Sun Lien felt that everything in front of him was crumpled into a ball. All kinds of colorful colors and shapes were twisted together and gathered into a blur in front of him. After about two seconds, the blur began to disappear, starting from the center of the field of vision.
It quickly disappeared in all directions. The scene that reappeared in front of Sun Lien was almost the same as before, but it seemed that the colors were richer.
"Are you okay?" Yuan Pingan, who was standing behind Sun Lien, noticed in time that something was wrong with Sun Lien's state. "Are you not feeling well?"
"It's okay, it's okay." Sun Lien shook his head and found an excuse to fool him. "I didn't stand firm just now." After he used very insincere prevarication to fool Yuan Pingan's concern, he looked at the lying person again.
Xia Hongyuan in bed.
"Xia Hongyuan, male, 26 years old, suffered from left common iliac vein thrombosis (78.27.33), left lower limb vein thrombosis (73.44.18), left pretibial blood blister (71.36.12), small intestinal ischemic necrosis (51.08.25)
Stroke (05.34.55)." The status bar was different, with a bracket after each symptom. Upgraded? This was Sun Lien's first reaction. Then, he fell into serious confusion.
What the fuck are these numbers?
Sun Lien was confused for five seconds.
Now is not the time to be in a daze! He brought his attention back to the symptoms in front of him. Didn't he still see the doctor before there were no numbers? Now that the status bar is still there, there is nothing to worry about.
"Should we contact the imaging department?" Yuan Pingan saw that Sun Lien seemed to be fine, so he began to put forward his own suggestions. "Let them prepare and do a head CT first?"
"Contact me and make arrangements as soon as possible." Sun Lien has already seen cases of venous thrombosis in Chen Wen. He frowned, and while talking to Yuan Pingan, he put on a mask, gloves and goggles, and then opened the
The quilt covering Xia Hongyuan's legs was completely naked when he was admitted to the hospital, which saved Sun Lien from having to use scissors to cut his trousers.
The blood blister on Xia Hongyuan's right tibia was displayed in front of Sun Lien and Yuan Pingan. After identifying it for a while, the two looked at each other, "This does not seem to be caused by trauma." Yuan Pingan said, "Thrombocytopenic purpura?
"
"There is no large-scale blood stasis. It may be vasculitis or tumor." Sun Lien frowned and replied, "Do a blood routine and check the tumor markers." He paused and pretended to have just remembered.
, "We can't rule out blood problems, let's check the coagulation time again." Sun Lien touched Xia Hongyuan's left foot and found that the pulse of the artery was a little weak.
Venous thrombosis, the most likely cause of this state is hypercoagulability. In addition, stroke is also likely to be caused by thrombus, so this examination is very important. "The pulse of the dorsalis pedis artery weakens, do a color ultrasound to see the blood flow
Condition."
Yuan Pingan went to arrange the examination, while Sun Lien walked to the small conference room. This small conference room had almost become a dedicated office space for the treatment team. Xu Yourong and Yuan Pingan both brought their laptops from home.
Although it is not possible to directly connect the laptop to the hospital intranet to issue prescriptions, it can at least be used to check information. It is still much more convenient than before.
"I thought you would be reluctant to leave." Xu Yourong raised his eyebrows at Sun Lien, "Rachel said that Hu Jia's gaming skills are very good, and she has finally found her opponent."
Sun Lien recalled Rachel's cheating method of unplugging the power supply. It was hard to believe that the two sides could be considered "matched opponents." But as people say, face must always be given. "I don't understand the game they played, so I studied it."
I didn’t know who was beating whom for a long time..."
"It doesn't matter if you can't figure it out. Just figure out what's wrong with this patient." Xu Yourong replied, "How about it? You've also met the patient and his family. Do you have any clues?"
"The patient has blood blisters. According to the description of the family members, the blood blisters have appeared for more than three days. And there seem to be gastrointestinal symptoms this morning." Sun Lien frowned and replied. He was a little worried that other routine examinations might delay the patient's brain.
The speed of checking the results of stroke. After saying that, he went out for a special trip, grabbed Yuan Pingan and said, "After the blood is drawn, send it to the imaging department immediately for a head CT, an abdominal CT... let's do the lower body.
By the way, take a look at the condition of your pelvis and legs."
After arranging the examination content, Sun Lien hurried back to the small conference room and began to read the patient's records before and after admission.
"This hyperalgesia is a bit strange." Sun Lien said to Xu Yourong after reading the content several times, "If it hurts to wear clothes all over his body, then why can he still stand on the plastic board? He also has nerves in his feet, right? It's physical.
With all the weight on his feet, wouldn’t his feet hurt? Will the pain sensitivity only be concentrated in other parts of the body?”
Xu Yourong pondered for a moment and replied, "I think... the key may not be contact."
There are many types of pain sensitivity, and most patients will experience attacks due to different types of feelings. Some people can't tolerate touch pressure, some people can't stand the touch of a brush, and some people feel pain due to heat or cold.
