands until it is fixed on the blood vessel.

   At this time, Chen Qi pumped back the pressure pump again, causing the balloon to retract into a single line. At this time, the blood vessel has smooth blood flow due to the support of the expanded stent.

  Chen Qi turned on the angiography X-ray machine, observed for a while and breathed a sigh of relief, and said to the tearful Cui Tongzhi:

"Old Cui, it's your fate that you met me. If I wasn't here, you would have to report to Lord Yan today. It's all right now. The blood vessels that were blocked in your heart have been dilated, and the blood flow is smooth. Your little life is saved."

  Cui Tongzhi wanted to say something, but couldn't open his mouth.

  Chen Qi hurriedly comforted: "Don't get excited, you will be observed in the hospital for a few days, but you can't eat big fish and meat in the future, your health is important."

  Myocardial infarction, or one of the causes of coronary heart disease, is that those rich people, or officials, have constant drinking and drinking all day long, big fish and meat, smoking and drinking, and irregular life.

  If you add chronic diseases such as diabetes and hypertension, the possibility of getting this disease will increase.

  Chen Qi knew that Cui Tongzhi was the section chief of the post office. Although he was not a big official, he had a lot of power. Anyone who installed a telephone had to ask him to open the back door.

  In the 1980s, installing a telephone in a private home not only required an initial installation fee of 5,000 yuan, but also had to wait in line.

  If your home is too far away from the telephone line, you have to pull a line for you separately. There is no human kindness in this, and the post office is not willing to install it for you at all.

   Cui Tongzhi heard Chen Qi's instructions and nodded with tears in his eyes: "Thank you, thank you..."

  Chen Qi pulled out the catheter and guide wire, put them away after simple disinfection; Yi Zewen applied pressure bandage to the needle entry port; Chen Li did a simple cleaning of the tented operating room.

  The entire operation took more than an hour, and all three of them stood for more than an hour with 30 catties of lead clothes on their backs. In addition, it was summer again, and all three of them were soaked in clothes.

  Chen Li's face was even paler, it was really not easy for the little girl.

  Chen Qi felt distressed when he saw the appearance of the two subordinates, so he said softly:

"If the family members come to give red envelopes later, don't refuse. I have agreed to this as the dean. It is not considered a violation of discipline. Anyway, the family is not short of money. You risked radiation to save his life and make the Cui family bleed. And it should."

  Yi Zewen and Chen Li looked at each other and smiled.

  (end of this chapter)

Chapter end