bookpower Chapter 639
Chapter 639
"What's going on?"
Lin Feng quickly came to the ICU.
Entering the door of the ICU, the nurse took Lin Feng and walked into the patient's bed.
As the nurse walked, she said:
"Just a few minutes ago, the patient reported that the abdominal pain had worsened, and our doctor looked at it and found that the bloating seemed to be getting worse, and the blood pressure was low again..."
Lin Feng took a look,
The face is serious.
Only 86/50mmHg!
Exactly the same as yesterday!
However, the ICU should not ignore the issue of drug administration.
So it's clear!
The patient's condition continues to worsen!
This is definitely severe acute pancreatitis, the most afraid of encountering!
Lin Feng walked into the ward,
"Doctor Lin!"
"Doctor Lin!"
A personal greeting.
Lin Feng smiled warmly: "Everyone early..."
Looking at the patient's abdomen, his abdomen had been lifted and his exposed abdomen could be seen.
really
The patient's abdominal distension is much more obvious than yesterday!!
What does this mean?
Increased flatulence!!
Or there is a build-up of liquid!
And the possibility of blood flowing out, which causes the abdomen to bulge.
If it is really bleeding, the patient may have low blood pressure due to this heavy bleeding, which is hemorrhagic shock.
That's even more serious!
(It may also be gas + liquid, not necessarily simply gas, or simply liquid)
At this point,
An ICU doctor is now performing ultrasound to see the patient's abdomen.
As soon as the probe is put in,
Lin Feng saw through the image that there was a large amount of fluid in his abdomen.
Substantial!
Lin Feng's face changed.
In this case, combined with low blood pressure, the probability of bleeding is very large, much greater than that of ordinary liquids.
"Go check the blood routine..."
"Also, prepare anti-shock treatment... In addition, I think the probability of bleeding is very high, so it is recommended to contact the blood bank and give the patient a blood transfusion before the results of the blood routine are available..."
At this time, it reflects the awesomeness of ICU.
You can check your blood routine yourself!
Have your own machine!
Awesome!
The nurse drew blood quickly, because there was a reason for the retention of the needle, so the blood was drawn quickly.
Then put it inside the machine.
One run,
Detect!
The results are out!
Hemoglobin is only 80g/L.
"Hiss~~~~~"
That's too low!
Lin Feng: "When was the last blood draw?" What is the value? "
A nurse said quickly: "The blood draw time is about 6:20, and the value is 120..."
6:20...
That's 2 hours.
This situation, without Lin Feng saying, is definitely bleeding!!
And it should be rich and strong bleeding, blood accumulates in the abdomen, causing the abdomen to bulge.
As for why the patient bleeds?
Quite simply, severe pancreatitis caused!
But
Still to verify!
In general, CT is used.
A doctor asked, "Do you want to pull it out for a CT to see better?" "
Lin Feng shook his head: "No, the patient is in shock now, it's still quite dangerous." "
"Let's go straight to the needle..."
soon
The nurse took out a syringe bag, tore it open, and put it in it.
The tube bed doctor took the syringe, simply sterilized it, and then poked it down.
Draw out!
Sure enough, the dark red blood was drawn.
Are you sure!
"Heavy bleeding"!
At this moment, everyone became nervous.
This patient, big trouble!
First of all, fluid replacement and plasma replenishment are conventional treatment.
It is important to stop the bleeding.
But
In case of laparotomy, vascular sutures are carried out ...
The risk is particularly large, after all, the patient is severe pancreatitis, blood pressure is unstable, shock state, at this time to move to the operating table, anesthesia, will die at any time!
At this time,
The ICU director rushed from other beds when he heard the news.
"Director."
"Lin Feng."
After the director understood the situation, he finally looked at Lin Feng.
"There is a way, it is safer... It may depend on you..."
The doctors were confused.
Lin Feng nodded: "Intervene... At this time, only intervention to stop bleeding, minimally invasive, regional small anesthesia, the impact on the patient is relatively small, I can do..."
At this time, do abdominal angiography, see where the blood vessel is bleeding, as long as it is found, you can quickly intervene in embolization to stop bleeding, this trauma is much smaller than open surgery, and the patient can survive.
The director smiled and nodded: "It's just to intervene... That's it! "
Call the interventional department and borrow the interventional operating room.
At the same time, contact the patient's family.
It just so happened that this morning, the patient's mother arrived from the provinces to hear the news.
After hearing the doctor's introduction, her mother suddenly cried, took Lin Fengsheng's hand, and begged.
"Doctor Lin, I know you are very powerful, you must save my son!"
"I'll do my best."
Sign.
At this time, the patient has been transfused with blood and quickly rehydrated to fight shock.
Then the doctors and nurses in the ICU, pushing him, went to the interventional department.
......
Interventional Section,
Soon the contrast agent was injected, and then a bleeding port was found.
Spleen!!
Lin Feng: ".................."
ICU doctors: ".................."
How is it a spleen?
Thought about going,
In the end, Lin Feng felt that the possibility was:
Because of severe pancreatitis, the blood viscosity increases, forming small thrombus, which blocks the splenic artery, and then the spleen will be ischemic necrosis, and once the necrosis falls off, causing rupture and bleeding.
Lin Feng neatly plugged the bleeding position...
In addition, open up the splenic artery and restore smooth blood supply...
Checked it,
There are no other bleeding locations.
And then
Push back the ICU!
As for those blood in the abdomen ...
Very simple, abdominal puncture drainage, gradually release the blood in the abdominal cavity, reduce intra-abdominal pressure.
......
......
Finish everything,
Lin Feng returned to the consultation room.
Start working.
First patient.
A young mother with a baby over 2 years old,
I walked into the consultation room.
"Dr. Lin, help me see my baby, who has a fever and a runny nose, and phlegm in his throat..."
And then let's say...
"3 days ago, my baby went to the park to play in the water, and the night he came back he had a fever... The highest is more than 39 degrees, and then the ups and downs, has been burning for three days, I have watched Dr. Lin's video, said that as long as the fever is in good spirits, there are no other symptoms, there is no need to send to the hospital, my baby has no symptoms in these three days..."
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ps: The above baby case, personal experience, for this also specially checked the "cough guide" and "fever guide" ...