Director Xiao: "Those who are engaged in clinical practice should always remember one sentence: indicators are just indicators and can assist in diagnosis, but they must not be regarded as the only basis.

Although there are no typical acute pancreatitis on the patient's film, the clinical manifestations are fully consistent, and there is actually slight exudation and edema.

The occurrence of the disease is progressive, and it is impossible to immediately increase serum amylase and lipase.

The book will teach you that when pancreatitis occurs, both enzymes will rise.

However, it is necessary to consider clinically that the patient is a living person and the disease is also in the process of development. It usually takes two or three hours for the patient to detect an increase in amylase, but it takes more than an hour for the patient to have an onset of the disease, to visit a doctor and undergo a examination. The amylase index naturally does not change much.

As for lipase, it is even slower, and there will be signs of an increase one day after the onset of the disease.

If you are really interested in these indicators, you will know clearly now if you draw blood again."

The primary attendant of the gastroenterology department nodded quickly.

The gap between excellent doctors and mediocre doctors is reflected in the details bit by bit. The former is to deeply analyze the mechanisms and mechanisms behind each disease, while the mediocre ones are more like cramming diagnosis, limiting the disease to rules and regulations.

For example, if amylase and lipase increase are pancreatitis, otherwise it is not.

This is the standard answer in the exam, but the reality is much more complicated. Elevations may also be cholecystitis, intestinal obstruction, gastric ulcer, etc. Reduction may also have acute pancreatitis, but there is not a time window for detection.

"Doctor Xu has anything else to add?" Director Xiao asked in a happy mood.

He finished everything he could say and saw how Xu Qiu taught them!

"I made a doctor's order before and fasted." Xu Qiu said.

Director Xiao said in a nutshell: "This is not very normal. The pancreas is a digestive organ. If you still eat at this moment, the pancreas will continue to secrete digestive enzymes, etc., and the inflammation will progress rapidly."

Xu Qiu threw out a new test report, which showed a blood oxygen saturation of 94.

Director Xiao's originally confident smile suddenly solidified, and the other digestive doctors present were stunned.

Ninety-four?!

The blood oxygen that I urgently checked before handing over early shifts was obviously ninety-nine, how could it drop so quickly in just one hour!

Why do patients suddenly feel hypoxia?

"What's going on!" Director Xiao's pupils trembled, and he suddenly realized that he had thought the patient too simply and had ignored a lot of things.

He quickly called out the patient's film.

"This manifestation is very similar to the onset of acute severe pancreatitis, and ARDS may occur, but... the patient's lungs do not seep out!"

ARDS, also known as acute respiratory distress syndrome, rapidly occurs in a short period of time, and generally occurs after various pathogenic factors such as severe infection, trauma, shock, etc. Among them, acute severe pancreatitis is one of the main causes...

The mortality rate of acute severe pancreatitis is very high, reaching about half.

ARDS itself also has a high mortality rate, between about 20% and 40%.

If it is acute severe pancreatitis and causes ARDS, it is a three-part relationship with NiuTouMamong Taoyuan, and no one can get it back.

"It's my life." Director Xiao felt a terrified heart.

Can't find it. I suddenly felt hypoxia after pancreatitis. What else can it be if it didn't cause ARDS, but the patient's lungs did not seep out at all!

Even the slight ooze of the pancreas is not edema, but it is completely normal, without any suspicious ground glass or infiltration shadows.

In other words, the female patient's lungs are even a bit too healthy. Most people can detect several lung nodules, but her lungs are beautiful and beautiful. It is not a problem for healthy people to be included in the textbook.

"Director, is there a possibility that the patient's lungs are actually fine?" Xiaoshu, who had previously supported the audience, made a bold guess.

Director Xiao waved his hand in disgust: "Pancreatitis is hypoxia, and the most likely thing is that ARDS is merged. If you don't understand, don't..."

Xu Qiu felt that if Director Xiao didn't say anything, there would be no place to put his face. He interrupted the other party and said, "The patient's lungs are indeed not infected, and the problem should appear elsewhere."

Director Xiao's body shook, and he turned his head and patted Xiao Zhiting on the shoulder, "Yes, it seems that the strict requirements for you have achieved certain results."

"Doctor Xu, the mask has already taken oxygen, but the patient's blood oxygen is still dropping."

At this moment, Yunmei, who came from the ward, hurriedly reported.

“Still descending?”

Xu Qiu frowned and asked again: "What about other situations? Has the abdominal pain improved?"

"No, I had anti-inflammatory treatment and painkillers, but the patient's abdominal pain was still very serious, and his breathing was getting worse and worse. If this continues, I'm probably going to be sent to the ICU!" ωωw..net

Everyone's faces immediately became serious.

I had just had abdominal pain last night, but my blood oxygen dropped rapidly today. The condition progressed so quickly. Maybe I would call ECMO in a few hours.

That thing is a money-burning machine, with a starting fee of 100,000 yuan, and the daily operating materials are also over 10,000 yuan, and medical insurance cannot be reimbursed.

Xu Qiu also realized the seriousness of the situation and stood up and said, "Let's go, go to the ward."

Director Xiao and others hurriedly followed.

...

Less than a day later, when I saw the patient again, the other party was already a little confused, but was crying for pain in a vague manner.

The man next to the bed looked haggard. When he saw Xu Qiu coming, a brief joy appeared on his face and immediately stood up, "Doctor Xu, please save Yuan Yu!"

Yuan Yu?

Xu Qiu noticed the change in the name. The other party suddenly called his real name because the patient confessed to him yesterday?

"Can you still sign for her?" Xu Qiu's question was very tactful.

But the man still heard the words, cried and laughed, and said, "Although we call each other a boyfriend and girlfriend, we actually got married at the beginning of the year, otherwise how could we prepare for pregnancy... She also explained all those things to me."

"Um."

"I won't forgive her, but I can't let go of my feelings for more than ten years easily. My whole youth is loving her, and all my imaginations of the opposite sex point to her, making me let go no matter what I can't do.

So this time, I just regard it as my farewell to youth and this relationship. From the bottom of my heart, I hope to say goodbye to her who is alive.”

The man's eyes turned red quickly and his voice trembled.
Chapter completed!