519 Tracheal stenosis

The press conference was very short and ended in a short while.

Su Yang quickly returned to the emergency department.

At this time, the patient had been transferred to the Burn Department, and was led by Hua Jun, director of the Burn Department.

Logically, at this time, Su Yang was fine. At most, the treatment was caused by someone calling a consultation, so he went to take a look.

But this patient is a bit special. First, the condition is relatively complicated. When Su Yang was conducting experimental treatment in the system space, many unexpected situations occurred. The condition was very dangerous and almost died several times. Of course, patients with severe burns often experience this situation. Therefore, as a responsible and kind doctor, even if it is not his own patient, they will be very concerned. Second, burns are actually a kind of war injury. On the battlefield, burns and knock injuries are common war injuries, so Su Yang also has increased his idea of ​​researching this disease. Therefore, he also wants to follow up on this serious injury patient. Third, the injured person knows him, and the two have spoken before. Su Yang is also a person who values ​​feelings and respects him so much. Then, when there is a problem with the other party, he should do his best to help others.

He was sitting in a chair thinking about the patient's affairs, and a jingle sounded in his mind.

[System Task: Rescue the fire-fighting hero with severe burns and help recover and discharge from the hospital.

Mission difficulty: Extremely difficult.

Task reward: Three million system experience, spray-type hemostasis, skin graft antibacterial drugs - pre-provision.]

Seeing this task, Su Yang frowned.

The reward for this task is very generous, but correspondingly, the patient's treatment difficulty is very high. The system also said that the treatment difficulty of this patient is extremely difficult.

Su Yang had never encountered such difficulty before.

Extremely difficult!

Extremely difficult!

Extremely difficult!!!

Su Yang's face gradually lost its warmth, leaving only a piece of coldness.

Fortunately, this time the task system gave a special reward, skin grafting antibacterial drugs, and can be prepaid in advance.

Among burns, especially severe burns, the most troublesome thing is the skin grafting stage, so if you can get the system's drug support, the difficulty will definitely be reduced.

This is the only thing that makes Su Yang a little easier.

After a while, he stood up and was about to go out when he suddenly saw Cao Jia walking past the door.

"Cao Jia!" Su Yang called her.

"Boss." Cao Jia stopped and turned around and walked in.

"I may stay in the burn department during this period, so you have to take care of the matter here."

"Me?" Cao Jia was shocked.

Although she is the hospitalization director now, she has become dependent on many things because of Su Yang. She asks Su Yang any questions. To be honest, she has never faced the situation of being alone, so when she hears it, she is immediately nervous.

Seeing her expression, Su Yang became even more sure of his thoughts. Yes, he couldn't take care of everything. He should let go. He should let go of things to Cao Jia and the others, just like Li Yun and the others. He should basically let them handle small things by themselves. He should try not to interfere. Unless he encounters a serious illness or a very dangerous condition, he will throw them all over. He will not be able to see the rainbow without experiencing the wind and rain. If he just keeps in front of them, they will not be able to grow.

Thinking of this, Su Yang said seriously: "My energy is mainly focused on the burn patient, so you are fully responsible for the matter here. Of course, if you have any questions, you can come to me. In addition, I will also explain to several other deputy directors and head nurses."

When Cao Jia heard this, although she was a little nervous, she nodded in the end and agreed.

Su Yang put on a white suit and went straight to the burn department. He wanted to go and see the patient first.

When I first arrived at the Burn Department, I saw Hua Jun, the director of the Burn Department, arranged his subordinates in the office: "From now on, there will be someone next to the patient for 24 hours. Everyone will cancel their leave. Unless there is a major situation, no leave is allowed. Everyone, this is a very harsh battle. This is a battle of either life or death. We cannot take it lightly, we cannot underestimate the enemy, and we cannot be careless. Moreover, everyone must be prepared for a long-term battle for at least one month. Do you understand?"

"clear!"

"Okay, let's talk about it first, let's break up first."

Crash.

A group of people walked out of the office.

After everyone left, Su Yang walked in.

Seeing Su Yang come in, Hua Jun smiled at Su Yang: "Thank you for what happened just now!"

"You're welcome." Su Yang said.

From now on, he and Hua Jun are also comrades-in-arms. From now on, the two of them will fight side by side with the disease.

