Chapter 56 The subdural hematoma patient you want
Although Song Siming's consciousness is clear, because of intracranial hemorrhage, his physical flexibility is not as good as before, and even after professional rehabilitation in the later stage, he may not return to a normal state.
Song Siming has woken up, and Yi Sheng is inconvenient to stay in the ward, after all, it was Song Siming who broke up Yi Sheng and Song Xin with his own hands, and Yi Sheng did not have a good impression of Song Siming, if Song Siming saw Yi Sheng, he would not be so angry that intracranial hemorrhage recurred!
Yi Sheng said goodbye to Aunt Mei and went to the operating room to wait for treatment, and Aunt Mei also pushed the door in and watched the doctors in the emergency department examine Song Siming.
"The patient's vital signs are quite stable, and I will adjust the doctor's order according to his recovery," Song Siming's attending doctor instructed: "Although the patient is awake now, he has not yet passed the dangerous period, and the period from 7 days to 14 days is the high incidence of lung infection, and now that the weather is so cold, don't try to get out of bed during this time to avoid wind chill and cold." ”
"Okay doctor, thank you, doctor. Aunt Mei hurriedly thanked: "If it weren't for you, my old man wouldn't know if he would be able to do well!"
"If you want to thank Dr. Yi Sheng, if he hadn't called Director Wu in time, we wouldn't have been able to rescue your husband. The little nurse in the emergency department who hung the bottle for Song Siming on the side said.
"It turned out to be Yi Sheng!" Aunt Mei was stunned, and hurriedly chased out to find Yi Sheng, but she didn't even see Yi Sheng's figure, so she had to go back to the ward and say to herself: "This kid is really! Why didn't he tell me!"
Although Song Siming was lying on the bed and couldn't move, his consciousness was still awake, and when he heard that it was Yi Sheng who saved him, Song Siming was obviously a little excited, and he couldn't speak, so he could only scream a few times.
"Uncle, you are not easy to get excited now, if you want Dr. Xie Yi to wait for you to get a little better, what you need most now is rest. The little nurse in the emergency department hurriedly comforted.
"Doctor Yi really cares about you, Doctor Yi never came to the ward before, you should be a relative of Doctor Yi, right?" the little nurse asked after reassuring Song Siming, recording the data on the monitor.
"Count.... It's not a relative," Aunt Mei sighed to herself, and asked with a forced smile, "Which department is Yi Sheng in now?"
"Dr. Yi is now in the Department of Neurosurgery with Director Li, the new director of the Department of Neurosurgery, Dr. Yi is handsome and has a good personality, and a few days ago he completed a case of brain stem tumor removal with Director Li and Director Meng, who can marry Dr. Yi will wake up with laughter in their dreams!"
The little nurse touched the ring on her ring finger, and said with a little loss: "If I knew that I wouldn't get married so early, maybe I would have had a chance." ”
The little nurse told Aunt Mei a few more words, pushed the nurse cart and left the ward, Aunt Mei looked at the back of the little nurse and was stunned, a few minutes later, she came back to her senses and helped Song Siming cover the quilt, held Song Siming's slightly trembling right hand with both hands and rubbed it and whispered: "Old Song, did you say that we were a little too much at the beginning......
At the same time, in the emergency operating room, Yi Sheng also ushered in the first patient with subdural hematoma who was operated on by himself.
"The patient, a 57-year-old male, fell from a height on the 3rd floor during construction at the construction site 5 hours before admission, hit his head on the ground, felt pain and discomfort in his head and neck in many places, and had no vomiting and convulsions, etc., and was immediately sent to the local hospital for treatment. Hao Zhe brushed his hands while briefly explaining the patient's situation to Yi Sheng.
"Did you do the MRI?" Yi Sheng asked with a quick brush of his hands.
Because epidural hematoma does not involve internal brain tissue, a enhanced CT image can completely expose the patient's condition, but subdural hematoma involves the loss of excess blood vessels in the brain, and the blood vessels in the brain often overlap, so the effect of MRI is better than that of CT.
Someone once did a statistical experiment of subdural hematoma MRI and CT imaging, 64 patients with subdural hematoma were examined by MRI and CT image at the same time, and after the final scan, the hematoma scanned by CT was 44, and the hematoma scanned by MRI was 89, so it can be seen that the efficiency of MRI is much higher than that of CT image.
"Not yet, I was pushed to the emergency operating room as soon as I was delivered, and the patient's family situation is not good, Director Wu specially asked me to ask you to use some cheap instruments as much as possible. ”
"You go and inform Director Li and ask him to send a teacher over. This time, Yi Sheng did not do it directly, but according to Li Shangai's request, he first asked a teacher from the department to supervise his operation, and only after confirming that there was no problem could he complete the operation independently.
