bookpower Chapter 531
Chapter 531
End surgery...
......
Although the operation was successful,
But Lin Feng knew that the patient's brain herniation was actually not light.
Brain herniation, once it appears, means that damage has been caused to the patient's brain.
Statistically speaking, the prognosis of cerebral herniation is very poor, and the rate of death and disability is very high.
So
Whether this patient can be good or not depends on luck.
Push back to the emergency department,
Lin Feng instructed the bed doctor and nurse to end this patient.
......
Lin Feng went to the alcoholic patient.
The patient's condition was checked.
A pain test was performed.
Although the patient is in a coma, he has a relatively strong pain response.
Lin Feng breathed a sigh of relief.
Obviously, the therapeutic effect of vitamin B1 has appeared.
This further inferred: the patient is indeed "Wernicke encephalopathy"!
Back to the office.
No patients come to the emergency room, it's quite relaxing...
It wasn't until 3:12 a.m. that the nurse on the other side of the ward came running.
"Dr. Lin... The alcoholic patient, woke up! "
"Awake?"
Lin Feng was delighted.
At this time, it is completely concluded: "Wernicke encephalopathy"!!
Lin Feng went to see the alcoholic patient, sure enough, he was sober, communicated, thought clearly, and did a movement test, and there was no problem.
Lin Feng smiled.
"Thank you Dr. Lin..."
The patient's son thanked Lin Feng one after another.
Lin Feng nodded, but couldn't help but instruct:
"Look at your dad in the future, don't drink too much, try to quit drinking..."
"Definitely!"
"Also, your dad's heart has atrial fibrillation, which is a very dangerous disease, emboli will form inside the heart, and once it falls off, it may cause cerebral embolism... So you have to tell him to take medicine regularly in the future - a medicine called "warfarin"..."
Warfarin is a classic anticoagulant that has an anti-vitamin K effect in the body. It can inhibit the synthesis of coagulation factors II., VII., IX., and X. involved in vitamin K in the liver.
It prevents the formation of blood clots on heart valves while preventing already formed blood clots from continuing to expand.
"Huh??"
The patient's son was taken aback.
He also thought that the alcoholism was over, and as a result, there were more dangerous diseases lurking in his father's body.
......
......
God of the night shift blesses...
Then this night, Lin Feng and the nurses lived very leisurely.
Happy night, passed.
......
On the third day,
Lin Feng works the day shift.
At the time of the rounds, the alcoholic patient had been unplugged from the ventilator and was ready to be discharged today.
Lin Feng told the patient that he must take warfarin regularly, and must stop drinking or drink less...
However, Lin Feng looked at the old man with a disapproving look, I am afraid that he is a stubborn old man, and it may be a little difficult to take the medicine on time.
Lin Feng can even imagine that in a few months, half a year, or a year, this stubborn old man will have "Wernicke encephalopathy" due to alcoholism, resulting in fainting, or direct thrombosis will lead to cerebral embolism and hospitalization...
Another patient with a car accident with a brain herniation on ward rounds, this patient had a poor prognosis, mobility problems, and this brain herniation should have affected the functional area of the brain.
At this time, Lin Feng knew that the police had come, and the patient had a car accident because he was fighting with someone else. It is estimated that on the other side of the bucket car, it is a bunch of rotten things.
......
Back to the consultation room,
Clinic opening,
The first dozen or so patients were all fever, abdominal pain and other diseases.
Lin Fengmali finished diagnosing.
The 18th patient, finally a little different.
......
The patient, 36 years old, a migrant worker who went to the city to work, Huang Jishuang.
Condition: right foot sole, suppurative infection.
The patient limped and walked in,
Take a step and twist your face, obviously your feet hurt.
Patient: "Dr. Lin, my foot has sores..."
Lin Feng: "Raise your feet, show me..."
The patient lifts his foot.
Lin Feng saw the soles of the patient's feet, pus, cavities, and redness and swelling around them...
Suppurated.
Look left and right, it doesn't look like a sore ...
"How long has it been..."
"It came up a week ago... At first, I went to the pharmacy to buy some poultices, and it had an effect, but then it didn't work, it became more and more painful, and I felt that the mouth was getting bigger and bigger..."
"Have you been injured before?"
"There is... I work at the construction site, and half a year ago, I stepped on a nail and pierced it ..."
"This is the same location?"
"Yes..."
"Have you ever had suppuration before?"
"Yes, I used to suppurate 2 times, but the back is better... Now it's suppuration again..."
"That is, in this half a year, suppuration three times ..."
"Yes..."
When Lin Feng heard this, he already had a rough judgment.
・A lesion, if the infection in the same place is repeated, there is likely to be a foreign body inside!
So
The probability is that the last time the patient pierced the ironclad, the debridement was not clean, and something was left inside.
"After you got your foot pierced, where did you go to debride?"
"What is debridement?"
"It's about cleaning wounds, disinfecting, bandaging..."
"The co-worker helped me get it..."
"Huh? Didn't go to the clinic? Hospital? "
"It's too expensive, it's not necessary, just make it all right..."
“.................."
Lin Feng didn't know what to say.
"Let's take an X-ray and see if there's anything in your feet..."
Lin Feng opened the bill.
X-rays are cheaper and suitable for the patient in front of him who wants to save money.
"How much is an X-ray?"
"Not much, 80..."
"That's okay, I'm afraid it's going to be hundreds, it's too expensive..."
The patient breathed a sigh of relief and took the receipts to pay and take the film.
......
An hour later,
The patient returns, with X-rays...
Lin Feng looked at it and sweated wildly.
· X-ray: osteolytic lesions (there is a hole) in the cuboid bone, but no signs of a foreign body.
X-ray, didn't see the problem.
(Some foreign bodies are not visible on X-rays.) ）
Lin Feng said helplessly: "Let's take another CT..."
X-rays are not so sensitive, and CT is needed at this time.
The patient was immediately dumbfounded: "What? Do you want to take pictures? "
Lin Feng had to patiently spend a few minutes to explain.
When the patient learned that CT cost 700 yuan,
The patient was even more difficult to accept, and a little angry: "Your hospital is too expensive, wait for the next medicine, I can't come under 1,000 yuan, I won't come next time..."
Lin Feng was very serious: "It's not like that, if you can go directly to the hospital for professional debridement when you are injured for the first time, then there will be no such things later..."
Patient: "Is there any other way?" "
Lin Feng: "There is... Don't take CT... I'll cut the wound directly for you, cut the wound, and re-debride..."
The patient's eyes lit up: "How much is this?" "
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