I can extract side effects

After the female reporter left, the Department of Cardiac Surgery quickly recovered its calm.

At 3 p.m., 6 hours after the operation, the patient finally woke up from anesthesia in the extracardiac ICU ward.

The doctors who heard the news surrounded the patient and carefully checked her physical condition.

"The patient's blood supply has recovered well. The skin temperature is 36.7, pulse rate is 78, heart rate, and blood pressure have all returned to normal."

Yunfeng checked the patient's body and compared it with the parameters on the monitor one by one. After confirming that it was correct, a smile appeared on his face.

When the operation started, he had already been busy all day and was directly tired, so he didn't participate.

Seeing the success of the operation now, I can't help but feel a little regretful. It would be great if such a major operation could be performed with the director.

However, he did not show any emotion, and gave the doctor's order like a precise machine.

"Close monitoring follows to prevent bleeding and signs of infection in the patient, as well as any neurological complications and liver and kidney damage."

"The patient is young and has good physical fitness. He should be able to recover quickly. It is estimated that he can be extubated tomorrow. As long as he survives the first three days without any problems, he can be sent to the general ward for rehabilitation."

The doctor next to him couldn't help but sigh with emotion: "It's amazing, the patient recovered so well after replacing a meter-long blood vessel."

Yunfeng said with a smile: "The director's aortic replacement operation is the signature of our department. Three months ago, there was a patient who had a 40 cm artificial blood vessel replaced. He recovered well after the operation and was extubated the next day. He was discharged from the hospital in less than ten days."

"I used the imported polyester blood vessel from Maikewei that time, didn't it work well? Why did you replace the 1-meter length with Sanqing's new product this time?" A young resident doctor asked puzzled road.

Yunfeng glanced at the patient, and found that he had fallen asleep, so he replied in a low voice: "Isn't it too expensive to import artificial blood vessels, one costs 20,000 to 30,000 yuan, and a 1-meter-long blood vessel replacement operation needs to be used at least. Three, that’s nearly 100,000 yuan, plus surgery fees and ICU hospitalization fees, the economic burden on patients is too heavy.”

"Sanqing's artificial blood vessels are still in clinical trials, so they are all free, including surgery fees and hospitalization fees. If you don't have money to ask patients, which one do you choose?"

The resident doctor scratched his forehead in embarrassment: "Of course it's free, I understand."

Yunfeng smiled slightly and explained: "Besides, Sanqing's artificial blood vessels are not inferior to those of Mai Kewei. Mai Kewei's artificial blood vessels are polyester blood vessels, but the surface layer is impregnated with natural silk fibroin coating, so the manipulability and ease of use are improved. Biocompatibility, patient rejection is also lighter than ordinary polyester blood vessels."

"However, Sanqing's artificial blood vessels are all made of biological elastin material, basically there is no polymer in it, the technical content of the material is naturally not the same, and the biocompatibility is even more impressive."

"It not only greatly reduces the rejection reaction of patients, but also has very high stability and tensile strength. Most importantly, it also has certain growth potential."

"I have read the animal experiment data of artificial blood vessels. After 14 days of implantation, Sanqing's bioprotein artificial blood vessels can perfectly replace the original aorta and perfectly integrate with the original blood vessels at both ends."

"Before this total aortic replacement operation, we also performed two replacement operations of about 20 centimeters last week, both of which used Sanqing's artificial blood vessels. Blood, the material is also very elastic, and after being placed in the stent, it can still maintain high stability."

Another doctor interrupted suddenly: "You don't have to be superstitious about the imported artificial blood vessels, that Mai Kewei, I heard that there was a recall a few years ago. I complained, and within two years, it was recalled again because of product packaging problems.”

"According to me, imported products are now increasingly being beaten by domestic products. We use domestic products if we can. At least Sanqing has not had any recalls in the world so far."

Yunfeng nodded in agreement, and said, "I agree with you, but it's not because of product quality, but because of supply issues. You may not know that the recent relocation of Maikewei's factory has led to a sharp drop in supply, and imported artificial blood vessels are no longer available. Demand exceeds supply."

"Currently there are only two manufacturers of artificial blood vessels, Terumo of Sakura Country and Maikewei of Europa, especially the latter, which occupies more than 70% of the market."

"In the past, only a few hospitals could perform artificial blood vessel replacement, but now more and more hospitals can do it, but the production of artificial blood vessels has not caught up, so it is becoming more and more scarce."

"In addition, there was a problem with the relocation of Mai Kewei's factory. The old factory was closed, but the new factory was unable to start operation. Now, except for the third-level hospitals in Beijing and Haishi, the imported artificial blood vessels still have goods, and hospitals in other regions are out of stock. gone."

"The domestic demand for artificial blood vessels has always been great, with 20,000 to 30,000 artificial blood vessels each year, accounting for 10% of the global consumption."

"If you think about it carefully, foreign manufacturers have supply problems. The first guarantee must be their domestic market supply. As for whether we are in short supply, whether the patient is in danger, waiting for artificial blood vessels to save lives, they don't care. .”

