Yin Liang was also suspicious:

"Purulent pancreatitis is there, and the area of the vitreous shadow of the lungs is very small, and the patient is asymptomatic, neither hypoxia nor cough, how can you be so sure?

Seeing their doubts, Lin Yi was also prepared, and he said:

It may sound like, but it's true.

Uncle Wei did not show symptoms of shortness of breath or lack of oxygen, probably because it was still in the early stages.

If you come to the hospital a day later, the CT scan of the lungs may become more concentrated.

Another point is that the cause of this interstitial pneumonia is actually related to pancreatitis.

During the onset of pancreatitis, the body produces a large number of inflammatory cytokines and inflammatory mediators.

Its degradation products can easily cause the capillaries of the lungs to shrink violently, resulting in enhanced permeability of vascular endothelial cells, resulting in poor lung perfusion, resulting in cell damage and dysfunction in the lungs.

It is currently early stage, and the patient's symptoms are very mild, or there are only obvious symptoms.

Yes, pancreatitis is also one of the many causes of ARDS.

And its mechanism is similar to that of interstitial pneumonia.

All are due to lung damage caused by inflammatory cytokines and mediators.

But I ruled out ARDS because ARDS is bound to have respiratory symptoms.

However, interstitial pneumonia will not be in the early stage, so in addition to octreotide and omelafrustration, which are drugs for the treatment of pancreatitis, glucocorticoids and diuretics should be used. ”

The words fell.

The entire office stared at Lin Yi in a daze.

Especially Wu Jiang and Yin Liang.

This guy ......

How did Brother Yi react so quickly that the inflammation in his lungs was caused by pancreatitis?

And also!

Regarding the auscultation of the lungs, I think he Wu Jiang has not heard anything abnormal for so many years in medicine.

As a result, Brother Yi heard it as soon as he heard it!!

For a while, Wu Jiang felt that he had goosebumps on his arms!!

Brother Yi's observation and judgment are really too strong!

In patients with severe pancreatitis or weakened immunity, this inflammatory cytokine damage to the lungs can indeed occur.

But the odds are very, very small.

It is difficult for ordinary doctors to find out that the cause of lung problems is pancreatitis.

Either it is suspected that it is the sequelae of a previous lung disease, or it is a viral infection of the lungs.)

In short, it is difficult to associate the shadows on the CT scan with pancreatitis.

Ay......

I have to say that Brother Yi is really amazing.

After a period of silence, Lin Yi gave a medical order under the gaze of all the doctors.

At this time, the nurse in the emergency room also ran over and said:

"The pancreatitis patient just now knows what's going on, and I feel that he is panting a little hard? And the oxygen saturation of the fingertips is 85%, do you want to use oxygen?

Also, he had a low-grade fever with a temperature of 38.1 and normal other vital signs. ”

Lin Yi hurriedly replied:

"To go up, first give oxygen at a high flow rate for an hour, and then switch to a low flow oxygen when the oxygen saturation reaches 90%."

"Okay!"

The nurse turned around and went about her work.

In the office, the doctors in this hospital all looked at Lin Yi with admiring eyes.

I didn't have symptoms yet, but the patient's symptoms came immediately!

Soon, after the infusion, the migrant worker's body temperature dropped.

The amylase index was also reduced after the re-examination.

The next step is to schedule surgery.

Purulent pancreatitis and fluid that has developed is to drain and remove purulent necrotic pancreatic tissue.

Soon, the migrant worker was taken to the operating room.

He didn't have any money, so he made it up with a few people.

In addition, the family also notified that it was a man wearing a high school uniform and a middle-aged woman who looked a little demented.

A middle-aged woman should be a suffering wife......

It feels like (this chapter is not finished!) )

Chapter 287: The operation was a success!

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He is a disabled person, and he can't talk or walk very well.

No wonder patients keep saying they don't have money.

Before entering the operation, Lin Yi tried his best to explain the main problems and surgical plans of the patients to the two family members.

The high school student's expression was flat, as if he understood, and as if he understood.

Not to mention the middle-aged women, they grabbed Lin Yi's hand and wanted to speak, but they couldn't say a complete sentence for a long time.

Lin Yi nodded and looked at them:

"Don't worry, the operation is not very difficult, and it will be over soon.

The two family members nodded in unison.

"Doctor, wait!"

Just as Lin Yi was about to enter the operating room, the high school student suddenly stopped him.

Lin Yi looked at him.

But the boy said hesitantly:

"Doctor...... I...... Our family conditions are not good, and we don't have the money to give you gifts...... But...... But if you cure my dad......

