bookmarkrole Chapter 434
Chapter 434
Chapter 434
Why do patients with “acute severe pancreatitis” have low blood pressure?
That is because the blood volume of patients with acute severe pancreatitis is lost in a short period of time and enters the third gap.
Therefore, adequate fluid resuscitation should be used at this time to prevent shock. Stabilize hemodynamics and prevent the occurrence of hypoperfusion damage in multiple organs and tissues.
Lin Feng stood up abruptly.
call out:
“Quick, send to the rescue room!”
“I want a quick infusion!”
Then said anxiously to grandma:
“Grandma, you are going to be hospitalized right away. I will arrange for a nurse to give you an infusion now, and you must do it quickly!”
“Huh?” The husband was surprised.
“Isn’t it just a stomachache? It’s so serious? I need to be hospitalized? Can I go home?” The grandmother said dissatisfiedly because of the money.
Lin Feng resolutely shook his head: “No, you have to be hospitalized. Your severe acute pancreatitis is very dangerous, and you have shocked blood pressure now. Maybe there will be danger at any time, so hospitalization is the safest!”
When the patient’s grandmother’s husband heard this seriousness, he made a decisive decision:
“Dr. Lin, you will listen to your arrangements, and you will be treated as you wish!”
With the consent of the patient’s family, Lin Feng began to quickly arrange a nurse.
08 “Hurry up, the rescue room… wait until it stabilizes before entering the ward…”
Pushing her grandma quickly, she went to the rescue room.
Pushed into the rescue room,
The nurses are busy, infusion, electrocardiogram, meridian channels…
Granny still doesn’t care: “Dr. Lin, you are quite scary, but I have seen too many diseases…You can’t scare me…”
Lin Feng stood in front of the hospital bed, staring at the electrocardiogram monitor with beating data.
· Blood pressure: 79/43mmHg
It’s dropped again! !
And the blood oxygen saturation is only 95%.
But this is also normal.
Because patients with acute severe pancreatitis are prone to respiratory insufficiency, and symptoms such as pulmonary interstitial edema.
Granny had obviously had a shortness of breath just now.
“Give the patient an oxygen mask to support positive pressure assisted oxygen ventilation…”
Lin Feng said to his grandmother with a solemn expression: “I have never joked in front of the illness, you should cooperate with the treatment seriously.”
at this time,
Grandma’s face seemed a bit wrong.
There is no such blessing at the beginning.
The reaction is a little slow…
The look is a bit indifferent…
Lin Feng is a little bit shit.
“No, shock is reflected!!”
Lin Feng glanced at the nurse who had pierced the meridian channel of his right arm, feeling unsafe:
“Not enough!”
“Add another meridian channel for the thigh, quickly…”
20 seconds later,
Rehydration started…
The liquid formula ordered by Lin Feng is based on supplementing the crystal solution, plus an appropriate amount of protein, blood or plasma, while actively supplementing electrolytes, and at the same time adding vasoactive drugs…
At this time, the grandmother was in a coma, and her blood pressure dropped to 70.
The condition progressed a bit quickly.
fine,
As the infusion goes in, plus oxygen,
The blood pressure began to rise and ran to 86mmhg…
Blood oxygen is increasing, returning to 95%…
Lin Feng and the other nurses breathed a sigh of relief.
Stable condition……
Then he pushed out the rescue room and sent to the ward.
In the next few days, the hospital needs to continue to observe grandma’s physical signs.
·Continuous use of antibiotics to prevent infection.
·Use drugs to reduce pancreatic juice secretion and inhibit pancreatic enzyme activity
·The use of magnesium sulfate can promote gastrointestinal peristalsis, reduce intra-abdominal pressure, protect the gastrointestinal barrier function, reduce the translocation of bacteria and endotoxins, and also promote the absorption of abdominal exudate;
·If necessary, hemodialysis is also required.
If the situation is a little more serious, surgical treatment is needed, such as:
·Abdominal lavage…
·Surgical treatment: necrotic tissue removal and drainage…
When Lin Feng left the ward,
The grandmother woke up, feeling lingering about her coma just now.
The grandmother’s husband took Lin Feng’s hand and thanked him again and again. Just now, he thought his wife was going to die and almost scared him out of a heart attack.
…
…
Back to the clinic, 30 minutes have passed…
The patients in line behind felt so distressed.
The next patient.
Broadcast: “Please go to Wang Jian’s No. 3 Clinic.”
soon,
A young boy in his 20s walked into the consulting room.
She was thin.
It’s a bit awkward to walk.
Holding his belly,
Paled face.
Lin Feng glanced at his face and felt that he should be pale with anemia.
“Doctor Lin…”
“Sit down and tell me what’s going on?”
Wang Jian began to complain: “Dr. Lin, I often have diarrhea recently, and there is some blood in the stool, abdominal pain…”
Lin Feng: “When did it start? How long has it been? What was the situation in the beginning?”
Wang Jian: “A year ago, I didn’t know why. I had frequent diarrhea suddenly. I don’t know if it’s not a problem… But this month, I don’t know why, I often have abdominal pain, and I started to have blood in the stool half a month ago… …”
Lin Feng frowned: “Have you ever seen a doctor before? Has it been diagnosed? What kind of illness?”
Wang Jian said embarrassedly: “I haven’t checked, I thought there was nothing wrong, but it became serious this month, so I came to the hospital to see a doctor…”
Lin Feng angered: “Why are you here now? Abdominal pain and blood in the stool are not minor problems. It’s been half a month…”
Wang Jian suddenly became nervous: “Doctor Lin, it’s very serious?”
Lin Feng glared at him: “Can it be serious?”
At this time, he had already begun to think:
·For half a month, a month of abdominal pain, blood in the stool… the first reaction is rectal cancer!
· Diarrhea with a course of more than 1 year may be a rectal polyp.
Combine the two 100,
It should be that rectal polyps have worsened and evolved into rectal cancer.
(Ps: 80-95% of rectal cancer is derived from polyps.)
(Ps: The position of the rectum: the upper part is connected to the colon, and the lower part is connected to the steel door.)
Lin Feng continued to ask: “Is there any prolapse of the steel door mass?”
Wang Jian was surprised: “Huh??”
Lin Feng explained: “When I touched the steel door with my hand, I felt a piece of meat sticking out from the inside (it may be that the meat inside has come out, or the meat on the outside may be swollen).”
Wang Jian tweaked: “There is…”
Lin Feng: “……………………”
The prolapse of the steel door mass is one of the manifestations of rectal cancer.
The weight loss is obviously caused by long-term abdominal pain and diarrhea, and it is also one of the manifestations of rectal cancer.
Combined with the above long-term diarrhea + blood in the stool + weight loss,
Comprehensive consideration: rectal cancer! !
Lin Feng didn’t dare to tell the guy in front of him the bad news.
If it is rectal cancer, it is definitely a nightmare! Because the rectum is short and connected to the sphincter, once the rectal cancer is to be removed, the sphincter will be cut off, and the patient cannot control fecal excretion. (A case was written in the seventieth chapter.)
And the guy in front of him, who is only in his 20s, will have a difficult life in the future!
“Go for a proctoscope…”
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ps: The update ends today.
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