Chapter 1738

"What's up?" Zheng Ren asked.

"A schoolgirl fell down the stairs." Su Yun's expression was a little strange, but he spoke quickly, "came to the hospital for examination and found that the right lower lung pneumonia was accompanied by a large amount of pleural effusion on the right."

"On the other side of Fanglin?" Zheng Ren asked.

Su Yun glanced at Zheng Ren and asked, "did I tell you I fell down the stairs?"

“……”

"Craniocerebral injury, left temporal bone fracture with gas accumulation, traumatic shock, occipital... This is not important." Su Yun said, "Fang Lin went to the consultation and felt something wrong. Give me a call."

"What did you think?"

"Massive pleural effusion, a 19-year-old girl, what would you consider?" Su Yun asked.

"Tuberculous pleurisy, the first impression is this." Zheng Ren said, "but if you consider that the fall also caused a fracture of the left temporal bone and traumatic shock, you can't rule out that she fell because of shock."

"Shock, accompanied by a large amount of pleural effusion, I think so." Su yundao.

"Take a look." Zheng renzhuo thought about the patient's situation and unconsciously restored his hand to the state when watching the film.

"Boss, if you keep this state on the road, you look very handsome and silly." Su yundao.

"Shock, pleural effusion... What if it doesn't matter? Just pure pleural effusion?" Zheng Ren didn't answer what he said, but whispered to himself.

"In that case, it would be simple."

"By the way, Fang Lin saw the patient. What did he think?"

"The patient has a left temporal bone fracture with gas accumulation, but the patient has a large area of bruise on his right leg. He feels like a vascular embolism." Su yundao.

"Well, Fang Lin is good." Zheng Ren said, "chest department can consider thrombosis at a glance. It should not be common. The patient may have pulmonary embolism... Maybe... No, it should be pulmonary embolism!"

"Boss, pulmonary embolism is very common, okay!" Su Yun said contemptuously, "it's just that the patient's situation is relatively special, so Fang Lin called me for echocardiography while calling me."

"I think Fang Lin's diagnosis is based." Zheng Ren outlined the patient's situation in his mind and said: "the strangest thing is that young students will have a large amount of pleural effusion, which is very rare. Falls and comas are very common."

"Well, with bruises on his legs, I think Fang Lin's logical process is the same."

"Yes." Zheng Ren said: "it's all right. After the examination, it's estimated that we have a definite diagnosis before we return to the hospital. Maybe even thrombolytic drugs have been used..."

Then Zheng Ren was stunned.

Intracerebral hemorrhage, thrombolysis, the two treatments are very different.

If thrombolytic therapy with low molecular weight heparin sodium and warfarin is used, will there be a lot of bleeding in the left temporal bone fracture? Finally lead to brain hernia?

But if not treated, thrombosis alone can be fatal!

"When will the bus arrive?" Zheng Ren asked.

"3 minutes."

"Tell Xiao Feng to go to the hospital." Zheng Ren's tone immediately became urgent.

Su Yun was stunned.

"Fang Lin, are you with the patient?"

"Call me! Do echocardiography right away!" Zheng Ren spoke loudly. "If you find any problems, immediately consult the whole hospital, vascular department and circulatory department."

"I think it may be pulmonary embolism with syncope. The situation is very urgent. I can't use a lot of anticoagulants. I need emergency thrombectomy." Zheng Rendao.

What should be explained has been explained. Zheng Ren hung up his cell phone.

Su Yun also finished calling. He looked at Zheng Ren's hasty expression and asked, "boss, will you make a fuss?"

"Fang Lin's intuition is right!" Zheng Ren said firmly: "the fracture of the left temporal bone is difficult to lead to a large area of bruise on the right leg, which is caused by venous embolism of the lower limbs."

"So young..."

"Contraceptives may lead to lower extremity venous thrombosis." Zheng Ren said, "hurry back and keep in touch with Fang Lin."

With that, a car stopped not far from the roadside with a double flash. At the same time, Su Yun's cell phone rang.

Su Yun glanced at the license plate number and walked over.

On the bus, Zheng Ren heard the task prompt sound of "Ding Dong".

[urgent task: misdiagnosis.

Task content: many times, people will focus on the "main" diseases, especially bleeding. But the inner disease is more serious and even fatal. Please rescue a patient with pulmonary embolism in time.

Task time: 3 hours.

Task reward: 10000 experience points and 1000 skill points.]

Er... Zheng Ren hasn't seen such a cheap task for a long time.

However, the emergence of this task is of great significance to confirm the speculation just now. Whether Zheng Ren, Su Yun or Fang Lin are right.

It's pulmonary embolism! Not a temporal bone fracture with gas accumulation.

The so-called traumatic shock is also a wrong diagnosis. It is because of pulmonary embolism that shock symptoms appear. Trauma, that's the future.

It is a clinical pathophysiological syndrome that various emboli of systemic circulation fall off and block the pulmonary artery and its branches, resulting in pulmonary circulation disorder.

The most common embolus of pulmonary embolism is thrombus. Pulmonary embolism caused by thrombus is also known as pulmonary thromboembolism.

The patient suddenly has unexplained collapse, pale face, cold sweat, dyspnea, chest pain, cough, etc., and has symptoms of cerebral hypoxia, such as extreme anxiety, fatigue, nausea, convulsions and coma.

Only when transient brain hypoxia leads to coma will there be falls.

A large amount of pleural effusion on the right suggests that the right pulmonary trunk is blocked, which belongs to acute pulmonary embolism.

Now the patient's oxygen saturation

Zheng Ren thought, simply enter the system space directly and click to buy the operation training time.

The system operating room rises from the ground, and Zheng Ren goes in directly.

The subjects lay down on the operating table and diagnosed pulmonary embolism, deep venous thrombosis of both lower limbs and so on.

Compared with pulmonary embolism, other diagnoses are really not enough to mention.

Zheng Ren took a look at the ECG monitoring of the experimental body. The blood oxygen saturation was 85%, which was a very dangerous value.

Let's have an operation. There's no other way. Zheng Ren takes a deep breath and starts the thrombus removal operation.

Generally speaking, after the deep venous thrombosis falls off, it flows with the blood flow to the right atrium, then to the right ventricle, and then to the pulmonary artery, which will block the branches of the pulmonary artery or the larger pulmonary artery.

This is a form.

In addition, small emboli in lower limbs continue to fall off, resulting in continuous embolism of small pulmonary arteries, and finally lead to large embolism.

Another reason is that the embolus formed in the right cardiac system falls off and flows to the pulmonary artery, resulting in pulmonary embolism, such as the enlargement of the right atrium caused by congenital heart disease, thrombosis, falling off, etc.

The present patient was caused by lower extremity deep venous thrombosis.

Zheng Ren is still quite confident in removing the bolt.

However... After the thrombus catheter passed through the inferior vena cava to the right atrium and right ventricle, he was stunned.