Start as an Emergency Physician

"What's the situation?"

Zhou Yuan asked while hurrying with Lu Chenxi to the obstetrics and gynecology department.

Lu Chenxi's face was very ugly, and said: "The two patients have been monitored, and there are no problems, but just now, the older one started to have a fever and had convulsions all over his body!"

Outside the rescue room, the patient's parents were crying silently.

Little did they know that the child, who had already undergone the skull separation operation, would be pushed into the operating room again.

Zhou Yuan quickly changed his clothes, made preoperative preparations, and entered the operating room.

"Zhou Yuan!" Wei Lili saw Zhou Yuan, and she didn't know why her mood suddenly relaxed.

"The patient's physical condition. Zhou Yuan stepped forward and asked.

Wei Lili said: "Preliminary judgment, pediatric epilepsy!"

Zhou Yuan's brows furrowed.

Pediatric epilepsy is a common neurological syndrome with complex etiology and recurrent seizures in childhood, and the clinical manifestations include recurrent muscle twitches.

"High fever and convulsions all over the body, we judge that it is caused by pediatric epilepsy!" He Jing probed the patient's body temperature, and his face changed slightly, "It's already 39.5 degrees Celsius!"

The baby lying on the operating table twitched and his lips were blue.

This is a symptom of pediatric epilepsy.

But...... I am not good at pediatric epilepsy, I am definitely not as good as Wei Lili in this regard, and I am not even as good as He Jing, who has come to further study, why are you looking for yourself?

Wei Lili seemed to see what Zhou Yuan was thinking, and said, "We have done routine tests of blood, urine, and stool before, and blood biochemistry shows that the patient's sugar, calcium, phosphorus, and electrolytes are all within the normal range. There is no abnormality in liver and kidney function, and the chromosomes are normal..."

"Moreover, the patient's parents were also questioned, and there was no family genetic history, so they basically rejected primary epilepsy!"

The so-called primary epilepsy, that is, epilepsy for which no cause has been found, is mostly genetic. This group of epilepsy patients accounts for about 20% of the total number of epilepsy patients, also known as cryptogenic epilepsy or hereditary epilepsy.

On the other hand, it is called secondary epilepsy, also known as symptomatic epilepsy, and has a specific cause.

Zhou Yuan glanced at Wei Lili and said, "You mean that the patient's pediatric epilepsy is related to the brain?"

I have just undergone skull separation surgery, and I think it is likely to be a problem with the head, and it is likely to cause postoperative complications.

Wei Lili nodded solemnly and said, "We suspect that it is pediatric epilepsy induced by cerebrovascular disease!"

Zhou Yuan frowned: the most worried postoperative complications still appeared.

This stuff can't be avoided by technology.

Sure enough, the skull separation surgery for conjoined children is not so simple, and even if the operation is completed, it only represents a dangerous period to pass.

"EEG examination!" Zhou Yuan said.

The surgery for the separation of the skull gave Zhou Yuan a mastery of the structure of the brain.

He now wants to confirm the cause of pediatric epilepsy, and if it is a tumor, he can only immediately ask someone from the brain surgery department and neurology department to come and have the tumor removed.

Wei Lili nodded: "It's been prepared for a long time, He went to get the list, it should come out." "

He Jing quickly ran out and came back again.

"It's epilepsy..."Zhou Yuan looked at the electroencephalogram and determined the type of disease.

"Now for single optical emission tomography and positron emission tomography!" Zhou said.

These two auxiliary methods are used in skull separation surgery to measure cerebral blood flow and brain metabolism respectively, which is now a good time to understand changes in brain function and help locate epilepsy.

"And... Have a cerebral angiogram!"

Zhou Yuan said quickly.

Soon, the results came down.

"Pediatric epilepsy caused by subarachnoid hemorrhage!" Zhou Yuandao.

Subarachnoid hemorrhage is a general term for blood flow to the subarachnoid space caused by the sudden rupture of cerebral blood vessels caused by various causes. In skull separation surgery, a series of complications occur due to the independent operation of the originally symbiotic brain, which is one of the most serious complications.

"Immediate critical illness notice!"

"Inject nimodipine!"

"Give 6-aminocaproic acid!"

Zhou Yuan had a calm face and issued a series of orders.

Nimodipine is a drug to prevent and relieve cerebral vasospasm, as long as it is to control the condition, while 6-aminocaproic acid is a hemostatic drug.

Zhou Yuan said, and quickly walked out of the operating room, "You control blood pressure and intracranial hypertension as soon as possible! Contact neurology and neurologists and ask them to come over for consultation as soon as possible!"

Now he must immediately get the blood gram results to confirm the cause of the subarachnoid hemorrhage, and if it is really a tumor or other induced rupture of cerebral blood vessels, he must ask a neurology department to remove it.

"Doctor, how is my child?"

Seeing Zhou Yuan walking out in a hurry, the patient's parents ran up anxiously.

Zhou Yuan's face was a little ugly, and he said, "I need you to sign a critical illness notice!"

The patient's mother sat on the ground with a weak leg and a sluggish expression.

"Why... Why! Isn't it already rescued? Why..."

The nurse quickly delivered the critical illness notice, and the patient's father picked up the pen, his hands shaking so much that he couldn't read what was written.

Zhou Yuan quickly obtained the results of the blood imaging.

"It's okay... Not an aneurysm and a ruptured blood vessel at the base of the brain. "

If the aneurysm ruptures, the situation can become dangerous, life-threatening, and even if it can be saved, it can become a vegetative state.

Fortunately, only the superficial blood vessels of the brain ruptured.

When Zhou Yuan rushed back to the operating room, Xiao Xuebo had already arrived.

"The blood pressure has risen back and the intracranial hypertension has been controlled. He Jing said.

Zhou Yuan explained the cause of the disease, and everyone breathed a sigh of relief.

Although everyone breathed a sigh of relief, it did not mean that it was not dangerous.

Complications near the brain, any one is fatal, but compared to the others, this is relatively good.

"Director Xiao, you come to perform a craniotomy, and I will suture it. "

Xiao Xuebo nodded.

The nurse then sent the family an informed consent form for surgery and a critical illness notice.

It is dangerous to give a second craniotomy to a baby who has just undergone cranial separation surgery, but it is the only way to do it in the face of this postoperative complication that cannot be avoided with technology.

"Scalpel. Xiao Xuebo cut the artificial skin along the incision line drawn by Zhou Yuan.

Because Zhou Yuan had left the operating room, he ran again for preoperative disinfection and so on.

"It's almost done. Xiao Xuebo saw Zhou Yuan walk in with his hand raised and said.

Zhou Yuan: "That's good. "

Hearing Zhou Yuan's praise, Xiao Xuebo was overjoyed, and said with a smile like the praised primary school students: "That's it! I'm also the director of the Department of Brain Surgery!"

After saying this, Xiao Xuebo's expression suddenly froze.

Damn...

Lao Tzu is the director of brain surgery, and I was praised by an intern doctor, I am happy to fart!!

Suddenly, Xiao Xuebo's whole person was not good. _

Feilu reminds you: there are three things to read - collection, recommendation, and points