This treatment is new and inexperienced. When the patient's father found out, he also rushed to Guangcheng from Yingzhou City. After listening to the doctor's introduction, he resolutely decided to treat his son.

The cost of such treatment is very high. His father raised a huge amount of money to receive treatment at Nanjiang Hospital in Guangcheng.

During the treatment, the treating doctor wants to completely destroy the huge and complex "arteriovenous malformation" and increase the amount of γ radiation irradiated a lot.

After the treatment, the lesion was indeed completely "destroyed", but the dangerous complications after radiotherapy hit the patient like a flood that burst the levee.

The patient began to develop headaches, vomiting, frequent seizures, and gradually became confused. The doctor who treated it said it was a reaction to γ radiation exposure, and it was dominated by severe, uncontrollable cerebral edema.

At this moment, the patient's father could no longer raise the cost of continuing his treatment in Guangcheng, and in desperation, he put all his hopes on the Affiliated Hospital of Yingzhou Medical College.

Yesterday afternoon, I took an ambulance from Guangcheng and galloped all the way to the Affiliated Hospital of Yingzhou Medical College.

These situations, yesterday afternoon, were learned by Lin Lin and Liu Yulan through communication with the patient's father and girlfriend.

"Ask Dr. Ma to show the director the patient's latest head CT scan." Liu Yulan said to Ma Shuiyuan.

Ling Xiaoyun took the CT film handed to her by Ma Shuiyuan, and casually placed it on the reading light beside her, turning on the switch of the reading light. When everyone saw it, they couldn't help but gasp.

I saw that the right cerebral hemisphere was obviously swollen, the right side ventricle had been compressed by the swollen brain tissue to almost disappear, and the midline structure was also significantly shifted to the left.

These signs indicate that the diseased brain tissue, edema is obvious, the pressure in the right cerebral hemisphere is very high, and the patient may die at any time due to brain herniation caused by high pressure.

"This patient's diagnosis is clear, please give your opinion on the next step of the patient's treatment." Ling Xiaoyun spoke, and the discussion officially began.

"I'm the doctor in charge, so I'll start with a few words." Liu Yulan spoke first.

"Since I took over yesterday afternoon, I have the feeling that this patient's condition is very serious, and the dehydrating agents currently being used have little effect. What's even more frightening is that the patient's epilepsy has not been effectively controlled, which in turn will lead to the aggravation of cerebral edema. ”

"At present, the patient's anti-epileptic drug is a combination of carbamazepine and phenytoin, which is not very effective, and seizures are still frequent."

"Therefore, my overall judgment is that the prognosis of this patient is not optimistic." Speaking of this, Liu Yulan stopped.

"Well, I also agree with Dr. Liu that the prognosis of this patient is indeed not optimistic. However, I remember that Dr. Lin had treated a patient with intractable status epilepticus before, and with Dr. Lin's experience and skills, it would be better to leave this patient to Dr. Lin in charge of diagnosis and treatment. Li Yun'e's speech can be described as "killing people without seeing blood."

"Hehe, this Li Yun'e is really competing with Lin Lin. It's better for someone to come forward than for me to come forward, so that this guy won't be so crazy in the future. Ling Xiaoyun secretly sneered.

Ding Feng had a good relationship with Liu Yulan and Lin Lin, and Li Yun'e's words made Ding Feng have nothing to say, so he simply kept silent.

"Dr. Lin, what do you think?" Ling Xiaoyun looked at Lin Lin with a smile. She wanted to see how Lin Lin took Li Yun'e's "move".

"I'll say a few words too." Lin Lin is not a junior brother, besides, he has already experienced this matter, and he knows very well what the result is.

"I agree with Director Ling's opinion that the diagnosis of this patient is clear, and the key at present is in the treatment."

"At present, the patient's condition is just at the peak of the brain response after the γ treatment, and the condition is very poor. Severe cerebral edema, which puts the patient at risk of dying from herniation at any time; Severe malnutrition puts the patient in an extremely debilitating condition and is prone to various serious complications, which can lead to the deterioration of the condition. ”

"Frequent and hard-to-control seizures can in turn make an already severe form of cerebral edema more difficult to control and brain damage more difficult to repair."

"At present, there are two main lines of treatment: first, to control and reduce the patient's cerebral edema; Second, control the patient's seizures. Controlling cerebral edema is a top priority. ”

"According to the "Foreign Medical Journal" that I checked in the library, it was reported that after γ treatment, the brain damage was divided into acute reaction phase and chronic reaction phase. In the chronic reaction period, the onset of the disease usually occurs six months to one year after radiation exposure. This patient does not belong to this case. ”

"The acute reaction phase is often caused by the sensitivity of brain tissue to radiation. This sensitivity, on the one hand, makes the therapeutic effect of radiation good; On the other hand, it will also make the brain tissue damage more large, and the edema will be more obvious, which is consistent with this patient. ”

"For the treatment of cerebral edema, I recommend adding hormones, glycerol fructose, and appropriate human plasma on the basis of mannitol. At this time, we must exert force, otherwise, there will be no chance to exert force in the future. ”

"For the treatment of epilepsy. I believe that as the cerebral edema improves, the control of epilepsy will also become easier. However, we can't wait, because, frequent attacks, can also lead to the aggravation of cerebral edema. ”

"Therefore, I recommend adding sodium valproate to the current anti-epileptic drugs for treatment, at a dose of 0.2 grams three times a day." This sentence was added by Lin Lin after being reborn, and he had never said this sentence in his previous life.

"Wait, you just said, combined with sodium valproate?" Ling Xiaoyun seemed to have caught Lin Lin's "pain point".

"Yes, that's right." Lin Lin knew what Ling Xiaoyun would say next.

"Do you know the metabolic difference between carbamazepine and sodium valproate?"

"Know, carbamazepine is a liver enzyme inducer, and sodium valproate is a liver enzyme inhibitor. However, this is only a theoretical thing, just like antibacterial drugs cannot be used in combination with bactericidal drugs, clinically, don't we have many cases of successful combined use? ”

"There is a difference between clinical and theoretical. Sodium valproate has been used in clinical practice since the late 60's and has been proven to be a safe, effective and broad-spectrum antiepileptic drug. Given the patient's current condition, I think it's worth it. ”

"Well, what you say is not unreasonable, you go on." Ling Xiaoyun was also persuaded by Lin Lin. In fact, in her previous life, Lin Lin used these two drugs in combination with a large number of epilepsy patients, not only achieved obvious results, but also proved that the monitoring of blood drug concentrations also proved that the interaction between these two drugs was very small.