"That's why we need to support domestic artificial blood vessels. This is a matter of principle. Otherwise, we will always be under the control of others and be stuck by foreign manufacturers."

"This is not only a quality issue, but also a matter of life and death. Even if the domestic artificial blood vessels are not as good as imported ones, we still have to use them, let alone Sanqing's artificial blood vessels are still better than imported ones, so we have no reason not to use them."

The doctors around were silent for a long time and nodded.

"That's the reason. It's about the life and death of the patient, so it's still in your own hands."

"I dare not even think about it. If I need an artificial blood vessel for aortic replacement surgery, but there is no stock at all, what should I do?"

"That's right, when did domestic products run out of stock? Only imported products are out of stock all day long, either because of strikes or relocation, for various reasons, even when the factory is powered off. No."

"That's right, since the production capacity is not enough, don't get used to them. We produce by ourselves, and we can have as much as we want."

Seeing that the crowd became passionate, Yunfeng quickly waved his hand and said, "It's enough for everyone to understand in their hearts. Let's go, let's go to the next patient."

*****

Guangdong Province, Yangcheng Zhongshan Hospital.

In the deep night, Dr. Cao, who was on duty in the emergency department, was very busy.

Suddenly, a rapid siren sounded, and a 120 ambulance rushed into the hospital.

Dr. Cao heard the familiar and piercing voice, looked at the long queue of waiting patients, and suddenly felt a little desperate: "Again?"

Soon, a 40-year-old male patient was lying on a cart and pushed in by a nurse.

"The fishbone stuck into the esophagus when the patient was eating, and he suddenly had difficulty breathing and chest pains, so he quickly called 120 and sent him to the hospital."

When Dr. Cao heard this, he was a little uneasy: "The fish bone stuck into the esophagus is not so serious, it can't be pierced through, it has entered the trachea."

He immediately checked the patient's esophagus. After checking for a long time, he did not find any fishbone.

"It is suspected that a fishbone has penetrated the trachea, let's take a film."

After prescribing the checklist, seeing the patient being pushed into the night CT room, Dr. Cao lowered his head and continued to serve other emergency patients.

Not long after, the family members came over with the CT scan results.

Dr. Cao took a look at the film and couldn't help gasping.

On the CT film, a white fishbone more than 2 cm long was clearly displayed, but it did not appear in the trachea position he predicted.

Instead, it pierces the patient's aortic arch like a sharp arrow.

Thinking of the patient's slight movement, the fishbone would pierce the thoracic aorta like a fish swimming into the sea at any time, leaving a rupture gap where blood spurts out, and fine beads of sweat instantly ooze from Dr. Cao's forehead.

"Go through the hospitalization procedures first. I have already notified the experts to come for consultation."

He told his family members, then got up suddenly, picked up the phone at the speed of light, and called the doctors on duty in the Department of Gastroenterology and Cardiac Surgery.

When the patient was admitted to the ward, the doctors from the Department of Gastroenterology and Cardiac Surgery all gasped after seeing the CT images.

This fishbone had penetrated the esophagus, broke through the mediastinum, and entered the thoracic aorta near the sixth thoracic vertebra, forming two fatal injuries in the patient's body.

The first is to penetrate the esophagus, and the risk of fatal infection increases geometrically.

Then it penetrated the aorta and formed a false aortic aneurysm. Once the tumor ruptured, the huge arterial pressure would cause the patient to die of hemorrhage quickly.

The thoracic aorta is the largest arterial vessel in the human body, and the pressure in the blood vessel is very high. Once a breach is formed, the bleeding will be jet-like, just like a dam bursting, and it is difficult to rescue.

"According to the experience and data of colleagues at home and abroad, there are a total of 23 similar cases among patients with similar conditions, 20 of them died, and only 3 were rescued, which can be called close to death."

The heart surgeon said with a heavy face: "I can't handle such an operation, I have to wait for the director to come and perform the operation."

The gastroenterologist also shook his head and said, "The hospital in Haishi shared a successful case. The operation needs to be advanced in stages. The first-stage operation includes esophageal fistula, thoracic aorta resection and replacement, and the second-stage esophageal reconstruction operation. Not only is the cost high, but patients will also lose their esophagus, which will greatly affect their quality of life."

An hour later, the directors of cardiology and digestive departments arrived one after another for a joint consultation.

Is it straight to surgery? Or combined with intervention and endoscopy?

Time passed by every minute and every second. After many discussions, the experts finally made a decision and chose to perform surgery to save the patient.

At this moment, the nurse suddenly rushed in.

"It's not good. The patient suddenly vomited blood, accompanied by hemorrhagic shock."

The director of the gastroenterology department looked at the crowd, stood up and said, "The time is running out, and the operation must be performed immediately. I will talk to the family members immediately, hoping to obtain their support."

"Wait, if there is an operation, there is another big problem." The Director of Heart Surgery said, frowning.

