Chapter 317: Pain
-
Live Surgical Broadcast
- 真熊初墨
- 1324 characters
- 2021-03-01 08:54:46
Yesterday there was no emergency patient, the ward was very stable, and there was nothing to say about the shift.
Hand over the class, round the room, the old Pan director went back to his office and went to the town.
Zheng Ren called in the two people known to Director Pan, asked the patient's medical history, and checked the test report.
The patient is a 69-year-old man who is in good health. One week ago, because he accidentally hit a hard object and went to the township hospital for examination, B-ultrasound found multiple liver occupying lesions. Considering a malignant tumor, the largest occupation was about 6×7 cm.
The entire medical history is simple, because the patient's liver-occupying lesions have had intrahepatic metastases, so surgical resection is not possible.
At this time, intervention is the best choice.
But the specific situation, for example, can not be done, the postoperative effect is good, but also depends on the 64-row CT enhancement can be determined.
嘱咐 Chang Yue, let her take the patient to the hospital, Zheng Ren and Su Yun all the way to see other postoperative patients.
When he came to the Department of Gastroenterology, Director Xia’s enthusiasm for Zheng Ren was significantly improved by two levels. Even the director of other departments of the hospital, Director Xia is not so enthusiastic.
She personally led and took Zheng Ren to see the postoperative patients.
After TIPS, the hematemesis has been significantly improved, and the symptoms of hepatic encephalopathy are not serious. Zheng Ren feels that after another day or two, he can take out the second stent.
The family members of the patient thanked Zheng Renqian, and Zheng Ren just smiled. He was able to "fishen" the patient back before the ghost gate, and Zheng Ren had already received the greatest satisfaction.
As for the gratitude of the patient's family, it is not important for Zheng Ren.
Patients with septic tank syndrome are also better, although they are still feverish, but body temperature has been controlled.
From yesterday's pre-operative 39.5 degrees Celsius to the current 38.5 degrees Celsius, this change is huge.
Zheng Ren has confidence in his surgery. The most important thing for patients with cessation pond syndrome is to treat sepsis. If she can pass this level, she will be alive.
After reading the postoperative patients, Xia Director sent Zheng Ren all the way to the gate of the ward.
Look at that, in the heart of Director Xia has already recognized the level of Zheng Ren. In the subconscious, she thinks that Zheng Ren has the qualification to be equal to himself.
Out of the Department of Gastroenterology, Zheng Ren and Su Yun went to the ICU.
There was no trace of hangover on Su Yun’s face, which was quite different from the situation of eleven boxes of big green sticks that day.
Zheng Ren is also very strange. It is said that the Scotch whisky alcohol content last night completely exceeded 11 boxes of green sticks, but Su Yun did not have anything at all.
"Last night, did you get it?" Walking, Su Yun suddenly asked.
I got it... Zheng Ren didn't know how to answer this question.
If you say hug, it should be a success. However, it is estimated that Su Yun is not saying this.
"Looking at your morning, it should be pretty good. Don't worry, the fierce woman is afraid of being stalked, step by step." Su Yunxiao taught.
Zheng Ren suddenly felt that Su Yun said it was also good, at least yesterday, the story, let yourself leap.
Otherwise, according to his own temper, the situation does not know where to go.
All the way to the ICU, change clothes into, the money director and other people look serious, discussing the condition.
"Xiao Zheng, come." When the money director saw Zheng Ren and Su Yun to see the patient, they waved.
Zheng Ren knew that there was a problem and immediately went over.
"Supervised 5 bed patients are more aggressive, originally estimated according to the condition, today can remove the tracheal intubation, stop the ventilator assisted breathing. But after the sedative drug power, she began to shake, vital signs became unstable."
The money director said briefly.
Supervised 5 beds, is the patient who fell from the height of the sky before Zheng Ren.
Is there anything else happening?
Zheng Ren has some doubts. It is said that her condition should be better every day. In a few days, she can go to the orthopedics to perform internal fixation for fractures.
The system issued a task for Zheng Ren to save people from water and fire, but Zheng Ren did not want to complete it.
Slow surgery is a slow operation and must not be done in an emergency. Otherwise, the patient will suffer more trauma and make the body recover unpredictable.
What is going on here?
Zheng Ren glanced at the patient, and the system panel at the top right of the field of view was still a faint red background.
This is normal, and she still has a lot of fractures that have not been treated.
Looking at the diagnosis given by the system, it seems that there is nothing special...
Zheng Ren wondered, quietly standing behind the doctors in the ICU, listening carefully to their analysis of the patient's condition.
"Boss, I have a feeling that the patient is suffering from severe pain in adenomyosis, which will lead to severe agitation when the concentration of sedative drugs is lowered." Su Yun whispered.
Zheng Ren also considered this point, but without a quantitative standard, there is no way to be 100% certain.
He nodded, holding his cockroach with his right hand, frowning and meditating.
"Small Su, what do you think?" asked the money director.
"Min Director, I think patients need to try to do embolization for adenomyosis. If there is no effect, they must remove the uterus." Su Yun waited for other people to question, and continued: "The reason for patients jumping off the stairs is Because of the severe pain caused by adenomyosis, it is unbearable, and this has chosen to be suicidal.
How high the peak of the pain is, we can't guess. But what is certain is that it must be very high. I guess it should be about 4 degrees.
Pain grading, grades 1-12 were created by netizens. The medical pain grade is professionally 0-4 degrees. 4 degrees is severe pain, accompanied by changes in blood pressure and pulse.
ICU doctors seem to get used to Su Yun's consistent correctness, subconsciously substituting what he said.
Although Su Yun said that things are relatively unconstrained, but think carefully, the more you think, the more reasonable it makes sense.
Director Qian Shen.
"The pain of the fracture, as long as it is lying down, can be tolerated. So I don't think the patient is agitated because of the pain caused by the fracture.
I suggest that you report the condition to your family. Really not, you need to remove the uterus. Su Yun is still firm. "If you drag on, the patient has been intubated for nearly 48 hours and will soon have a tracheotomy."
In that case, ~EbookFREE.me~ will face complications such as intrapulmonary infection and it is more difficult to recover.
"You can try." Although Zheng Ren is not sure whether the patient is agitated because of the pain of adenomyosis, he still agrees with Su Yun.
Now that the patient has no acute distress in hemorrhagic shock, there is no harm in trying the possibility.
After all, interventional surgery is minimally invasive.
If the patient does not have such a heavy trauma, they can go to the ground 24 hours after surgery.
Of course, if you have a series of high-value consumables such as the emperor's hemostatic plate, you can go to the ground in 4-6 hours.
The director of the money feels incredible. After all, the disease of adenomyosis is not particularly rare, but most people have chosen to remove the uterus once and for all.
For women who have not yet given birth, the disease is rarely attacked and the money director has no experience.
After meditation for a long time, the money director finally made a speech: "I will communicate with my family and try it."