Sun Lien felt that everything in front of him was crumpled together, and all kinds of colorful colors and shapes were distorted together, gathering into a blur in front of him. After about two seconds, the blur begins to fade away, starting from the center of the field of view and rapidly fading around. The scene that reappeared in front of Sun Lien's eyes was still the same as before, but it felt like it was more colorful.

"Are you okay?" Yuan Ping'an, who was standing behind Sun Lien, noticed that something was wrong with Sun Lien's state in time. "Uncomfortable?"

"It's okay, it's okay. Sun Lien shook his head, and casually found a reason to fool around, "I didn't stand firm just now." After fooling Yuan Ping'an's concern with very insincere prevarication, he looked at Xia Hongyuan who was lying on the bed again.

Xia Hongyuan, male, 26 years old, left iliac common vein thrombosis (78.27.33), left lower extremity popliteal vein thrombosis (73.44.18), left anterior tibial blood blister (71.36.12), avascular necrosis of the small intestine (51.08.25), stroke (05.34.55). "The status bar is different, with a parenthesis after each symptom. This was Sun Lien's first reaction. Then he fell into a deep state of confusion.

What the fuck are these numbers?

Sun Lien was confused for five seconds.

Now is not the time to be in a daze! He drew his attention back to the symptoms in front of him. Before, when there were no numbers, he didn't see a doctor as well, and now that the status bar is still there, there's nothing to worry about.

"Do you want to contact the imaging department?" Yuan Ping'an saw that Sun Lien seemed to be fine, so he began to put forward his own suggestions. "Let them prepare, do a head CT scan first?"

"Get in touch and arrange as soon as possible. "This case of venous thrombosis has been seen by Sun Lien in Chen Wen. He frowned, and while talking to Yuan Ping'an, he put on a mask, gloves and goggles, and then lifted the quilt covering Xia Hongyuan's legs - he was not covered when he was admitted to the hospital, which saved Sun Lien from cutting his pants with scissors again.

The blood blister on Xia Hongyuan's right shin bone was displayed in front of Sun Lien and Yuan Ping'an, and the two looked at each other after identifying it together for a while, "This doesn't look like it's caused by trauma." Yuan Ping'an said, "Thrombocytopenic purpura?"

"There is no extensive bruising, it may be vasculitis or a tumor. Sun Lien frowned and replied, "Do a blood routine and check the tumor markers." He paused, pretending to have just remembered, "I can't rule out blood problems, check the clotting time again." Sun Lien touched Xia Hongyuan's left foot, and the pulse of the artery was a little weak.

Venous thrombosis, the most likely cause of this condition is hypercoagulability. In addition, it is very likely that the stroke is due to a blood clot, so this test is important. "The pulse of the dorsalis pedis artery is weakened, do a color ultrasound to see the blood flow. ”

Yuan Ping'an went to arrange the inspection, while Sun Lien walked to the small conference room. The small conference room has almost become a dedicated office space for the treatment team, and Xu Yourong and Yuan Ping'an have both brought their laptops from home. Although it has not been done yet, it can be used to directly connect to the hospital's intranet to issue prescriptions through laptops, but at least it can be used to check information. It's still a lot more convenient than before.

"I thought you wouldn't want to go. Xu Yourong raised his eyebrows at Sun Lien, "Rachel said that Hu Jia's game competition level is very good, and she can be regarded as having found an opponent." ”

Sun Lien recalled Rachel's cheating method of pulling out the power supply, and it was hard to believe that the two sides could be regarded as "chess opponents". But people say so, face is always given. "I can't understand the games they play, and I don't know who is playing who is playing who after studying it for a long time......"

"It doesn't matter if you don't know this, just figure out what the problem is with this patient. Xu Yourong replied, "How is it? You have also met the patients and their families, do you have any clue?"

"The patient had blood blisters on his body, and according to the family's description, the blood blisters had been present for more than three days. And it seems to be still having gastrointestinal symptoms this morning. Sun Lien replied with a frown, a little worried that other routine tests might delay the results of the patient's stroke. After finishing speaking, he went out again, grabbed Yuan Ping'an and said, "After the blood is drawn, I will immediately send it to the imaging department to do a head CT and an abdominal CT...... Let's do the lower body, and by the way, look at the pelvis and legs. ”

After arranging the examination content, Sun Lien hurriedly returned to the small conference room and began to look at the records of the patient before and after admission.

"It's a bit weird. After reading the content several times, Sun Lien said to Xu Yourong, "If it hurts all over his body and wears clothes, then why can he still stand on the plastic plate? There are nerves in his feet, right? The weight of his body is pressed on his feet, won't his feet hurt? Pain sensitivity will only be concentrated in other parts of his body?"

Xu Yourong pondered for a moment and replied, "I think it's ...... The key may not be contact. ”

There are many types of pain sensitivity, and the vast majority of patients experience flare-ups due to different types of feelings. Some people can't tolerate the pressure, some can't stand the touch of a brush, and some people feel pain from heat or cold. And these tolerance differences are also a reminder to doctors that patients have different diseases.

