Chapter 2182 Who is Liu Muqiao
The Neurology Department of Xiangya Hospital is very powerful and has always been very powerful. It is the chief editor of the 8-year "Neurology" textbook.
The ambulance entered the hospital gate and was immediately sent to the CT room for scanning.
At this time, Liu Miqiao was already looking at the computer in the neurological operating room.
The computer and the CT room are connected to the Internet, so you can watch the film directly on the computer. This is more comprehensive and you can see more things.
Wu Anhua has already gone to the CT room, and he is with the 120 transport personnel.
Professor Liu Hai stood behind Liu Miqiao and underestimated: "The amount of bleeding exceeds 100, it breaks into the ventricle, the midline deviates, there is supratentorial hernia, dangerous!"
Liu Hai is the leader in the stroke field in Hunan Province. His real name is Liu Yunhai. He is currently the chairman of the Stroke Association of Hunan Province. He is an absolute boss and is also the deputy chairman nationwide.
In the past, the Department of Neurology of Xiangya Hospital was so far away that the Department of Neurology of Antai Hospital was nowhere to be seen.
Who would have thought that things would turn around, and now Liu Miqiao is sitting there watching a movie, while Liu Hai is standing behind him watching.
"I'm afraid I need a craniotomy to decompress." Liu Hai estimated the condition.
This patient suffered a lot of bleeding, and the first priority now is to relieve the supratentorial hernia, otherwise he may die at any time.
Liu Muqiao heard this and said, "Don't open the cranium. Quickly puncture and extract the hematoma. It's still too late."
The treatments of Liu Miqiao and Liu Hai are completely different. Liu Miqiao mostly advocates craniotomy and decompression for severe patients, because it is difficult to achieve adequate puncture and decompression, and the return of brain tissue is a problem, and many patients become vegetative.
For bangs, use whatever method is beneficial, and saving lives comes first.
This is a different consideration.
Liu Hai and others have not yet fully accepted the experience Liu Miqiao summarized. This is not a matter of concept, but the difference in the effect of the puncture itself.
"Considering the identity of the patient, it is better to be as conservative as possible." Liu Hai said to Liu Miqiao.
This makes sense. This consideration takes into account the identity of the patient, and saving life is the first priority. On the premise of saving life, consider the effect.
"No, no, it's better to take a gamble to become a vegetable." Wu Anhua came in, and he noticed their different opinions. He supported Liu Miqiao.
Liu Muqiao saw Wu Anhua coming and knew that the patient would be arriving soon.
"Old Wu, I will just perform the puncture. You are responsible for the conversation. I will only take care of the technical aspect." Liu Maqiao took out the black metal box he carried with him and cleaned the outside with alcohol.
He didn't discuss which technique with Liu Hai at all.
The patient came in.
Yes, the patient has had his hair trimmed in the ambulance and his skin has been prepared.
Liu Hai's student asked, "Decompression or puncture?"
Although this sentence itself is not rigorous, what he means is craniotomy or puncture. For craniotomy, you need to ask a neurosurgeon to perform the operation, and puncture or bangs will do.
In many hospitals, hematoma puncture is performed in the neurosurgery department. In medicine, the general classification is the same, and puncture is classified in the neurosurgery department.
However, some powerful neurology departments and punctures were brought over by them.
This does not violate relevant laws.
According to the Physician Act, neurologists are within the scope of practice of internal medicine, and neurosurgery is within the scope of practice of surgery. As for puncture, you are right to say it is surgery, and it is not a big problem to say it is internal medicine.
Someone once filed a similar lawsuit, accusing a neurologist of exceeding the scope of practice and performing a cerebral hematoma puncture. In the end, the lawsuit was lost.
There is a very simple analogy that can illustrate the fact. Which department does thoracentesis, lumbar puncture, abdominal puncture, pelvic puncture, and bone marrow puncture belong to?
There is no specific classification! They are the same as venipuncture by nurses.
Therefore, it is not necessary to worry about whether hematoma puncture belongs to neurology or neurosurgery.
"Hematoma puncture." Liu Hai did not hesitate anymore. He was originally the first person in charge, but he chose to listen to Liu Miqiao.
"Please ask Professor Liu Muqiao to demonstrate in person."
Liu Hai's words are actually a kind of procedural authorization. Because Liu Miqiao's professional location is at Antai Hospital, not Xiangya. If Liu Hai authorizes it, then his practice is legal.
No anesthesia is required.
The patient is already in a deep coma and has no response to pain.
Liu Miqiao made a mark on his scalp, "Drill holes here."
Liu Hai's doctor quickly drilled a small hole with an electric drill, and Liu Miqiao began to puncture.
The puncture needle was very accurately sent to the bottom of the hematoma and blood was drawn.
Have cerebral hernia.
When decompressing, pay attention to the movement of the tentorium. It is best to reset the brain tissue in one go.
There was nothing special. Like many things he had done before, Liu Miqiao drew out the congestion and finally reinjected some common Western medicine ingredients.
Epinephrine, glucocorticoids, sodium aescin and Xingnaojing.
This is an empirical prescription, and there are not many controlled experiments. Liu Muqiao feels that it is effective. Although it is not rigorous, clinical experience itself is not rigorous.
Experience is experience. Experience is different from theory. Theory must be rigorously demonstrated.
Therefore, Liu Hai will never ask Liu Miqiao, what is the basis for your formula?
"I guess the brain tissue has returned to its original position." Liu Miqiao took out the needle and applied a patch to give Liu Hai and the others a job.
Liu Hai was still worried and asked the student to send the patient back to the CT room for another CT scan.
The CT room produced the results very quickly, and most of the congestion was removed. If not for the previous examination, it would have been difficult to notice intracranial bleeding.
Liu Hai couldn't help but admire Liu Miqiao. The bleeding from the puncture was as clean as sweeping the floor.
Liu Hai himself has done hundreds of punctures and blood draws for cerebral hemorrhage, and it can be said that the results have never been so clean.
This is the difference.
Liu Hai's own level is considered top-notch in the country, and he can be said to be a super boss in the field of stroke.
He never thought that someone could make the intracranial puncture, drainage and irrigation procedure so clean.
Not only was the hematoma washed away, but the midline returned very well with almost no deviation.
There is no need to doubt that the patient will wake up soon. He only needs to give mannitol a few times to dehydrate and the patient's consciousness will be restored.
This prediction was quickly fulfilled, and the patient went directly from a deep coma to a drowsy state, and after a while, he opened his eyes.
At first glance, what he saw was Wu Anhua.
"Dean Wu, thank you!" Lao Zhang said.
"You are so lucky. Liu Maqiao happened to be here. He personally made the hematoma puncture book for you. The blood in your head was completely drained. No trace was left, and there will be no sequelae." Wu Anhua comforted her.
Him.
"Liu Muqiao? Who is Liu Muqiao?" Of course Lao Zhang doesn't know Liu Muqiao.
"He is Director Liu Muqiao of Antai Hospital, a subordinate hospital. He is a global leader in stroke treatment. We in Xiangya used to be good at treating stroke, but now we are lagging behind. Antai Hospital is number one in the country and the world."<
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This chapter has been completed!