The patient's various up-to-date real-time test results come down:

T36.3°C, P67 times/min, R10 times/min, BP135/85mmHg, ICP1.9kpa, interleukin-6+, blood loss 46ml, ADC enhancement, DWI showed low signal, midline left shift, thrombin enhancement, cerebral protein increase, cerebral blood flow 18ml/100g/min, hemoglobin metabolism was enhanced, tumor marginal edema was enhanced.

Previously observed hypothalamic hamartomas were only accompanied by cerebral edema, but now cerebral edema has begun to worsen, with severe breathing, leukocyte inflammation, increased APQ4, and strong thrombin penetration and intracranial hematoma, resulting in damage to the optic nerve and spinal cord.

At the same time, the results of the eye MRI also came out, and the orbital-like enhancement was visible, which would later progress to binocular blindness.

Perhaps in the next step, the patient will really be like Professor Jack said, the patient will never see the sun tomorrow.

In a word?

Sedum doesn't believe it.

But the fact is that in less than half an hour, cerebral edema has worsened, far beyond Sedum's imagination, intracranial hemorrhage, epidural hematoma, blood-brain barrier has been destroyed, and stroke vasogenic cerebral edema has been formed, even if diffuse cerebral edema will not be formed in the future, it will not affect the worsening symptoms of cerebral infarction, cerebral herniation and cerebral palsy.

In order to avoid further deterioration, Sedum immediately asked the nurse to raise the head position of the operating table to 30 degrees, and administer another injection of 1mg of bumetanide to maintain the normal value of PaCO2.

Another nurse was asked to perform a Gd-DTPA scan with contrast, because the water molecules of vasogenic cerebral edema spread relatively freely, so the ADC and DWI just now would show different results.

"Why did you check it again? Did it get worse again?"

"That's for sure, three kinds of tumors grow together, and they are completely intertwined, and if one is eliminated, another will grow, and it will not be completely eliminated. ”

"But I think the next step is to use thrombosis and mannitol to treat it together. ”

"Well, I also think so, after all, this is the first choice for treatment, the effect is absolutely good, if it were me, I would be like this. ”

Doctors outside began to express their opinions and make their own statements.

But Jing Ye knew that although some drugs had been injected before, which controlled epilepsy and intracranial pressure, and improved blood circulation, the patient's condition was still unstable, and thrombosis and mannitol treatment were no longer considered.

"You look at the way Sedum looks like you've given up on your treatment. ”

"Hehe, even if he gives up, I think if he has surgery, he will definitely choose minimally invasive removal surgery. ”

"Yes, minimally invasive removal surgery has many advantages, minimizes trauma, and makes patients more satisfied, which is undoubtedly the best choice. ”

The doctors outside continued to be in high spirits, pointing out the country.

However, Jing Ye knows that although the minimally invasive removal surgery can theoretically be punctured within two minutes with the LY-type, and then combined with a needle-shaped hematoma grinder and a blood clot liquefaction agent, the intracranial hematoma can be healed without leaving sequelae, but it is important to know that the patient's intracranial hematoma is as high as 46ml, which means that if the above surgery is insisted on, the patient will bear extremely high surgical risks.

So how high is the risk?

The mortality rate of the patients is almost 100 percent, and even if they survive, they are half-paralyzed.

Hearing that the risk of death was very high, the twelve crows, who were originally worried, suddenly flashed with boundless hope in their eyes.

Of course, for people who have three advanced tumors, it is actually a good choice to survive half-paralyzed.

Although the patient is a criminal, as a doctor, you should ensure that the patient's pain is minimized while the patient maintains vital signs, which is the same concept that people hope for conservative non-amputation treatment.

Therefore, Sedum undoubtedly ruled out minimally invasive removal surgery, and could only consider other methods.

......

For the study of the blood-brain barrier, Jingye is also relatively fresh.

When I was in medical school, the mice I used were usually C57/BL6.

The lifespan of rats is only about two years, because the genome and physiological structure of mice and humans are as similar as 99%, which is why they will never become extinct or even breed in captivity.

I was fortunate enough to take my supervisor to the University of Medicine, where I did several studies on nerves and tumors using C57BL/6, BALB/c and SD rats.

Using CZ-960, DCT-700 ultrasonic cavitation instrument and DW-T8 ultrasound color Doppler ultrasound diagnostic instrument, lanthanum tracer and Evansland EB examination were carried out on mice using lipid microbubble UCAs perfluoropropane ultrasound contrast agent, 2% sodium subbarbital sodium intraperitoneal anesthesia and some appropriate measures were performed, the tumor blood supply of each group was shown under contrast-enhanced ultrasound, and finally SPSS25.0 statistics were used.

When Jing Ye saw the patient's condition, he immediately remembered the past and began to think about how to solve the patient's problem.

In a hurry, Jing Ye immediately said: "Nurse, first inject a 250mg injection of acetazolamide intramuscularly to see the situation." ”

The nurse did so.

And the doctors outside began to talk again, and the words were full of words.

"Jingye, this kid, does he treat patients as test subjects? Doesn't he know that acetazolamide is very toxic?" said Vice Dean Shibato with a smile.

"That's right, the toxicity level of acetazolamide is intermediate, and patients who use the drug will inevitably experience potassium depletion, thrombocytopenia, metallic taste in the stomach and intestines within a few days, and long-term use will also lead to kidney failure and metabolic acidosis. ”

"Well, acetazolamide was sold too cheaply at that time, and it was discontinued because of its toxicity, and now basically all hospitals don't sell it. It has been a full ten years since the production was stopped, and acetazolamide has only a 24-month shelf life for oral administration, and 36 months for the drug, that is to say, even if acetazolamide is available in the hospital now, it is still an expired drug...... Isn't that even worse?" Shibato wondered.

A gentleman's word, ten thousand horses to chase.

The crowd was panicked, their hearts were confused, and their eyes were wide open.

"What? Sedum needs to use expired potions?"

"Is this sure there will be no death?" What the hell was he thinking?"

"According to the "Drug Administration Law", after the drug expires, the failure of the preservative may lead to the spoilage of the drug, and hospitals and pharmacies must put an end to the use of expired drugs for patients. Shibato was so loud this time that Qi Xiuyuan, who was standing next to him, heard it.

Qi Xiuyuan hurriedly explained: "Don't think about it, it's true that we have stopped production here, but last month I asked the purchasing team to go to Xiangjiang to purchase a batch, which was produced this year, and it is definitely new." ”

Hearing this, everyone fell silent.

The atmosphere was a little awkward.

It's just that after being silent for a long time, Shibato still broke out in an unwilling silence, and continued to say tenaciously: "But even if it's a new product, it's also very toxic, and he is doing this to completely aggravate the patient's condition, are you sure there is no problem?"