Those who can go to the intensive care unit are not good patients.

This is good, it has nothing to do with character, money, etc., it just has to do with his personal state.

Senior Brother Zhuoyuan was still reporting his medical history, but Lu Cheng was taking notes quickly.

Based on the knowledge he learned in the textbook, the word pulmonary infarction almost represented half a life handed over to Lord Yama, and there was no mention of such a thing as surgery after pulmonary infarction.

Lu Cheng was a little skeptical that he had gone to the wrong set.

A master who always digs a hole for himself, and Professor Min who has to operate on an elderly patient who has a pulmonary infarction in the hospital.

He wants to do it, is the anesthesiologist willing to give anesthesia?

Even if the surgery is done, will he be able to keep up with his post-operative recovery?

How long will he live?

Is this surgery really necessary?

If, as long as there is the slightest problem in any link, then what are we going to face? Professor Min, do you really not know?

……

Unanswered, another difficult magazine arrived.

A 27-year-old young woman with idiopathic thrombocytopenia suffered from bilateral avascular necrosis of the femoral head after taking hormones.

Because of the clear history, the signs on plain pelvic radiographs also support the diagnosis of femoral head necrosis.

But there is a problem, because there is necrosis of the femoral head, hormones must be stopped, the patient's platelets, which have been reduced to 17, have long been reported as a crisis worthy of the situation.

There are still two indicators left, and it has reached an extremely low value.

"What does the Department of Hematology say?" Suzaku's eyelids jumped violently when he heard that the platelets were only 17.

Idiopathic thrombocytopenia itself is one of the incurable diseases in hematology, and the main clinical manifestation is thrombocytopenia, and due to thrombocytopenia, purpura, unexplained bleeding throughout the body may occur, etc.

Senior Brother Zhuoyuan printed out the consultation record and said carefully: "The hematology department recommends that the platelets be raised to at least 45 or more before surgery. Surgery is followed by platelet transfusions if necessary. ”

"In addition, patients are strictly allowed to stay on bed rest and must not go out during the hospital. ”

"I called and asked the blood transfusion department, and I was directly scolded there, saying that there were no platelets, and there were several patients with platelets around 10 waiting for platelets in the queue, and there were no extra platelets to prepare for the operation. ”

"If the patient has no bleeding symptoms, tell us not to call again. ”

Through knowledge storage, Lu Cheng didn't feel that Senior Brother Zhuoyuan was adding oil and vinegar, and thrombocytopenia was also graded.

Usually, less than 50 is severe.

17？

Lu Cheng only remembered a sentence in the textbook, when platelets < 20X109/L, the bleeding was more serious, and life-threatening intracranial hemorrhage was prone to occur, so platelets and high-dose gamma globulin needed to be transfused to keep platelets above 20X109/L.

And that's just the natural state, as for surgery?

Why surgery is done and what is considered an indication for surgery?

Lu Cheng was like listening to a book from heaven.

But fortunately, there is a medical record collection system, and every sentence of Professor Min and Associate Professor Zhu Queguang's discussion of the condition has been recorded.

"Professor Min, I still don't think that the patient's current condition is suitable for surgery, and she should be transferred to the Department of Hematology for adjustment. Suzaku argued for a while, and could only weakly express his last insistence again.

Lin You is also on the side of Vermilion Birdlight, this kind of patient, once the operation, there may be bleeding during the operation, and this bleeding may not be limited to the surgical wound, the chest, abdomen, lungs, intracranium, muscles, as long as you want to see the place, there may be bleeding.

Professor Min originally thought that if he could raise the platelets to a certain level, he would try to have this surgery done, but his associate professor and attending were so insistent that he didn't know how to refute it for a while, but he didn't want to let the patient out of the hospital.

This kind of patient, if it were not for the necrosis of the femoral head to the point of intolerability, would not have found an orthopedic department, and she herself knew where the worst part of her body was.

The continuous treatment of thrombocytopenia will definitely not cost less, and it is impossible to come here to replace the joints for free.

It is not uncommon for superiors and subordinates to disagree with each other.

Of course, if Professor Min insists on doing it, he can definitely do it, anyway, he is the main knife, and the responsibility is on his shoulders.

"The patient was first treated according to the consultation opinion of the Department of Hematology, first with TPO, and then observed for a period of time. Then Professor Min explained to the patient: "You have also heard the current situation of platelets, which are not suitable for surgery, and the blood bank cannot apply for platelets at all, and there are more critical patients waiting." ”

"Let's try it with TPO first, if the platelets can reach more than 45, we will do the surgery for you, if not, then you can only go to the hematologist to adjust the platelets before coming over. ”

"The purpose of surgery is to get you back functional, not to put you on the operating table and there's a good chance that you won't be able to get up, do you understand?"

What is the situation of her own disease, of course the patient knows, she can only bite her lip and nod, but the pain in her hip and the limitation of movement have already made her life miserable, she is only 27 years old, since giving birth to a baby, she has never held the baby and walked a step.

Naturally, it is impossible for a child to be sensible, except when she drinks milk, she can be quiet, and at other times, she cries as soon as she arrives in her arms.

Although she knew that he didn't mean it, such an unfamiliar behavior towards her child would not make her heart feel comfortable at all.

What she thought was that the caesarean section before labor must be the last choice she had to make in her life, and this sentence became empty words.

"I know, Professor Min. Thank you. There was grievance and determination in her eyes.

She knows that there are definitely more than these few years in this life, even after a few years, the child is older and doesn't need to be hugged, so do you need to be picked up by her mother to go to and from school?

Will his dad buy him clothes? Will his grandparents buy him clothes, will he like them? Will he want to eat a meal that I cooked?

From the county hospital to the outpatient clinic of the city hospital, her blood draw results were swung there, and the doctor said that you should go to the hematology department, and you can't do surgery.

……

……

The teaching rounds lasted for two hours.

Compared with the 15 minutes of the ward rounds on the day of the operation of Professor Min's group, the time to check all the patients was eight times longer.

Lu Cheng listened all the way, except for the patients with two and a half meniscus, he could understand a little, and the conditions of other patients, he felt that he was completely superfluous, and he did not belong to the doctors in this group.

I really don't know how those teachers who say that surgeons can only operate and don't understand theory at all came to this conclusion, Lu Cheng really wanted to kill him at this moment.

The degree of theoretical expertise of surgeons is certainly no less than that of physicians.

Moreover, the degree to which they apply these theories is absolutely perfect.

Not inking, but that doesn't mean you don't care.

Theory is absolutely the premise and foundation guiding all actions.

Diagnosis, basis for diagnosis.

Surgery, indications for surgery, surgical method;

The prognosis of different surgical modalities and the rehabilitation options of different surgical procedures......

No surgery is the same.

Lu Cheng felt that he had a long way to go.