Since 1981 Health School Chapter 652

  Xia Hua is the old director of internal medicine, relatively experienced, so he was the first to stand up:

   "The child has already had gastric lavage, and it has been too long, so now we can only treat the symptoms, slow intravenous injection of calcium gluconate, vitamin B, vitamin C, and vitamin K supplementation; hormone injections are also used to inhibit hemolysis.

   Then inject 10% sodium thiosulfate intravenously to assist renal excretion. Oh, by the way, penicillamine also has a certain effect of repelling arsenic, so it can be used. In addition, the child's hemoglobin has been as low as 4g, and blood transfusion is also needed to expand the volume, and attention should be paid to correct dehydration and electrolyte imbalance. "

  Although Yi Zewen is already an expensive department director, he still holds a doctor's order book like a little doctor. Director Xia said a medicine, and he recorded a medicine.

  At this moment, Director Zhu Huoyan shook his head:

   "Old Xia is talking about symptomatic treatment, so this is still not enough. The child has been poisoned by arsenic for two weeks, and the toxicity has penetrated into every organ and every aspect. It is best to have specific medicines. Do you have any suggestions in this regard?"

  Lan Lijuan said at this time:

   "There are indeed specific medicines for arsenic poisoning, such as sodium dimercaptosulfonate and disodium dimercaptobutane, but these two medicines are not available in Yuezhong, and I am afraid that there are few in the whole country, because they cannot be produced in China."

  Director Xia nodded in agreement: "Yes, if there is such a special medicine, I would have said so."

  Sodium dimercaptosulfonate, disodium dimercaptobutane?

  Chen Qi was stunned when he heard it. In fact, he was looking for these two medicines in the space operating room with his mind. After all, he emptied a top hospital in the United States, and there were all kinds of rare medicines.

   Then he came back to himself and made a fist, because he found it.

   Now is not the time to think of excuses, Fu Zhenzhen is already on the verge of life and death, the sooner the patient takes the medicine, the more possibility of living.

   "Sodium dimercaptopropanesulfonate, disodium dimercaptobutane, right? After I received the call from Yangshan Hospital, I asked someone to transfer the goods, and now I'll go get them."

  The other doctors were excited when they heard it: "Great, Dean Chen is really powerful, and he can get any medicine."

   Lan Lijuan was secretly puzzled, because her man had been asking the physician what medicine to use before, why did he suddenly change his words and say that he already knew what medicine to use and had someone bring it?

  But she is not going to get to the bottom of it. Everyone has their own secrets, so it's rare to be confused.

Chen Qi ran out of the ward, ran around outside the hospital casually, and ran back as fast as he could. In the blue medicine box in his hand were needles of sodium dimercaptosulfonate and dimercaptobutane. disodium needle.

   "Director Xia, Lijuan, hurry up, I've brought the special medicine, how do I use it?"

  Director Xia Hua eagerly took the medicine and took a look, with a golden light in his eyes:

   "This is a product from the United States. It is too precious. Quickly, inject 0.2g of sodium dimercaptopropane sulfonate intramuscularly, and another 2g of sodium dimercaptobutadiene, dissolve in 20ml of normal saline and inject intravenously."

  The head nurse Liu Min took the medicine immediately, went to the nurse station to dissolve the medicine, and came to give the medicine to the patient in person, for fear that the little nurse would spill such a precious medicine.

   Director Zhou of Yangshan Hospital, who was pretending to be small and transparent, looked at it and was stunned.

Sodium dimercaptosulfonate and disodium dimercaptobutane, of course, he knew about the two specific medicines, and he also went through the information, but Yangshan Hospital contacted all major hospitals and pharmaceutical companies across the country for these two medicines, and they answered that they were all out of stock. .

(Except for special departments in the country that have stocks, other major hospitals dare not import them. After all, foreigners sell them to domestic hospitals for thousands of dollars, and medicines have an expiration date. If they expire, the responsibility No one dares to bear it.)

  Good guy, Yangshan Hospital tried their best to get the special medicine, but Yuezhong Hospital got it in a few hours.

  How outrageous is the network and channels of this Yuezhong Hospital? How does this Yangshan Hospital compare? It's not on the same level at all.

  That night, Yuezhong Hospital arranged two doctors, two nurses, and two nurses to take care of the young patient Fu Zhenzhen.

  The condition of the little patient also affects everyone's heart.

  The next day, Chen Qi and Lan Lijuan deliberately arrived at the hospital at 7:00 in the morning, and went directly to the burn surgery ward, only to find that many doctors were already there.

