Huo Shuangqing is also an expert in cardiology. How could she not know that radiofrequency ablation is one of the most effective methods to cure atrial fibrillation? But she knew better that this operation was to puncture blood vessels and release radiofrequency current inside the heart, thereby causing coagulative necrosis of the subendocardial myocardium, thereby destroying the origin of the arrhythmia.
"If you kill one thousand enemies, you will suffer eight hundred losses." Although this kind of surgery has remarkable effects, Huo Shuangqing still hesitates. It's better for young people. Once the elderly undergo this kind of surgery, it is likely to cause heart failure. If this complication does occur, the elderly will incur a lot of medical expenses later. Secondly, the key is that the elderly Your body will deteriorate.
If it weren¡¯t for Zhou Yi¡¯s magical performance, Huo Shuangqing would have learned radio frequency without hesitation at this time. But Zhou Yi gave her another hope, and she didn't want to use radiofrequency ablation in such a hurry. After all, the patient was over seventy years old, and using this method to treat her was more of an "explanation" than a real treatment for the patient. For your own sake.
¡°What kind of treatment is radiofrequency ablation?¡±
Zhao Xuechu asked, it was about his mother, so he had to be cautious.
"This is not possible. Is this called curing a disease? Causing myocardial coagulation necrosis? My mother is seventy-two years old, how can she endure it!"
Zhao Xuechu snorted coldly, without giving Hua Wenfeng any face at all. He turned his attention to Zhou Yi again: "Dr. Xiao Zhou, I just want to hear your opinion."
"Xiao Zhou, tell me what you think?"
Huo Shuangqing looked at Zhou Yi seriously: "If you have an opinion, just say it. As long as it is good for the patient, there is nothing to worry about."
Hua Wenfeng looked at Zhou Yi with a sneer: "Tell me, I want to hear what you have to say." Although the methods Zhou Yi showed before were miraculous, they did not completely cure the patient after all, which gave him confidence. , I feel that Zhouyi is nothing more than this.
"Director Huo, Mr. Zhao. I think blindly using radiofrequency ablation before the cause of the disease is found is extremely irresponsible to the patient." Zhou Yi shook his head and said: "The patient is over seventy years old, and radiofrequency ablation is performed at this age. , there is an 80% chance of developing heart failure. I think everyone should understand, what is the concept of heart failure for a 70-year-old man?"
Having said this, Zhou Yi glanced at everyone: "We can't 'cure' the patient, but not long after he was discharged from the hospital, the patient was completely sick, right? How can such a hospital have the face to face patients? "
"Zhou Yi, be careful what you say!" Hua Wenfeng was almost mad at him. This guy was clearly here for me, why did he look at me specifically before speaking? Damn, what are you looking at? "Even in the United States and Hong Kong, radiofrequency ablation is the best way to treat atrial fibrillation! The surgical standards of our hospitals are not necessarily worse than those abroad, right?" He seems to be quite patriotic.
"Haha, let me ask Director Hua"
Zhou Yi said leisurely: "Don't talk about foreign countries, let's talk about our own hospital. We have also done a lot of radiofrequency ablation surgeries. This is a small surgery in itself, and there is no technical level. The key is, under what circumstances are we all doing? Did you just do it? I think there are two situations!"
"One is secondary atrial fibrillation after a patient's heart surgery. For example, atrial fibrillation caused by mitral valve replacement cannot be converted to 'sinus rhythm' for more than a week, and severe atrial fibrillation may lead to heart failure. Radiofrequency ablation will be considered, but even so, the patient's age and physical condition must be taken into consideration, and those who can be treated conservatively should still be treated conservatively."
"The second case is primary atrial fibrillation. It is generally difficult to wait for conversion to sinus with conservative treatment. Even if conservative treatment is managed, radiofrequency treatment is usually required after a period of time." Zhou Yi hehe Yixiao: "However, these primary atrial fibrillations have very obvious 'arrhythmia origin points'. With the X-ray angiography machine, they can be ablated accurately, and the surgical prognosis is good. But, does patient Zhao Shuyi fall into this situation? Director Hua?"
Hearing this, Dr. Guo, who was standing behind Hua Wenfeng, couldn't help but froze: "How is it possible? How is it possible! He is just a newly graduated master's degree. It is said that he has never even experienced an internship. He obviously relies on Dean Liu's relationship He just became a resident doctor, how did he see the problem?"
Huo Shuangqing was also stunned. As the chief director, she is responsible for the eight major departments of the Department of Traditional Chinese Medicine. How can she go through every medical record in detail? She had read Zhao Shuyi's medical record in detail, but most of her attention was on the diagnostic opinions of the doctor in charge in the early stage. At most, she could only look at the conclusions of various reports. There was really no examination one by one. Look at the pictures carefully. This is like the commander-in-chief of the armed forces. It is impossible for her to have to take on the work of a scout.
¡°It happened that when she was discussing the treatment plan with several directors, Zhou Yi looked at the old lady¡¯s angiogram and didn¡¯t find it at firstWell, if you look closely, you can find the problem.
