Chapter 2077： Lethal dose

For the uninvited boss Zheng, Ringer is still full of hope.

Zheng boss is indeed awesome, but this kind of clueless consultation, can he have any good ideas? I hope I can.

Ringer looked at Zheng Boss with a look of anticipation.

"I agree with Professor Gu that it is systemic lupus erythematosus and the diagnosis is clear." Zheng Ren said in a deep voice.

"Zheng boss..." The gynecological director stunned.

Gynecology, obstetrics, and doctors in two departments are all in a small hospital. Although the 912 is a different department, the gynecology has a deep understanding of obstetrics.

The intrauterine interventional surgery that Zheng Bo has just completed is no less than a fantasy for gynaecologists.

But it is not a rumor, Zheng boss is full of confidence, and even dare to do direct live surgery.

This is a great power. Even the gynecological director of 912 has a deepest worship from Zheng, even awe.

In the same way, Professor Gu said it was an attitude. However, speaking from the boss of Zheng, it has become another attitude.

The director of the gynecology hesitated a moment, and did not condescend to blame Zheng boss, but put on an eager gesture.

"I see the history record, after the application of immunotherapy, the patient has symptoms of shortness of breath and shortness of breath.

Considering acute left ventricular dysfunction, after treatment with diuretic and cardiac therapy, the patient's wheezing improved, but the palpitations gradually increased. The UCG showed a LVEF of 36% and a pulmonary artery pressure of 35 mmHg. ”

Zheng Ren did not look at the medical records, smiled and said: "So far, the diagnosis still considers systemic lupus erythematosus. There is no evidence that there are heart valves, cardiac conduction system and coronary artery involvement, so heart failure may be systemic lupus erythematosus involving the myocardium Caused."

"The condition of patients treated with systemic lupus erythematosus is exacerbated," the gynecological director asked.

Ringer is also very confused, the doctors in the office are very confused.

"In the case of the application of hormones and immunosuppressive agents, heart function damage is aggravated, I have several considerations.

First, the original treatment plan is not strong enough. I agree with Professor Gu that he can give shock treatment to save the function of important organs.

Second, after the application of hormones, sodium and water retention increases cardiac dysfunction, and similar symptoms may occur.

third,……"

Everyone in the room is silent.

Rheumatic immune diseases are indeed difficult to diagnose and treat. Even years old clinicians may not even be exposed to rheumatoid immunity.

The related diseases are complex and the treatment is diverse. This is why Su Yun said that he encountered a disease that he could not understand and directly went to rheumatism immunity.

As for the doctors of the high-level rheumatology and immunology department, most of them will stand on the peak of medical technology and look down on other subjects. They scornfully say, "Do they also see a doctor?"

Zheng Boss, a doctor in the intervention department, sitting here and talking, firm and confident, is really embarrassing.

"The lungs seem to have problems." I don't know who whispered.

"The patient's lungs are obviously thickened, which is the performance of imaging." After hearing the questions, Zheng Ren said that he had long been confident.

"At this time we need to judge whether the thickness of the lung texture is a lung infection induced by the application of hormones; or the performance of systemic lupus erythematosus in the lungs.

Of course, I just went to see the patient.

The patient has a nasogastric tube due to intestinal obstruction, and there is still vomiting and coughing. In addition to bed rest, hormones and aspiration are applied, so inhalation pulmonary infection cannot be excluded. ”

This is the rumor, and the professors of the Department of Respiratory Medicine have said the same thing, and there is suspicion of avoiding the weight.

However, Zheng Ren’s words turned and said: “But fever, pulmonary symptoms and cardiac insufficiency occur at the same time, and high-resolution chest CT does not suggest a clear infection in the lungs, anti-infection is not effective, more likely systemic lupus erythematosus Due to activities."

"The medical record is written, the patient is suspicious of the phenomenon of Raynaud, I think this is one of the judgments of Professor Gu."

"If you are worried..." Zheng Ren began to pursue the rationality of clinical diagnosis.

Under normal circumstances, the diagnosis of rheumatic immune disease is relatively erratic, the patient's condition is best to do a cystoscopy to take tissue biopsy. But the urology department also said that the condition of the bladder wall is not suitable for biopsy.

The best way to do this is to have a renal biopsy.

"I suggest that you still have to convince the patient's family to do a needle biopsy of the kidney." Zheng Ren said with firmness: "After the biopsy, you can determine the problem."

Linger felt that a **** pot was overwhelmingly buckled to himself.

The reason for the diagnosis is that the family members think that nausea, vomiting, diarrhea and the kidneys have nothing to do with each other, so insist that it is a problem of gynecological surgery.

Want a biopsy?

If other people say that a needle biopsy is necessary, Ringer will certainly not believe it. This kind of operation is a fuse that may lead to intensification of contradictions. Once there is no positive finding, it is hard to say how the patient's family's mood changes.

But if Zheng Boss said, Ringer’s mind began to figure out how to explain to the patient’s family.

"If the patient's family agrees with the renal biopsy, the result is positive, and can be treated with a more radical approach." Zheng Ren thought, said: "Methylprednisolone 1g, once a day impact treatment + intravenous immunoglobulin ~ www.novelhall .com~ once daily treatment. Then give cyclophosphamide 1.0g impact, hydrocortisone succinate 300mg daily."

This dose...

If you judge the mistake, it is enough to die.

Ringer looked at Zheng Boss with a sorrowful look. The dose was so big.

0.2 g of cyclophosphamide was used for one day, and the patient's myocardium was severely damaged. But Zheng boss actually gave 1g of usage, this...this...

Not very good to explain.

Ringer thought of lightning, and when he thought of the amount of medication, this should be a little more careful.

He looked up and looked at Zheng Boss, a gentle, steady smile, giving Ringer almost unlimited confidence.

The office was silent, and Professor Gu looked at Zheng Ren with a strange look. This amount is the most extreme amount he imagined.

Although he has just said that he wants to treat high-dose shocks, Professor Gu knows that it is almost impossible to use such a limit to give patients medication.

Impact treatment with this amount is usually performed after a needle biopsy to determine systemic lupus erythematosus. Before this, Zheng Boss definitely said the dosage of the drug...

The courage of the boss of Xiao Zheng, this is too big. Whether he is a doctor in the intervention department or an expert in rheumatism immunity.

After a while, Linger closed the notebook and smiled. "That way, the family members of the patient are going to the medical office. I will discuss with them the kidney biopsy."

Ringer is forced to helpless.

It is estimated that there will be a tough battle in the medical office.

vertex

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