BXBX NOVEL Chapter 1115: 【1115】How to see from a surgical perspective
Fang Xueqing raised her head to look at the real light in Song Xuelin's brown eyes, and nodded unconsciously.
The medical record was opened, and several doctors were studying it with their heads together.
The patient's family members outside can hardly wait, and today they have to ask for an explanation.
"It's a patient with massive gastrointestinal hemorrhage." Fang Xueqing pointed to the key points on the medical record to the two young doctors, "Three days ago, he arrived at the emergency department of our hospital during the day. The main symptom was hematemesis and the amount of bleeding was large. Three-lumen two-capsule tube Compression was used to stop the bleeding, and after blood transfusion, the condition was slightly stable. The emergency CT examination report came out, esophagogastric varices bleeding, liver cirrhosis, and portal hypertension were indispensable.”
"Because there are no beds in surgery, the patient's condition has stabilized. With the consent of the patient's family, he was first transferred to our internal medicine department for treatment." Dr. Ma followed up with the patient's situation, "In our internal medicine department, Director Zhang helped the patient with endoscopic esophagus the day before yesterday. Gastric varicose veins were treated with sclerotherapy, and ligation was performed. Then last night, the patient suddenly became very irritable, and the cause was unknown. The vital signs were relatively stable, and there was no rebleeding and no loss of consciousness. The pupillary reflex and other tests are all normal. The family members are very nervous and have always hoped to be transferred to surgery for reoperation.”
Listening to what Dr. Ma said, it seems that the irritability caused by brain-derived diseases such as acute cerebral hemorrhage and cerebral infarction can be ruled out first? There was no further sign of hemorrhage. It is true that the patient's condition is irritable at the moment, which makes people feel a little strange.
Fang Xueqing tapped her fingers on the medical record, feeling that the patient's strange reaction was out of her professor's medical experience, and she couldn't figure it out for a while. Turning her head, she asked Song Xuelin, "Dr. Song, what do you think? Can this patient be sent to surgery for another operation?"
Endoscopic treatment is completed after emergency hemostasis. If further radical cure is required, it can be done by devascularization or shunt, sent to surgery for traditional surgery, or by interventional surgery such as TIPS transjugular intrahepatic portocaval shunt.
Therefore, after the surgery came for consultation, he said that an elective radical operation could be done, and the patient was asked to wait. Who made the patient now have no indication for emergency surgery.
"Let Dr. Xie speak first." Song Xuelin said.
The female medical student must first say, what is this Song Xuelin thinking? Fang Xueqing was puzzled, so she looked at Xie Wanying and asked, "You want to be a surgeon. How do you think this case should be viewed from a surgical perspective?"
"I personally think that the consultation report given by the surgery department yesterday is justified. The patient's condition seems to be in no particular urgency and must undergo surgery for this esophagus and gastric varices." Xie Wanying said, "Yes, his bleeding is controlled. Not only that, his initial hemoglobin was 97, which was only considered mild anemia. I guess it was an exaggeration for the family members of the patients in the emergency department to say that the patient vomited a lot of blood at home. Because the patient was conscious when he arrived at the emergency department, the amount of bleeding should be Not very big. Endoscopic treatment doesn't seem to be too much bleeding."
"What do you mean?" Fang Xueqing and Doctor Ma could hear a deeper meaning buried under her words.
Xie Wanying said with a serious expression: "I am afraid that if the patient's situation is no longer good, he will immediately be transferred to surgery, not general surgery, but cardiothoracic surgery."
(end of this chapter)