I can see the status bar

Chapter 21 Dilemma
"What are you still doing in a daze? Go directly to the operating room." Dong Xin, the deputy chief physician of neurosurgery who came to consult, looked at the CTA film of the high school student and scratched a piece of dandruff from his head.He knocked on the video film in his hand, knocking a huge CTA film with a clatter. "Obvious left anterior communicating artery aneurysm, but luckily it didn't rupture. It should be just spontaneous bleeding, and the amount of bleeding is not too large."

"What about the surgery plan?" Zhou Jun asked with his arms folded, "The family members are on their way here, but they may have to wait a while."

"Thanks to the narrow-necked aneurysm." Dong Xin put the CTA light on his face and looked again, "Do intervention. Insert a catheter through the opening of the femoral artery. Extend to the left anterior communicating artery, and put a platinum coil go in."

Zhou Jun looked at the high school student who was still in a coma, "You do it?"

"Cerebral vascular intervention is a tertiary surgery, and now Dean Liu is the only one who can do it in the hospital besides me." Dong Xin didn't mind Zhou Jun's straightforward question. "I asked the dean to do this kind of operation. I was afraid that he would deduct my performance later."

"How much does this operation cost?" Zhou Jun looked at the high school students' attire.High school students who need to ride their electric bikes to school every day usually have poor family conditions.The most expensive part of this brain aneurysm interventional operation is always the coils sold by pharmaceutical companies.Hospitals can advance a considerable part of drug costs and surgical expenses, but it is impossible for hospitals to advance such medical devices from pharmaceutical companies that are not covered by social security.

If the condition of the patient's family is not very good and cannot afford the cost of the coil, even if the hospital wants to lose money for the operation, the pharmaceutical company will never agree.

"At least 10 yuan." Dong Xin sighed, "10 yuan is the base, and there is no upper limit. Without actual operation, I don't know how many spring coils this child needs. I can't get [-] yuan...he even went on stage. have no qualifications."

"The price is too high." Zhou Jun frowned, "Can't the traditional craniotomy work?"

"The operation time is long, the risk is high, and the prognosis is not good." Dong Xin put forward three reasons in a row, and then said helplessly, "It can be done if it is not possible, mainly because the prognosis is really not good for the patient." He looked at The high school student lying unconscious on the bed shook his head and said, "How old is this? After the craniotomy, there is a piece of head missing. When I get older, I can't find a girlfriend."

"Actually..." Sun Li'en couldn't help interjecting, "Even if there is no shortage, finding a girlfriend is not easy..."

Dong Xin and Zhou Jun turned their heads and stared at Sun Lien who interrupted for a long time.They didn't look at each other unfathomably until they stared at him until his back began to sweat.

"I heard that there is a head nurse surnamed Hu in your department, right?" Dong Xin raised her volume a little, deliberately so that Sun Lien could hear clearly. "Her niece works as an instrument nurse in the operating room. She looks pretty."

Zhou Jun continued with a distorted expression, "Yes, the little girl is called Hu Jia. She may be two years younger than Xiao Sun." He paused and emphasized, "The little girl cooks very delicious food. Last year When I first joined the company, I gave us braised vegetables a few times, but they were all robbed in less than 2 minutes."

The two paused together, and then sighed in a very blunt tone, "What a good girl! It's a pity that she doesn't have a boyfriend yet."

You... Sun Li'en felt his face twitch wildly.How much benefit have you received from Aunt Hu?
The door of the emergency room was pushed open, and Chen Wen, who came to seek medical treatment in a helicopter, was pushed back.Dr. Cao Yanhua was wearing a mask, with a slightly nervous expression on his face.

"Is the operation done?" Zhou Jun walked over to help, and directed the nurses to start connecting the monitoring equipment.

"The thrombus on the coronary artery has been knocked out." Cao Yanhua reported the situation to the superior doctor. "But the situation is a bit troublesome."

Zhou Jun wondered, "What's the matter?" He looked around and asked in a low voice after making sure there were no outsiders, "Is there a coronary artery injury?"

Cao Yanhua shook his head like a rattle, "No." He looked at Chen Wen who was sleeping on the hospital bed, shook his head and said, "She woke up suddenly during the operation."

Coronary interventional surgery does not require general anesthesia, and it is not a big problem for patients to be awake during the operation.Sun Li'en raised his ears and listened curiously to what happened next.Something must have happened during the operation, so Cao Yanhua sent the little girl back to the emergency room instead of the PICU in the Children's Intensive Care Unit of the Fourth Central Hospital.

"She was furious, manic, and even tried to bite the nurse's hand." Cao Yanhua looked serious, "I gave her 10ml of haloperidol to calm her down again. I was worried that she had a cerebral hemorrhage, so I gave her a CTA."

"The result?" Zhou Jun also began to frown, "Is there a problem?"

"There is a problem. But it's not in the brain." Cao Yanhua pointed to Chen Wen's lower abdomen, "She has deep vein thrombosis in the lower extremities. The length is about four centimeters, and it has moved up to the position of the renal vein."

Deep vein thrombosis of the lower extremities, another disease that is unlikely to occur in children of this age.

Zhou Jun pondered for a while, and asked Sun Lien, "What do you think of this patient?"

"She is too young, and high blood lipids will not cause coronary heart disease and deep vein thrombosis." Sun Lien tapped his notebook with a pen, "The mania that appeared during the operation may be a new symptom of an unknown disease..." He turned his head, He looked at Chen Wen, who was still in a calm state. "Chen Wen, female, 10 years old, hypercalcemia state" However, this observation has made new progress, the five words hypercalcemia state are still shining, and there are five new words in the back, "hypercoagulation state .”

"Perhaps we should think about it in terms of blood." Sun Lien began to change the subject, "Although it will not be hyperlipidemia, if she is in a hypercoagulable state, it may indeed cause her to have multiple blood clots. Some of the blood clots appear in the In her coronary artery, ST-segment elevation myocardial infarction was caused. Part of it appeared in the deep vein of her lower extremity, causing an extra embolus on the wall of her blood vessel, which fell off with the vibration of the helicopter , followed the blood and re-stuck to the position of the renal vein. As for the mental state..."

"The microthrombus appeared in the brain, and then flowed into the amygdala." Dong Xin raised his eyebrows, "It sounds reasonable, the microthrombus in the amygdala may indeed cause unstoppable rage, and the CT in the compound operating room The machine is not accurate enough to see traces of that tiny thrombus."

For this bold speculation, Cao Yanhua objected, "There is no disease that will cause a ten-year-old child to have multiple blood clots throughout the body, and she has not had liposuction in a small clinic, let alone fat embolism."

"In any case, the thrombus in her inferior vena cava will never go away by itself." Zhou Jun made a decision, "Give her anticoagulant treatment with low molecular weight heparin and warfarin, at least to ensure that the venous thrombus will not disappear." killed her."

"I'll ask Professor Li and Director Qian to have another consultation to make sure there are no problems with the medication." Cao Yanhua nodded, turned and left the emergency room.

(End of this chapter)