Start with an emergency physician
Chapter 107
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"What's going on?"
Zhou Yuan asked as he hurried to the obstetrics and gynecology department with Lu Chenxi.
Lu Chenxi's face looked very bad, and she said,"The two patients have been under surveillance and there have been no problems. But just now, the older one started to have a fever and convulsions all over his body!" Outside the emergency room, the patient's parents were already crying.
They never thought that the child who had already completed the skull separation surgery would be pushed into the operating room again.
Zhou Yuan quickly changed his clothes, made preoperative preparations, and entered the operating room
"Zhou Yuan!"When Wei Lili saw Zhou Yuan, she suddenly felt more relaxed.
"The patient's physical condition." Zhou Yuan walked forward and asked.
Wei Lili said:"Preliminary diagnosis, pediatric epilepsy!"
Zhou Yuan frowned.
Pediatric epilepsy is a common neurological syndrome with complex etiology and recurrent attacks in children. Clinical manifestations include recurrent muscle twitching, etc.
"High fever, whole body convulsions, we judge���It is caused by pediatric epilepsy!" He Jing checked the patient's temperature and her face changed slightly,"It's already 39.5 degrees Celsius!"
The baby lying on the operating table twitched from time to time, and his lips were blue and purple.
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 aspect, and I am not even as good as He Jing who came here for further studies. Why did she ask me to come?
Wei Lili seemed to see what Zhou Yuan was thinking and said,"We have done routine blood, urine and stool tests before. Blood biochemistry shows that the patient's sugar, calcium, phosphorus and electrolyte conditions are all within normal range. There are no abnormalities in liver and kidney function, and the chromosomes are normal.……"
"Moreover, the patient's parents were also asked, and there was no family history of genetics, so primary epilepsy was basically ruled out!"
So-called primary epilepsy means that the cause of the disease has not been found, and most of them are related to genetics. This part of epilepsy patients accounts for about 20% of the total number of epilepsy patients, also known as cryptogenic epilepsy or hereditary epilepsy.
The opposite is called secondary epilepsy, also known as symptomatic epilepsy, which has a specific cause.
Zhou Yuan glanced at Wei Lili and said,"You mean, the patient's pediatric epilepsy is related to the brain?"
He had just finished a skull separation operation, and it was obvious that there was a high probability that it was a problem with the brain, and it was very likely that it caused postoperative complications.
Wei Lili nodded seriously and said,"We suspect that it is pediatric epilepsy induced by cerebrovascular disease!"
Zhou Yuan frowned: the most worried postoperative complications still appeared.
This thing cannot be avoided by technology.
Sure enough, the skull separation operation for conjoined twins is not that simple. Even if the operation is completed, it only means that a dangerous period has passed.
""EEG check!" Zhou Yuan said.
The skull separation surgery gave Zhou Yuan a good understanding of brain structure.
He now had to confirm the cause of the childhood epilepsy. If it was a tumor, he would have to immediately ask the neurosurgery and neurology department to come for a consultation and remove the tumor.
Wei Lili nodded:"It's been prepared a long time ago. He... Go get the order, it should be out."
He Jing ran out quickly and came back.
"It's epilepsy……"Zhou Yuan checked the EEG and determined the type of disease.
""We are now performing single-light emission tomography and positron emission tomography!" Zhou Yuan said.
These two auxiliary methods are needed in the skull separation surgery to detect cerebral blood flow and brain metabolic function respectively. Now we can understand the changes in brain function and help locate epilepsy.
"And... perform cerebral angiography!"
Zhou Yuan said quickly.
Soon, the results came out.
""Childhood epilepsy caused by subarachnoid hemorrhage!" Zhou Yuan said.
Subarachnoid hemorrhage is a general term for the sudden rupture of cerebral blood vessels due to various reasons, and blood flows into the subarachnoid space. During the skull separation operation, a series of complications will occur because the originally symbiotic brains operate independently. This is one of the most serious complications.
"Issue a critical illness notice immediately!"
"Nimodipine injection!"
"Give 6-aminocaproic acid!"
Zhou Yuan frowned and issued a series of orders.
Nimodipine is a drug that prevents and relieves cerebral vasospasm, and it is used 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 the blood pressure and intracranial hypertension as soon as possible! Contact the neurologists and neurosurgeons, and ask them to come for a consultation as soon as possible!"
Now he must get the angiography results immediately to confirm the cause of the subarachnoid hemorrhage. If it is really a rupture of cerebral blood vessels caused by tumors, he must ask the neurology department to perform the resection.
"Doctor, how is my child?"
Seeing Zhou Yuan hurried out, the patient's parents ran up anxiously.
Zhou Yuan looked a little ugly and said,"I need you to sign a critical illness notice!"
The patient's mother's legs softened and she sat on the ground with a dazed look.
"Why...why! Hasn't he been rescued? Why?……"
The nurse quickly brought the critical illness notice. The patient's father picked up the pen, but his hands were shaking so much that he couldn't see what he wrote.
Zhou Yuan quickly took out the blood angiography results.
"Fortunately... it's not an aneurysm or a ruptured blood vessel at the base of the brain."
If it's an aneurysm that ruptures, the situation will become very dangerous and life-threatening. Even if the life can be saved, it may become a vegetable.
Fortunately, it's just a ruptured superficial blood vessel in the brain.
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.
Any complication near the brain could be fatal, but compared with the others, this was relatively good.
"Director Xiao, you open the skull and I will suture it."
Xiao Xuebo nodded.
The nurse then sent the family the informed consent form and critical illness notice.
It is very dangerous to open the skull again for a baby who has just undergone skull separation surgery, but in the face of postoperative complications that cannot be avoided by technology, this is the only way.
""Scalpel." Xiao Xuebao cut the artificial skin along the incision line drawn by Zhou Yuan.
Zhou Yuan had left the operating room before, so he ran to do the preoperative disinfection again.
"Almost done." Xiao Xuebao said when he saw Zhou Yuan walk in with his hand raised.
Zhou Yuan:"Not bad."
Hearing Zhou Yuan's praise, Xiao Xuebao was delighted, just like a primary school student who was praised, and said with a smile:"That's right! I am the director of neurosurgery after all!"
After saying this, Xiao Xuebao's expression suddenly froze.
Damn...
I am the director of neurosurgery, and I am praised by an intern, how can I be happy!!
Suddenly, Xiao Xuebao felt bad._Feilu reminds you: Three things to do when reading - collection, recommendation, and sharing
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