   "Guo Shuji, Teacher Zhu, Teacher Xia, have you come here so early?"

  No one answered Chen Qi, everyone looked down at the progress record of the night, and the inspection reports that came out one after another after being admitted to the hospital.

  Chen Qi didn't take it seriously either, and stretched his head to see the inspection report as well.

  I don't know if I don't look at it, and my mood fell to the bottom when I saw him. No one greeted him, but he didn't want to answer them.

  Because several indicators are very pessimistic.

  The head nurse Liu Min has been taking care of the little patients in the hospital last night. An experienced old nurse can be as good as a senior doctor:

"Let me tell you that when I defecated the patient last night, I found that the stool was black, so I deliberately took an extra blood and took it to the emergency room for testing. You see, the hemoglobin is only 70, which means there is internal bleeding. "

   This is really a wave of ups and downs, and another wave. The poisoning and burns have not been fixed yet, and the digestive tract is bleeding first.

   This matter is Lan Lijuan's specialty, so she immediately went to the little patient and performed a physical examination on Fu Zhenzhen who was in a coma.

   A few minutes later, Dr. Lan gave his opinion:

   "I think it should be a stress ulcer. It's hard to say whether there is a perforation, but such a low hemoglobin is still quite dangerous."

  Stress ulcer generally refers to acute gastritis that occurs after shock, trauma, surgery, and severe systemic infection, and is often accompanied by bleeding symptoms. It is an acute gastric mucosal lesion.

   Chen Qi saw that everyone was frowning, and decided to cheer up the team:

"Other hospitals can't do anything about ulcer bleeding. Is it still a problem in our hospital? Head nurse, ask Professor Zhang Weizhong to come over with a gastroscope immediately. Let's endoscopically stop the bleeding first. In addition, Dr. Lan, you can order omeprazole immediately. Use the injection."

  Everyone heard the same thing. The best endoscopic technique in the world is Yuezhong Hospital. Gastrointestinal bleeding is not a problem.

   After a while, Professor Zhang Weizhong and several students came with tools and began to perform endoscopic ulcer hemostasis.

   But Chen Qi was pulled aside by Director Xia of the Department of Internal Medicine, pointed to a page of report and said:

"President Chen, look at the liver function. Both aspartate aminotransferase and alanine aminotransferase have exceeded 1000U/L, and the creatinine value has reached 1500μmol/L. This is acute liver and kidney failure. If it is not treated, follow-up treatment is meaningless. Well, this patient probably won't last a week."

  The normal value of aspartate aminotransferase and alanine aminotransferase is 0-40U/L, and the normal value of creatinine is generally 44~132μmol/L.

  The two indicators of the little patient in front of me can only be described as drag racing.

  The consequence of these biochemical indicators breaking the table is that the detoxification function of the liver and the detoxification function of the kidney have almost been lost.

  In addition, the risk of hemorrhage in liver failure will increase, hepatic encephalopathy and blood ammonia will increase significantly, and some patients may develop hepatorenal syndrome, which has a fatal risk.

   When renal failure occurs, the ability to drain water and detoxify is significantly reduced, which will lead to heart failure. Some patients may develop uremic pneumonia and uremic encephalopathy, and severe patients may have hyperkalemia and metabolic acidosis.

  The related conditions mentioned above may have fatal risks. For example, hyperkalemia can lead to cardiac arrest, or even the risk of sudden death.

  As long as a doctor understands the danger of liver and kidney failure, let alone there is a respiratory failure now.

   Director Xia added:

"The liver and kidney functions are so bad. The fundamental problem is that the arsenic toxicity in the patient's blood cannot be completely eliminated, and it is still continuously harming the liver, kidney and other organs in the whole body. It seems that the two imported special effects drugs you brought yesterday did not work. Effect."

  The meaning is also very simple, this little girl was poisoned by arsenic, and now she is about to be poisoned to death.

  This problem can't be solved. It's just a few days before the patient dies. Even if your burn surgery technique is outrageous, it's useless. You won't last this day.

  Chen Qi was also worried. He was bragging to the reporters yesterday, but today the **** is about to explode. Where does this put his credibility?

  The most important thing is that he also pitied Fu Zhenzhen, a little patient, and wanted to do his part.

   Just when everyone was sighing, a little nurse muttered a few words to herself:

   "You said that if we doctors can also heal the patient's injuries like a qigong master, and then force out the toxins in the body, and then the patient spits out two mouthfuls of black blood, the arsenic toxicity will be eliminated, how good it is?"

  The little nurse's words first aroused Director Xia Hua's rebuttal. The old lady has the same temper as Lao Guo, and she can't tolerate sand in her eyes.

