It's not right, it's very wrong. No one suddenly goes from a low blood pressure of 55/85 to a high blood pressure of 90/155 in a few minutes. Sun Lien shook his head vigorously and refocused his attention on the electronic blood pressure monitor in front of him. He turned the machine back on, and the second test result was 94/156, a slight fluctuation, but still within a reasonable margin of error.

Sun Lien frowned and tore off the air sleeve tied to the patient, and then tested it again on himself. Blood pressure 75/125 and the sphygmomanometer is working perfectly normal.

"What's wrong?" the nurse who had collected Li Jianguo's blood asked with a frown, "Is there a problem with the blood pressure monitor?"

Sun Lien shook his head and said with some hesitation, "I think there is something wrong with this person." He went around the hospital bed again and tied the blood pressure monitor to Li Jianguo's right arm.

Blood pressure 57/90, still low blood pressure.

In general, the blood pressure on the left side of the upper limb is slightly higher than that on the right side of the upper limb, and the pressure difference is basically about 10 mm Hg. But such a huge pressure difference is definitely not a normal phenomenon.

"Push the ultrasound machine over. Sun Lien thought about it and hurriedly began to carry out the next step of the examination, "Let the CT room prepare quickly, and send people over immediately after the B ultrasound!"

His expression was a little anxious, and Zhou Jun leaned over, "Very serious?"

"It's serious. Sun took a deep breath behind the N95 mask, "I think it's an aortic dissection." He continued to raise his voice, "Let Xinwai send someone to the operating room to prepare!"

Aortic dissection is an acute cardiovascular disease with a high mortality rate. Without treatment, about 25% of patients die within 24 hours of onset. More than half of patients die within a week of onset. Mortality rates are higher than 75% and 90% after one month and one year after onset, respectively. However, if treated with aortic replacement and followed by regular medication, the 10% survival rate for patients is about 50%.

It is a horrific disease that almost certainly kills without treatment, and has a half chance of dying within 10 years after active treatment. And Li Guoqing's situation should obviously be the most troublesome category.

Most of the symptoms of aortic dissection are very obvious, and severe chest pain and tear-like pain can be overwhelming. Sweating profusely, more than 60 percent of patients experience a strong sense of impending death – a panic and restless fear that seems to be imminent.

The onset of aortic dissection is caused by a break in the lining of the aortic wall, and the high-pressure blood that has just been pumped from the heart rushes directly into the breach and enters the middle layer of the arterial wall, forming a dissected hematoma and gradually peeling off the intima and media of the aorta. The greatest risk of this serious cardiovascular emergency comes from the risk of aortic rupture that patients face at all times after the aortic layer is removed.

If the aorta ruptures before surgery, the time left for doctors to rescue them is as short as seconds, and there are only a handful of successful cases of rescue after aortic rupture. Unless the patient is extremely fortunate enough to get enough blood transfusion after the heart has been sprayed with all body blood, and the heart is successfully repeated.

For a healthy 20-year-old man, the aorta ruptures before surgery can have a 99% mortality rate. But if the patient is replaced by 60-year-old Li Jianguo, who has suffered from stage 3 hypertension for more than 10 years and hyperlipidemia, the mortality rate is absolutely 100%. There's no way he's going to survive.

Therefore, Sun Lien directly opened a green channel for him and reported the situation to Zhou Jun.

"Ultrasound can be done on the road. After hearing Sun Lien's diagnosis, Zhou Jun gave more positive instructions, "Send people directly to the imaging department and do CTA immediately." Surgery is performed as soon as it is confirmed. ”

"I'll do the family talk. Sun Lien can't care about other problems now, aortic dissection is the most dangerous cardiovascular disease. The faster his movements, the better Li Jianguo's chances of survival.

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"Your father's condition is very bad, very bad, and he could die at any moment. When Sun Lien rushed out of the emergency room again, Li Jianguo's son hadn't even found a place to sit down. "We now have a high suspicion that he has aortic dissection. ”

"It's not that I haven't even done the inspection yet...... Li Jianguo's son looked very confused, "I haven't paid the money yet......"

"The evidence is clear, but we'll do another CTA to clarify the symptoms. "If it is determined that it is an aortic dissection, then surgery will be done immediately to replace his broken aorta with an artificial blood vessel." ”

"Do you have to have surgery?" Li Jianguo's son looked embarrassed, "This can't be treated with medication?"

"His vascular damage was a physical injury that progressed quickly, and it wasn't the type of infection that could be cured with antibiotics. "It's like a high-pressure plastic water pipe that has been pierced with a hot steel needle." The effect of drug therapy is to remove the needle. Under the action of high pressure, the hole will only get bigger and bigger, and there is no second way to go except to change the pipe. ”

Sun Lien's explanation was very straightforward, and Li Jianguo obviously understood. He asked cautiously, "Is this a good operation...... How much does it cost?"

"It's hard to say. Sun Lien sighed, "If the operation goes smoothly and the recovery is fast, you will have to prepare about 200,000 to 300,000 yuan." The cost of the operation is almost 150,000 yuan, and the subsequent treatment and care are almost the same. ”

For such a major surgery, the cost of the surgery itself is very expensive. Aortic replacement, like the atlantoaxial replacement and liver transplantation that Sun has seen before, is the most restrictive fourth-level surgery. The operation is difficult, high-risk, and requires a very high level of doctors. At present, the only person in the four hospitals who can perform aortic replacement surgery is Tong Chunlai, director of cardiac surgery.

Director Tong was not on duty tonight, and when he was preparing for the operation just now, the doctors in the cardiac surgery department were already calling people - he didn't sleep in the middle of the night, and Sun Lien was not the only doctor who came to the hospital to save him. Other third-line doctors often experience this as well.

"The operation is very difficult, and there is a possibility that the patient will die due to deterioration or other complications after being put on the operating table. Although a green channel was opened for Li Jianguo, Sun Lien still had the opportunity to communicate with his family before Tong Chunlai rushed to the hospital for surgery. "Your financial situation may be difficult, so I still have to remind you – the surgery is an opportunity for us to try to fight for his life. Aortic dissection is a very dangerous disease, and there are cases where people cannot get off the stage. Even the artificial blood vessel was replaced, but there were also people who did not lose it because of various complications. If you're going to continue treatment, be prepared for the possibility of losing both money and money. ”