"How is the patient's condition?" Su Yang asked.

Hua Jun shook his head, his face very bad: "It's very serious."

Su Yang's pupils shrank.

"It means that you searched through all the documents and textbooks and finally found that everyone had only one consensus on this condition - this situation was very serious."

After hearing Hua Jun's words, Su Yang was stunned for a moment, and then burst into laughter.

He sat down in front of Hua Jun and said, "I came here mainly to tell you that you must be careful of tracheal stenosis."

"Transtracheal stenosis?" Hua Jun tightened his eyebrows, and the faint smile on his face disappeared.

"Yes." Su Yang nodded: "The patient has a scar constitution."

Scar constitution?

Hua Jun was shocked when he heard this.

Su Yang nodded.

Before, he had an experimental treatment.

Scalp was cut on the third day after the injury.

After the operation, the airbag pressure gauge was used to monitor the airbag for tracheal catheter to maintain the airbag pressure between 1.96 and 2.94 kpa, and the airbag was deflated for 10 minutes every 6 hours.

After one day of blocking the tube, the tracheal catheter was removed on the 17th day after the injury.

During the patient's tracheal incision healing process, sputum microorganisms were cultured once every 3 days, and sensitive antibiotics were selected according to the results of drug sensitivity tests;

Use gastrointestinal motility drugs to prevent gastroesophageal reflux;

Try to regulate the care and suction.

After two skin grafting surgeries, the patient's wounds were basically healed, but scars formed at the healing point and began to grow.

On the 73rd day after the injury, the patient developed cough symptoms and there was no obvious relief when taking cough-relieving drugs.

On the 75th day after the injury, a neck CT examination showed that the local tube wall of the proximal left anterior wall of the C7 horizontal horizontal trachea was thickened, and immediately atomized and inhaled and treated with antispasmodic treatment for 6 days.

On the 81st day after the injury, the patient developed wheezing and breathing difficulties. The examination showed obvious signs of three depressions and a fibronectomy was performed. The results showed severe granulation tissue hyperplasia in the upper part of the trachea, severe stenosis of the lumen, and difficult to perform the examination below the granulation tissue hyperplasia plane.

The plan to perform endotracheal stent implantation failed, the patient's breathing difficulty gradually worsened, the pulse oximetry decreased, and the trachea was incised below the stenosis and a metal tracheal cannula was placed.

On the 87th day after the injury, hyperplasia was surgically removed under bronchoscopy, and granulation tissue was taken for pathological examination. The result was inflammatory granulation tissue.

On the 92nd day after the injury, in order to prevent the trachea from recurring hyperplasia and stenosis and affecting breathing, the patient brought a metal cannula.

On the 108th day after the injury, the patient felt no obvious discomfort. The fibrous bronchoscopy showed that the granulation tissue in the original hyperplasia was proliferated again. Most of the granulation tissue was removed with a high-frequency electrocutor and cryotherapy was performed.

After 1 week, there was no obvious granulation tissue hyperplasia after fibre bronchoscopy.

For patients with severe burns with or without inhalation injury, tracheotomy is often required to prevent or relieve their respiratory obstruction or establish mechanical ventilation artificial airways. Tracheotomy is one of the postoperative complications, and in severe cases, it can be life-threatening.

The incision of the cartilage ring during tracheotomy can cause the soft tissue of the anterior wall of the trachea to sink into the trachea after removing the trachea sleeve, forming stenosis;

Irregular suction operations after tracheotomy can also cause damage to the mucosa in the trachea, forming granulation and blocking the trachea;

Long-term mechanical ventilation causes long-term compression of the tracheal catheter, especially the airbag, to the tracheal wall. Among them, high-pressure airbags or excessively low-pressure airbags have direct pressure destruction of the tracheal wall mucosa, causing damage to the tracheal wall mucosa, local blood flow drops or even interrupts, which causes the tracheal wall mucosa to be necrotic and fall off, and granulomas to form during the later healing process, leading to the formation of tracheal scars, thereby causing tracheal stenosis or occlusion.

In addition, gastroesophageal reflux, repeated respiratory infections, and a history of diabetes, especially scar constitution, are important influencing factors of tracheal stenosis and occlusion after tracheotomy.
Chapter completed!