【1152】A good doctor must have a strong heart

In surgery, the most feared accident is not the gut reflex. Why, because surgeons and anesthesiologists have experience in this and know that patients are at risk and can prevent it in advance. Even if there is an accident, you still know how to deal with it quickly.

For common surgical accidents such as bile-cardiac reflex, as long as the doctor makes a good plan, the success rate of rescue is very high.

"Senior Brother Tao has made a plan. If necessary, a closed method will be used during the operation to freeze the vagus nerve here and avoid the bile and heart reflex." Xie Wanying said the arrangement of the surgeon so that Dr. Zhang, who was under anesthesia, could rest assured about it. some.

For a deputy chief like Tao Zhijie, how to avoid such predictable surgical risks is a small case that is too easy to solve.

Zhang Tinghai knew Tao Zhijie's plan. Besides, as an experienced anesthetist, he could handle such surgical problems with ease.

Patients are routinely injected with atropine in the ward before surgery to calm the vagus nerve. When they arrive in the operating room, the patient is given oxygen through a mask and given general anesthesia, which can further calm the patient's vagus nerve and prevent it from causing trouble.

If something happens during the operation, he will prepare rescue medicine in advance before the surgeon touches the special area, and he also knows what medicine will be needed at that time, so it is not scary.

With all the plans in mind, Zhang Tinghai was not worried about this, but: "Teacher Lu's heart is not in good condition. Could it be related to biliary heart syndrome?"

There is a big difference between biliary-cardiac syndrome and biliary-cardiac reflex. Although both affect the patient's heart, they may have different causes. The latter, as mentioned earlier, is a vagus nerve reflex triggered by the surgeon's operation. Biliary heart syndrome is an inherent disease of the patient itself, and is a heart problem caused by chronic cholecystitis and other diseases in the human body.

Here we will further talk about the anatomical relationship between the human heart and the gallbladder. The human heart is innervated by the T2-8 spinal nerves. T is the abbreviation for thoracic vertebrae. The common bile duct of the gallbladder is innervated by the T4-9 spinal nerves. Looking at it this way, the nerves innervated by the two cross at T4-5.

Where there is an intersection, problems on one side are bound to affect the other.

When the gallbladder is inflamed, the pressure in the bile duct increases, which is transmitted to the heart through crossed nerve reflexes, causing the coronary arteries of the heart to contract and reduce blood flow. Undoubtedly, typical heart disease symptoms will appear, such as myocardial infarction.

There have been many discussions in the department about Teacher Lu's condition. Xie Wanying said: "Yes, I have thought about this possibility. Therefore, the gallbladder is probably required to be removed during the operation, even if there is no infiltration of cancer cells. This is because Teacher Lu's gallstones are very serious."

At this point in the discussion, cutting out the patient's gallbladder is a radical cure for biliary heart syndrome, so it seems to have nothing to do with his nightmares.

Zhang Tinghai sighed, not sure what his nightmare was about.

"Doctor Zhang." Xie Wanying could feel the anxiety in his heart. All the teachers and seniors were anxious before the operation, because the patient was Teacher Lu, so it was understandable. She comforted Dr. Zhang just like she gave candy to Senior Brother Cao last time, and said, "Drink something sweet to feel better."

Zhang Tinghai wanted to roll his eyes at her. If he were a medical student, who wouldn't be worried about the teacher and extremely nervous now, but she was so calm and calm that it would be sweet to eat spicy.

Squinting his eyes, Zhang Tinghai remembered what many seniors had said to junior doctors: an excellent doctor must have an extremely strong heart.