Xu Qiu glanced at Yang Yuen.

Yang Yuen's eyes widened, and her expression was very surprised.

Are idols testing me?

She quickly stood up, "The key is right heart failure. The cause of blood congestion is the hepatic venous blood return disorder, and right heart failure will just cause this."

"But it's not so serious, and why did it improve so quickly..."

As soon as he finished speaking, the doctor of the god suddenly stopped and then showed a happy expression.

He also figured it out!

Sibutrmin!

Because of the long-term use of sibutramine, the patient does have chronic liver damage.

In addition, heart failure causes blood congestion in the liver, which leads to the patient's liver function index so severe.

As for why he can recover within half an hour—

Blood-congestion liver, the patient's liver itself is not too serious as the underlying disease of chronic liver damage. As long as the blood congestion is relieved and the hepatic venous return is restored, it will naturally improve quickly.

...

There was silence in the conference room.

Everyone was savoring the medical records this time.

The tortuous diagnosis process, the thrilling several rescues, and Xu Qiu's incredible point-pointing point...

This patient alone is enough to write a fine article, at least to post a core Chinese!

Moreover, Wei Ding's condition is so classic, with repeated life and death crises and frequent twists and turns, and can definitely become a demonstration diagnosis and treatment case.

After the morning shift, everyone followed Xu Qiu to check the room in a tacit understanding.

Wang Ping, who only left the teaching rounds, looked confused.

Wang Fan walked to Wang Ping with his hands behind his back: "Director, we are really a person who has fallen into the world. I am the one who has been bullied the most. You are the one who has the most miserable among the directors."

"Stop talking to me, go with me to go to the rounds."

"I...I'm going to go with Xu..."

"What are you allowed? Your patient hasn't taken care of enough this month. I want me to punish you for the bonus?"

"What's this? Director Wang, hurry up and check the rounds. I'm still waiting to learn more!"

"Yes." Wang Ping nodded with satisfaction.

What they said was right, it felt really good to bully Wang Fan.

...

After the rounds were over, Xu Qiu formulated a further treatment plan.

At the same time, he also received a joint request from the directors of the emergency department, Shennei, Extrabrain, Hepatology Department and Cardiac Surgery Department, hoping that he could supplement and improve this case and use it as a standard textbook for medical treatment.

After half a day of visiting the outpatient clinic, he returned to the office at noon. Xu Qiu finished Wei Ding's medical records while having dinner.

Blood gas analysis suggests respiratory alkalosis metabolic acidosis.

The conventional hemoglobin in blood suggests extremely severe anemia, and later he also analyzed malnutrition.

In fact, this step can also be confirmed by checking serum ferritin to identify iron deficiency anemia and then confirm malnutrition...

It is also due to anemia that the patient cannot provide enough oxygen. After the body decompensated, glucose can only anaerobically ferment and produce lactic acid, resulting in a rapid increase in lactic acid. The subsequent confusion and coma are likely to be hypoxia in the brain.

Performance.ωωw..net

also.

Liver function indicates liver function damage, but all doctors are misled by this indicator and focus entirely on finding the causes of acute liver damage.

In fact, the patient has chronic liver damage, which causes blood congestion due to heart failure.

In fact, Xu Qiu should have discovered this point long ago.

The patient's bilirubin was not high, only the alanine aminotransferase increased sharply. At that time, all the rescue doctors were frightened by the preoperative aminotransferase, and their attention was also focused on this to show off.

In addition, the patient's coagulation function was extremely poor, which made doctors, including Xu Qiu, lean towards acute liver injury as soon as possible.

But when Xu Qiu looked back at this time, he noticed some details.

For example, bilirubin is not high!

This indicator actually indicates that there is no problem with the catabolic function of the liver.

The coagulation difference may not be all due to impaired liver synthesis function. It may also be due to long-term malnutrition, leading to imbalance of gastrointestinal flora, and ultimately leading to insufficient part of the coagulation raw materials - there is not even the raw materials, so how can coagulation be good?

The key to the final rescue is the rapid infusion of red blood cells.

This step corrected anemia and also saved the blood-congestion caused by the return disorder. Therefore, lactic acid dropped rapidly and liver function improved in a very short period of time.

The next plan is to treat the right treatment.

At the same time, correct electrolyte disorders as soon as possible.

Nutritional support is not so urgent. For Vidin, whose gastrointestinal function may be damaged, this process must be cautious and slow.

“Otherwise, refeeding syndrome is likely to occur.”

As the name suggests, this is long-term hunger. After malnutrition, the patient has long been accustomed to a low-nutrition state after oral feeding or internal and external nutritional support. Suddenly receiving a lot of nutrition, blood sugar will rise rapidly, and insulin secretion will increase rapidly, resulting in potassium ions.

Magnesium ions, phosphorus ions, etc. transfer into cells, causing hypophosphatemia, hypokalemia, hypomagnesemia...

The consequence is that the heart, brain, liver, lung and other cells are damaged, and may even lead to organ failure and death.

These experiences are exchanged for blood and tears.

There have been several major earthquakes in Daxia. Countless victims did not eat for several days. After being rescued, they started to take food. When they were full, they immediately developed symptoms such as arrhythmia and difficulty breathing.

These are pretty light.

The symptoms of the victims who provided nutritional support were even more serious. Some people were rescued from collapsed houses. Many people died because of the emergency import of sugar-containing preparations, which induces acute heart failure, etc.

...

After summarizing the report of this medical record, Xu Qiu and the new treatment plan were approved.

Soon, the case spread throughout the doctor.

It caused a wave of discussion.

"Damn, after reading it, I feel like I don't look like a doctor, but rather like a killer. If I give this kind of patient to me, ten will die of ten!"

"The scalp is numb! If Dr. Xu becomes a detective, he feels that he can become a leader, and he will definitely not be worse than being a doctor!"

"From lupus brain to heart failure, many of them were something I never thought of. People are so angry that they are so angry that they are. Dr. Xu is so strong!"

"The cases under Dr. Xu remind me that I am a useless person..."

A large group of Linyu Medical Group flooded the screen with crazily.

There are also many Xu Qiu's emoticons mixed in.

The photo of Xu Qiu holding the scalpel, captioned by: Lying up by yourself.

The photo of Xu Qiu's auscultation, captioned by: Let me hear if you have anything wrong with it.

There is also a photo of Xu Qiu staring at the distance, actually simulating a brainstorming in the operating room, with the caption: Tired, let’s destroy it…

In the office.

Xu Qiu held his cell phone from afar. This was a habit developed by the elderly in their previous lives when they looked at their cell phones, and they have not changed it until today.

Others thought Xu Qiu wanted to protect his eyesight. After all, as long as he was a genius, others would always find a reasonable explanation for any abnormal behavior of him.

If you really can't find it, that's the quirk of genius.

Xu Qiu originally wanted to share the electronic version of the medical records into the group, but he saw these emoticons...

Suddenly, he fell silent.
Chapter completed!