"Why are you still standing there? Go straight to the operating room." Dong Xin, the deputy chief physician of neurosurgery who came for consultation, looked at the high school student's CT scan and scratched out a piece of dandruff from his head. He tapped the image in his hand.
The film made a huge clattering sound. "It was an obvious left anterior communicating artery aneurysm, but fortunately it did not rupture. It was probably just spontaneous bleeding, and the amount of bleeding was not too large."
"Where is the surgical plan?" Zhou Jun asked with his arms crossed. "The family is on the way, but I guess they will have to wait for a while."
"Thanks to the aneurysm with a narrow neck." Dong Xin put the CTA photo on his face and looked at it again, "Perform intervention. Insert the catheter from the opening of the femoral artery. Extend it to the left anterior communicating artery and put a platinum spring coil.
Go in."
Zhou Jun looked at the high school student who was still in a coma, "Are you going to do it?"
"Cerebrovascular intervention is a third-level surgery. Now, the only one who can do it in the hospital besides me is Dean Liu." Dong Xin didn't mind Zhou Jun's straightforward inquiry. "I'll ask the director to do this surgery. I'm afraid of turning back."
He deducted my performance."
"How much does this surgery cost?" Zhou Jun looked at the clothes of high school students. High school students who need to ride electric bikes to school every day generally do not have very good family conditions. This kind of interventional surgery for brain aneurysms is the most expensive.
The remaining part is always the spring coil stent sold by the pharmaceutical company. The hospital can advance a considerable part of the drug costs and surgical fees, but it is impossible for the hospital to advance the medical equipment from the pharmaceutical company that is not covered by social insurance.
If the patient's home conditions are not very good and he cannot afford the cost of coils, even if the hospital wants to perform surgery at a loss, the pharmaceutical company will never agree.
"It must be at least 100,000 yuan." Dong Xin sighed, "The base is 100,000 yuan, and there is no upper limit. Without actual operation, there is no way to know how many brackets this child needs. If he can't raise 100,000 yuan... he is not even qualified to stand on the stage.
nothing."
"The price of the stent is too high." Zhou Jun frowned, "Can't traditional craniotomy work?"
"The operation takes a long time, is high risk, and the prognosis is not good." Dong Xin gave three reasons in succession, and then said helplessly, "It can be done even if it is not possible. The main reason is that for the patient, the prognosis is really not good." He looked at it.
The high school student lying unconscious on the bed shook his head and said, "How old are you? After the craniotomy, a piece of your head is missing. When you get older, you won't be able to find a girlfriend."
"Actually..." Sun Lien couldn't help but interjected, "Even if there is no shortage, finding a girlfriend is not an easy task..."
Dong Xin and Zhou Jun both turned around and stared at Sun Lien who interrupted for a long time. It wasn't until they started sweating from behind that they stared at each other, then looked at each other inscrutably.
"I heard that there is a head nurse named Hu in your department, right?" Dong Xin raised her voice slightly, specifically to let Sun Lien hear clearly. "Her niece works as an instrument nurse in the operating room. She is very beautiful.
.”
Zhou Jun continued with a distorted expression, "Yes, the little girl's name is Hu Jia. She is probably two years younger than Xiao Sun." He paused and emphasized, "The little girl's cooking was particularly delicious. Last year.
When I first joined the company, they even delivered stewed vegetables to us a few times, but they were all sold out in less than two minutes."
The two of them paused together, and then sighed in a very stiff tone, "What a good girl! It's a pity that she doesn't have a boyfriend yet."
You... Sun Lien felt like his face was beating wildly. How much benefit did you receive from Aunt Hu?
The door to the emergency room was pushed open, and Chen Wen, who came by helicopter to seek medical treatment, was sent back. Dr. Cao Yanhua was wearing a mask and had a slightly nervous expression on his face.
"Is the operation finished?" Zhou Jun walked over to help and directed the nurses to start connecting the monitoring equipment.
"The thrombus on the coronary artery has been removed." Cao Yanhua reported the situation to the superior doctor. "But the situation is a bit troublesome."
Zhou Junqi asked, "What's wrong?" He looked around, made sure there were no outsiders, and then lowered his voice and asked, "Is there any coronary artery damage?"
Cao Yanhua shook his head like a rattle, "No." He looked at Chen Wen who was sleeping on the hospital bed, shook his head and said, "She suddenly woke up during the operation."
Coronary artery interventional surgery does not require general anesthesia, and it is not a big problem for the patient to be awake during the operation. Sun Lien raised his ears and listened curiously to what was going on. Something must have happened during the operation to make Cao Yanhua send the little girl back.
In the emergency room, instead of the pediatric intensive care unit picu in the Fourth Central Hospital.
"She was furious, manic, and even tried to bite the nurse's hand." Cao Yanhua looked serious. "I gave her 10 ml of haloperidol to calm her down again. I was worried that she had a cerebral hemorrhage, so I gave her the treatment by the way.
cta."
"What's the result?" Zhou Jun also started to frown, "Is there a problem?"
"There is a problem, but it's not in the brain." Cao Yanhua pointed to Chen Wen's lower abdomen, "She has deep vein thrombosis in the lower limbs. It is about four centimeters long and has moved up to the renal vein."
Deep vein thrombosis of the lower limbs is another disease that is unlikely to occur in children of this age.
Zhou Jun pondered for a long time and asked Sun Lien, "What do you think of this patient?"
"She is too young, and high blood lipids will not cause coronary heart disease or deep vein thrombosis." Sun Lien tapped his notebook with a pen, "The mania that appeared during the operation may be a new symptom of an unknown disease..." He turned his head,
He looked at Chen Wen who was still in a calm state. "Chen Wen, female, 10 years old, hypercalcemia." However, there was new progress in the observation this time. The words "hypercalcemia" still flashed, and behind
Then there are five more words, "hypercoagulable state."
"Perhaps we should think about it from the perspective of blood." Sun Lien began to change the topic, "Although it is not hyperlipidemia, if she is in a hypercoagulable state, it may indeed cause her to have multiple thromboses. Some of the thromboses appeared in
In her coronary artery, it caused an ST-segment elevation myocardial infarction. Part of it appeared in the deep veins of her lower limbs, causing an extra emboli to appear on her blood vessel wall, and it fell off with the vibration of the helicopter.
, followed the blood and got stuck again at the location of the renal vein. As for the mental state..."
"Micro-thrombi appear in the brain and then flow into the amygdala." Dong Xin raised his eyebrows, "It sounds reasonable. Micro-thrombi in the amygdala may indeed cause uncontrollable rage, and CT scans in the combined operating room
The machine is not precise enough, so you can't see the traces of the micro-thrombus."
Cao Yanhua was opposed to this bold speculation. "There is no disease that can cause multiple systemic thrombosis in a ten-year-old child. She has not had liposuction surgery in a small clinic, and it is not likely to be a fat embolus."
"No matter what, the thrombus in her inferior vena cava will never go away on its own." Zhou Jun made a decision, "Give her anticoagulant treatment with low-molecular-weight heparin and warfarin, at least to ensure that the venous thrombus will not disappear.
Killed her."
"I'll ask Professor Li and Director Qian for another consultation to make sure there are no problems with the medication." Cao Yanhua nodded, turned and left the emergency room.