Lin Lang blocked a bunch of people with a word, and then turned around and left. Huo Tianlei was not stupid, he directly bypassed these people, passed through the crowd lightly, and landed behind Lin Lang, and soon, he was ready for surgery. Lin Lang was the main knife, and Huo Tianlei was the first to do it, but the patient's situation was too tricky.

The emergency occurred in which patient with a comminuted fracture of the thigh leg bone, for unknown reasons, now there is systemic inflammation, and it is more serious near the wound. Now the whole person is lying on the operating table, and he has less air in and more air out.

Lin Lang, who got on the operating table, became more capable. After checking the patient's condition, he arranged it in an orderly manner. However, when calling Huo Tianlei, there were inevitably some problems, that is, Lin Lang asked Huo Tianlei to hand him a scimitar, and Huo Tianlei handed him a hook knife.

Suddenly, Huo Tianlei felt Lin Lang's cold gaze stay on him.

"Actually, there is no need to be so troublesome, there is another way. Huo Tianlei, who was very uncomfortable, shook his head and said.

"Systemic inflammatory response syndrome (SIRS): is a systemic inflammatory response that is uncontrollably self-amplifying and self-sabotaging caused by the body's action on the body by infectious or non-infectious causes. It is a clinical process in which the body repairs and survives and an excessive stress response occurs. When the body is hit by exogenous damage or infectious toxic substances, it can promote the initial inflammatory response, and at the same time, the endogenous immune inflammatory factors produced by the body form a "waterfall effect". ”

Critically ill patients are most likely to develop SIRS due to reduced compensatory anti-inflammatory response and metabolic dysfunction. In severe cases, it can lead to multiple organ dysfunction syndrome (MODS). ”

"Inflammation has already occurred, and a large number of infectious agents, inflammatory mediators, and cytokines are in the initial stage of acting on the target cell tissue, and some are even circulating freely in the bloodstream. Circulatory function is only initially impaired, but organ function is not impaired. What else can be done with systemic antibiotics and then local intestinal sterilization to remove inflammatory mediators?"

Lin Lang endured his anger and spoke, just sitting on the matter in his hand while talking. She didn't think that Huo Tianlei had other ways to treat it. However, he still subconsciously asked Huo Tianlei what he thought.

"Traditional Chinese medicine believes that the righteousness is vigorous, the health is solid, the disease is difficult to invade, and the disease cannot occur. Just like the cloud of "Su Wen, Last Chapters, and Assassination Method": "Righteousness is stored in the body, and evil cannot be done." "In the early stage, it was mainly manifested as hot and poisonous fever, congestion and blockade. In the later stage, the evil qi is positive, which is mainly manifested as viscera, yin and yang, qi and blood deficiency, etc. The main symptoms are four diseases: hot poison, blood congestion, damage to the internal organs, and yin and yang reversal. It can be treated by clearing heat and detoxifying, invigorating blood and removing blood stasis, and strengthening the foundation. ”

Huo Tianlei said his thoughts, and Lin Lang was a little moved when he heard his remarks. In this case, only grandpa will say this, and she has more or less understood it since she was a child. Then she thought of her purpose and continued her inquiry.

"Dididi..."

At the moment when the two of them were stunned, the instrument on the side was dripping. Later, a special inspector reported a lot of data, Lin Lang no longer paid attention to Huo Tianlei, but asked him to stay while another doctor came to help.

After intense treatment, the patient's condition stabilized. Just when everyone was relieved, Huo Tianlei spoke.

"Wait, something isn't right. ”

Hearing Huo Tianlei's words, Lin Lang also subconsciously observed the patient's condition.

"Yes, the patient had blood clotting. Cefotaxime 100 mg/kg.d is given intravenously in 2 divided doses, combined with high-dose penicillin 400,000 U/kg.d or ampicillin 200mg/kg.day, or vancomycin 40 mg/kg.day combined with ampicillin 200mg/kg.day intravenously, immediately. ”

Lin Lang took a closer look and found that the patient's condition was not good and had not stabilized. What has just been done is only the first stage. Now, already in the second stage, the patient has coagulated. Lin Lang immediately asked people to push antibiotics into the vein. Subsequently, other drugs such as high-dose intravenous gamma globulin (IIG) can reduce the occurrence of MODS and reduce the mortality rate of SIRS. At present, high-dose IIG, 200 to 400 mg/kg.d., is routinely used for SIRS.

The drug has just been pushed, but the effect is not so fast, and the patient's condition is very bad. There are so many inflammatory mediators in the blood that drugs can do very little.

"Exchange blood, exchange blood for the whole body. I'll go to the blood bag, you stabilize his current situation first. ”

After Huo Tianlei finished speaking, he got off the operating table and pushed open the door of the operating room, and then went to the blood bank to transfer 17,000 ml of plasma.

