The first possibility that Sun Lien could think of was the coordinate system. Three points seemed to be able to constitute the xyz three-axis coordinate system. And these coordinate systems may directly point to the areas and organizations involved in the state. But this conjecture was quickly
He was rejected by himself. The first set of numbers for common iliac vein thrombosis is 78, while venous thrombosis in the left lower limb is 73, and stroke is 05. If the numbers are coordinate systems, then the head and legs should not appear.
It is not logical that the coordinates of the two locations are lower than the common iliac vein under the lower abdomen.
Could it be something else? It matched the three sets of numbers... Sun Lien sat on the stool and started scratching his head. All of them had only numbers and no letters. This was not the ICD10/11 disease code. The most important thing was that Sun Lien didn't think these numbers were possible.
What needs additional interpretation? The status prompts in the password status bar are all clues directly related to the patient's current disease. Since they are clues, there is no point in adding a password system.
"The results you want." Sun Lien was scratching his head, but Shi Yan walked out of the laboratory and threw another test report in Sun Lien's face. "The coagulation function is normal."
"Normal?" Sun Lien was stunned when he heard the result, "How is it possible?"
"What's impossible?" Shi Yan was very confident in the results he had produced, "This is the result of the experiment. We are responsible for every sample!"
"The result is here." Sun Lien was looking at the coagulation time result in a daze, and the roasted gluten in his pocket began to sing again. On the other end of the phone, Xu Yourong said calmly, "Multiple blood clots."
"There's no blood clots, right..." Sun Lien had not yet gotten over the test result that the coagulation time was normal, and Xu Yourong's tone was so calm that he completely misheard the content.
"There are multiple blood clots." Xu Yourong emphasized again, "Is there anything wrong with your ears?"
Sun Lien immediately became energetic, "Besides deep vein thrombosis, where else can there be thrombosis?"
"There is an ischemic focus in the small intestine under CT scan, and there may be ischemic necrosis. But the specific situation may not be known until the abdomen is opened." Xu Yourong replied, "There seems to be an ischemic focus in the brain, located in the thalamus. But the whole body
No hardened plaque was found in Tongmai cat."
If there is no hardened plaque, it is not a cerebral artery embolism caused by arteriosclerosis. But the coagulation time is normal, and it should not be a thrombus. Especially in the absence of pulmonary embolism, the thrombus cannot skip the lungs and directly enter Xia Hongyuan's brain.
Go inside.
"I know." Sun Lien rubbed his face in pain, "Take the patient back to the emergency room first, and I'll call for a consultation."
There was a strong feeling of powerlessness lingering in Sun Lien's heart. He originally thought that after he had the status bar, he would be able to move forward from now on, and all kinds of strange diseases would be at his fingertips. But now he realizes that he was a little too wrong. Even though he has done so much
After checking, he still had no clue. He didn't even know what kind of disease Xia Hongyuan had. Was it an autoimmune disease or was it caused by infection? Sun Lien had no idea at all.
Having no idea means that when he calls experts from other departments for consultation, he needs to ask more doctors from more departments to try his luck. Instead of having a rough suspicion interval and then calling in corresponding doctors as before, he has no idea.
Experts in the department.
Doctors from the Department of Hematology, Interventional Surgery and General Surgery came to the emergency room.
"My suggestion is to continue to stay in the hospital for observation." The doctor from the Department of Hematology first expressed his opinion, "Coagulation dysfunction may fluctuate. One test is normal, but the patient has obvious hypercoagulation, so he definitely needs to stay in the hospital.
Observational.”
"This stroke case is not a large vessel embolism, and mechanical thrombectomy is basically impossible." The doctor in the interventional department said, "Intravenous thrombolysis can be considered, and mechanical thrombectomy can be used to treat deep vein thrombosis."
Thrombus, judging from the CTA results, the patient's deep vein thrombosis is not too large and there is no free thrombus."
The general surgeon's attitude is more frustrating, "The patient's deep vein thrombosis is too close to the renal vein. There is no problem with the filter placement surgery, but the effect is not necessarily good, and it is difficult to guarantee that no thrombus will fall off during the surgery. Since
The interventional department recommends thrombolysis, so it is better to simply undergo conservative treatment, with anticoagulation and thrombolysis as the main method."
The doctors from the three departments all put forward their own opinions on the patient's condition, but there was no diagnostic content that Sun Lien wanted to know most. What disease did Xia Hongyuan have?
"Let's prepare according to the thrombolytic treatment. How long will it take for the interventional department's operating room to be ready?" Facing the doctors from these three departments, Sun Li'en thought about it for a long time and decided to treat the symptoms first. At least Xia Hongyuan's cerebral infarction should be relieved first, and through
Mechanical thrombectomy was performed to treat his deep vein thrombosis.
"Take the green channel and it will be done within ten minutes." The doctors in the interventional department attach great importance to Xia Hongyuan's condition. When the patient's coagulation function is normal, they are indeed the best department to deal with deep vein thrombosis and cerebral infarction. "
I'll let the operating room prepare it now."