Yi Sheng entered the operating room after sterilization from the clean room, Su Jin had already hung the CT image taken by the patient in the local hospital on the projection table, Yi Sheng observed it and frowned: "Why is this CT image a little blurry?"
"The equipment of the small hospitals in the countryside is backward, and it is all the equipment used by our hospital in the past, so there will definitely be some ambiguity. Su Jin sorted out the instruments and said casually.
"This CT image is not good," Yi Sheng shook his head and said: "There is no way to determine whether the patient has other potential intracranial hemorrhage points with such a CT image, notify the imaging department and do an emergency high-field MRI." ”
"Emergency high-field MRI costs about 2,000 yuan, which is 500 yuan more expensive than ordinary MRI, can the patient's family agree?"
"That's no way, this CT image can't be seen at all, I'll go out and explain it to the patient's family first. Yi Sheng thought about it for a while, and walked out of the operating room directly, at the door of the operating area, Yi Sheng looked at the group of people in Wuyang and asked, "Who is the family of the patient who was sent in just now?"
Yi Sheng didn't have time to see the patient's case at all, so he didn't know the patient's name at all, Yi Sheng watched the crowd leaning towards him, and hurriedly added: "The family of the 57-year-old construction worker." ”
"I am!" A man who looked to be in his forties, wearing a hard hat and dressed as a worker, squeezed out and raised his hand.
"Who are you?"
"He's my dad!"
Yi Sheng looked up at the appearance of the man in front of him carefully and asked, "The CT image that your father did in the local hospital before was a little blurry, and I need to take a high-field MRI for the patient to confirm whether there is an intracranial hemorrhage point, which costs about 2,000 yuan." ”
"What? 2,000 yuan! We only spent 200 yuan for a CT scan in that hospital! Why are you so expensive?" The patient's family looked at Yi Sheng and said suspiciously: "I don't read much, but I'm not stupid! Your doctor said that I paid for the direct operation, why do you have to do an examination after paying the money? Are you fooling us countrymen?"
"Your father's CT image is indeed a little blurry, and I can't tell if there is an intracranial hemorrhage, so I need to do a more detailed examination, which will also help your father's surgery. Yi Sheng patiently explained: "We can't proceed with the operation without identifying your father's possible problems. ”
"Oh~~~~, I see that you are not good at learning!" The patient's family shouted: "I see that the people who see my father are bald, and his hair is still half gray and not black, why did you go to the operating room to operate on my father?"
Yi Sheng also has no experience in communicating with patients, and now he doesn't know what to say, but fortunately, Hao Zhe called He Zhen over, and He Zhen grinded his mouth, and the patient's family scolded and paid the money.
Because it was an emergency MRI, Yi Sheng quickly got the patient's MRI image.
Observing the patient's MRI image, Yi Sheng didn't reply: "I think it's time to have a special person to be responsible for communicating with the patient, I'm still not very good at this." ”
He Zhen changed into a surgical gown and lifted a bench to sit down in the position of the first assistant, Hao Zhe's position naturally moved to the position of the second assistant, hearing Yi Sheng's words, He Zhen was stunned for a moment and said: "What?
"Well, there's something to do for the secretary, nothing to do..... Ahh
Yi Sheng recorded the MRI images of the patients one by one in his brain. Then he closed his eyes slightly, and used the 3D holographic tomography technology taught by the Xiaoyixian system to model it in his mind, and a model of the brain appeared in Yi Sheng's mind.
Under the operation of Yi Sheng's consciousness, this brain model was stripped and disassembled, brain tissue, nerves or blood vessels appeared clearly in front of Yi Sheng's eyes, and all the bleeding spots in the patient's brain were exposed.
Yi Sheng opened his eyes, a feeling of dizziness came from his brain, Yi Sheng shook for a moment before standing still, and slowly eased up.
"It's too much physical exertion! I have to replenish some energy before using it in the future, otherwise I will lie down before the operation starts." Yi Sheng thought to himself.
Picking up the pen and noting the bleeding points on the MRI image, Yi Sheng said: "Teacher He, the patient has a total of three bleeding points, and two of them need to be sutured at the same time, please help at that time." ”
He Zhen stood up, looked at the MRI image carefully, and asked, "Why did I see two places?"
"Here, here, and here," Yi Sheng explained, pointing to the dots he marked on the MRI image with a pen: "There are two blood vessels at the bottom of the subarachnoid space that have different degrees of damage, and because these two blood vessels overlap, they show the illusion of two bleeding spots." ”
"How do you see it?" He Zhenhu wondered, he hadn't seen it after watching the MRI images for so many years, how could an intern of Yi Sheng see it, and besides, undergraduates basically don't teach students how to read MRI images, where did he learn this?
"Bleed!"