Doctor: It's reasonable to perform surgery on yourself.
Chapter 1056 The only way out among countless dead ends!
Under the solemn gazes of everyone, Xu Qiu gave the next treatment plan.
For glomerulonephritis, his strategy is very simple. First, take a sufficient amount of the hormone prednisone orally to lower the blood creatinine and resolve the gross hematuria.
In a short period of time, urine occult blood and urine protein will definitely still be positive.
Therefore, it is necessary to be prepared for hormone plus immunosuppressive treatment.
"The patient's burn wounds are most likely to be infected by Staphylococcus aureus, and then hematuria, proteinuria, and blood creatinine increase. If autoimmune diseases are excluded, it can basically be determined to be acute nephritic syndrome..."
Xu Qiu spoke eloquently and explained Tian Ling's illness in just a few words.
It would take at least three or four days for the golden index pathology results to be released, and Tian Ling couldn't afford to wait. Therefore, what had to be considered at this time was the doctor's experience and the patient's luck.
However, this is not a problem for Xu Qiu.
He can combine the knowledge of various departments to make judgments, sometimes considering more than a machine.
After all, the laboratory department is only responsible for a single sample, while Xu Qiu can have an overview of the patient as a whole.
"...glucocorticoids work?"
At this time, doctors from the nephrology department and endocrinology department were a little surprised.
Xu Qiu's method of dealing with nephritis turned out to be hormone shock... Are you sure it will work?
"You can check the literature later." Xu Qiu simply replied.
After all, this meeting is urgent, so it is impossible to teach in a leisurely manner.
Xu Qiu's treatment plan was naturally well prepared. He reviewed many literatures and confirmed that the use of glucocorticoids for patients with post-burn nephrotic syndrome can effectively reduce urinary protein and microscopic hematuria, and promote renal function and blood pressure. recover……
Although the current mechanism is unclear and there are different opinions, the effect is indeed fidelity.
The only thing that needs to be noted is that after the patient's renal function improves, he cannot stop hormone treatment too early, otherwise the blood creatinine will rebound explosively. This is important to note.
After hearing this, many people swallowed their saliva and lowered their heads in embarrassment.
Although Xu Qiu did not reprimand them, the meaning of his words was obvious - there were already similar studies in the literature.
Xu Qiu's ability has reached such a high level, but he still frequently browses through various cutting-edge research, while they, the underachievers, do not have the same attitude as the other party...
This comparison makes many people feel ashamed!
But when I changed my mind, I realized that perhaps it was precisely because of this that the gap between Xu Qiu and them was so exaggerated.
…
"Then there's severe enteritis and DIC."
Before everyone had time to digest the contents of the previous page, Xu Qiu started a new round of symptomatic treatment.
He said slowly:
“The causative bacteria are most likely Clostridium difficile, and the patient has antibiotic-associated diarrhea. The treatment method is simple, just stop using antibiotics, terminate the trigger, and replace with other effective antibiotics.
"However, Tian Ling cannot change antibiotics rashly at the moment. Once the medicine is stopped and changed, her body may not be able to survive.
Therefore, my idea is to use vancomycin in combination with oral administration to increase the intestinal drug concentration.
In addition, the cause of the patient's DIC is also very simple. It is most likely due to the decrease in vitamin K production caused by intestinal flora imbalance, which in turn affects the abnormal coagulation mechanism... Treatment with VitK1 and the addition of a small dose of heparin can correct it..."
After Xu Qiu finished speaking, countermeasures also appeared on the screen.
Oral vancomycin in addition to antibiotic treatment;
Transfusion of red blood cell suspension and homotype plasma;
VitK1+low dose heparin…
…
After Xu Qiu gave the plan, the meeting did not last long. The feasibility was briefly discussed. After no one could raise any objections, the new treatment plan was implemented.
Looking at Xu Qiu's back rushing to the next surgery, the awe in the eyes of everyone in the conference room became more and more intense.
"Is this your multidisciplinary clinical discussion?" Kong Lan didn't respond.
She was prepared to have a big quarrel among various departments and argue over a certain indicator. She might even have a protracted fight, and there might not be a conclusion until noon.
The result...is this? !
This efficiency is simply off the charts!
The eyes of the others looking at the clinical doctors were full of envy.
I had only heard that you all hugged each other, and I thought it was really cool.
Only now do I realize that this is more than just fun!
There is no need to use your brain at all, just know how to shout 666!
"However, medicine is too cruel. Even if all the plans are correct and the best countermeasures are taken, various accidents may still happen." Suddenly, someone said this.
Not only did this cold water splash not arouse dissatisfaction, but it made many people sigh secretly and think of their own unbearable past.
Who among the people present has not tried his best to save a patient, but in the end failed to do so?
I just hope that Tian Ling can develop according to the textbook burn process and not have too many accidents!
If he really can't be saved, it's not because Xu Qiu is not capable, but because extremely severe burns are still a threshold that modern medicine cannot overcome!
If he is rescued... No, he is still unable to cross the threshold to be rescued. The difficulty that only Xu Qiu can overcome does not count as being overcome by the medical community!
…
In a tense and expectant mood, Tian Ling's condition continued to fluctuate over time.
During this process, medical staff took care of her around the clock, and dressing changes were performed forty or fifty times.
And Xu Qiu was not idle either. During these six days, with the application of hibernation drugs, the patient's vital signs were reduced to the lowest level, but the crisis still existed!
For this reason, Xu Qiu personally took action and performed six operations such as wound expansion and eschar removal. Any operation was equivalent to pushing Tian Ling into the hands of the King of Hell.
However, even so, Tian Ling still miraculously survived.
It felt like a pair of hands moved the King of Hell's pen. "Tian Ling" was just written. Tian Ling made a mistake halfway through, crossed it out, re-wrote it, and then made another mistake...
The extreme pull belongs to yes.
Finally, on the sixth day of the hibernation therapy, 144 hours later, good news came back from the ICU.
Tian Ling survived the ravages of high fever, renal failure, acute renal injury, enteritis, DIC and other diseases under the background of extremely severe burns!
Each disease is like the last snowflake that overwhelms the avalanche, and then she did not collapse after all, and won a short respite in this tug-of-war between modern medicine and the god of death!
Everything shows that Tian Ling has passed the most dangerous stage of shock, and since then she can finally start to tackle the real problem!
It is not an exaggeration to say that she has survived from a desperate situation!
After receiving the news, Kong Lan, Cheng Pingsheng and others were extremely shocked.
During this period, those with burns less than 50% have basically been discharged from the hospital, and only a few severely burned patients in the clinical medicine are still being treated.
And several patients with burns of 60% have begun skin grafting, and their lives have been saved. The next step is basically to consider the recovery effect.
As for Tian Ling, most people in the industry and the outside world believe that Tian Ling is dead.
After all, who can live so long in a state of burns and shock, not even Saiyans!
However, the hibernation plan proposed by Xu Qiu bypassed this problem in a nearly bug-free way, and gave Tian Ling a glimmer of hope!
Kong Lan and Cheng Pingsheng were also ecstatic and were about to share the good news with their peers in the industry.
But before the news could be sent out, the emergency department suddenly started to make noise again, and then a temporary group chat popped up.
[Linhai First Hospital Burn Treatment Expert Group]
Xu Qiu: The patient's condition has taken a turn for the worse, please come to the emergency department office for consultation!
…
Kong Lan and Cheng Pingsheng looked at each other, their eyes full of shock.
At this time, what happened again... Shouldn't it be stable?
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