nyslfriends Chapter 352 Abnormal Ventricular Wall
Chapter 352 Abnormal Ventricular Wall
Chapter 352 Abnormal Ventricular Wall
Chapter 354 Abnormal Ventricular Wall
After negotiating with the patient's family, the family agreed to indwelling the tube, but anesthesia is required during the indwelling tube.
As soon as he started anesthesia, Qin Feng discovered another big problem.
That is, the patient's body is already severely edematous, and after the femoral vein catheter is pushed into the stomach, water seepage will appear on the edge of the indwelling catheter.
"Wrap another layer of gauze." Qin Feng instructed Zhang Yao.
"Are you still feeling uncomfortable?" Qin Feng asked after completing the catheter placement.
"There is always phlegm in the throat and I can't cough it out," the patient said.
Phlegm in your throat?
For ordinary people, there is no need to worry about phlegm in the throat. However, the patient himself has acidosis, chronic renal failure, heart failure and other diseases, so Qin Feng still needs to treat it with caution.
For the time being, Qin Feng thinks that the patient's phlegm and cough is chronic pharyngitis. Of course, it may also be other diseases, such as swelling of the throat mucous membrane, etc., which are all chronic diseases. Even if they are diagnosed and treated by CT, they cannot be cured in a short time. .
At present, the most important job is to recuperate the patient's acidosis and systemic edema.
After waiting for about 10 minutes, the patient's urine test came out.
Qin Feng did not find any abnormalities in the data, that is, the aggravation of acidosis and changes in oxygen partial pressure this time had nothing to do with the patient's kidney function.
This time, the diagnosis of the patient's disease once again fell into confusion.
"You continue to strengthen dehydration, I will come back tomorrow morning." Qin Feng said to the bed doctor.
The bed doctor agreed, and Qin Feng went back to do his own business.
The next morning, during ward rounds, Qin Feng went directly to the old lady's ward for ward rounds.
After a night of dehydration, the patient's mental state obviously recovered a lot, and the old lady herself expressed a lot of comfort.
It's just that the water in the body is still very serious, and at the same time there is no solution to the abnormal changes in acidosis and partial pressure.
Qin Feng could only arrange to do a lung CT for the patient, and found that there was a lot of sputum in the patient's throat, and there was no other abnormality.
This examination result can be said to be no different from no examination at all, and it does not help in diagnosing the disease.
Qin Feng found the patient's family members and chatted about nebulization treatment.
Fortunately, the family members are not short of money, in a word.
"As long as it's good for my mother's health, you can just go and get it. Money is not an issue."
Nebulization therapy refers to aerosol inhalation therapy.
Aerosols are tiny solid or liquid particles suspended in the air. Aerosol therapy uses a special atomization device to disperse the drug into tiny droplets or particles, suspend it in the gas, and make it enter the respiratory tract And in the lungs, so as to achieve the effect of cleaning and moistening the airway.
"Do you spray it directly with injection water?" Zhang Yao asked.
Nebulization is one of the nurses' jobs.
The difficulty of this kind of treatment is very low, and ordinary people can do it after a short period of training, so hospitals generally leave this job to nurses.
"No, atomize with salt water." Qin Feng said.
The patient himself has severe water intoxication, and if he uses water for injection to atomize it, his condition may be aggravated.
A better option is saline, which neutralizes certain elements in the patient's body.
Zhang Yao nodded and left, starting to prepare the atomized medicine according to Qin Feng's requirements.
The atomization process is not complicated. Zhang Yao puts the brine to be inhaled into the liquid storage tank of the nebulizer to dilute it, and then adjusts the flow rate of the released gas to 8L/min.
Then connect the nozzle of the nebulizer to the patient, Qin Feng instructed from the side.
"You don't need to deliberately inhale, just breathe normally."
The patient nodded, as if breathing normally. Qin Feng took a look and left without finding any problems.
Returning to the consulting room, Qin Feng met a young man who looked about 20 years old, but his face was pale and he sat down with shortness of breath. He even covered his heart with one hand.
When Qin Feng saw the appearance of the young man, his first reaction was a heart disease.
"Doctor, I'm in so much pain here." The young man panted while clutching his chest.
"Don't worry, talk slowly, what's going on?"
"Just a few days ago, I just got off work and felt a vague pain in my sternum. When I went to work the next day, I also felt pain in my left hand..."
After Qin Feng listened, he came to a conclusion.
That is angina pectoris, angina pectoris is a typical substernal pain, which is a clinical syndrome mainly manifested by episodic chest pain or chest discomfort caused by acute temporary ischemia and hypoxia of the myocardium.
Generally speaking, angina pectoris is common in people who stay up late for a long time and are overworked, but it can be relieved after adequate rest.
However, the patient's pain was connected to the arm the next day, indicating that the patient's myocardial ischemia is already very serious, and even if it is delayed for a few days, death will tell him hello.
"Let's do an electrocardiogram for the patient." Qin Feng asked Yue Meng to connect the electrocardiogram.
Soon, the electrocardiogram band began to lengthen. Qin Feng's face suddenly became serious as he looked at the sharply rising band.
The patient no longer had angina pectoris, but a more severe acute anterior wall myocardial infarction, which meant that the patient had suffered a large amount of myocardial death due to angina pectoris.
"Quickly, bring the nitroglycerin tablets and let the patient swallow them sublingually." Qin Feng shouted urgently.
This time, Qin Feng felt that death was very close to the patient, not on the operating table, but in the outpatient department.
On the contrary, the patient was frightened by Qin Feng's series of behaviors.
"Doctor, is my condition serious?"
Qin Feng explained his diagnosis again, and the young man was too frightened to speak, sitting on the chair trembling all over.
"Contain it under the tongue." Qin Feng handed the nitroglycerin lozenge to the patient, and the patient obediently took it and swallowed it.
Nitroglycerin lozenges are a drug that dilates blood vessels quickly and accurately, and are even more effective than those quick-acting Jiuxin pills.
In order to prevent the patient from sudden death, Qin Feng could only use this lozenge to extend the patient's life.
"Take the patient for a B-ultrasound, join a team, forget it, I'll make a call there." Qin Feng directed Yue Mengdao.
Now Qin Feng arranges work, it is Yue Meng and Zhang Yao who take turns to arrange, so that both of them can learn something.
Qin Feng quickly issued a bill, and the patient hurriedly stood up, wanting to go for an examination, but was stopped by Qin Feng.
"Don't move, you sit in the wheelchair and let the nurse push you over." Qin Feng said.
"So serious?" The young man was startled, he couldn't even walk by himself?
"Yes, walking will affect the blood supply of the heart."
Originally, the patient's blood supply was insufficient. If he took two steps and lay straight on the ground, he would be dead.
Qin Feng also called the CT room in time, and they also arranged an urgent call, knowing the seriousness of myocardial infarction.
Half an hour later, the patient's examination results were sent to Qin Feng's computer.
As soon as Qin Feng saw the abnormal wall motion above, he knew that his diagnosis was correct.
(End of this chapter)