bookpower Chapter 512
Chapter 512
"Check, did you find atrial fibrillation when you were admitted to the hospital?"
Lin Feng reacted and felt wrong.
Dr. Wang Jiayi was stunned for a moment.
"This... When the shift was handed over, I didn't seem to say this..."
"Xiaoru, check it..."
"Yes..."
Soon, Xiaoru checked the admission records and found that there was no relevant information.
I called Li Xing, the attending doctor who contacted the patient after the day shift.
"Atrial fibrillation? Yes, I checked it when I entered the park..."
Li Xing said.
The Wang family was speechless: "Then why didn't you tell the next doctor when you handed over the shift?" Also not on the medical records? "
Li Xing apologized again and again: "I'm sorry, I'm sorry... What's wrong? Found the cause? "
Wang Jiayi was not angry: "Fortunately, Dr. Lin just checked it and thought it was atrial fibrillation, and then said that it may be atrial fibrillation thrombus detachment, blocking the gastrointestinal artery, or renal artery, ischemic necrosis..."
"Huh? Colonic artery, or renal artery embolism? "
"Yes!"
Dr. Li Xing suddenly felt cold.
"Why didn't I think of that?"
Thinking of the danger of this disease, Li Xing was shocked.
If there is a real problem, it is definitely a medical dispute (at least in terms of the writing of the report, if it is not written in accordance with the norms, it will cause medical disputes. ）
At this time, Lin Feng thought of another thing.
"Hypertensive nephropathy"! (501-502 written)
The patient's old lady has a history of hypertension for more than ten years, and it is likely that kidney function is also problematic.
In the examination results of the old lady of the patient who just saw, the renal function and blood creatinine are still a little high, indicating that there is indeed a problem with the kidney, and hypertensive nephropathy is not excluded.
If contrast is used, kidney damage should be aggravated, but it should be countered with dialysis.
"By the way, what is the amount of urine? How much hydration? "
The tube bed nurse flipped through the records and said:
"In the last 4 hours, about 1800ml of fluids have been rehydrated, and the urine is... 60 ml..."
Lin Feng was shocked!
So little urine?
Could it be an aggravation of shock?
In order to ensure the blood supply to the brain and heart, the body must sacrifice a number of organs, and the kidney is the first to be abandoned by the body.
However, Lin Feng looked at the blood pressure curve.
It's no problem.
However, the problem of kidneys is still prioritized.
Lin Feng did not hesitate:
"Can't delay, urine is so little, there should be something wrong with the kidney... Go to the family immediately. "
The Wang family nodded: "Good!" "
Quickly left the ward, went to find the old lady's eldest son, and informed the details.
The old lady's eldest son is very calm.
"Doctor Wang, you mean damage to my mother's kidneys, right?"
"Yes..."
"Is it a lot of damage?"
"If it really leads to the deterioration of kidney function, we can also do hemodialysis, and help the kidneys in the short term, there will not necessarily be a big problem."
"Then there may still be a big problem... I want to ask, there is no diagnosis of what kind of thrombus and what embolism, right? "
"It's not determined yet, we just think it's more likely..."
"Dr. Wang, I want to ask, how much does CT imaging cost?"
"About 3,000..."
In fact, generally a part, only more than 1,000 is enough, but this is not only the mesenteric artery, but also the renal artery. In addition, the machines of Harmony Hospital are relatively advanced 64 rows, which are more expensive than ordinary nature.
"Then we won't do it." The son of the old lady made the decision directly.
"Huh??"
The Wang family was taken aback.
Then came the questioning voice of the old lady's son.
"You have said, the side effects are a little big, even dialysis may not be able to avoid all side effects, and I can't be sure what arterial embolism is really this, in addition, this test is so expensive, how do I know if you want us to do more tests and pay more?"
Filled with distrust.
Wang Jiayi: "........."
He was so angry on the spot that he wanted to curse, he really sincerely saved people, and he was also worried about the old lady's condition.
But soon it was discouraged again, who made the doctor-patient relationship so tense now?
At this time,
Lin Feng walked out of the ward.
"What's wrong? Haven't negotiated yet? "
"The old lady's family does not agree..."
Wang Jiayi said a little deflated.
When the eldest son saw Lin Feng, his eyes immediately lit up: "Doctor Lin, my mother's illness, can you help take a look?" "
Lin Feng was surprised: "I've already seen it..."
Wang Jiayi: "The diagnosis just now was given by Dr. Lin..."
When the eldest son heard this, he suddenly turned a hundred and eighty degrees.
His expression suddenly became solemn.
"It turns out that Dr. Lin, you diagnosed... Do the check you just said, do it right away! I believe Dr Lim is a good doctor! "
Wang Jiayi: "..........................."
Stepping on a horse!
Feeling like being offended in person.
I said a hundred words, the patient's family just didn't listen, and thought I was greedy for money, but as soon as Lin Feng came out, his position immediately changed.
Do you want to treat it so differently!
However, the patient's son agreed, which is a good thing.
Open your bill now and get checked!
......
As a child,
Enhanced CT results are out!
Superior mesenteric artery, no problem!
Renal artery, blocked (one large artery, go down, two arterioles left and right, open to two kidneys)! And it is very coincidental that the renal arteries on both sides are blocked, there is a little gap on the left side, a little blood can pass through, and the right side is completely blocked!
Obviously,
Lin Feng's reasoning in front was correct.
Atrial fibrillation causes emboli to form, fall off, and then enter the renal artery, where it becomes blocked.
After blockage, because of ischemia, it leads to kidney necrosis, and leads to kidney function problems, so the urine output is very small.
"It's really a renal artery embolism!"
The Wang family was shocked.
。