Although Hua Wenfeng is not the directly responsible doctor, the patient is in his department. He has plenty of time to see this problem, but why didn't he raise it? Instead, they insist on using radiofrequency methods on patients? Huo Shuangqing had to question the character of the chief physician. In her impression, Hua Wenfeng was not this kind of person. Did he give up his principles as a doctor just to compete with Zhou Yi?
Who is Huo Shuangqing? After listening to Zhou Yi's words, and seeing Hua Wenfeng's somewhat stiff face, I immediately felt that something was wrong. After giving him a cold look, I quickly pulled out the angiogram of Mrs. Huang Shuyi from the file bag beside me, and carefully Looked up.
"Hua Wenfeng, what's going on? You need to give me a reason!"
What is her experience? He soon saw the problem. In anger, he threw the film heavily on the desk and stared at Hua Wenfeng coldly
"Is there a problem?" Hua Wenfeng took the angiogram and looked at it carefully: "Thishow is this possible? The patient's 'arrhythmia origin' is too strange, too strangethissuch a case, Only three cases have been discovered in the world so far!¡±
Although there is only one 'origin point of arrhythmia' shown on the angiogram that is the most obvious, if you look carefully, you can see that there are dozens of small dots densely arranged like a spider web around the origin point. If you don't look carefully, It's really easy to ignore.
¡°Director Hua is right, this ¡®cobweb-like arrhythmia origin point¡¯ was first discovered in a patient in Australia¡±
Huo Shuangqing looked at the bewildered Hua Wenfeng and seemed to understand something. She then looked at Dr. Guo behind him: "At that time, the Australian hospital also used radiofrequency ablation to destroy the largest point of origin, but what was the result? Because The coagulative necrosis of the subintimal myocardium produced a conditioned reflex, which successively triggered the remaining thirty-seven micro-origin points. As a result, the patient died suddenly due to acute heart failure less than a month after being discharged! Later, two cases were also discovered in the United States. But they all found the cause of the 'spider arrhythmia' and successfully saved the patient through corresponding surgeries."
"Director Hua, the general diagnostic doctors in the laboratory department didn't discover this problem, didn't you find it either? You are the chief physician and an expert in the eyes of the patients!" Huo Shuangqing became more and more excited as she spoke, and her chest heaved violently: "Even if you are not a patient The doctor in charge, but Guo Yun is your student and the doctor in charge of the patient. Didn¡¯t you follow up on everything?"
"Director Huo, I I was negligent. I blindly believed in the diagnosis of the diagnostician without seeing the angiogram. It was my fault. I shouldn't have been so careless." Hua Wenfeng glared at Guo Yun: " Guo Yun! Are you going to deal with me like this? Tell me, what¡¯s going on!"
"Teacher, I admit that I discovered this problem and concealed it just now"
Guo Yun glanced at Zhou Yi with some resentment: "But who am I doing it for? Since you know this case, you should know that now even Americans must find the cause of the disease in order to take effective treatment. I have also read the United States for this Those two cases, but the causes of those two cases do not exist in Zhao Shuyi, that is to say, the cases in the United States have no reference for us!"
"Our hospital is already a well-known tertiary hospital in Henan Province. We have tried every means, but we have not been able to find out the cause of the disease. Even if we transfer the patient to Kyoto or Shanghai, I am afraid the result will be the same! The old lady has a special status, we must not Nothing can go wrong, let alone it can¡¯t be cured. So"
"So you concealed the patient's true condition and rushed to use radiofrequency methods?" Huo Shuangqing said: "If the patient is like the Australian patient and died of heart failure soon after being discharged, can you live up to your conscience?"
"Director Huo, this is a dead horse treated as a living horse doctor. Huang Shuyi's condition is so weird, there is no precedent at all. Since no hospital has a 100% effective treatment method, radiofrequency ablation is the only effective method. The Australian patient was Inducing heart failure, doesn't it mean that she will definitely have the same problem? Speaking of danger, what kind of surgery is not dangerous? For those surgeries with a success rate of no more than 20 or 30%, the patient's family still has to sign ?¡±
Guo Yun sneered and glared at Zhou Yi: "I just can't stand some clowns being so proud!"
"Haha, Guo, I see clearly, you are really a bastard!"
Zhou Yi sneered and said: "You are paralyzed. People do surgery only after they know it clearly. Even if the risk of surgery is as high as 90%, the family members still admit it. What do you call this? Isn't this treating people as guinea pigs? You keep saying that for the reputation of the hospital, I think it¡¯s for your own sake, right? If the old lady disappears after being discharged from the hospital, it¡¯s because she was unlucky.Well, it has nothing to do with you. If she is lucky enough to be fine, it will be your credit. You can write a paper with this case, get a professional title, put on a vest and become a scholar, right? I, Zhou Yi, am a real villain, but I am a hundred times better than you, a hypocrite! "
"Well done!" Huo Shuangqing's face turned livid: "Guo Yun, get out of here!" rs! .