blenderwars Chapter 311
Chapter 311
Chapter 311
Because the elderly’s condition is more urgent,
So Lin Feng went directly to the green channel and asked the imaging department to expedite it.
…
20 minutes later,
The CTA result came out.
·10 years ago, the position of aortic dissection was next to the soft tissue of the esophagus, and the two were next to each other!
·The distal end of the originally inserted arterial stent punctured the artery wall and punctured the esophageal wall next to it, and entered the esophagus.
·Why punctured? According to the CTA, the arterial stent and the distal blood vessel are one large and the other small. The blood vessels are relatively narrow and do not match the diameter of the arterial stent. After a long time, it bursts.
This check result can explain:
Why do old people vomit blood!
Because arterial blood flows into the wall of the esophagus through that opening!
Then the esophagus is uncomfortable, coughing,
Cough up the blood inside.
Lin Feng heaved a sigh of relief when he saw the result. It was a blessing to find the cause so quickly. But at the same time, vigilance was raised.
This artery + blood vessel opening can cause massive bleeding or even shock at any time!
Introduce the elderly into the imaging department,
The son outside quickly ran over and asked nervously:
“Doctor Lin, how is my dad?”
Lin Feng: “I found the cause. It was the arterial stent, which broke the artery and created a gap in the esophagus… Fortunately, you sent it in time, otherwise, when the mouth is bigger, the arterial hemorrhage may cause direct shock. NS……”
Lin Feng took the CT film and explained it in detail to his son.
When the son heard this, his heart suddenly raised.
“Doctor Lin, what do you do next? Admission?”
“You must be admitted to the hospital, but the most urgent thing is to pay the fee and then perform the operation… I will tell you about the operation plan now…”
Lin Feng began to face the photo and described the operation in detail to his son:
“In your dad’s current situation, the front end of the blood vessel is thick, the distal end of the vessel is narrow, and the distal diameter does not match the size of the original stent. (The stent is large, but the distal end of the vessel is small.)”
“So, two more stents need to be put in for this operation together!”
“The specific surgical plan is: first choose to implant a stent with a diameter that matches the distal blood vessel in the distal blood vessel, and then select a stent matching the original stent model to limit it to the small stent implanted just now. Inside…In this way, the mismatch between the end of the original stent and the distal blood vessel can be completely solved.”
Lin Feng explained Scheme 3 again. 003
“In other words, to put two brackets?”
The son hesitated suddenly.
If he remembers correctly, it’s very expensive to make a brace…
One is worth tens of thousands!
The son asked ashamedly: “Doctor Lin, do I have to put two stents? Can’t one work?”
Lin Feng shook his head and explained patiently:
“If I choose a stent that is the same as the original stent. There will be a disadvantage: the model is too large, and the distal end of the new stent will still break the distal blood vessel.”
“And if you choose a new stent that matches the distal blood vessel. There will be another disadvantage: the model is too small, and the contact position between the new stent and the first stent will cause endoleak.”
Lin Feng is very patient, and even draws on the pictures so that his son can understand.
Of course, Lin Feng also understands his son’s behavior.
Because arterial stents are really expensive.
The price ranges from 10,000 to 100,000…
The most expensive stent is the fourth generation of stents, which are absorbable stents, which are implanted in arterial blood vessel replacement and can be absorbed by blood vessels…
The son suddenly thought: “Dr. Lin, couldn’t the stent be taken out 10 years ago? After taking it out, will the breach be easily repaired soon?”
Lin Feng sweats wildly.
“I want to make it clear to you that the implanted stent can’t be taken out. Try to figure out why it is called “implantation” instead of placement? It is because the stent will grow with the blood vessel tissue, making the stent a part of the blood vessel. ”
“In addition, the role of the arterial stent is like a house to collapse (arterial blood vessel), which needs to be supported by a frame (arterial stent). If the frame is removed, the house will collapse.”
When my son heard this, he also knew that the money could not be saved.
Lin Feng urged: “It’s better to decide quickly, your dad’s situation will be in danger at any time…”
Lin Feng has seen too many cases on the eve of the operation, thinking about it, and finally dragging the patient to death.
The son gritted his teeth: “Then do it… just follow Dr. Lin’s plan!”
