Brother Chuan watched Xu Jiuyanle blooming, but he felt like a ball in his heart. Guan Zheng still didn't know what Guan Zheng was like now, and he had to do all these things by himself, which of course also meant Guan Zheng.
Shi Jinyu's heart really can't stand the toss. Guan Zheng's illness repeatedly makes people unable to stand it. How many times have I really wanted to fall to the ground and take a good rest
The doctor came out of the ward and said: "The patient really has difficulty in recovering. Originally, it was impossible to survive with a knife inserted into the heart, but his condition has been very good before. This is fortunate, but now the patient’s wound is inflamed and complicated. There are many symptoms, and it is difficult for us to guarantee that we will get better. Even if we recover, we may not be able to run and jump in the future."
Shi Jinyu said, "But you know, he is a policeman."
The doctor nodded and said: "I know he is a policeman, because I know he is a policeman, so we are all working hard to hope that he can recover as before, even if it will not be the same as before, at least let him be a criminal policeman. Keep going. We have been working towards this goal, so as long as the patient has strong willpower and determination to survive this hurdle, then we will do our best."
Shi Jinyu didn't say a word, so he looked at Guan Zheng who was still smiling at him in the ward. The wound was so painful, the body was so uncomfortable, and the mood was so bad, why did he still smile? Why not cry and vent your grievances? Why not complain about the unfairness of this world
To be honest, Guan Zheng gave Xu Jiuyan a place in the task force. Maybe Xu Jiuyan will be very happy, but Guan Zheng will definitely not be happy. He has been guarding a case for ten years, and now he says to give up and give up. You can imagine how much suffering and sadness there is.
Shi Jinyu walked into the ward, and Guan Zheng said, "How did you stand at the door just now?"
Shi Jinyu said: "It's okay, think about something."
Guan Zheng took Shi Jinyu's hand, but comforted him, saying, "I'm really fine, I'll get better."
"Do you know your current physical condition?" Shi Jinyu asked.
Guan Zheng nodded and said: "Clinical ** repeated short-term use of antibiotics, and fever often recurs. Especially in patients with valve murmurs, undergo echocardiography. Progressive anemia can cause general weakness, weakness and shortness of breath. Patients with a longer course of disease often There is general pain, which may be caused by toxemia or embolism in various parts of the body. Arthralgia, low back pain and myalgia are common at the onset, mainly involving the gastrocnemius and thigh muscles, ankles, wrists and other joints.
The murmur of the original heart disease or the original normal heart murmur, petechiae of the skin and mucous membrane, linear bleeding under the nail bed, petechiae are the toxins acting on the capillaries to increase the brittleness of the blood vessels, or the spleen caused by embolism. Patients with mild to moderate swelling, soft or tender, recurrent pneumonia, liver enlargement, mild jaundice and progressive renal failure.
In the affected endocardium, especially fungal infections, large and fragile neoplasms can be attached, and the detached emboli can cause multiple emboli and metastatic abscesses, including myocardial abscess, brain abscess and purulent meningitis If the embolus comes from the infected right side of the heart cavity, pneumonia, pulmonary embolism and single or multiple lung abscesses may occur, and the skin may have multiple ecchymosis and purpuric hemorrhagic lesions.
Most patients with subacute infective endocarditis have a slow onset, with only non-specific insidious symptoms, such as general malaise, fatigue, low fever, weight loss, etc. A few onset begin in the form of complications of the disease, such as embolism. Explained stroke, progressive exacerbation of valvular heart disease. like me. "
Shi Jinyu listened lightly, and said, "What then?"
Seki said: "Low cardiac output syndrome. Dissatisfaction with the correction of cardiac malformations is an important reason for low cardiac output after surgery. During intracardiac operations, the heart circulation needs to be blocked, and ischemia and hypoxia can cause damage to the myocardium. , Resulting in myocardial insufficiency; postoperative hypoxia, hypoxia or acidemia can aggravate myocardial insufficiency; tachycardia or bradycardia affect atrioventricular insufficiency, arrhythmia such as hypoxia or surgical trauma The third-degree conduction block caused is often the cause of low discharge after surgery. I think my tachycardia is just a minor problem.
Patients with large left-to-right partial flow of the heart are likely to cause pulmonary hypertension. In patients with severe pulmonary hypertension, pulmonary arteriolar wall hardening, thickening of the pulmonary arterial wall and stenosis of the lumen are often accompanied by thickening of the tissue between the alveoli and capillaries, and interstitial edema. The pulmonary vascular resistance increases, the right ventricular hypertrophy is enlarged, and the balance of supply and demand of myocardial oxygen before surgery is already in a compensatory state. Improper intraoperative treatment can also become a precipitating factor for low cardiac output syndrome.
Low cardiac output syndrome is the final result of the imbalance between myocardial energy supply and demand during hypothermic cardiopulmonary bypass. After the aorta is blocked, the metabolism changes from aerobic metabolism to anaerobic metabolism, and energy production is sharply reduced, making it difficult to maintain the needs of normal cell metabolism. The function of the cell membrane sodium pump is impaired, and a large amount of sodium ions stay in the cell, causing myocardial edema. Increased lactic acid, the end product of anaerobic metabolism, causes intracellular acidosis and damages myocardial cells. During the period of ischemia and hypoxia, the hypoxia of the left ventricular myocardium is the most serious, the local metabolites accumulate, and the subendocardial microvessels dilate. If the myocardium is not well protected, severe myocardial structural damage may occur during ischemia, the permeability of cell membrane will increase, the integrity of capillaries will be destroyed, and a large amount of water and electrolytes can enter the cells in a short time after reperfusion. Exacerbate myocardial edema, increase subendocardial vascular resistance, reduce blood flow, and further aggravate the imbalance between the supply and demand of subendometrial oxygen, and eventually subendometrial hemorrhage and necrosis occurs.
Active use of various effective myocardial protection methods during cardiopulmonary bypass can prolong the tolerance time of myocardial ischemia and reduce the degree of myocardial edema and necrosis. Continuous perfusion with normal temperature oxygenated blood can continuously supply oxygen to the myocardium and block the myocardium during circulation. Changing from anaerobic metabolism to aerobic metabolism can avoid negative balance of myocardial energy metabolism, which is conducive to the recovery of myocardial function after surgery. "
Shi Jinyu smiled and asked, "Are you so clear?"
Guan Zheng smiled and said, "I have studied biology for six years, specializing in anthropology. This is not difficult for me."
Shi Jinyu nodded and said, "Then you must actively cooperate with the doctor to get better sooner."
Guan Zheng said with a smile: "Of course, I have to go back and continue investigating the case."
Shi Jinyu touched the three scars on Guan Zheng's wrist, as if saying to himself: "When will this scar be healed?"
Guan Zheng replied: "It's coming soon." (End of this chapter)