No end. And these differences in tolerance also remind doctors that patients suffer from different diseases.
"You mean...temperature?" Sun Lien immediately followed Xu Yourong's judgment, "The reason why he took off all his clothes was because the temperature made him hyperalgetic?"
"It's possible." Xu Yourong replied, "Hyperalgesia usually resolves on its own and rarely lasts. And when he woke up in the hospital, he was still in pain. In order to help him recover from hypothermia, it was actually
It's heated."
"So, at first I thought it might be burning mouth syndrome or erythromelalgia." Yuan Pingan also walked in and joined the conversation between the two without any scruples. "But the problem is, he feels pain.
, rather than burning. Therefore, burning mouth syndrome is ruled out. Moreover, his limbs did not have paroxysmal redness, swelling, heat and pain, and he took off all his clothes, indicating that the pain did not come from the extremities, but was systemic. The color ultrasound results suggested venous thrombosis.
, the blood flow in the left common iliac area is not very clear, but the flow rate is also slow."
"I still think we should contact the pain department." Xu Yourong ignored Yuan Pingan and said seriously to Sun Lien, "The pain department should have more contact with this kind of patients than the emergency department. At least they can give some opinions."
"Let's just call Shenai and the dermatology department for consultation." Yuan Ping'an sat behind the desk and sighed, "Professor Liu is not in the hospital, he is rushing here from the college."
Sun Lien thought about it for a while, but did not dare to take anticoagulation treatment casually. Stroke is divided into two types: hemorrhagic and ischemic. If it is ischemic, anticoagulant and thrombolytic treatment is the right way, but in case of hemorrhage, anticoagulant treatment
It will directly kill Xia Hongyuan. "Don't rush into anticoagulation first. Wait for the coagulation and imaging test results to come out. As for the consultation, wait for the results to come out before calling us. Although it is a major emergency department, we cannot use other departments as auxiliary departments."
.It’s not appropriate to call it a consultation without even a bit of information for diagnosis.”
"Total aortic CTA?" The imaging department prepared as quickly as possible, but when Xia Hongyuan arrived, Sun Lien made a request for more examinations. This made the doctor in the imaging department a little embarrassed. "There is no prescription."
open ah."
"I'll have someone do it now. You guys go ahead and do it first." Sun Lien was also a little helpless. Who would have thought that the imaging department could prepare so quickly. He didn't even have time to ask Yuan Pingan to add more examination items. "This patient's situation is quite special.
Thank you."
The doctor in the imaging department scratched his head, but didn't say anything else. It's just that the developer needs to be prepared, and it also has to wait for the developer to be injected into the patient's body before it can take effect. "I'll have people prepare it now, but the CTA will have to be done later.
.”
Sun Lien nodded, handed over to Xu Yourong who had come with him, and hurried to the laboratory department to collect the results. Since he had nothing else to do, it would be good to harass Shi Yanquan to relieve the pressure.
"Brother, don't rush me." Shi Yan showed his troublesome expression as expected. "The blood test is very fast. What's the use of urging me on the coagulation time? There is no need to compare the samples?!"
"I'm trying to save people, please be smart!" Sun Lien knew that the person doing the coagulation time experiment was not Shi Yan, so he felt no pressure to rush him. There was no need to worry about him making mistakes while he was busy. "You've been doing this for so long, why are you still so clumsy?
What about?”
Shi Yan cursed a few times, and then threw the blood test results in Sun Lien's face. "If you want to be fine, read the report first, and don't come here to rush me!" After saying that, he turned around and entered the laboratory.
The blood routine results were not a big problem. The platelet count that Sun Lien was most worried about was still within the normal range. The white blood cell index was also normal, and there seemed to be no signs of infection.
It didn't look like an infection, and the platelet count was normal. Sun Lien rubbed his chin, and the prompt on the status bar was actually very straightforward. Xia Hongyuan's abdominal pain should be the result of small intestinal necrosis, which may indicate that his stroke was ischemic, or
It is the so-called cerebral infarction, which can also be consistent with left common iliac vein thrombosis and left lower limb venous thrombosis. And if cerebral infarction is confirmed, pain sensitivity can also be explained. Brain damage can indeed lead to pain sensitivity.
But the problem is, when the number of platelets is normal, where do so many blood clots come from? The status bar alone shows two venous blood clots in the lower limbs, and cerebral infarction shows that there is at least one small blood clot in the cerebral blood vessel. But the blood circulation route of the veins in the lower limbs
It is determined that deep vein thrombosis must first enter the heart and then be pumped to the lungs for gas exchange. If there is a blood clot, Xia Hongyuan should have pulmonary infarction first.
How do these blood clots skip the lungs and go directly to the brain?
Sun Lien rubbed his head and put this problem aside for now. He still had more important problems to solve. What do the numbers following the status mean?