Chapter five hundred and eighty third postoperative treatment consultation
"Let's go with these things for now."
Fang Le first observed the patient's condition, then asked the ICU doctor to temporarily remove some equipment that affected the diagnosis, and then carefully diagnosed the patient's pulse.
After some examinations, Fang Le wrote down the conditions of the two patients, and then he and Niu Baohua and others were discharged from the ICU.
"Professor Fang plans to use traditional Chinese medicine methods?"
As associate professor ICU led Fang Le and others out, he said: "As far as I know, traditional Chinese medicine does not have any very effective means of anti-rejection after liver transplantation."
"As far as I know, where does Director Xu come from?"
Fang Le said with a smile: "We have only performed two liver transplants in China so far. One is a living donor liver transplant. This is the first non-related liver transplant, right?"
Director Xu was stunned for a moment.
"Old Xu, Professor Fang is not only great in surgery, but also in Chinese medicine."
Niu Baohua smiled.
Niu Baohua actually knew what Director Xu was thinking.
In Shanghai Hospital, the ICU is also an independent department at present, and each major department does not yet have its own ICU ward.
An independent department means that the ICU department bears relatively large risks. Although other departments can also participate in the treatment appropriately, the ICU department must weigh the pros and cons.
The operation was performed under the guidance of Fang Le, who is now the top liver surgery expert in the country. The ICU must respect Fang Le's opinion after surgery, but Director Xu is not very happy to let Fang Le use traditional Chinese medicine.
means.
Fang Le said as he walked: "Postoperative complications for liver transplant patients include acute rejection, bile duct stenosis, lung infection and other conditions. There are many complications and the situation is complex..."
"There are still relatively few cases of liver transplantation in our country, and the participation of traditional Chinese medicine is almost zero, but this does not mean that traditional Chinese medicine has nothing to do."
"I myself have also learned about the postoperative conditions of some foreign liver transplant patients. As far as traditional Chinese medicine is concerned, the clinical pathogenesis characteristics of complications after liver transplantation are basically poisonous, heat, and wet. The cause of the disease is grasped.
The disease is caused by the combination of dampness, heat, poison and evil. The main pathogenesis is liver stagnation and blood stasis. Particular emphasis is placed on protecting the liver, promoting bile, and detoxifying..."
"TCM treatment varies from person to person. Specific measures are adopted for dialectical treatment according to the patient's specific situation."
Listening to what Fang Le said, Director Xu couldn't help but smile and asked: "Dr. Fang, I often hear people say that Chinese medicine varies from person to person, and treatment is based on dialectics. So how can Chinese medicine vary from person to person once we encounter a major epidemic?
?”
"TCM is a very flexible medicine."
Fang Le laughed twice and said: "Many people don't know enough about traditional Chinese medicine. Traditional Chinese medicine varies from person to person, and it is difficult to quantify in specific treatments. However, in actual treatment, although diseases vary from person to person, most diseases can be cured.
The causes are still similar, so there are many traditional Chinese medicine prescriptions and classic prescriptions..."
"Therefore, when encountering some common diseases, ready-made pills and powders only need to be mastered in dosage to temporarily control the spread of emergencies and large-scale diseases, and then doctors can focus on diagnosis and treatment. This is the uniqueness of traditional Chinese medicine."
"Like in the past, when large-scale epidemics occurred in history, TCM control basically consisted of powders or pills to control the dosage, which were generally taken. The doctor would carry out key treatments and diagnoses based on individual differences..."
"Treat the symptoms if it is urgent, and treat the root cause if it is slow. It varies from person to person. You should adapt to circumstances. How can you stick to formalities."
Chu Jianlin, Niu Baohua and others beside them all nodded their heads after hearing this.
They don’t know much about Chinese medicine, but after practicing medicine for so many years, they will inevitably encounter some scenes of disputes between Chinese and Western medicine.
Similar to the question that Director Xu asked just now, many people have it, and it varies from person to person. What should I do if a large-scale disease occurs? Can it be treated?
I am asking this question because I am a layman who does not understand the essence of traditional Chinese medicine.
Traditional Chinese medicine also classifies diseases. Some diseases have something in common. However, in specific treatments, patients have individual differences, and the dosage or certain drugs need to be adjusted.
Such individual differences, some are large and some are small, are always observed by doctors when powders are used on a large scale. Traditional Chinese medicine is used correctly under the guidance of traditional Chinese medicine doctors, not used casually.
While they were talking, several people had already left the ICU.
After coming out of the ICU, Fang Le and Niu Baohua went to a consultation room.
"From the perspective of symptoms, both patients had fever symptoms. Because the postoperative time was not long and other symptoms were not obvious yet, it was obvious that rejection reactions had occurred."
After sitting down in the consultation room, Niu Baohua was the first to speak: "Currently, the ICU is only conducting routine treatment based on international treatment experience after liver transplantation."
"It has been more than twelve hours since the operation. The patient is still awake and has a fever. Fortunately, there is no clear abnormal bile excretion or bleeding from the abdominal drainage tube."
Chu Jianlin also expressed his own views.
"Professor Fang is planning to use traditional Chinese medicine treatment."
Niu Baohua looked at Fang Le: "How about I ask someone to invite Director Qi to come over?"
"also."
Fang Le nodded.
In terms of postoperative treatment, Fang Le really plans to focus on traditional Chinese medicine treatment, and postoperative recovery treatment is also a relatively long-term process. After all, Fang Le is not a doctor in Shanghai Hospital. When the time comes, he will need someone to take over.