…
Next,
signature……
I chose the bracket, and finally I chose the 13,000 bracket…
Pay…
Then Lin Feng took the patient to the interventional department for arterial stent intervention.Contrast machine, arteriography…
Insert the guide wire catheter…
Feed into the bracket 1…
Feed into the bracket 2…
Because the patient’s (aicd) blood vessel is more troublesome, it took 3 plans to send the guide wire before it was sent in.
The total time spent more than 3 hours…
End the operation…
…
“The operation is over…”
“Thank you Doctor Lin!”
Lin Feng urged: “In the past few days, your dad should not eat, just use intravenous infusion of nutrients…”
Son: “Okay…”
Lin Feng: “The next treatment does not need to be too troublesome. It only needs the mucosa of the digestive tract to heal. The CTA will be reviewed four days later to see if there will be endoleaks…”
Son: “Okay, good…”
Lin Feng: “There is another problem. After the arterial stent is done, there may be stent thrombosis. It is one of the complications during and after the stent…”
“Phases: within 24 hours, 24 hours to 1 month after surgery, 1 month to 1 year after surgery, more than one year… You must stare at your dad’s ECG monitor, if anything happens No, just tell the nurse in time.”
The son looked serious: “Okay, okay…”
…
It’s almost noon after getting this patient.
Lin Feng’s dining room,
In the eyes of many doctors and nurses, the aunt gave Lin Feng a lot of meat…
…
After eating,
Continue to see a doctor…
An old man, sitting in a wheelchair, pushed in.
Still inhaling the oxygen mask!
Lin Feng was surprised, this was the first time he saw such a ‘scene’.
Ask about the condition quickly!
·Patient, male, 58 years old,
·Have fever, cough, sputum, chest pain, shortness of breath…
· Five days ago, I checked in other hospitals and CT did not find lung cancer or tuberculosis. However, when pneumonia was found, antibiotic treatment was performed, and the effect was almost zero.
Lin Feng listened to the patient’s main complaint,
“…………………………”
Why this patient,
Like the last female patient of “Hantavirus”?
The similarity is 99%! !
All the same symptoms!
All pneumonia has no therapeutic effect!
“Do you have mice in your house?”
Lin Feng went straight to the subject.
“mouse?”
The daughter who came with the old man shook her head again and again: “My family is on the upper floors of the complex, and I have never seen a mouse…”
Lin Feng nodded, that probably can rule out “Hantavirus.”
However, when pneumonia is confirmed, but the treatment effect is not good, you must be more vigilant.
“Go get a chest CT enhancement, collect sputum, get a tuberculosis…”
Lin Feng looked at the CT film of the hospital in front of him. It was obvious that there was no lung cancer or tuberculosis, but tuberculosis could not be ruled out. Some tuberculosis could not be seen by CT.
…
Two hours later,
CT enhancement results come out…
·No lung cancer, tuberculosis…
but!
Sputum smears revealed “acid fast bacilli”…
· Confirmed to be tuberculosis!
(Why did the previous hospital not find tuberculosis? It may be because the CT results determined that there was no tuberculosis, or the sputum smear did not find “acid-fast bacilli”, because even if there are acid-fast bacilli, it may not be detected once or twice.)
so,
This old man is: tuberculosis patient!
The next treatment is simple: anti-pneumonia + anti-tuberculosis medication…
…
A construction site.
A group of workers are unloading goods, moving tiles into the building, waiting for the next step of renovation.
Talk while unloading the cargo.
“It’s strange, why do you think Lao Zhang is still awake?”
“Yes, 15 hours have passed now, and I’m still asleep…”
“How much wine did Lao Zhang drink last night?”
“I don’t know… a bottle of white?”
“Lao Zhang drank very hard anyway…”
“I called him when I was eating at noon, why didn’t he wake up…”
“You said, will there be an accident with Lao Zhang? He also drank before and never tried to sleep for so long?”
“this……”
“If you die here, wouldn’t it be bad luck?”
“Why don’t you take it to the hospital?”
“Talk to the foreman…”
“Yes, talk to the foreman…”
Soon, the foreman heard the news and rushed over.
“Where is Lao Zhang?”
“In the iron shed…”
I rushed to the iron shed, and as soon as I entered, I saw a worker who was about 50 years old, his hair was a bit white, and his skin was turned purple red all the year round.
Is ‘sleeping’.
This worker is Lao Zhang.
At 8 o’clock last night, a group of workers drank, and then Lao Zhang fell asleep, and then he hasn’t woken up yet.
15 hours have passed!
