There were no emergency patients yesterday, the ward was very stable, and there was nothing to say about the shift change.
After shift handover and ward rounds, Old Director Pan returned to his office to take charge.
Zheng Ren called in two people known to Director Pan, asked about the patient's medical history, and checked the test report.
The patient is a 69-year-old male who is in good health. One week ago, I accidentally hit a hard object and went to the township hospital for examination. B-ultrasound found multiple liver space-occupying lesions, which were considered malignant tumors. The largest space-occupying lesion was about 6x7cm.
The entire medical history is simple. Because the patient's liver space-occupying lesion has intrahepatic metastasis, surgical resection cannot be performed.
At this time, intervention is the best option.
But the specific situation, such as whether it can be done and whether the postoperative effect is good or not, can only be determined after 64-slice CT enhancement.
After instructing Chang Yue to admit the patient to the hospital, Zheng Ren and Su Yun went to see other postoperative patients.
When he came to the Department of Gastroenterology, Director Xia's enthusiasm for Zheng Ren obviously increased by two levels. Even Director Xia, who is the chief director of other departments in the hospital, is not so enthusiastic.
She personally led and took Zheng Ren to see the postoperative patients.
After tips, the patient's hematemesis has improved significantly, and the symptoms of hepatic encephalopathy are not severe. Zheng Ren thinks that after a day or two of observation, the second stent can be removed.
The patient's family members thanked Zheng Ren profusely, but Zheng Ren just smiled. Being able to "fish" the patient back before death would give Zheng Ren the greatest satisfaction.
As for the gratitude of the patient's family, it is actually not important to Zheng Ren.
Patients with cesspool syndrome are also in better condition. Although they are still feverish, their body temperature has been controlled.
From 39.5 degrees Celsius before the operation yesterday to 38.5 degrees Celsius now, this change is huge.
Zheng Ren is confident in her surgery. The most important thing for patients with cesspool syndrome now is to treat sepsis. As long as she can survive this, she will be alive.
After seeing the postoperative patients, Director Xia took Zheng Ren all the way to the gate of the ward.
Looking at it like that, Director Xia already recognized Zheng Ren's level in his heart. Subconsciously, she believed that Zheng Ren was qualified to be equal to her.
After leaving the Department of Gastroenterology, Zheng Ren and Su Yun headed towards the ICU again.
There was no trace of hangover on Su Yun's face, which was completely different from the eleven boxes of big green sticks that day.
Zheng Ren was also very surprised. It was supposed that the alcohol content of the Scotch whiskey last night completely exceeded eleven boxes of Big Green Sticks, but Su Yun was fine with it.
"Did you succeed last night?" Su Yun suddenly asked as he walked.
Succeeded... Zheng Ren didn't know how to answer this question.
If it comes to hugging, it should be a success. But I guess that's not what Su Yun meant.
"Judging from your appearance in the morning, you should be doing well. Don't be anxious, the martyr girl is afraid of pestering the man, so take it step by step." Su Yun taught earnestly.
Zheng Ren suddenly felt that what Su Yun said seemed to be good. At least yesterday's story made him rein in the cliff.
Otherwise, according to your own temper, you don’t know which direction the situation will develop.
All the way to the ICU, I changed clothes and went in. Director Qian and others looked serious and were discussing the condition.
"Xiao Zheng, here we come." Director Qian waved when he saw Zheng Ren and Su Yun coming to see the patient.
Zheng Ren knew there was a problem and walked over immediately.
"The patient in the 5th bed was quite agitated. According to the estimate of her condition, the tracheal intubation could be removed today and the ventilator could be stopped to assist breathing. However, after the sedative drug wore off, she began to become agitated and her vital signs became unstable."
Director Qian said simply.
Prison bed 5 is the same bed that Zheng Ren treated the day before yesterday for patients injured by falling from a height.
Something else happened
Zheng Ren was a little confused. Normally, her condition should be getting better every day at this time, and she would be able to go to the orthopedics department for internal fixation of the fracture in a few days.
The system issued a task to Zheng Ren to save people from fire and water, but Zheng Ren had no intention of completing it.
Chronic diagnosis surgery means slow diagnosis surgery and should never be done in an emergency. Otherwise, the patient will suffer greater trauma, making physical recovery unpredictable.
What's going on
Zheng Ren glanced at the patient. The system panel on the upper right side of his field of vision still had a faint red background.
This is normal, she still has many fractures that have not been treated.
Looking at the diagnosis given by the system, it seems there is nothing special...
Zheng Ren was confused and stood quietly behind the ICU doctors, listening carefully to their analysis of the patient's condition.
"Boss, I have a feeling that the patient becomes violently agitated when the concentration of the sedative drug is reduced because of the severe pain of adenomyosis." Su Yun whispered.
Zheng Ren also considered this, but without quantitative standards, there was no way to be 100% sure.
He nodded, holding his chin with his right hand, frowning in thought.
"Xiao Su, what do you think?" Director Qian asked familiarly.
"Director Qian, I think the patient needs to try interventional embolization to treat adenomyosis. If it still doesn't work, the uterus must be removed." Su Yun did not wait for others to question, and continued: "The reason why the patient jumped off the building was Because the severe pain caused by adenomyosis was unbearable, she chose to commit suicide.
How high that pain peak is, we can't guess. But one thing that is certain is that it must be very high. I estimate it should be about 4 degrees of pain. "
The pain rating, 1-12, is made up by netizens. The medical pain scale, professionally speaking, is 0-4 degrees. Level 4 is severe pain, accompanied by changes in blood pressure and pulse.
The doctors in the ICU seemed to be used to Su Yun's infallibility and subconsciously substituted what he said.
Although what Su Yun said is rather unreasonable, if you think about it carefully, the more you think about it, the more it makes sense.
Director Qian pondered.
"The pain of a fracture is bearable as long as you lie still. So I don't think the patient's agitation is due to the pain caused by the fracture.
I suggest explaining the condition to the patient’s family. If it doesn't work, the uterus needs to be removed. Su Yun remained firm, "If it continues, the patient will have been intubated for nearly 48 hours and will need a tracheotomy soon."
In that case, you will face complications such as pulmonary infection, which will make recovery more difficult. "
"You can try it." Although Zheng Ren was not sure whether the patient was agitated because of the pain of adenomyosis, he still agreed with Su Yun.
Now that the patient no longer has the acute problem of hemorrhagic shock, there is no harm in trying the possibility.
After all, interventional surgery is a minimally invasive treatment.
If the patient does not have such severe trauma, he can be active within 24 hours after surgery.
Of course, if you have a series of high-value consumables such as Imperial City's hemostatic plate, you can get to the ground in 4-6 hours.
Director Qian found it incredible. After all, adenomyosis is not a particularly rare disease, but most people choose to have their uterus removed once and for all.
For women who have not yet given birth, this disease rarely occurs, and Director Qian has no experience.
After pondering for a long time, Director Qian finally made the final decision: "I'll go communicate with the family and give it a try."
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