When Huo Tianlei proposed to exchange blood, Lin Lang was a little incredulous. But she soon figured out that there is no way to remove the inflammatory factors in the patient's blood at the moment, and the most effective and direct way is whole-body exchange transfusion. It's just that the risk of whole-body exchange transfusion is too great, so Lin Lang made a rough assessment.

The conclusion is that patients who do not exchange transfusion will not be able to resist tonight. There is still a glimmer of life in the exchange of transfusion, but the operation of the whole body exchange transfusion in the world is not so stable now, that is to say, the exchange of transfusion also has a great risk, and the success rate is only 20%. But now, even the hope of 20 percent success cannot be spared.

"Immediately go and ask the patient's family to sign the agreement for total body exchange transfusion, as soon as possible. ”

handed over the matter to another doctor, while Lin Lang was always paying attention to the patient's condition on the operating table. The body temperature of others has risen rapidly, and a lot of cold quilts have been taken out to wrap the patient's body, which only slows down a small part of the progress.

Soon, Huo Tianlei appeared in the operating room with plasma. "You are in charge of exchange transfusion, and I am in charge of patient stabilization. ”

Although this was the first time that Lin Lang had been ordered in the first half of her life, Lin Lang did not refute it, and it just so happened that she also wanted to see Huo Tianlei's ability.

"Wait, the exchange agreement has not been obtained yet, and we cannot exchange blood directly without the authorization of the patient's family. ”

Huo Tianlei also knew the stakes, so he was not in a hurry. Soon, another physician walked in with the agreement. As for what happened during this signing, the doctor did not say much.

In fact, when the doctor went out to ask the family to sign the agreement, the family only asked one question. What can be done to keep him alive. But the doctor dutifully informed the family of the contents of the agreement.

When they heard that they were either waiting for death or hoping to live, the family members were all scared to death when they heard the news, and they were fine more than an hour ago, but now why is it suddenly like this? Because of the urgency of time, the family members must make their attitude clear, and in the end, it is the patient's mother who has made up her mind. If you change it, you still have hope to live, and if you don't change it, you can only wait for death in pain, it's better to fight, isn't there still a 20% chance of winning? The worst result is nothing more than death, since sooner or later it will come, why not take advantage of this opportunity to fight. Maybe it's fine?

It is really surprising that the old man can be enlightened to this extent, there are often some surgeries that happen, and it is a big problem here to sign the agreement, and now there is such an enlightened person all of a sudden, it is like a clear stream.

"The family signed an agreement to exchange blood. ”

After the doctor took the agreement and showed it to Lin Lang, he was ready for the super big project of blood exchange.

"Hmm. ”

Lin Lang nodded at Huo Tianlei, and then directly started to take measures. And Huo Tianlei stood calmly aside. When Lin Lang turned around, he had already found that there were several bright silver needles inserted in the patient's body, and then looked at the instrument and found that the patient's condition had slowly stabilized.

I didn't think much about it, and directly started the big blood exchange project. The whole process was unexpectedly smooth, flowing in and out, and in this way, most of the blood in the patient's body was replaced.

The patient's body temperature changed and slowly decreased. When the blood package was transfused to 1500cc, Huo Tianlei stopped. Loving You didn't completely remodel the patient's blood, but kept a part of it.

Because there are many complications caused by blood problems, Lin Lang also agrees with this point of view. Immediately stopped the input of the patient's blood packet, Huo Tianlei just focused on looking at the patient's situation, and then the silver needles in his hand were arranged in a strange posture, slowly, pricking the needles for the patient, ensuring blood drainage and stasis, and consolidating the foundation.

The second needle of the thirteen needles of the ghost gate has such an effect, although there are only a few needles, but the whole process still consumes a lot of Huo Tianlei's true qi, and when he stopped, Huo Tianlei's forehead was full of sweat.

Just when Huo Tianlei wanted to wipe his sweat, a tissue was pasted on his forehead. I saw Lin Lang pinching a tissue with his hand and wiping the sweat for Huo Tianlei.

"Alright. Now it's just a matter of recuperating for a while. After picking out the last silver needle, Huo Tianlei breathed a sigh of relief and spoke. After finishing speaking, he turned sideways and saw Lin Lang's thoughtful appearance, and it was probably not a trivial matter that could make the iceberg beauty frown.

In fact, Lin Lang was thinking about Huo Tianlei. Huo Tianlei does not have a medical qualification certificate but treats patients everywhere, which is obviously not in accordance with the rules. However, it is a pity that there is such a good medical skill in treating diseases and saving people, and it is not used to save people. After thinking about it for a while, he couldn't come to a conclusion, Lin Lang glanced at Huo Tianlei, but found that he was looking at him, and his heart flickered for no reason.

Soon, Lin Lang adjusted her state and spoke, asking people to send the patient back to the ward to recuperate, and she herself took Huo Tianlei into a lounge.