I...... I can be a cow and a horse for you, thank you! ”

After speaking, the boy bowed ninety degrees to Lin Yi.

Lin Yi was quite moved when he heard this.

Although this kid is only in middle school, he looks much more sensible than students of the same age.

Hey, too, the children of some poor families didn't become homemakers early

Lin Yi stepped forward and pulled the boy up and said:

"Kid, my doctor doesn't need you to give gifts, you know?

It is our duty to govern people, and we don't need any additional strings on our part.

If you really want to thank me, you can study hard and get admitted to the best university, and the best way for you to repay me is to make a difference in the future.

Do you think that your dad is so tired from working on the construction site all day, isn't it all for you? ”

The boy looked up, his eyes twinkling with stars.

"I ...... I will! Thank you, doctor, please make sure to cure my dad. ”

"Hmm."

Lin Yi gave a positive answer.

In the hand room, disinfect, prepare skin, and lay surgical towels.

Lin Yi is the main knife.

The surgery is minimally invasive, with two holes in the abdomen.

Place the laparoscope on one side and the operating tools on the other.

Inhalation anesthesia, general anesthesia, the patient quickly closes his eyes.

Song Borui helped to clamp the skin with round forceps, and Lin Yi took a scalpel to make an incision in Zhou.

After the incision is made, place the multi-channel single-hole PORT.

Song Borui helped Lin Yi take the camera, and when the camera just poked into the abdominal cavity, the position of the pancreas was still completely exposed.

However, part of the tissue of the abscess can already be seen.

The liver and stomach were pulled to the side, and the entire pancreas was completely exposed to everyone's eyes.

"More than half of the area is necrotic."

Song Borui sighed with emotion, and put the flushing tube in.

Rinse and suction first, clean the surgical field, and facilitate operation.

Lin Yi's side held the pole electrocoagulation forceps and began to do blunt separation.

When the bipolar electrocoagulation forceps are clamped, they can be used as a charged blunt knife.

When opened, it is a charged scissor.

It is a surgical instrument that is currently very commonly used in clinical medicine.

Multiply~

The operating room is quiet, and the sound of electrocoagulation forceps can be faintly seen.

Lin Yi first clamped the large blood vessels of the pancreas.

Then start to remove the swollen parts in turn.

Treatment of purulent pancreatitis is mainly anti-inflammatory, drainage, and removal of abscesses.

In the sight of others, Lin Yi held the electrocoagulation forceps and separated the abscess tissue very cleanly.

There was also a lot of blood in the places where he passed.

Song Borui was also very attractive, and always maintained a relatively clear vision of his hand.

After the separation is complete, the dead part of the abscess is clamped out.

Stop bleeding and open pancreatic blood vessels.

The entire abdominal cavity is cleaned to remove the purulent fluid.

Place a drain in the laparoscopic hole on the other side)

Drain residual blood to the body in a timely manner.

The entire operation is less than thirty (this chapter is not finished!). )

Chapter 287: The operation was a success!

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Minute.

It takes only 20 minutes.

"Okay, it's over, pay attention to the patient's drainage, and be careful of secondary infection."

"Okay, got it."

After a while, a patient came to the emergency center.

Zhou Chao hurriedly walked out of the hall to pick up the patient, and Lin Yi followed.

"Male, 48 years old, previously healthy. Severe chest pain for one hour. In community hospitals, sublingual nitric acid was not relieved, there was no dyspnea, and there was no malignant vomiting. ”

The doctor in the ambulance hurriedly gave Zhou Chao a brief introduction to the patient's condition.

And the person was lying on the first-aid stretcher, his face was slightly pale, his head was large, he was clutching his chest, and his face was full of pain.

A middle-aged woman, while holding on to a stretcher, asked worriedly: "Doctor, hurry up and show my husband, what is his illness?" The pain in his chest was unbearable. ”

Hearing the emergency student's complaint, Zhou Chaoli already had a general direction.

He hurriedly used his stethoscope to listen to the patient's condition)

The heart rate was neat, there was no murmur, and the lungs had normal sound absorption.

Using a stethoscope alone, there are no obvious questions.

The pain is so severe, it's no wonder that there is no illness.

Auscultation with a microscope is only a preliminary screening.

Only a few diseases can be diagnosed.

For example, arrhythmia, atrial fibrillation, premature contractions, and valvular insufficiency of the heart, as well as dry and wet rales in both lungs, etc., can be judged with a stethoscope.

However, in this case, the patient complains of severe chest pain and there is no abnormality on cardiopulmonary auscultation, and further investigation is needed.

Zhou Chao hurriedly said to his sick lover: "Did your husband have this situation before?" ”

"No, he's in good health, and this is the first time he's sick!"