   "Fart, what qigong fart, what a mess, if qigong can cure diseases, why do we need doctors?"

  Chen Qi's eyes lit up when he heard it, and he clapped his hands excitedly:

   "That's right, if there is a treatment method that can force out the toxins in the blood and then remove them."

   Director Zhu Huoyan raised his eyebrows when he heard this: "Chen Qi, why do you believe in qigong?"

  Lan Lijuan was lowering her head to treat patients, but when she heard that her husband was going to use qigong for treatment, she stood up straight in fright, and looked at Chen Qi with puzzled eyes.

  She was a little puzzled, because when the couple chatted privately, Chen Qi always said that Qigong was a pseudoscience, a deceptive thing, and even said that it would affect national security in the future.

  Why now he also believes in Qigong?

  That is, old Comrade Guo went out just now. If he was present, it is estimated that Chen Qi would be hit on the back of the head again.

   And Zhou Siqi, director of the Department of Surgery of Yangshan Hospital who has been acting as a little transparent by the side, rolled his eyes, thinking that Qigong can really cure diseases? Anyway, he is more or less trustworthy.

  Chen Qi got angry when he heard this, rolled his eyes and said:

   "Why is Qi not Qigong? My belief in Qigong is not as good as Brother Xinchun. Think about it, what is the topic that Dr. Wu Ping is working on in China?"

   At this time, the eyes of several veteran doctors lit up: "You mean hemodialysis?"

  Dr. Wu Ping's major is urology. Urology or nephrology has a very difficult disease "uremia".

   There is almost no cure for this disease, and it is irreversible.

  If you want to survive, besides kidney transplantation, there is another treatment is "hemodialysis", which can also be called "artificial kidney".

  Hemodialysis is no stranger to ordinary people decades later, because with changes in the environment and food, there are more and more uremias. Which community or village does not have many such patients?

   Dialysis can be divided into three types: hemodialysis, peritoneal dialysis, and colon dialysis. In the 1980s, it was mainly hemodialysis.

  The hemodialysis that everyone knows is very simple. It is to insert two tubes into the blood vessel, one for bleeding and one for inflow, and then the machine will automatically remove toxins in the blood when it is turned on.

  However, in Huaguo in the 1980s, although hemodialysis technology existed, it was not popularized. Except for the capital, Tianjin, and Shanghai, there were no hospitals that could perform hemodialysis at all.

   There are two main reasons.

  One is that the cost of hemodialysis is too high.

  All equipment consumables and medical products are imported. It costs 180 yuan to do one hemodialysis, almost 500 yuan three times a week, and 2000 yuan a month as a base.

  But these days, an ordinary worker can get 200 yuan a month, which is not bad. The expensive expenses are beyond the reach of ordinary people. The key is that hemodialysis is lifelong, and it must be done continuously.

  So those who can afford hemodialysis, in the 1980s, basically either climbed snow-capped mountains by themselves, or the parents of patients climbed snow-capped mountains.

  The second is that hemodialysis equipment is too backward.

  When advanced instruments such as continuous high-flux dialysis (CHFD), continuous high-volume dialysis (HVHF), and on-line hemodiafiltration (on-line HDF) have been clinically applied abroad.

  The domestic hemodialysis machines are still very primitive machines, such as "baby scale hemodialysis machines".

  This is using a single pump as the blood pump, while the fluid in and out of the filter is still dependent on gravity, and the balance of the fluid is monitored using two baby scales and achieved by manually adjusting the infusion rollers.

  This hemodialysis machine does not have any fully automatic links, and many steps need to be adjusted manually, and people cannot be separated for a moment.

  As long as it is a manually operated machine, there will be mistakes. If you are not careful, there will be a problem of capacity balance, which will lead to the failure of dialysis.

   There is definitely a curative effect, but how good the curative effect is, it can only be said that it can only save life.

   To use a helpless saying, something is better than nothing.

  In the original history: the first modern continuous renal replacement therapy machine in China, that is, the automatic hemodialysis machine Prisma, was not introduced until 1998.

  So the hemodialysis profession was still very backward in China in the 1980s, and it was far from meeting the conditions for promotion.

  So when many people in Yuezhong Hospital heard about "hemodialysis technology", their eyes lit up at first, and then dimmed.

  Because of "hemodialysis technology", there is no doctor in Haidong Province who can play it, and there is not even a hemodialysis machine in Haidong Province.

   Not to mention the local hospital, Yuezhong Hospital. (end of this chapter)

Chapter end