blenderwars Chapter 350
Chapter 350
Chapter 350
“Doctor Lin, am I serious now?”
Mr. Zhang didn’t understand what an infarction meant, and he looked relaxed at this time.
Lin Feng glanced at him: “You should call your wife right away. Next, you will be hospitalized…”
“Huh? Hospitalized?” Mr. Zhang was shocked.
Lin Feng is serious: “Yes, you must be hospitalized immediately, the situation is very critical!”
“Good, good…” Mr. Zhang called nervously.
And Lin Feng is thinking urgently and looking for the cause.
This is because infarction of the spleen and kidneys is rare. If it does, it means that the lungs, liver, and even the brain may have infarctions.
That’s the big trouble!
at this time,
time is life! !
Lin Feng started using a stethoscope to listen to Mr. Zhang’s heart.
See if there is a problem with the heart.
Before, because the patient kept talking about the lungs and the ECG was okay, Lin Feng did not auscultate the patient’s heart.
Place the stethoscope on the heart.
This listen,
Terrible,
Lin Feng’s face changed.
Lin Feng heard a murmur in Mr. Zhang’s heart area.
Under normal circumstances, the heart is a clean sound, experienced doctors understand.
But now, there is noise.
Listen carefully!
It’s reflux! !
Lin Feng’s experience is so rich that he immediately heard the sound of blood reflux inside the heart at this time.
The heart has four rooms: left atrium, left ventricle, right atrium, and right ventricle. In the middle, there will be a “valve (mitral valve and tricuspid valve)” as the gate.
Once the valve is broken, the blood can enter or retreat, then “reflux” is formed.
(Ps: I wrote before, [284] Chapter Mitral Valve)
This is definitely a terrible condition!
At present, the patient’s condition is inferred:
·Reflux is not serious, otherwise the blood oxygen saturation will have fallen.
· If the reflux is not serious, it means that the patient’s spleen and kidney are infarcted because the blood vessel is blocked by a thrombus (or foreign body), causing tissue ischemia.
So here comes the question:
·Is it a thrombus? Or a foreign body?
·Where do you come from?
Lin Feng thought of a disease! !
“Infectious endocarditis”!
It is very consistent with the patient’s current symptoms.
The approximate meaning is: the heart valve is infected by bacteria, and emboli (a mixture of bacteria and necrotic tissue) are formed locally.
If this embolus falls off, it can also block many organs and cause infarction.
This corresponds to “splenic infarction and renal infarction.”
At the same time, because of bacterial infection, the patient has fever and cough… also corresponded.
Lin Feng told him about “infective endocarditis”.
Mr. Zhang is stupid.
I thought it was a common cold and fever, but it developed into pneumonia, and then it developed into some kind of heart or inflammation…
These doctors,
That’s awesome!
Fortunately, Mr. Zhang was fortunate to find Dr. Lin instead of continuing to go to the outpatient clinic, otherwise he would be finished.
“Be hospitalized, let’s be hospitalized first…¨々…”
In this case, Lin Feng feels a bit tricky.
Need to be as soon as possible.
If this “infective endocarditis” is not treated in time, maybe more emboli will fall off and infarct other organs, such as blocking blood vessels in the intestines or blocking blood vessels in the brain. The consequences are disastrous… …
“Xiao Ai, draw him some blood…”
The nurse Xiao Ai took several tubes of blood for him.
Lin Feng explained: “This blood is used for blood culture. Now the bacteria must have entered the blood. As long as you find the bacteria, which bacteria it is, and use the corresponding medicine, you can quickly cure your “infection.” Endocarditis”. ”
At this time, Mr. Zhang was already grateful and admired for Lin Feng.
Nodding again and again.
“Doctor Lin, do whatever you want, I will cooperate unconditionally!”
Lin Feng nodded: “Next, I will do a cardiac color Doppler ultrasound to confirm whether it is really “infective endocarditis.” ”
Patient: “Go now!”
…
Expedited,
20 minutes later…
The results of the heart color Doppler ultrasound came out.
·Diagnosed: infective endocarditis!
· Mitral valve and tricuspid valve, there are several black objects, which are the neoplasms of bacterial infection.
·The embolus, it is very likely that this kind of vegetation fell off.
·When the condition becomes more serious, the reflux will aggravate-for the body to provide oxygen, the heart rate must be greatly increased, pumping blood faster-finally leading to heart failure…
·More emboli fall off, which will embolize other tracheal tissues and cause infarction…
The situation is serious.
…
at this time,
The patient’s wife, Mr. Zhang, has not yet come to the hospital.
The “Notice of Critical Illness” was signed by the patient Mr. Zhang himself.
At this time, Mr. Zhang didn’t know whether it was the psychological reason or the worsening of his condition. He started to have difficulty breathing, he felt more strenuous, and his heart rate was also increasing. (Reflux is getting worse)
Lin Feng determined that it was “infective endocarditis”,
Then, the next step is to use antibiotics.
Although, blood culture, what kind of bacteria has not yet come out.
But it does not affect the use of broad-spectrum antibiotics.
Increase the dose!
At this time, you can’t worry about resistance, and a small amount of antibiotics must be used in a large amount.
As long as antibiotics kill the bacteria on the valve vegetation, they can prevent the emboli from forming and falling off…
The blood culture takes three days, and the speed up takes 2 days…
Therefore, during this period, broad-spectrum antibiotics need to be used first.
…
On the second day, review the patient’s most important lung and brain CT…
I found that there was a small cerebral infarction inside the brain, that is to say, the most worried situation appeared. The new embolus fell off and ran to the cerebral blood vessel, blocking a part of the blood vessel!
no way,
Can only increase antibiotic treatment,
It is hoped that the bacteria can be quickly suppressed, and the emboli in the heart valve can be prevented from further forming and falling off.
Moreover, this drug can reach the brain, inhibit the bacteria in the embolus, and then let the emboli ablate, achieving the effect of’thrombolysis’, restoring the blocked blood flow, and then Mr. Zhang can escape from the dead.
Kill two birds with one stone…
…
On the third day, in the evening,
The result of the blood culture came out.
The murderer was found!
“Staphylococcus aureus”!
Then the next thing becomes simple.
From a broad-spectrum antibiotic to a specific antibiotic against “Staphylococcus aureus”.
Antibiotics go on,
The patient’s condition improved quickly…
·Reduced cardiac reflux…
·Heart rate reduction, recovery…
·The thrombolytic effect appeared…
·Other embolisms and heart failures that I worried about did not appear…
·Valve damage is not too big, and there is no need to replace the artificial valve…
This may be the patient’s own luck, or it may be Lin Feng’s own passive ability “lucky” at work.
…
…
the other side,
Qin R & F, the boss of a certain company.
At the age of 48, it is the pinnacle of a man’s career!
However, he has a problem,
Since 5 years ago, he has had low back pain, intermittent, backache, and slight pain.
At the beginning, he didn’t care too much, because that was the time when the company was developing rapidly and he was busy. He thought that he was too tired, which caused the waist muscles to strain.
He also has a problem.
Think those doctors are shit.
Then I checked it on the Internet and put on some pain-relieving plasters for a while.
The pain was indeed better for a while, but soon it started to get worse again.
over and over again……
In a flash, 5 years have passed…
————————————
ps: The three shifts are over…
. .