However, the situation has suddenly changed.

Even Xu Qiu did not expect that S surgery would reduce the surgical damage to 50%!

In addition to the additional rewards, the control of complications, etc., the patient's recovery effect will probably be much better than Xu Qiu's estimate.

He promised to bear the money that exceeded the medical insurance limit and was likely to be unable to spend it...

...

"Doctor Xu, after the operation of this patient..." After leaving the operating room, after dealing with the patient's family, the director of the brain surgery department rushed to find him.

For general patients with subarachnoid hemorrhage, follow the routine postoperative care.

In addition to closely monitoring vital signs, changes in nervous system signs, etc., there are specialized care such as dehydration and lowering cranial pressure, controlling blood pressure, improving circulation, and nutritional nerves.

But taking blood pressure control as an example, it has been quite controversial in clinical practice, and there is no accurate conclusion yet.

First, hypertension and hypervolemia are one of the most important measures to reduce vasospasm and prevent ischemia; but at the same time, increased blood pressure can also lead to systolic pressure exceeding the cross-wall pressure of blood clot compliance.

This is similar to the replantation of broken fingers in hand surgery.

After the finger breaking replantation surgery, rehabilitation exercises are carried out too early, and the sutured tendons, muscles, nerves, etc. are at risk of tearing; but if it goes too late, tissues such as tendons and tissues in the healing state will become adhesions.

If it is just a general aneurysm closure surgery, blood pressure will probably be cured, but in the face of such a dangerous condition, there is a high probability that medical insurance will be exceeded, so the specific nursing details still need to be finalized by Xu Qiu.

The director of brain surgery said: "According to the recommendations of the European Stroke Management Organization, systolic blood pressure less than 180mmhg can reduce the risk of rebleeding..."

Xu Qiu shook his head: "The systolic blood pressure is less than 140mmhg, and it is still difficult to offset the risk of early rebleeding."

The director of the brain surgery department was shocked: "Where is this research? Or is it a Little Sword?"

Xu Qiu couldn't give an answer... These are the lessons summarized from simulation operating rooms and master-level experiences. Without evidence-based medical evidence, authoritative research data will naturally not be produced.

"Continue to press down, and control the blood pressure to about 130mmhg." Xu Qiu said.

The head of the brain surgery department's face changed slightly: "The clinical practice is generally controlled at around 160... If it is too low, the incidence of vasospasm and ischemia will be greatly improved!"

"No." Xu Qiu said confidently.

The incidence of rebleeding is directly related to hypertension. When the blood pressure is high, the blood vessels will be broken, which is difficult to avoid the additional bonus of S.

However, vasospasm and ischemia can be controlled with the help of various amplification effects.

Therefore, the best way is to lower blood pressure as much as possible. As for other complications caused by lower blood pressure, they can be avoided by the addition of s...

Thinking of this, Xu Qiu added: "The blood pressure control of 130 is limited to this patient and should not be used in clinical practice."

He has systematic help, but other doctors don't.

The director of the brain surgery department wiped his sweat... Such a bold blood pressure control plan, even if they were asked to learn from them, they would not have the courage to do so!

"By the way, there's another one."

After the office was silent for a long time, Xu Qiu suddenly spoke.

The director of the brain surgery department was ready immediately: "Doctor Xu, you said!"

"One additional postoperative monitoring is the iron metabolism level."

"Iron metabolism?" The director of brain surgery was a little confused.

Clinical iron metabolism monitoring is mostly used for the diagnosis of blood diseases, such as iron deficiency anemia.

But if we really want to connect it with neurosurgery, it can indeed involve some theories - for example, iron is an essential trace element during the growth and development of nerve cells, which plays an important role in neurotransmitter synthesis, DNA synthesis, and even maintaining the normal function of nerve cells.

However, he still has never heard of monitoring iron metabolism levels after brain surgery.

Xu Qiu gave an answer: "It has nothing to do with growth and development. The key is that iron metabolism will produce neurotoxic oxygen free radicals, which play an important role in ebi."

ebi means early brain injury, so the director of the brain surgery department will naturally understand it.

He was a little surprised: "What is the principle?"

Xu Qiu asked back: "What is the mechanism of brain damage in patients after subarachnoid hemorrhage?"

This is the director's research direction, and he blurted out: "Microvascular dysfunction, as well as cortical depolarization."

Xu Qiu nodded: "I also ignored the damage to the brain due to bleeding itself."

The director was shocked: "You mean... red blood cells can damage brain tissue?!"

"No, red blood cells themselves have no effect on brain tissue, but hemoglobin will be released during the lysis of red blood cells. If hemoglobin continues to dissolve, iron ions and reactive oxygen... and both substances are strongly neurotoxic."

The director's face changed completely, and he stared at Xu Qiu in disbelief.

The latter continued: "Let iron ions accumulate, nerve cells induce autophagy mechanisms."

The director of the brain surgery department said seriously: "Okay, I will immediately notify the nursing department to monitor the iron metabolism level of cerebrospinal fluid and minimize it as much as possible!"

"No."

Xu Qiu shook his head: "The induction of the autophagy mechanism of nerve cells by iron ions can to a certain extent protect damaged neurons and even fight brain damage."

The human body's intelligence is far beyond the most sophisticated machinery. Its own phagocytosis mechanism can eliminate damaged organelles and degradable cellular substances, which is one of the body's ability to stabilize itself.

What Xu Qiu had to do was to maintain the autophagy mechanism at the critical point where it could just swallow damaged neurons, but not be too excited and cause damage to normal nerve cells.

The doctrine of the mean runs through medicine, and "just just right" is the three most essential words.

"I understand..." The director of the brain surgery department breathed a sigh of relief, the expression on his face was so serious that it was unrepresentative, and the look at Xu Qiu also had a little more respect and gratitude.

In just a few days, he had learned a lot of incredible clinical experience from Xu Qiu. Just monitoring iron metabolism level can greatly improve the prognosis of the brain surgery department of Greentown No. 1 Hospital.

...

In the fourth hour after the operation, the brain surgery department and ICU were still guessing whether the patient could wake up within the golden seventy-two hours, and news came from the ward that the patient was awakened.

For a moment, the director of brain surgery, director of iciu and others were shocked.

What is this an outrageous recovery speed?

Critical subarachnoid hemorrhage also affects the brainstem. After one surgery, it is considered good to wake up within three days. Many patients may even develop into vegetatives of varying degrees...

As a result, I woke up in three hours?!

"No wonder Dr. Xu can give a lecture..."

"Four hours! Even if you have an ordinary general anesthesia surgery, you dare not say that you will wake up in four hours!"
Chapter completed!