NOVEL WEB I can see the status bar
Chapter 1135 Choice
Chapter 1135 Choice
The results of Zhuang Xinhao's angiography examination soon came out, and the angiography confirmed Sun Lien's guess - there were as many as six new tiny arteries on the left descending branch of his coronary artery, and two of these blood vessels had been completely blocked.
The completely blocked small blood vessels caused another infarction, but due to the small size and long time of infarction, such infarction has basically no symptoms.The only thing that can be called a symptom is that his heart is currently experiencing arrhythmia under the influence of hypoxemia.
Now the problem has returned to the doctor's side. Given that the patient has hyperlipidemia at the same time, it is very practical to intervene with him.But the question is the timing of the intervention—whether to start the intervention now, or wait until Zhuang Xinhao recovers.
When to operate on a patient is something that needs to be carefully weighed most of the time.
In the past, the patients Sun Lien faced often had no choice. As long as he was able to get on the operating table, he would have to start the operation immediately——if it was delayed, this person would be gone.
But Zhuang Xinhao's situation is completely different. Of course his heart is at risk, but the risk is not urgent enough to require immediate surgery.
For doctors, what they are now facing is an alternative situation.
Zhuang Xinhao is currently in the stage of transferring from mild to severe. The reason for the transfer is the extra load on the heart caused by hypoxemia.His heart cannot bear the load of hypoxemia, and there is a high possibility of malignant arrhythmia and even direct arrest.
But if he is to be operated on right now, he needs to consider the burden of the postoperative rehabilitation process on his body, as well as the impact of the surgical trauma itself.In addition, the response to the new coronavirus infection and the entire postoperative period must also be considered.
Frankly speaking, Sun Li'en is very skeptical about performing bypass surgery now...whether Zhuang Xinhao can resist the past.The cause of his current symptoms is hypoxemia caused by the new coronavirus infection. The core key to heart rate imbalance caused by hypoxemia is still oxygen supply.If he can maintain his blood oxygen level, Zhuang Xinhao's heart should not have any major and more urgent problems.
But this is where the difficulty of choosing lies. No doctor—at least at this stage, no medical staff can guarantee that Zhuang Xinhao's condition will not continue to deteriorate.
This is why it is difficult to wait until he has completely turned negative before elective surgery.Zhuang Xinhao really might not be able to... wait until that day comes.
Judging from the current situation, about [-]% to [-]% of patients infected with the new coronavirus are mild.People with mild illness will be able to recover on their own with only basic treatment and support.But how to judge the direction of a patient's disease-to determine whether he or she will turn from mild to severe or even critically ill is still an unsolved question.
According to some current experience, patients with underlying diseases, men, and middle-aged or older patients are more likely to become severe and critically ill.But this is not absolutely the case.
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"Okay, so we're going to play Russian roulette next?" Bruen threw the report on the table and rubbed his legs.No way, after entering the red zone, everything above the chest should be regarded as a relatively clean zone, and he can't habitually rub his beard with his hands. "Our next job is to open a market, and then take a gamble to see whether the patients currently in our hands died of the new coronavirus or malignant arrhythmias caused by hypoxemia?"
"Actually, there is no difference between the two." Zhou Ce muttered to the side, "Anyway, based on the current statistical caliber, such patients are considered to have died from the new coronavirus infection."
Xu Yourong explained some of the Chinese contents of the report to Bernard and asked, "So, what is the consultation plan for the Department of Cardiology?"
"The patient's current condition is stable, and elective surgery can be considered after controlling blood lipids—provided that the hypoxemia will not continue to worsen." Chen Xuerong sighed, "Patients with new coronavirus-infected pneumonia are combined with cardiac vascular hyperplasia... No one can do this." I've seen it."
"Treat it according to pneumonia?" Sun Lien asked, "Don't think about the new coronavirus, just consider ordinary viral pneumonia?"
"It depends on the condition of the pneumonia. If there is severe insufficiency or the inability to tolerate surgical trauma, it is absolutely contraindicated." Wang Guonan spread his hands and said, "The original contraindications are simply impossible to use here. As a reference. We are hesitant now because we cannot be sure whether the patient can tolerate the surgical trauma and recovery period.”
