285 Venous thrombosis of the lower extremities

(Thanks to my friend Zi Zimu, book friend 160427220733746, and Happy Luoba monthly ticket for encouragement)

"Teacher Liu, these people are the family members of the patient who was injured in the fall just now. While chatting with Xu Hui, Huang Bo, who was in charge of triage, came over.

"Doctor, what's wrong? I'm his daughter-in-law. The patient's wife said.

"It's not very clear at the moment, it's time to move forward to the operating room. However, when we were first diagnosed, we had internal bleeding and multiple fractures on our body, and we did chest intubation on the spot. Liu Banxia said.

"You can wait here for a while and we will know the results of the X-rays. You can also wait at the door of the operating room, and the surgeon will notify you at any time if there is a situation. ”

Hearing Liu Banxia's words, the patient's wife sat on the ground all of a sudden, but the two old men who followed her were more calm.

"Dr. Liu, the X-ray results are out. At this time, Xu Hui shouted.

Liu Banxia hurriedly ran to the computer, sighed in his heart after seeing it clearly, and glanced at the three family members who surrounded him, "The situation is very serious, you must be mentally prepared." ”

"There is a fracture in the left pelvis, three fractures in the cervical vertebrae, there is no problem with the thoracic vertebrae, and the left leg and left arm are also long bone fractures. Now it depends on how much damage the internal organs have during the operation, Huang Bo, you lead them to the door of the operating room and wait. ”

In fact, his prediction has not been said, the fractures and injuries are already so serious, I am afraid that the condition of the internal organs will not be very good. Even if there is no rupture of a large blood vessel, lacerations on the organs are certainly indispensable.

It's just that this is his prediction, and he can't tell the patient's family without a definite diagnosis. If this is the case, the family will definitely need to be consulted during the procedure.

This is still on the basis of not examining the head, and when the abdominal injury is dealt with, the head will be examined, and it may not be what the situation is.

"Yo, Curator Qu, come here. Which leg is uncomfortable? As soon as the patient's family was sent away, Liu Banxia saw Curator Qu and several people walking in.

"Dr. Liu, I'm really causing you trouble. Xiao Han's leg has been a little uncomfortable for the past two days, so I have to take him for a check-up. Curator Qu said.

"Actually, it's nothing, I guess it's just that I've been driving for a long time lately, and I'm a little tired. Xiao Han said with a smile.

"Driving? Did you drive around by yourself or something? I didn't seem to see you when I had dinner last time. After coming to the internal medicine clinic, Liu Banxia asked.

"I'm a Didi runner, and I used to play boxing with Brother Qu. There happened to be a passenger at the gym today, so I went up and had a look. Xiao Han said.

"Which leg hurts, I'll take a look first. Liu Banxia nodded.

Xiao Han picked up the trouser tube of his left leg, Liu Banxia checked it briefly, and then lifted his right leg up and lifted the trouser tube as well.

"See, your left leg is now thicker than your right, and it's still tender. Does your left leg feel a little swollen and painful?" asked Liu Banxia.

Xiao Han nodded, "It's strange, it's not like this when I get up in the morning." ”

"Have you had a similar medical history before?" asked Liu Banxia.

Xiao Han shook his head, "This is the first time. ”

"You lie down first and your leg muscles relax. When Liu Banxia spoke, he held up Xiao Han's left leg, pressed his left hand to the position of his knee, and pressed the sole of his foot with his right hand to the position of the instep with a little force.

"It hurts, it hurts, it hurts. Xiao Han couldn't help but shout.

"Do you have a history of high blood pressure or diabetes, do you usually like to drink?" asked Liu Banxia with a frown.

"I always go home and drink after collecting the car, otherwise I am too tired, and sometimes I am so tired that I can't sleep. I don't think I have high blood pressure or diabetes, I haven't had it, and I've been boxing for years. Xiao Han said.

"Then let's take a blood pressure first. Liu Banxia said.

"Doctor Liu, is Xiao Han serious?" asked Curator Qu.

"I suspect it's deep vein thrombosis in the lower leg, which sedentary people tend to get easily. The examination just now is an indication, and I have to do a double-power color ultrasound to check the veins of the lower limbs. Liu Banxia said.

"Oh my God, see? Low pressure 90, high pressure 164. I'll make an order, go to the color ultrasound room to check it first, and if it's diagnosed, we'll discuss how to get it. ”

"Don't worry too much, see if there is a blood clot and if so, how long. If it's not very long, we can completely dissolve it with thrombolytic drugs. Even if it's long, we can take it out surgically. ”

"Doctor Liu, do you still have to cut my leg if I have surgery?" Xiao Han asked nervously.

"That's not it, now that the technology is very developed, we have minimally invasive technology. Don't worry, if you really need surgery, I'll find you a master to do it. Liu Banxia comforted.

"Dongyang, Gangzi, you two should accompany him for an examination. That's it, I don't want to check it yet. Curator Qu said.

"In fact, people who sit a lot are most likely to get this disease, and they should occasionally move their legs and feet. Running Didi is actually similar to running long distances, and you usually have to pay attention. Liu Banxia said.

