bookpower Chapter 683
Chapter 683
In fact.
The two systems of blood coagulation and fibrinolysis in the human body have always been in a state of equilibrium.
This ensures that neither bleeding nor severe blood clots occur.
But because of the emergence of certain diseases, this balance will be upset, then it will mean the arrival of danger.
Seeing the elevated D dimer, Lin Feng believed that Director Wang Zhengchao reflexively thought of pulmonary embolism.
Not really.
D dimer elevation, in fact, there are thousands of possibilities, pulmonary embolism is only one of them.
Just like the pneumonia diagnosed by the previous patient, there is inflammation inside the lung tissue, there may be local blood vessel rupture, which may cause bleeding, bleeding will be coagulation at the same time, coagulation will occur immediately after coagulation, then the D dimer count will definitely rise.
"Xiao Lin, what do you think?" Seeing that Lin Feng did not speak, Wang Zhengchao asked.
"Director, elevated D dimer does not indicate what the patient's condition is!" Lin Feng smiled and said.
"That's right, but it always gives us a general direction, doesn't it?" Director Wang said.
"Director, are you going in the direction of pulmonary embolism?" Lin Feng asked.
"Good!" Director Wang nodded and continued: "First of all, we must rule out this situation, after all, pulmonary embolism is still very dangerous. "
Lin Feng nodded.
That's right.
There is nothing wrong with Director Wang's approach, and the most serious and deadly condition must be eliminated.
Even if it cannot be ruled out, it can be dealt with in the first place.
The patient in the hospital bed clearly heard the conversation between the two.
Especially the three words "pulmonary embolism".
He immediately said excitedly: "Doctor, are you mistaken!" How could it be a pulmonary embolism! "
"Don't get excited, it's not certain yet, further examination is needed!" Director Wang immediately soothed.
For Director Wang's words, the patient could no longer listen to them, and said in a somewhat choked voice: "I know, I know!" When my grandmother passed away, the doctor suspected that my grandmother had a pulmonary embolism. Now it seems that the doctor must be right, our family has this genetic disease! "
Seeing that the patient is getting more and more emotional, he is about to collapse.
Lin Feng immediately shouted, "Don't be cranky! Put any disease on yourself, scare yourself and scare people to death! You are now in the emergency department, it is difficult to die! "
"That's right! Don't think about it! With Dr. Lin here, you'll be fine! "
"Yes, Dr. Lin is very powerful, he will definitely be able to cure you!"
"Don't worry! Haven't you heard of Dr. Lin's name? With him there, you don't have to worry at all! "
“....."
Other doctors and nurses also soothed the patients.
This made Wang Zhengchao very embarrassed.
I'm a big director, you make up the, shoot this Lin Feng?
Immediately said to Lin Feng: "Xiao Lin, this patient is entrusted to you, I believe in your ability!" "
"Director, don't worry!" Hearing this, Lin Feng also knew what Director Wang meant, and immediately nodded in response.
Wait for the director to leave for a while.
The patient gradually calmed down.
It was also clear that it was the famous Dr. Lin who was treating her now, and immediately asked softly: "Dr. Lin, am I really okay?" "
"Of course something! How else would you be in the hospital! But with me, I can guarantee that you will be able to leave the hospital without any problems! Lin Feng chuckled.
The patient in front of him was a young woman, thin and weak, chest pain, coughing up blood, although the amount of coughing up blood was not large, but after all, it was coughing up blood, and he had to follow Director Wang's idea to prevent the possibility of pulmonary embolism.
If the thrombus really blocks the pulmonary artery, the lung tissue will be ischemic and necrosis, and after a long time, the blood vessel is broken, which is more serious.
At present, the first priority is to rule out pulmonary embolism.
Then the best thing to do is to go for a CT angiography (CTA).
Hearing that he had to do CT again, the patient immediately refused, and asked Lin Feng: "Didn't you already do CT just now, why do you have to do it again, I didn't check it out just now, can I check it out by doing CT again." "
Lin Feng didn't care, just explained softly: "The CT done just now is a plain scan, it's okay to look at the lung tissue, you can't see the blood vessels." Your current situation is not sure whether you are caused by pneumonia or inflammation exudation caused by pulmonary embolism, and to figure it out, you need CT angiography, another CT, and a contrast injection into your blood vessels. "
Without waiting for Lin Feng to finish speaking, the patient directly refused.
Without CTA, there is no way to determine whether a patient has a pulmonary embolism.
After a burst of persuasion, Lin Feng.
The patient wavered and said that he would call his family to discuss it.
Of course, the patient's family can persuade the best.
Lin Feng naturally did not object, but his attitude was very clear, that is, this CTA must be done.
Now.
He didn't dare to leave at all.
If the patient is really pulmonary embolism, it may not be okay now, but maybe there will be a danger to life in the next second, so let Xiaoru prepare the endotracheal intubation box, ventilator, etc. in advance.
Then.
The patient handed the phone to Lin Feng, who was the patient's husband.
Lin Feng did not hesitate and immediately took the phone.
The patient's husband spoke very aggressively.
The main thing is to question why Lin Feng's side did not do this CTA at the beginning, but now he has to do another examination, in general, he suspects that the hospital side deliberately wants them to do more examinations.
Lin Feng was also not angry, explaining that where a patient came to improve all the examinations, of course, what problems were found to do targeted examinations, if all the examinations were done as soon as they came, it would cost more money, and the doctor would become a fool.
Then he said that the patient's current condition was very serious and his life was in danger at any time, so he hurried over, understood the condition, and signed.
After hearing that his wife's life was in danger, the patient's husband did not hesitate and said that he would come immediately.
Waiting for the patient's husband to arrive.
The patient's condition is quite stable, there is no coughing up blood again, blood pressure and blood oxygen are relatively good.
But Lin Feng did not dare to be careless.
If it is really a pulmonary embolism, then the thrombus has the possibility of continuing to grow, from a small embolism to a large embolism, which means that the patient can still be energetic one second, and the next second may need immediate rescue.
Almost half an hour.
The patient's husband, the dust servant, arrived.
Lin Feng called him aside, explaining the current situation, especially the danger of the patient.
Against all odds.
The patient's husband did not have the aggressiveness on the phone before, and very cooperatively agreed to do CTA.
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