"Do you have a history of high blood pressure, illness, or anything like that?"

The patient's wife hurriedly shook her head.

"There is no disease, his blood pressure measured a few years ago, and it is still normal!"

There is little useful information from the patient's family.

The patient had now been pushed into the emergency room, and Zhou Chao immediately gave him an electrocardiogram first.

At the patient's age, coupled with the severe mouth pain, Zhou Chao's first thought was acute myocardial infarction.

Acute myocardial infarction can be a very serious visceral disease.

Patients can have ventricular fibrillation and cardiac arrest at any time, which is seriously life-threatening.

While Zhou Chao gave the patient an electrocardiogram, he gave other medical orders to the nurse.

"ECG monitoring, oxygen inhalation, blood tests, liver function, electrolytes, and coagulation 5 items and cardiac enzymes."

The patient's ECG came out.

Zhou Chao took a closer look and found that there was not much problem with the electrocardiogram.

There is no problem with the ECG, and acute myocardial infarction can usually be discharged.

In the case of this patient, there is no obvious problem with the ECG, and a myocardial infarction can basically be ruled out.

Then the danger to the patient will be greatly reduced.

It stands to reason that the Zhou Dynasty should be relaxed.

But the patient's chest pain did not lessen at all, and Zhou's brows furrowed even tighter.

He had a bad feeling.

At this time, the nurse has already connected the various leads of the cardiac monitor to the patient, and the patient's pressure is quickly displayed on the monitor.

The blood pressure was 200/120Hg.

Zhou Chao couldn't help but take a breath.

The blood pressure of a normal person will not exceed 140/90Hg, and the number of patients exceeding this has reached a very high risk level.

The bad premonition in his heart became stronger and stronger.

Lin Yi couldn't help but frown slightly.

If there is no problem with the patient's electrocardiogram, there is a high probability that myocardial infarction can be ruled out.

So why is the disease still so severe chest pain?

Lin Yi immediately thought of that, a very serious cardiovascular disease.

In his mind, the patient's aortic vessels and other conditions have already surfaced (this chapter is not finished!). )

Chapter 287: The operation was a success!

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。

As he expected, the patient was suffering from an aortic dissection tumor.

Aortic dissection aneurysm, a rare, fatal disease, is associated with a variety of diseases.

Hypertension is an important factor in the development of aortic dissection.

About 70% of patients have a history of hypertension, with distal aortic clips, and hypertension is more common.

The symptom of this illness is a sudden onset, sudden severe pain.

It is usually in the chest, and some of the pain may occur, but it can also appear in the back, abdomen, and lower limbs.

Its symptoms are similar to those of acute myocardial infarction.

Sometimes, the electrocardiogram of patients with active dissection aneurysm will also show myocardial ischemia, which is more likely to cause confusion.

This is a very serious cardiovascular disease, the patient's aortic aneurysm can rupture at any time, causing massive bleeding, and the patient can die instantly.

This disease has a relatively high mortality rate.

Once the aneurysm is ruptured, even if the patient is lying on the operating table, the doctor saves his life.

Because the pressure of the main vein is very high, once the artery is cracked, the blood in the whole body will be very drained.

Even if you are lying on the table, the doctor does not have time to rescue it)

Obviously, the Zhou Dynasty also considered the possibility of this disease.

He didn't wait for Lin Yiti, and hurriedly said to the nurse:

"Quick, first inject a *** pain reliever, and then, 50 ml of normal saline, add 50 mg of sodium nitroprusside, 4 mg intravenously pumped every hour, and quickly bring his blood pressure down."

Then Zhou Chao said to the person again: "You must relax now, you must cooperate with my treatment, don't be overly nervous, don't move, give you a painkiller in a while, you won't be so painful, I also need to take you to do a few tests to confirm the diagnosis." ”

This patient is simply a time bomb that could explode at any time.

Zhou Chao's heart also mentioned his throat.

He just guessed in his mind that the patient was an aortic dissection aneurysm.

But without being examined, she is not 100% diagnosed.

Lin Yi was already aware of the patient's illness, but he couldn't stop it, and Zhou Chao went to examine the patient.

This patient will definitely need immediate surgery.

However, surgery is not possible without a clear diagnosis from those tests.

Zhou Chao had already taken into account this dangerous disease, and he also knew that it was very dangerous to take the patient for examination.

During the examination, the aneurysm may rupture, and the patient will die in the examination room.

However, there was nothing she could do, even if it was dangerous, she had to take the patient for a check-up.

Otherwise, the following surgeries and treatments are not performed.

Chapter 287: The operation was a success!