Indications.
Qi Yuanming's level is not low, you can invite him to discuss it.
Traditional Chinese medicine has certain advantages in postoperative recovery and treatment, and Fang Le has rich experience in this aspect.
Before his rebirth, Jiang Zhongyuan had accumulated very valuable experience in this area. Fang Le's father, Fang Han, was a master in the field of surgery. He was also proficient in Chinese medicine and had a very high level of Chinese medicine.
Whether it’s the liver, heart or brain, we have rich experience in all aspects.
At this time in 1995, Chinese medicine did not have much experience in post-liver transplant treatment, but Fang Le, as a reborn person, had participated in many treatments.
In about ten minutes, Qi Yuanming arrived at the consultation room.
"Congratulations to Dr. Fang, Director Niu and Director Chu."
After entering the door, Qi Yuanming first congratulated him.
The country's first split liver transplant operation is something that must be congratulated.
"It will be Professor Fang from now on."
Niu Baohua said with a smile.
Qi Yuanming was stunned and looked at Fang Le unexpectedly.
"Director Qi, don't listen to Director Niu's nonsense."
Fang Le smiled and a group of people waited for Qi Yuanming to sit down. Fang Le then handed Qi Yuanming the records he had just checked in the ward.
While watching, Qi Yuanming smiled and said happily to the other party: "This is my first time doing this after liver transplantation. Fang Le, you can tell me your opinion first."
After all, due to Qi Yuanshan's factors, Qi Yuanming also calls Fang Le more casually. Sometimes he is Dr. Fang more formally, and Fang Le is casually called him.
"I have simply said this just now."
Fang Ledao: "Complications after liver transplantation are often manifested in the form of fever, coma, abdominal pain, etc. Clinically, the pathogenesis is mainly characterized by poisonous weight, heat weight, and damp weight. As for the cause, we can start from the combination of dampness, heat, poison, and evil.
The main causes of disease are liver stagnation and blood stasis..."
"Judging from the postoperative performance of some previous liver transplant patients, some patients have a sudden onset, severe illness, rapid progression, many syndrome changes, and are often accompanied by symptoms of systemic failure, and the prognosis is often very poor."
As he spoke, Fang Le took out a small notebook: "I have also made a more detailed understanding and summary of some post-operative manifestations of previous liver transplant patients."
"Syndrome symptoms, from the perspective of traditional Chinese medicine, are nothing more than fire-heat evil poisons or epidemic poisons that injure qi, damage yin, and consume blood. Damp-heat epidemic poisons accumulate in the liver, often causing turbidity, blocking the clearing of the orifices, and causing jaundice;
Damp poisoning often causes lingering symptoms, and as time goes by, it often presents a sign of yin, cold, and stagnation."
Regarding the prognosis of liver transplantation, Fang Le has indeed made some preparations.
As the saying goes, a good memory is worse than a bad writing.
Experience is experience. To sum up the systematic understanding, on the one hand, we can have a flexible thinking in actual clinical practice. On the other hand, Fang Le really wants to promote traditional Chinese medicine to participate in the treatment of some serious and emergency diseases. These are also experiences.
.
Looking at the notebook that Fang Le took out, Qi Yuanming, Chu Jianlin and others couldn't help but sigh. It was really not a coincidence that Fang Le could reach such a level at such a young age. Fang Le had indeed considered many preparations very carefully.
Today is the second day after surgery, and Fang Le has made detailed plans for postoperative treatment.
Fang Le continued: "According to the analysis of some previous cases, complications after liver transplantation are caused by toxins, which are caused by the interaction between external epidemic toxins and endogenous damp toxins, blood stasis toxins, etc. The disease is sudden, critical, and the pathogenesis is
It’s very variable, so it’s difficult to treat.”
"As far as traditional Chinese medicine is concerned, the human body has a natural rejection of things that do not belong to the body. This is also the reason for rejection after transplantation. Traditional Chinese medicine has understood this aspect quite early."
"In clinical practice, no matter what kind of disease, including wind, cold, and dampness, accumulates and develops to the stage of detoxification, it will inevitably have heat symptoms. At the same time, fever is also a manifestation of the body's struggle against good and evil and its resistance to foreign substances."
"So complications after liver transplantation include fever that persists, jaundice of the scleral skin as if it were gold, urine like cypress juice, vomiting, bitter mouth, constipation, red tongue with yellow and greasy coating, slippery or stringy pulse, and more.
They are all caused by damp-heat epidemic poison; if the evil poison is strong, it will cause liver wind and convulsions; the evil poison will enter the blood and cause bleeding; the blood stasis and heat will form internal obstruction, and water bulges will be seen; the evil poison will disturb the pericardium and cause coma.
, delirium; the heat poison damages the lower burner, causing the kidneys and bladder to become incapable of gasification, leading to symptoms of renal failure such as oliguria and anuria."
“Dr. Fang’s summary and classification in this regard is quite comprehensive and accurate.”
Chu Jianlin said sincerely.
Niu Baohua, Tanabe Yuro and others also admired Fang Le. Although they did not understand traditional Chinese medicine, Fang Le analyzed the complications after liver transplantation from all aspects, and they could still get a rough idea.
Because of Fang Le, classmates Xingxing, who was also lucky enough to listen in, were already a little bit bright-eyed.
Sure enough, being handsome has no direct relationship with whether you have surgery or not.