Xia Hua is the old director of internal medicine, and he is relatively experienced, so he was the first to stand up:

"The child has already washed the stomach, and the time has been too long, so now it can only be treated symptomatically, calcium gluconate intravenous delay, vitamin B, vitamin C, vitamin K; Hormone injections are also used to inhibit hemolytic reactions.

Sodium thiosulfate 10% is then injected intravenously to assist renal excretion. Oh yes, penicillamine also has a certain arsenic repellent effect, and it can be used. In addition, the hemoglobin of the child is as low as 4g, and blood transfusion and expansion should also be performed, and attention should be paid to correcting dehydration and electrolyte imbalance. ”

Although Yi Zewen is already the director of the department, he still holds the doctor's order book like a little doctor, and when Director Xia says a medicine, he will record the next medicine.

At this time, Director Zhu Huoyan shook his head:

"What Lao Xia said is symptomatic treatment, this still doesn't work, the child has been poisoned by arsenic for two weeks, and the toxicity has penetrated into all organs and all aspects, it is best to have special drugs, do you have any suggestions in this regard?"

Lan Lijuan said at this time:

"There are indeed special drugs for arsenic poisoning, such as sodium mercaptopropanesulfonate and dimercaptobutyldisodium disodium butanium, but these two drugs are not available in Vietnam, and I am afraid that there will be no ones in the whole country, because they cannot be produced in China."

Director Xia nodded in agreement: "Yes, if there was this special medicine, I would have said it a long time ago." ”

Dimercaptopropanesulfonate, dimercaptobutyldiate?

Chen Qi was stunned when he heard it, in fact, he was looking for these two drugs in the space operating room with his mind, after all, he had emptied a top hospital in the United States, and there were all kinds of rare medicines.

Then he came to his senses and clenched his fist because he had found it.

At this time, it is not the time to think of excuses, Fu Zhenzhen is already on the line of life and death, and the sooner the patient is medicated, the more likely he is to live.

"Dimercaptopropanesulfonate, dimercaptobutyldisodium right, right? Since I received the call from Yangshan Hospital, I have asked people to pick up the goods, and now I will go and pick them up. ”

The other doctors were excited when they heard this: "Great, Dean Chen is really powerful, and he can get any medicine." ”

Lan Lijuan was secretly puzzled in her heart, because her man had been asking the internist what medicine to use before, why did he suddenly change his words and say that he already knew what medicine to use in advance, and he had already been sent by someone?

But she is not ready to get to the bottom of it, everyone has their own secrets, and it is rare to be nonsense.

Chen Qi ran out of the ward, casually ran around the outside of the hospital, and ran back as fast as he could, with sodium mercaptopropanesulfonate and dimercaptobutyldisodium injection in the blue medicine box in his hand.

"Director Xia, Lijuan, quick, I've already brought the special medicine, how to use it?"

Director Xia Hua eagerly took the medicine and took a look, and his eyes were full of golden light:

"This is a domestic product, too precious, fast, 0.2g of sodium dimercaptopropanesulfonate intramuscularly, and 2g of dimercaptobutyl disodium disodium are dissolved in 20ml of normal saline intravenously."

Liu Min, the head nurse, immediately took the medicine, personally ran to the nurse's station to make the medicine, and personally came to give the medicine to the patient, for fear that the little nurse would spill such a precious medicine.

Director Zhou of Yangshan Hospital, who pretended to be small and transparent, was he stunned and stunned?

Of course, he knew about the two special drugs of dimercaptopropanesulfonate sodium and dimercaptobutyldisodium dioxide, and he also looked through the information, but Yangshan Hospital contacted major hospitals and pharmaceutical companies across the country for these two medicines, and the answer was that they were all out of stock.

(In addition to the special departments in China, other major hospitals dare not introduce, after all, foreigners sell to domestic hospitals, a price is thousands of dollars, and drugs have an expiration date, in case of expiration, no one dares to bear this responsibility.) ）

Good guys, Yangshan Hospital tried its best to get the special medicine that it couldn't get, and the Vietnamese Hospital got it in a few hours.

How against the sky are the connections and channels of this Vietnamese Hospital, how can this Yangshan Hospital compare? It's not good at all on the same level.

In the evening of the same day, the Vietnamese Central Hospital arranged two doctors, two nurses, and two nurses to take care of the little patient, Fu Zhenzhen.

The condition of the little patient also affects everyone's hearts.