“Old Zhang, wake up…”
The foreman patted Lao Zhang’s face.
After seven or eight shots, Lao Zhang just didn’t wake up.
The foreman thumped…
Ruined!
problem occurs!
Call 120 quickly! !
After 10 minutes, Beep Beep Beep ~~~120 ambulance arrived, and then took Lao Zhang to the ambulance and rushed to the nearest Harmony Hospital.
The construction site is a small society, and the news cannot be kept away.
Soon the whole construction site began to spread, Lao Zhang drank too much, did not wake up for 15 hours, and was taken to the hospital.
For a while, the entire construction site was ‘panicked’ and worked unintentionally.
…
Lin Feng’s side,
After seeing a patient, I went to the toilet and came back…
Beep Beep Beep Beep~~~~~
An ambulance drove outside the door of the emergency department.
Lin Feng walked over quickly.
Watching a flat car push off the car, a patient in his 50s was lying on the bed, connected to the ECG line.
Lin Feng walked over: “What’s the matter?”
The doctor in the car said quickly: “Dr. Lin, this patient was picked up from the construction site. His co-worker said that he drank alcohol last night, and then 15 hours later, he still hasn’t woken up…”
“I did a partial check on him on the way…”
“Deeply faint…”
“The eyes don’t react to light…”
“The blood pressure is low, only 80/56…”
“Arrhythmia…”
“Check the whole body, there are no wounds…”
“The preliminary judgment is cerebral hemorrhage…”
A series,
Speak out very quickly.
Lin Feng nodded: “Okay, thank you… I will send him to be a CT right away…”
At this time, Lin Feng looked at another worker who came with the car.
“Are you his colleague? Go to the window to pay the bill and be hospitalized…”
Workers stammered: “Okay, okay…”
He hurried to the window, and when asked, he found that he still had to register his ID card, but he didn’t bring his ID card…
“I didn’t bring my ID card…”
“Do you know him? Look at where he lives. I should get an ID card and let someone hurry over…”
“Oh oh oh yeah…”
“By the way, I have to prepare 10,000 yuan, admission procedures…”
“Huh? Ten thousand? So many?”
The workers stayed where they were all at once.
…
Here in the imaging department,
Lin Feng personally got on the CT machine,
Brain CT…
Soon, Lin Feng found a dense mass of shadow on the patient’s brain.
·Cerebral hemorrhage! ! !
In addition, Lin Feng also found a certain “brain space”.
That is, the blood that was released ‘squeezed’ other brain tissues to other locations.
This condition is usually accompanied by “cerebral hypertension.”
That is, this patient has “brain hemorrhage”, “brain space occupation”, “brain hypertension”, and it is estimated that there will be “brain edema” and “cerebral infarction” soon…
Lin Feng quickly pushed the patient back to the emergency department.
Lin Feng asked Xiao Ai: “The patient’s friend, have you gone through the admission procedures?”
result,
Xiao Ai said, “Dr. Lin, patient friend, ran away…”
Ran? ? ?
Lin Feng: “……………………”
The whole person is Spartan!
Lin Feng quickly urged: “Call the police and let the policeman come, and ask the policeman to check his family’s phone number and call his family… the patient must have an operation, and it must be as soon as possible!”
After 10 minutes, the policeman arrived and found the patient’s identity information and found the family’s phone number.
Call family…
“Hey?”
“Is this Zhang Jifa’s wife?”
“What’s wrong?”
“I am the policeman at the XX Police Station in the Imperial City. Your husband has a cerebral hemorrhage and needs surgery…”
The uncle policeman explained it again, returned the video, and made relevant proofs.
The wife said: “Sorry, I have nothing to do with him anymore, bye…”
hang up the phone!
Uncle Police Officer: “……………………”
Lin Feng: “……………………”
Nurses: “……………………”
Lin Feng: “Hurry up and make other calls. The patient’s condition can’t be delayed, he will suffer from cerebral infarction at any time!”
Then, call the patient’s brother.
Repeat the above process.
The brother finally said: “Sorry, let’s discuss it…”
hang up the phone.
Policeman: “………………”
Lin Feng: “………………”
Nurses: “………………”
silence……
this moment,
Lin Feng looked at the patient on the hospital bed, motionless and fainted.
My heart felt cold all of a sudden.
Lin Feng seemed to hear the beating pulse in the patient, and it was getting weaker…
The scorching hard work is about to become cold…
. .