blenderwars Chapter 473
Chapter 473
Chapter 473
And the patient’s parents are completely blown up!
Turned over three times four times, the operation did not sew well!
quack!
Finally, the emergency doctor thought of the big rounds this morning, and quickly promised the patient’s parents that he would arrange the patients for the big rounds in the morning and let a bunch of chief physicians help with the diagnosis.
This allowed the patient’s parents to temporarily calm their anger.
then,
This was the scene of the big rounds this morning.
The chief surgeon was puzzled: “I obviously have no problem with stitching, but the patient always bleeds…”
Director Zhang Guofeng: “This case is really strange… Everyone expresses their opinions, what do you think about this disease…”
Lin Feng was the first to raise his hand.
“Have you checked the coagulation index?”
The surgeon in charge: “That’s for sure. They have been performed before the operation. The set of coagulation function indicators checked are basically normal. Some indicators are a little higher, but considering that it is caused by bleeding, it is not particularly meaningful. …”
Lin Feng shook his head: “What I’m talking about is that 08 plus complete blood coagulation function indicators, specific values…”
When a surgical patient queries “coagulation function”, only “prothrombin time”, “activated partial thrombin time” and other commonly used indicators are checked. These indicators are a combination of coagulation factors.
Generally speaking, these indicators are normal, which means that coagulation is basically normal.
No one will directly check the value of each specific coagulation factor, which is more troublesome and of little significance.
but,
The patient in front of me has repeated attacks!
It is better to make a more detailed coagulation index.
The other doctors looked at Lin Feng.
There is no doubt in his eyes, but respect and expectation.
Chief surgeon: “Dr. Lin, what do you mean?”
Lin Feng: “I just think, is it possible to have hemophilia? Or vitamin K deficiency? Or coagulation abnormalities caused by severe liver disease?”
These three,
Will cause coagulation dysfunction.
Hemophilia is famous!
It’s the kind of bleeding that can’t heal, and the blood flow doesn’t stop.
However, because hemophilia is rare, doctors generally rarely consider it.
A doctor asked: “Dr. Lin, with hemophilia, shouldn’t it be possible? If it’s hemophilia, the patient shouldn’t be in their 20s and still don’t know it, right?”
Lin Feng shook his head: “If it is mild hemophilia, and the usual manifestations are not obvious, the patient may not really know that he has hemophilia.”
…
The next patient…
…
In the afternoon,
The patient with “steel door bleeding”, the results of the examination came out.
We ruled out liver disease and vitamin K deficiency, and finally found the cause in “hemophilia.”
·The coagulation factor results show that the patient is “hemophilia-type A”!
“Impossible, how could it be hemophilia?”
“Doctor, did you make a mistake?”
The patient’s parents are unbelievable.
Hemophilia is so famous that no one knows it.
Typical hemophilia is easier to bleed, bumps will cause ecchymosis, and even dental bleeding cannot be stopped.
Although the patient’s parents did not believe it, the family members accepted this fact in the face of the examination results.
Since the patient suffers from hemophilia, the chief surgeon cannot really be blamed for this ‘medical accident’.
The next treatment is easier.
Although hemophilia is ‘frightening’.
but,
There are many ways to treat hemophilia clinically, and the curative effect is also very significant.
Some of the most commonly used treatment methods are substitution therapy. The infusion of “plasma” and “cryoprecipitation” and other blood products can supplement some of the coagulation factors lacking in the patient’s body, thereby achieving the purpose of correcting the patient’s abnormal coagulation function. So as to achieve the effect of hemostasis.
Due to the recent earthquake, all blood donations were sent to the front line, so the hospital was very nervous about blood use.
Therefore, the patient did not use fresh plasma, but used ordinary plasma, so the supplemented coagulation factor was not enough. It happened that the patient had hemophilia again, so he bleeds repeatedly.
…
…
The big round is over,
It is already 9:30.
Lin Feng returned to the clinic,
“call…………”
Sitting on the chair in the consulting room, Lin Feng felt like a world away.
Cozy!
The patient can finally be diagnosed, which is much more interesting than surgery.
The process of peeling off the cocoon and looking for the cause is always fascinating.
Turning on the calling machine familiarly, the first patient walked in.
The first patient,
It’s a pregnant woman!
Lin Feng: “???”
Shouldn’t pregnant women go to the obstetrics and gynecology department?
The pregnant woman itself is relatively thin, about 160, overall thin.
But her belly is very bulging, and it looks like she should be full-term.
“Hello, Doctor Lin…”
“Come on, what’s the situation?”
“Dr. Lin, this is the case. I am now 34+3. I just went for a baby B ultrasound. The B ultrasound showed amniotic fluid depth of 9.3cm and amniotic fluid index 230… This should be a bit too much amniotic fluid. I checked Baidu and said it is possible. I’m a little afraid of the fetal malformation, so I come to you…”
Lin Feng wondered: “You should go to the obstetrics and gynecology department, right?”
The pregnant woman is embarrassed: “It’s like this. I was the second child. I almost died and suffered from amniotic fluid embolism at the time of the first child. Although I was looking for a director to give birth to me, the director’s student gave me birth in the end, so For the second child, I want to find a 127 doctor who has enough time and is not so busy to give birth…Dr. Lin, do you have time?”
His face is full of trust in Lin Feng.
The pregnant woman obviously already has a lot of experience.
All the situation was clearly described to Lin Feng at once.
In her words, the message is as follows:
·The first birth is amniotic fluid embolism, which is a very dangerous disease. Amniotic fluid has entered the blood (for risk, refer to thromboembolism, cerebral infarction). Therefore, she is very likely to have amniotic fluid embolism in the second child, that is to say, she is a high-risk mother.
·The fetus is only 34 weeks old, but Lin Feng saw that the pregnant woman’s big belly is almost full-term. There is obviously a lot of amniotic fluid.
·Pregnant women are divided into three situations: oligohydramnios, fit, and too much amniotic fluid. Don’t think that more amniotic fluid means that the fetus is rich in nutrition, no, too much will cause big problems.
· Causes of polyhydramnios: gestational diabetes (changes in osmotic pressure), or fetal malformations (such as fetal esophageal atresia (written in chapters 370-371), unable to swallow amniotic fluid, resulting in polyhydramnios).
·Polyamniotic fluid is easy to cause many complications: pregnancy-induced hypertension, abnormal fetal position and premature delivery, placental abruption, umbilical cord prolapse, postpartum hemorrhage, etc… are all very serious.
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ps: end of update
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