"I'm going to ask the family members for signatures." Yuan Ping'an consciously assumed the responsibility of a junior doctor. He didn't even need Sun Lien to take the initiative to ask for anything. He took the treatment consent form to Xia Hongyuan's parents to sign it.
The doctors from the Department of Hematology and General Surgery left immediately, and only Sun Lien and Xu Yourong were left in the small conference room. Xu Yourong was sitting in his seat, looking at the information, and suddenly asked Sun Lien, "You haven't figured out what his illness is.
What disease?"
Sun Lien smiled bitterly and nodded, "What I can't understand the most is what kind of magic was cast on his blood clot, so that it could start from the deep veins, bypass the pulmonary circulation system, and go directly into his brain." Sun Lien really didn't understand.
, he doesn’t even intend to continue to wonder how people with normal coagulation function develop deep vein thrombosis.
"What I can't figure out is different from yours." Xu Yourong closed the laptop in front of him and frowned, "A physical education teacher who has to run around every day is not like DVT (deep vein thrombosis).
He is not an otaku who sits in front of the computer and plays games all day long."
"The three major factors of DVT are slow blood flow, vein wall damage, and hypercoagulability." Xu Yourong continued, "A national first-level athlete has very normal cardiopulmonary function. And his daily work requires regular exercise, so it is unlikely to be
The blood flow is slow. Vein wall damage has been ruled out by CTA, and the hypercoagulability makes it even more unreasonable that his coagulation time is normal."
"If there are only three reasons that may cause this situation, and all three reasons are ruled out, it means that either there is a cause of DVT that has never been discovered by us, or that some of these three states occurred after causing the patient's DVT.
Changes." Sun Lien frowned and continued following Xu Yourong's train of thought, "The probability of new causes of disease is too small to be considered for now. The damage to the vein wall will not heal on its own so quickly, and the slow blood flow and his daily life
Work and life are incompatible, so he must have experienced a hypercoagulable state?"
Having said this, Sun Lien suddenly had an idea. If Xia Hongyuan had been in a hypercoagulable state for a long time, it would be normal for him to have blood clots in his brain. Thrombosis is not limited to the deep veins of the lower limbs. In a hypercoagulable state, other blood vessels can produce blood clots.
And it may fall off, or even thrombosis may form directly in his cerebral blood vessels!
Xia Hongyuan's cerebral thrombosis was not caused by the detachment of deep vein thrombosis, but by systemic hypercoagulability!
Compared with traditional surgeries, the biggest feature of the surgeries performed by the interventional department is that they are less invasive and faster. To be honest, before the birth of the interventional department, craniotomy was performed to remove blood clots and DVT treatment was performed on the legs at the same time.
It is simply impossible. The interventional department only needs to insert an implanted sheath into the patient's left femoral vein and right femoral artery to perform two operations at the same time, and the trauma left is only slightly larger than the two.
The pinhole. It must be said that the difference in the performance of scientific and technological progress in medicine is indeed very obvious.
An hour later, Xia Hongyuan's interventional treatment was completed. The thrombolysis effect in the brain was obvious, and two venous thrombi in the lower limbs were also removed. However, the follow-up work was not over yet, and the removed thrombi were directly sent to the pathology department for pathological testing.
Sun Lien hopes that the pathology department can clarify the nature of the emboli, which will make subsequent diagnosis easier.
And Sun Lien found his strongest helper.
"Well...such a complex and changeable condition, such a troublesome situation, does feel like an autoimmune disease." Dr. Pascal made a not-so-funny joke. "Cat, are you sure there is no thickening of the blood vessel wall?"
"
Sun Lien nodded, "I used this result to rule out coagulation caused by vasculitis, but I really can't think of any other disease that can cause such multiple thromboses when the coagulation function is normal."
"We haven't been able to confirm that this is a blood clot." Dr. Pascal corrected Sun Lien, "Until the pathology department's examination results come out, we can only think that blood clots are the most likely."
After correcting Sun Lien's statement, Dr. Pascal frowned and said, "Let's do an autoimmune disease test and check his antibody status first."
"I have just asked the operating room to take samples, blood samples taken before thrombolytic treatment." Sun Lien replied, "Including the latest blood routine and coagulation status, the results should be out soon."
"I bet you." Dr. Pascal said with a smile, "This blood sample must be in a hypercoagulable state."
Sun Lien was shocked when he heard this. He couldn't figure out why Dr. Pascal was so confident.
"You forgot a very important reason that affects coagulation function." Dr. Pascal smiled. He was actually a little disappointed. After all, in the previous cases, Sun Lien noticed this difference in time and made the correct diagnosis.
.But this time he seemed not to be aware of the existence of this variable at all.
"Body temperature. Don't forget, when he was admitted to the hospital, his body temperature was only 33 degrees." Dr. Pascal shook his head. "Low temperature will reduce the number of platelets and reduce the coagulation function. You took samples to check the coagulation function soon after he was admitted to the hospital.
, the result is normal. In other words, when his body temperature is normal, he should be in a hypercoagulable state."