"The patient's thoracic aorta was pierced with fishbone, and a hemangioma also formed. No matter what, it had to be replaced with an artificial blood vessel."

"But," he spread his hands, and said helplessly, "Now the tertiary hospitals in Yangcheng don't have any artificial blood vessels in stock, so we have to find them in Beijing and Haishi."

"Oh, there is such a thing?" The director of the gastroenterology department instantly showed an expression of disbelief: "Don't you use a lot of artificial blood vessels? Are they still out of stock? Why don't you stock up?"

The director of cardiology coughed lightly, and explained: "Imported artificial blood vessels are all purchased through agents, and now the agents have no money left."

"Originally we had two suppliers, one in Sakura Country and one in Europa. Logically speaking, it should be safe, but we never expected that the two suppliers had problems at the same time."

"Because in Sakura Country, it seems that the manufacturer replaced the anti-seepage coating inside the artificial blood vessel, which failed the domestic filing and audit, and then the manufacturer in Europa closed the old factory, but the new factory has not been opened, and the production capacity has been greatly increased. question."

"These two foreign manufacturers have problems at the same time?" The director of the gastroenterology department looked at him in shock: "Why such a coincidence?"

The director of Xinwai smiled awkwardly: "Although the chance of two manufacturers having problems at the same time is small, it does happen."

"Is there no substitute for domestic manufacturers?"

"It's very difficult. It seems that there is no such thing at present. In fact, artificial blood vessels are already a technology fifty years ago. Although there has been slow progress, it is not too high-tech. I don't understand why it is so late. There has been no domestic artificial blood vessel coming out."

The director of Xinwai patted his forehead, a little speechless.

"Okay, then you should hurry up and contact the higher-level hospital, so that the goods can be transferred as soon as possible. I'll go find the family members." The director of the gastroenterology department was also very speechless. It was a major operation with extremely high risks and many difficulties.

As a result, before the operation even started, a problem was encountered, and the artificial blood vessel was out of stock.

The reason turned out to be that the two major manufacturers lost the chain at the same time.

It was outrageous, the director of the gastroenterology department swore he had never seen such absurd things in his life.

"Isn't this holding me back? If I delay my illness, whose fault is it?" He thought angrily when he went out.

"It's better to make it domestically, at least it won't be so ridiculously out of stock."

The director of cardiac surgery also quickly took out his mobile phone, and was the first to call Professor Zhang, the director of cardiac surgery at Anzhen Hospital in Beijing.

Professor Zhang is a master in the field of cardiovascular surgery in China. He performs 600 cases of aortic dissection surgery every year. The amount of artificial blood vessels has been given priority by the manufacturer, so he should not be out of stock.

"Professor Zhang, I'm the old Wang from Zhongshan Hospital in Yangcheng. Hehe, I want to ask you something. Aren't artificial blood vessels always out of stock recently? You are an authority in this field in China, and you are also the VIP of Mai Kewei. Is there any stock left?"

"Hey, Lao Wang, it's really unfortunate. Recently, artificial blood vessels are in short supply everywhere. I don't have many stocks here. There are only five. You should tell me sooner. I have already made an appointment for five surgeries. It's all used up."

However, what I never expected was that there was a shortage of artificial blood vessels in Anzhen Hospital.

The director of heart surgery was stunned for a while, and then tremblingly said: "Then, if there is no stock, what should we do if the patient has an accident?"

There was a long silence on the other side, and after a while, a difficult voice came.

"It can only be used for the most dangerous patients, and other patients should be delayed first."

The director of cardiac surgery lost his voice: "But my patient has already started hemorrhagic shock, and he will die at any time if we don't save him."

"Hey, it's the same with us. Now we can only search through the inventory, find some blood vessels of the wrong type, and make do with them. Use whatever you can find." Professor Zhang said with a sigh.

The director of Xinwai was silent, and finally managed to say thank you, and then hung up the phone.

Even Anzhen Hospital, the first brother of Xinwai, is out of stock. It seems that there is really no other way.

As for the last solution the other party said, it is also a solution, but it is not suitable for him.

It is a handicraft job to process the wrong blood vessel into a model that matches the patient's blood vessel on site. Changing a large-diameter blood vessel into a small-diameter one requires stitches and stitches. If you are not careful, the blood vessel will bleed easily.

To change small-caliber blood vessels into large-caliber vessels, the feasibility is extremely limited, and only materials with a very small range of difference can be used at risk.

The other party's family has a big business, and they can find second-hand goods in the warehouse to renovate.

And here, no matter whether it is a large blood vessel or a small blood vessel, it is out of stock.

"It's hard for a clever woman to cook without rice. If you want to change it, you have to have it." Director Xinwai sighed, feeling a trace of despair.

He rubbed the center of his brows, opened the phone's address book, and prepared to continue calling the Xiangshu Hospital in Haishi.

At this moment, a resident doctor timidly raised his hand.

"Director, that artificial blood vessel seems to be made in China. Shall we try it?"