"At the same time, we are not sure whether COVID-19 combined with heart problems will cause fatal effects after the patient chooses elective surgery." Dr. Bernard Xu added, "I personally think that less invasive surgery should be considered first. Surgical plan. Is it okay to treat coronary artery stenosis with PCI?"
"I think it's okay." Yuan Ping'an agreed with Bernard's opinion, "Although traditionally PCI intervention is not recommended for patients with three-vessel lesions, PCI is less invasive and quicker to recover, and it can indeed effectively improve myocardial hypoxia. The situation. If surgery is required, this should be the most suitable solution at present."
Almost the entire treatment group joined the discussion, only Dr. Ma Yongfang was still outside to adjust the patients' daily medication.
Sun Li'en has no particularly good solution to the current situation, and the reason is very simple - although the prompt in the status bar is blue, it does not mean that the situation will not change.
The prompt in the status bar is not permanent. Since it can indicate the change of the situation by changing the prefix and adjusting the color depth of the writing, it can naturally change from blue to black when the situation permits.The blue status bar reminds that Zhuang Xinhao's condition cannot be guaranteed. The only thing that can let the doctors make a judgment is their current experience.
"How long does it take for him to recover?" Sun Lien decided to analyze the problem fundamentally. "How long has he been infected with the novel coronavirus pneumonia so far?"
"Bridge recovery will take at least two weeks, and the course of the disease... has been five days since the onset of symptoms." Yuan Pingan quickly gave the answer, "After the Fangcang Hospital found out that he had an arrhythmia, Zhuang Xinhao was sent to the hospital immediately. Our hospital."
The course of the disease began to worsen after five days, which is not a good sign.The two-week recovery period is unacceptable for patients who are getting worse.
Sun Lien immediately made a decision, "I'll do PCI, and I'll go talk to the patient directly. Monitor the blood oxygen closely, and if necessary, use plasma from the recovered patient first."
The condition is not good today, I will make up for it tomorrow
(End of this chapter)
The results of Zhuang Xinhao's angiography examination soon came out, and the angiography confirmed Sun Lien's guess - there were as many as six new tiny arteries on the left descending branch of his coronary artery, and two of these blood vessels had been completely blocked.
The completely blocked small blood vessels caused another infarction, but due to the small size and long time of infarction, such infarction has basically no symptoms.The only thing that can be called a symptom is that his heart is currently experiencing arrhythmia under the influence of hypoxemia.
Now the problem has returned to the doctor's side. Given that the patient has hyperlipidemia at the same time, it is very practical to intervene with him.But the question is the timing of the intervention—whether to start the intervention now, or wait until Zhuang Xinhao recovers.
When to operate on a patient is something that needs to be carefully weighed most of the time.
In the past, the patients Sun Lien faced often had no choice. As long as he was able to get on the operating table, he would have to start the operation immediately——if it was delayed, this person would be gone.
But Zhuang Xinhao's situation is completely different. Of course his heart is at risk, but the risk is not urgent enough to require immediate surgery.
For doctors, what they are now facing is an alternative situation.
Zhuang Xinhao is currently in the stage of transferring from mild to severe. The reason for the transfer is the extra load on the heart caused by hypoxemia.His heart cannot bear the load of hypoxemia, and there is a high possibility of malignant arrhythmia and even direct arrest.
But if he is to be operated on right now, he needs to consider the burden of the postoperative rehabilitation process on his body, as well as the impact of the surgical trauma itself.In addition, the response to the new coronavirus infection and the entire postoperative period must also be considered.
Frankly speaking, Sun Li'en is very skeptical about performing bypass surgery now...whether Zhuang Xinhao can resist the past.The cause of his current symptoms is hypoxemia caused by the new coronavirus infection. The core key to heart rate imbalance caused by hypoxemia is still oxygen supply.If he can maintain his blood oxygen level, Zhuang Xinhao's heart should not have any major and more urgent problems.