"You mean...... Temperature?" Sun Lien immediately followed Xu Yourong's judgment, "The reason why he took off his clothes was because the temperature made him hyperalgesia?"

"Possibly. Xu Yourong replied, "Hyperalgesia generally relieves on its own, and it rarely lasts. And he woke up in the hospital still in pain – we actually put heating in order to get him back from hypothermia. ”

"So, at first I thought it might be burning mouth syndrome or erythromelalgia. Yuan Ping'an also walked in and joined the conversation between the two without hesitation, "But the problem is that he feels pain, not burning." So burn mouth syndrome is ruled out. And there were no paroxysmal redness, swelling, heat and pain in his limbs - stripping off all his clothes showed that the pain did not come from the extremities, but from the whole body. The results of color ultrasound showed popliteal vein thrombosis, and the blood flow in the left total iliac area was not very clear, but there was also a slow flow rate. ”

"I still think I should contact the pain department. Xu Yourong didn't pay attention to Yuan Ping'an, but said seriously to Sun Lien, "The pain department should have more contact with this kind of patient than in the emergency department, at least let them give some opinions." ”

"Let's call Kaminai and dermatology for a consultation as well. Yuan Ping'an sat behind the desk and sighed, "Professor Liu is not in the hospital, he is rushing here from the academy." ”

Sun Lien pondered for a while, but he didn't dare to take anticoagulation therapy casually - stroke is divided into two types: hemorrhagic and ischemic. If it is ischemic, anticoagulant thrombolytic therapy is the right way, but in case of bleeding, anticoagulation therapy will directly kill Xia Hongyuan. "Don't rush to anticoagulation first, wait for the results of coagulation and imaging tests to come out, and as for the consultation, wait for the results to come out before calling - although we are a major emergency, we can't use other departments as auxiliary departments. If there is not even a little information for diagnosis, it is called a consultation, which is not appropriate. ”

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"Whole aorta CTA?" The imaging department made preparations as quickly as possible, but when Xia Hongyuan arrived, Sun Lien put forward a request for additional examinations. This makes it a little difficult for the imaging doctors. "I didn't get a prescription. ”

"I'll have someone make it up now, you guys do it first. Sun Lien was also a little helpless, who would have thought that the speed of preparation in the imaging department was so fast, and he didn't even have time to ask Yuan Ping'an to increase the examination items. "This patient's situation is quite special, so I'm sorry for you. ”

The imaging doctor scratched his head and didn't say anything more. It's just that the developer needs to be dispensed, and it also has to wait for the contrast agent to be injected into the patient's body before it can take effect. "I'll get people ready now, but the CTA will have to be done later. ”

Sun Lien nodded, handed over to Xu Yourong, who came with him, and hurried to the laboratory to urge the results - anyway, there was nothing else to do, so it was not bad to harass Shi Yanquan to relieve the pressure.

"Brother, don't rush. Shi Yan really showed a tireless expression for face. "The blood routine is very fast, what's the use of you urging me for the clotting time?

"I'm a first aid person, you have a little bit of hands and feet!" Sun Lien knew that it was not Shi Yan who was doing the coagulation time experiment, so he naturally had no pressure to urge it—anyway, he didn't have to worry about making mistakes in his busyness, "I've been doing it for so long, why are you still clumsy?"

Shi Yan cursed twice, and then threw the results of the routine blood test on Sun Lien's face. "If you're okay, read the report first, don't come to me to urge!" After speaking, he turned his head and entered the laboratory.

The blood routine results are not a big problem, and the number of platelets that Sun Lien is most worried about is still in the normal range. The white blood cell index is also normal, and there seems to be no signs of infection.

Unlike an infection, platelet counts are normal. Sun Lien rubbed his chin, and the hint in the status bar was actually very direct. Xia Hongyuan's abdominal pain is the result of necrosis of the small intestine, which may indicate that his stroke is ischemic, which is called cerebral infarction, which can also be matched with the left iliac common vein thrombosis, as well as the popliteal vein thrombosis of the left lower extremity. And if cerebral infarction is confirmed, then pain sensitivity can also be explained – brain damage does cause pain sensitivity.

But the problem is, when the number of platelets is normal, where do so many blood clots come from? The status bar alone indicates two venous thrombosis of the lower extremities, and cerebral infarction indicates that there is at least one small blood clot in the cerebral blood vessels. The route of blood in the veins of the lower extremities determines that deep vein thrombosis must first enter the heart and then be pumped to the lungs for gas exchange. If there is a blood clot, Xia Hongyuan should have a pulmonary infarction first.

How do these blood clots skip the lungs and go directly to the brain?

Sun Lien rubbed his head and put the question aside. He has a more important question to solve - what do the numbers that follow the state mean?