The next day, Chen Qi and Lan Lijuan deliberately arrived at the hospital at 7 o'clock in the morning and went directly to the burn surgery ward, only to find that there were already many doctors.

"Guo Shuji, Teacher Zhu, Teacher Xia, are you here so early?"

No one answered Chen Qi, everyone looked down at the record of the night's illness and the examination reports that came out one after another after being admitted to the hospital.

Chen Qi didn't care, and stretched out his head to see the inspection report.

I don't know if I don't see it, I see that his mood has also fallen to the bottom, and no one is greeting him, and he is unwilling to answer people.

Because several indicators are very unoptimistic.

Head nurse Liu Min has been taking care of the little patients in the hospital last night, and the experienced old nurse is completely worthy of a senior doctor:

"Let me tell you, when I defecated the patient last night, I found that the stool was black, so I specially took an extra piece of blood and took it to the emergency room for testing, you see, the hemoglobin is only 70, which is internal bleeding."

This is really a wave of unsettled, wave after wave, this poisoning and burns have not been resolved, and the digestive tract is bleeding first.

This matter is Lan Lijuan's specialty, so she immediately walked to the little patient and started a physical examination of Fu Zhenzhen who was in a coma.

A few minutes later, Dr. Lan gave his opinion:

"I think it should be a stress ulcer, it's hard to say whether there is a perforation or not, but such a low hemoglobin is still quite dangerous."

Stress ulcer refers to acute gastritis that occurs during shock, trauma, surgery and severe systemic infection, often accompanied by bleeding symptoms, and is an acute gastric mucosal lesion.

Chen Qi saw that everyone was worried, and decided to cheer up the team:

"Bleeding ulcers can't be done in other hospitals, is our hospital still a problem? Head nurse, you ask Professor Zhang Weizhong to come over with a gastroscope immediately, let's endoscopy to stop the bleeding first, and Dr. Lan, you immediately prescribe a doctor's order, and use omeprazole injection. ”

As soon as you hear it, the best endoscopic technique in the world is Viet Chung Hospital, and gastrointestinal bleeding is not a problem.

After a while, Professor Zhang Weizhong and several students came with tools and began to perform endoscopic ulcer hemostasis.

But Chen Qi was pulled aside by Director Xia of Internal Medicine, pointed to a page of report and said:

"Dean Chen, looking at this liver function, aspartate aminotransferase and alanine aminotransferase can both exceed 1000U/L, and the creatinine value has reached 1500μmol/L, which is an acute failure of liver and kidney function, and if it is not treated, follow-up treatment is meaningless, and this patient is estimated to not last for a week."

The normal value of aspartate aminotransferase and alanine aminotransferase is 0-40U/L, and the normal value of creatinine is generally 44~132μmol/L.

These two indicators of the little patient in front of him can only be described as drag racing, and the speedometer is about to explode, and he can't pull it.

The consequence of these biochemical indicators is that the detoxification function of the liver and the detoxification function of the kidneys have almost been lost.

In addition, the risk of bleeding from liver failure will increase, hepatic encephalopathy may occur, blood ammonia may be significantly elevated, and some patients may develop hepatorenal syndrome, which is at risk of fatality.

When kidney function fails, the ability to drain water and detoxify is significantly reduced, which will lead to the occurrence of heart failure. Some patients may develop uremic pneumonia and uremic encephalopathy, and severe patients may have hyperkalemia and metabolic acidosis.

These conditions can be fatal, such as hyperkalemia can lead to cardiac arrest and even sudden death.

As long as the doctor understands the danger of liver and kidney failure, not to mention that there is still a respiratory failure.

Director Xia said:

"The liver and kidney function is so bad, the fundamental problem is that the arsenic toxicity in the patient's blood cannot be completely removed, and it continues to harm the liver, kidneys and other organs in the body.

The meaning is also very simple, this little girl was poisoned with arsenic, and now she is about to be poisoned.

This problem can't be solved, and the patient won't die for a few days, even if your burn surgery skills are useless, and you won't be able to survive this day.

Chen Qi was also worried, he bragged to reporters yesterday, but today this cowhide is about to explode, where does this make his credibility?

The most important thing is that he also takes pity on Fu Zhenzhen, a little patient, and wants to do his part.

Just when everyone sighed, a little nurse muttered a few words:

"You said that if our doctors can also heal the patient's injuries like a qigong master, and then force out the toxins in the body, and then the patient spit out two mouthfuls of black blood, the arsenic toxicity can be cleared, how good?"

The little nurse's words first aroused Director Xia Hua's rebuttal, the old lady's temper was the same as that of Lao Guo, and there was no room for sand in her eyes.

