He doesn't like to talk and is not very good at talking, but when he really has to say something, every word this person says must have weight.
Fang Xueqing raised her head and looked at the true light in Song Xuelin's brown eyes, and unconsciously nodded.
The medical records were opened, and several doctors gathered their heads to study them.
The family members of the patients outside can hardly wait. They must ask for an explanation today.
"It's a patient with massive gastrointestinal bleeding." Fang Xueqing pointed to the key points in the medical record to the two young doctors, "The patient arrived at our hospital's emergency room during the day three days ago. The main symptoms were hematemesis and heavy bleeding. Three-lumen, two-capsule tube.
The bleeding was stopped by compression, and after the blood transfusion, the condition became slightly stable. The emergency CT examination report showed bleeding from esophageal and gastric varices, liver cirrhosis, and portal hypertension."
"Since there are no beds in the surgical department, 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 then added about the patient's condition, "In our internal medicine department, Director Zhang performed endoscopic esophageal surgery on the patient the day before yesterday.
After treatment of gastric varicose veins, sclerotherapy and ligation were performed. Then last night, the patient suddenly became very irritable, and the reason was unclear. The vital signs were relatively stable, there was no further bleeding, and there was no loss of consciousness.
The pupillary reflex and other examinations were all normal. The family members were very nervous and always hoped to be transferred to a surgery department for further surgical treatment."
Listening to Dr. Ma's words, it seems that the irritability caused by brain-derived diseases such as acute cerebral hemorrhage and cerebral infarction can be ruled out first? There is no sign of major bleeding. Indeed, the patient's irritability at this moment is a bit strange.
.
Fang Xueqing tapped her fingers on the medical record, feeling that the patient's strange reaction was beyond her medical experience as a professor, and she was a little confused for a moment. Turning around, she asked Song Xuelin: "Doctor Song, what do you think? This patient
Can I be sent to a surgeon for further surgery?"
After endoscopic treatment has been performed to stop the emergency bleeding, if further radical treatment is required, the patient can undergo devascularization or shunting and be sent to the surgery for traditional surgery, or interventional surgery such as TIPS transjugular intrahepatic portocaval shunt can be performed.
Therefore, after the surgeon came for consultation, he said that elective radical surgery could be performed and asked the patient to wait. But now the patient has no indication for emergency surgery.
"Let Dr. Xie speak first," Song Xuelin said.
I have to let this female medical student tell me first, what is Song Xuelin thinking? Fang Xueqing didn't understand what he meant, so she had to look at Xie Wanying and ask: "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 reasonable. Yesterday, the patient's condition did not seem to be particularly urgent and he had to undergo surgery for esophageal and gastric varices." Xie Wanying said, "Yes, his bleeding was under control.
Lived. Not only that, his hemoglobin at the beginning was 97, which can only be considered mild anemia. I think the family members of the patients in the emergency room said that the patient vomited a lot of blood at home was an exaggeration. Because the patient was conscious when he arrived in the emergency room, and the amount of bleeding should be
It’s not very big. It doesn’t seem like the bleeding is too big after endoscopic treatment.”
"What do you mean?" Fang Xueqing and Doctor Ma heard that there was a deeper meaning buried under her words.
Xie Wanying looked serious and said: "I'm afraid that if the patient's condition continues to deteriorate, he will be transferred to surgery immediately, not to general surgery, but to cardiothoracic surgery."