"I haven't seen him for a few months, and my daughter-in-law just gave birth to a boy, so he has to play hard to make money. Curator Qu sighed.

"It's okay, he's not a major operation. And now it's all minimally invasive, and the recovery is fast. Thanks to the fact that you brought it early, if it sinks for another two days, this leg will not be easy to say. Liu Banxia said.

"You too, although boxing is quite enjoyable, there will be varying degrees of damage. When you have time, you can do regular check-ups, and sometimes the blow injuries can be serious. ”

"Hey...... Isn't that how useless my arm is? Curator Qu sighed.

"It doesn't affect normal life, it's just that you can't box. Let's go outside to talk, and we have to continue to receive treatment from Dr. Xu here. Liu Banxia said with a smile.

As soon as he came outside, he was stunned. Because Wei Yuan and the others who participated in the emergency surgery actually came back, the expressions on their faces were not very good.

"Didn't you rescue it?" asked Liu Banxia.

"There was so much blood loss in the liver and pelvis that the intestines were broken, so we had to cut off the broken bowel, suture the mesenteric arteries, and then stuff the abdominal cavity with filling. Wei Yuan said.

"Now I push to do a head CT, and then transfer it directly to the ICU, and wait for the physical condition to stabilize and then see if I can do surgery. The fall was too bad, not too optimistic. ”

Liu Banxia also sighed in his heart, which was similar to his prediction. It's just that although his prediction was verified, this result was not what he hoped to see.

In fact, what it means now is to maintain, and it is difficult for patients to return to normal vital signs, just like the last time he and Shi Lei were treated in the middle of the night.

And now the condition of the patient's head is not clear, and if there is another head injury, the patient is even more hopeless. The end result is that it costs a lot of money, and it may not be able to be saved.

"Doctor Liu, can you often encounter such things in your hospital?" asked Director Qu.

"It's not very often, but it's not infrequently. Just now, the patient, who was a worker sealing the balcony, fell from the upper floor. More of them are car accident victims, and some are really badly injured. Liu Banxia said.

"By the way, that Zhou Yang, you should also be on guard. Last time he lost face with us, he definitely can't let go like this according to his temperament. Curator Qu reminded.

This is also rare, after all, the relationship with Zhou Yang should be closer. Don't look at eating and drinking with Qiaoqiao, those are two different things.

Remind me that it's love, don't say anything, that's duty.

After a few more idle words, Xiao Han, who had done color ultrasound, came back with the two brothers.

"Dr. Liu, the diagnosis is confirmed, and it is really the venous embolism you said. However, the doctor who did the color ultrasound said that it was not very serious, and the thrombolytic medicine should be similar. Xiao Han said.

"I'll take a look. Liu Banxia took the report as he spoke.

It's really not very serious, it's about six centimeters long. Sometimes if the venous thrombosis of the lower limbs is found late, more than ten centimeters, it is the conventional version.

It's just that now he is a little hesitant.

"Doctor Liu, what's wrong?" asked Curator Qu.

"There are some things I have to ask. Xiao Han, how many years have you been boxing?" asked Liu Banxia.

"It's only seven or eight years, right? But I'm just playing around, I have nothing to do with the brothers, and occasionally go on stage to play a mat game. Xiao Han said.

"In that case, we really can't use thrombolytics now. Liu Banxia frowned and said.

"Because your boxing years are not too short, and in the process of boxing, you must have been hit in the head. And these thrombolytic drugs are blood thinners. ”

"If you have suffered a head injury from boxing before, it may not affect your normal life, but after using blood thinners, it is easy to cause bleeding and stroke. ”

"So I'm going to have to do a brain CT for you first to see how your brain is doing. Otherwise, there would have been nothing wrong, and something bad might have happened. ”

"I don't think it's okay, right? I don't usually feel anything. Xiao Han said with some hesitation.

It's not that he feels sorry for the money for a brain CT scan, but that he is worried that Liu Banxia seems to be a little serious. Hemorrhage, stroke, he has the impression that such a disease is very dangerous, and he needs to be taken care of by his family.

"This is just a precautionary measure, but I do have some concerns. Although you usually have a good relationship, after you really came to power, you did your best when you played. Liu Banxia said.

"Even if you have gloves, it hurts to hit it. If I hadn't had a fight last time and received a few punches, I wouldn't have thought about it today. ”

"Just listen to Dr. Liu, safety first. Curator Qu said.

"That is, when we did color ultrasound just now, the doctors praised Dr. Liu, so they listened to Dr. Liu. You make a bill, I'll pay the fee, and we'll do it. Gangzi said.

"Okay, I'll do it. Brother Qu said well, safety first. Liu Banxia said with a smile.

"Okay, then I'll listen to everyone. Xiao Han also nodded and responded with a smile.

It's just that as soon as he finished speaking, the expression on his face was a little wrong, he covered his chest with his hands, and his mouth was panting widely.

"Even the monitor, protect the airway, give oxygen. Liu Banxia shouted.

He hadn't predicted that there would be such a change.