But this is where the difficulty of choosing lies. No doctor—at least at this stage, no medical staff can guarantee that Zhuang Xinhao's condition will not continue to deteriorate.
This is why it is difficult to wait until he has completely turned negative before elective surgery.Zhuang Xinhao really might not be able to... wait until that day comes.
Judging from the current situation, about [-]% to [-]% of patients infected with the new coronavirus are mild.People with mild illness will be able to recover on their own with only basic treatment and support.But how to judge the direction of a patient's disease-to determine whether he or she will turn from mild to severe or even critically ill is still an unsolved question.
According to some current experience, patients with underlying diseases, men, and middle-aged or older patients are more likely to become severe and critically ill.But this is not absolutely the case.
·
·
·
"Okay, so we're going to play Russian roulette next?" Bruen threw the report on the table and rubbed his legs.No way, after entering the red zone, everything above the chest should be regarded as a relatively clean zone, and he can't habitually rub his beard with his hands. "Our next job is to open a market, and then take a gamble to see whether the patients currently in our hands died of the new coronavirus or malignant arrhythmias caused by hypoxemia?"
"Actually, there is no difference between the two." Zhou Ce muttered to the side, "Anyway, based on the current statistical caliber, such patients are considered to have died from the new coronavirus infection."
Xu Yourong explained some of the Chinese contents of the report to Bernard and asked, "So, what is the consultation plan for the Department of Cardiology?"
"The patient's current condition is stable, and elective surgery can be considered after controlling blood lipids—provided that the hypoxemia will not continue to worsen." Chen Xuerong sighed, "Patients with new coronavirus-infected pneumonia are combined with cardiac vascular hyperplasia... No one can do this." I've seen it."
"Treat it according to pneumonia?" Sun Lien asked, "Don't think about the new coronavirus, just consider ordinary viral pneumonia?"
"It depends on the condition of the pneumonia. If there is severe insufficiency or the inability to tolerate surgical trauma, it is absolutely contraindicated." Wang Guonan spread his hands and said, "The original contraindications are simply impossible to use here. As a reference. We are hesitant now because we cannot be sure whether the patient can tolerate the surgical trauma and recovery period.”
"At the same time, we are not sure whether COVID-19 combined with heart problems will cause fatal effects after the patient chooses elective surgery." Dr. Bernard Xu added, "I personally think that less invasive surgery should be considered first. Surgical plan. Is it okay to treat coronary artery stenosis with PCI?"
"I think it's okay." Yuan Ping'an agreed with Bernard's opinion, "Although traditionally PCI intervention is not recommended for patients with three-vessel lesions, PCI is less invasive and quicker to recover, and it can indeed effectively improve myocardial hypoxia. The situation. If surgery is required, this should be the most suitable solution at present."
Almost the entire treatment group joined the discussion, only Dr. Ma Yongfang was still outside to adjust the patients' daily medication.
Sun Li'en has no particularly good solution to the current situation, and the reason is very simple - although the prompt in the status bar is blue, it does not mean that the situation will not change.
The prompt in the status bar is not permanent. Since it can indicate the change of the situation by changing the prefix and adjusting the color depth of the writing, it can naturally change from blue to black when the situation permits.The blue status bar reminds that Zhuang Xinhao's condition cannot be guaranteed. The only thing that can let the doctors make a judgment is their current experience.
"How long does it take for him to recover?" Sun Lien decided to analyze the problem fundamentally. "How long has he been infected with the novel coronavirus pneumonia so far?"
"Bridge recovery will take at least two weeks, and the course of the disease... has been five days since the onset of symptoms." Yuan Pingan quickly gave the answer, "After the Fangcang Hospital found out that he had an arrhythmia, Zhuang Xinhao was sent to the hospital immediately. Our hospital."
The course of the disease began to worsen after five days, which is not a good sign.The two-week recovery period is unacceptable for patients who are getting worse.
Sun Lien immediately made a decision, "I'll do PCI, and I'll go talk to the patient directly. Monitor the blood oxygen closely, and if necessary, use plasma from the recovered patient first."
The condition is not good today, I will make up for it tomorrow
(End of this chapter)
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