"Fart, what kind of qigong fart work, what kind of messy things, if qigong can cure diseases, then why do we doctors need to do it?"

Chen Qi's eyes lit up when he heard this, and he clapped his hands excitedly:

"Yes, if there is a treatment that can force out the toxins in the blood, and then remove them."

Director Zhu Huoyan raised his eyebrows when he heard this: "Chen Qi, why do you believe in qigong?" ”

Lan Lijuan was originally bowing her head to deal with the patient, but when she heard that her husband was going to use qigong treatment, she was so frightened that she stood up straight and looked at Chen Qi with doubts in her eyes.

She couldn't figure it out, because when the couple chatted in private, Chen Qi always said that qigong was pseudoscience, a deceptive thing, and even said that it would affect national security in the future.

Why does he actually believe in qigong now?

That is, Comrade Guo went out just now, if he was there, it is estimated that the back of Chen Qi's head will be hit again.

And Zhou Siqi, the director of the general surgery department of Yangshan Hospital, who has been a small transparent next to him, rolled his eyes, he thought to himself that qigong can really cure diseases? Anyway, he was more or less trustworthy.

Chen Qi was angry when he heard this, rolled his eyes and said:

"What is not qigong? I believe in qigong as well as Brother Xinchun, think about it, what is a topic that Dr. Wu Ping is working on in China? ”

At this time, the eyes of several veteran doctors lit up: "You mean hemodialysis?" ”

Dr. Wu Ping's specialty is urology, and urology or nephrology has a very difficult disease "uremia".

There is almost no cure for this disease, and it is irreversible.

If you want to survive, in addition to kidney transplantation, there is also a treatment called "hemodialysis", which can also be called "artificial kidney", which is to replace the work of the kidney with hemodialysis to maintain homeostasis.

Hemodialysis is no stranger to the people decades later, because with the changes in the environment and food, there are more and more uremias.

Dialysis can be divided into three categories: hemodialysis, peritoneal dialysis, and colon dialysis.

As we all know, hemodialysis thinks it is very simple, that is, two tubes are inserted into the blood vessels, one is bleeding and the other is blood, and then the machine is turned on to automatically remove the toxins in the blood.

However, in the 80s, although hemodialysis technology existed, it was not popularized, except for the capital, Tianjin, and Huhai, there were no hospitals for hemodialysis in other places.

There are two main reasons.

One is that the cost of hemodialysis is too high.

All equipment, consumables and medical products are imported, and it costs 180 yuan to do hemodialysis, almost 500 yuan three times a week, and 2,000 yuan a month.

But this year, it would be good for an ordinary worker to get 200 yuan a month, and the expensive cost is simply unaffordable for ordinary people, and the key is that hemodialysis is lifelong and must be done all the time.

Therefore, those who can do hemodialysis have basically climbed the snow-capped mountains by themselves or the patient's parents have climbed the snow-capped mountains in 80 years.

The second is that the hemodialysis equipment is too backward.

When advanced instruments such as continuous high-throughput dialysis (CHFD), continuous high-volume dialysis (HVHF), and on-line hemodialysis filtration machine (on-line HDF) have been used in clinical practice abroad.

Domestic hemodialysis machines are still very primitive machines, such as "baby scale hemodialysis machines".

This is done with a single pump as the blood pump, while the liquid inlet and outlet filters still rely on gravity, and the balance of the fluid is monitored by two baby scales and the infusion rollers are manually adjusted.

There is no automatic link in this hemodialysis machine, and many steps need to be manually adjusted, and it is inseparable from people for a moment.

As long as it is a manually operated machine, there will be mistakes, and if you are not careful, there will be problems with volume balance, resulting in dialysis failure.

There is definitely a curative effect, but how good the curative effect is, it can only be said that it can only save one's life.

In a helpless phrase, something is better than nothing.

In the original history, the first modern continuous renal replacement therapy machine in China, that is, the automatic hemodialysis machine Prisma, was not introduced until 1998.

Therefore, the hemodialysis profession was still very backward in China in the eighties, and it was far from meeting the conditions for promotion.

So when many people in the Vietzeng Hospital heard about the "hemodialysis technique", their eyes lit up at first, and then they dimmed.

Because of the "hemodialysis technology", not a single doctor in the whole Haidong Province can play, and even the entire Haidong Province does not have a hemodialysis machine.

Not to mention the Viet Chung Hospital, a local hospital. (End of chapter)