Sun Lien was in the office of the comprehensive diagnosis center, looking at the literature with some apprehension.

He couldn't quite understand why Song Wen had to save his limbs, but at least he had succeeded in convincing his dean that this matter was none of my business.

The physician's sense of powerlessness at this time is very strong. Unlike their colleagues who play with knives, physicians can't just inject or take some drugs to restore some function to a smashed leg. This kind of thing is physically impossible.

Although usually physicians tend to look down on the surgeon's rough and direct treatment - where it is wrong. But any physician must admit that only surgery can help in this case. And they ...... At most, I can only try to help clean up the battlefield after the surgical treatment is over. Prescribe medication to prevent infection and speed up the patient's recovery a little.

But there are some battlefields that surgery can't reach.

Wang Ge was sentenced to death by surgery. It's not that he can't do the operation, but that he dies as soon as he does it. So in this case, there is and only an internist who can help him.

Under Dr. Pascal's "careful adjustment", Wang Ge was treated with multiple drugs at the same time. These include belimumab and chlorpheniramine maleate injection, recombinant human interleukin-2, thymus pentapeptide for injection, and prednisone.

The drug has caused obvious side effects to Wang Ge, his triglycerides have soared under the influence of hormones and other factors, and at the time of the latest examination, Wang Ge's triglycerides have almost reached 50mmol/L.

This is a very dangerous number, and when this data was first found out, Sun Lien even suspected that there was a problem with the equipment of the inspection department of the comprehensive diagnostic center. But soon, he saw a sample of blood taken from Wang Ge's body—it was a tube of pink blood.

Normal human blood is basically two colors - bright red arterial blood and dark red venous blood. And pink obviously doesn't belong to either of these colors. This is the "unique" color of dark red venous blood mixed with white fat.

"This thing looks like a description from a previous article I've read. When Xu Yourong saw this tube of blood, he made the above comment, "I used to be quite famous on the Internet, which said that the heroine's blood was pink. ”

Sun Lien asked while giving a doctor's order, "Did the heroine die of acute pancreatitis later?"

"Dead but not dead. Xu Yourong replied seriously, "Her blood turned rainbow color later." I'm still researching with Rachel how sick it would take to turn the blood into seven colors — probably five or six times she's going to die......"

Pink blood means that the patient's blood lipids are unacceptably high. The blood lipid content of normal humans is generally at the level of 0.45~1.69mmol/L. 1.7~2.25mmol/L is considered to be elevated at the margin, while more than 2.26mmol/L is hyperlipidemia.

It is nearly 25 times higher than the blood lipids of hyperlipidemia patients, which is Wang Ge's current state. Hyperlipidemia means that his blood will be extremely viscous, which can easily lead to further blockage of coronary arteries, or blockages of cerebral blood vessels.

However, pulse hormone therapy cannot be stopped, and other immunosuppressants cannot be adjusted. In this case, Sun Lien decisively chose the most direct means.

Plasmapheresis.

"Give him plasma exchange, and ask a specialist for advice on the dosage. My idea is to at least double the volume. Sun Lien and Xu Yourong continued to discuss the disposal plan, "He now weighs 68 kilograms, and the total blood volume is about 4760 milliliters. The red blood cell ratio is 0.45, and the total plasma volume is about 2600 ml. Sun Lien pressed the number on his mobile phone and quickly gave his plan, "Exchanging double the volume of plasma can remove 63.2% of the original plasma...... His blood lipids should be able to drop to about 18......"

Xu Yourong frowned and said, "That's still too high...... Let's ask a specialist, I think this kind of patient has to change the volume at least twice, and after clearing to 86.5%, at least his blood lipids can be reduced to single digits. ”

It was also the first time that the specialist who was called in for consultation had encountered such a severe hyperlipidemia patient. He looked at the plan given by Sun Lien and Xu Yourong, and asked with some concern, "From the perspective of changing the pulp alone, we generally recommend doubling the capacity." This regimen has a high enough clearance rate and a little less complications. However, the lipid content of 18.4mmol/L ...... This did not completely remove the risk of cardiovascular and cerebrovascular accidents......"

In general, patients with such high blood lipids will have very unhealthy lifestyle habits. After receiving such a patient, the doctor usually directly intervenes in the person's lifestyle habits, and adjugates it with medication or even plasma exchange. A variety of measures are used to remove fat from the patient's blood.

But now Wang Ge's situation is different from those patients, his high blood lipids are not due to unhealthy lifestyle habits, but from the large number of hormones used by doctors to save his life. In this case, lifestyle habits do not work, and other solutions based on hindering fat absorption cannot be applied to Wang Ge.

How much can plasmapheresis alone reduce his blood lipids - to what extent can it be reduced to prevent possible cardiovascular and cerebrovascular accidents?

"There aren't many ways we can think of now, and the safest solution is to watch while governing. After several minutes of consideration, Sun Lien decided to tell the truth. He asked the specialist, "Is it okay to monitor the patient's vital signs and adjust the plasmapheresis regimen at the same time?"

"Plasmapheresis is an ongoing process, and it is difficult to fully determine a patient's condition based on vital signs alone. The specialist sighed, "If nothing else, side effects such as hypokalemia will not be directly reflected in the patient's vital signs, and late-onset hypokalemia has also been reported." Other side effects are even more difficult to say. ”

This question...... In fact, Sun Lien has a solution. As long as he kept an eye on Wang Ge - the reaction speed of the status bar was much faster than any other vital signs monitoring device. And it's also more responsive.

But Sun Lien can't tell the specialist doctor directly, "You can rest assured that I am better than a lifeline monitor." If he dared to say such a thing, Xu Yourong on the side could directly send him to a mental hospital.

"You guys do it first...... Sun Lien thought about it, so he could only choose this, "Even if there are late side effects, we can find them in time if we strengthen the monitoring." But if there is a heart attack or stroke, even if it is rescued, the collateral damage is still too great. ”