MTLNOVEL I can see the status bar
Chapter 268 Hemoglobin
Chapter 268 Hemoglobin
It was completely dawn, and there were many people in white coats or hospital gowns waiting in line at the entrance of the hospital cafeteria.On the other side of the cafeteria, more than a dozen tightly wrapped incubators were slowly entering the inpatient building under the push of the cafeteria staff.These are breakfasts delivered to patients who ordered meals.
As for doctors...they don't get such good treatment.Either come in line to eat, or order takeaway or go out to eat.Hospital canteens are also very helpless, their supply capacity is not enough to cover all hospital staff and inpatients.Today's stove equipment has reached its limit.Unless the canteen is completely covered, it is absolutely impossible to meet the needs of everyone who needs to eat.
Xu Yourong and Zhou Ce were eating in the cafeteria. They looked around, but they didn't see Sun Lien.
"Dr. Sun has already gone back, right?" Zhou Ce joked to Xu Yourong, "Supposedly he should have left work long ago, but you stopped him with a click, be careful that the leader will give you small shoes to wear in the future."
Xu Yourong wiped the traces of soy sauce from the corner of his mouth, and calmly replied, "If he can learn to wear small shoes for people, then I don't have to worry about this treatment group being dismantled."
Zhou Ce heard that Xu Yourong's words meant something else, and couldn't help asking in a low voice, "What's the news?"
"It's nothing special." Xu Yourong continued to eat rice rolls with his head down. The Guangdong rice rolls that the chef in Hunan learned from the boss in Jiangxi tasted unexpectedly delicious. "Anyway, my boss is supporting me now, so the sky won't fall."
·
·
·
"With such a tossing method, you will collapse sooner or later." Zhou Jun looked at Sun Lien in front of him, furious.
After pondering for several hours in the small conference room, Sun Lien finally raised his hand and surrendered.He is just a trained doctor, not a professor who specializes in nephrology.No matter how he tried, he couldn't connect the staphylococcal pneumonia with the rapid exacerbation of chronic glomerulonephritis.
But the biggest advantage of being a front-line doctor is that you have a backer to rely on.If you don't understand the question, you can ask your brother!
Then Sun Lien was scolded by Zhou Jun.
"Streptococcus infects both lungs, causing acute glomerulonephritis. What's wrong with this diagnosis?" Zhou Jun knocked on the table at Sun Lien, "This is not tuberculosis, and it can also explain the patient's symptoms. Isn't it a good diagnosis?"
"However, the performance of imaging studies is wrong." Sun Lien took out the CT examination report he just got with a bitter face. "The patient's lungs showed ground-glass shadows, which did not meet the typical symptoms of pneumococcal pneumonia."
Zhou Jun took the CT report in Sun Lien's hand suspiciously, frowned and looked at it for a while, and said in a deep thought, "Is it the result of inflammatory changes or alveolar hemorrhage? Considering his coughing up blood, it is diffuse alveolar Bleeding (DAH)."
"Then I couldn't figure it out." Sun Lien said with a bitter face, "Streptococcal pneumonia cannot cause diffuse alveolar hemorrhage. The patient's five items of infectious diseases were all negative, and Pneumocystis carinii pneumonia can be ruled out. Recently He has not been exposed to chemicals or toxic substances for a month. The tumor markers are all good, and the blood coagulation function is also normal..." Sun Lien sighed, "I really can't figure out what's wrong with him."
Zhou Jun glared at Sun Lien, "You know he's not tuberculosis?" He seemed a little dissatisfied with Sun Lien's attitude in his words, "You, Sun Lien, can't just pour cold water on someone, but you have to find a way to figure out what's wrong with this person. What's the use of complaining? Complaining can let you know what disease he has, or can he simply cure him?"
Sun Li'en nodded bitterly to show that he had heard Zhou Jun's criticism.He sighed, as if resigned to his fate, he picked up the checklist again and read it again.
"Brother Sun, the morning routine blood test is out." While Sun Lien was struggling with the checklist, the nurse Xiao Guo knocked on the door, holding a piece of paper in his hand, and shook it at Sun Lien. "It's the test result of your patient."
Sun Lien took the checklist and thanked Xiao Guo.Then he looked down at the report.
"HB (hemoglobin) is only 80g/L?" Sun Lien frowned looking at the freshly released report.Holding the report with one hand, he began to rummage through the case records with the other.After flipping through the sorted examination reports all over the table, he found the first blood routine examination report when the patient was admitted to the hospital about six hours ago.
Hemoglobin content, 88g/L.Within eight hours, the amount of hemoglobin in the patient's body decreased by 8g/L.
"The patient coughed up blood twice after being admitted, about 150 milliliters." Zhou Jun also came over, looked at the freshly released data, and said thoughtfully, "It counted that he coughed up 200 milliliters of blood today, and it was all Suspended red blood cells are only 1U, and it would be great to reduce 5g. The ratio of hemoglobin reduction is too large.”
Generally speaking, in the blood of normal adult males, the normal reference value of hemoglobin should be around 120-160g/L.And once it drops below 120g/L, it can be considered anemia.When the hemoglobin concentration drops to 90g/L, the patient will experience hypoxia such as asthma and fatigue.When the hemoglobin concentration drops to 60-40g/L, the patient will suffer from acidosis due to insufficient circulation.Once it is lower than 40g/L, it is basically equivalent to declaring the death of the patient.
According to Wang Lin's current hemoglobin drop rate, within a day, his hemoglobin concentration will drop to the critical value of acidosis.After about 38 hours, his hemoglobin concentration will drop to the death line.
"Supplement two units of suspended red blood cells." Sun Li'en responded immediately, Wang Lin's hemoglobin content could not be lowered any further, and must be kept at a minimum level of 70g/L.He called Xiao Guo in again, and arranged, "Increase the oxygen concentration to 98%."
"We must find out the cause as soon as possible." Zhou Jun patted Sun Lien on the shoulder, "Communicate with your team members more. Brainstorming will help you find out the real cause."
·
·
·
"The concentration of hemoglobin drops rapidly. This is not a symptom of streptococcal infection." Returning from the cafeteria to the conference room, Zhou Ce rejected his diagnosis in frustration.He was quite confident in his diagnosis of streptococcus, but he was slapped in the face twice by video and blood routine just after he went to eat.
"Could it be an autoimmune disease? I think it might be SLE (systemic lupus erythematosus)." Dr. Pascale said after pondering for a moment, "SLE first acts on the kidneys, causing chronic glomerulonephritis, and then turns to attack Inflamed his lungs, causing a cough and coughing up blood."
"The patient's WBC (white blood cell) count increased, indicating an infection." Xu Yourong shook his head, "It must be a symptom caused by some kind of infection. This is not SLE."
Yuan Pingan raised his head and asked in a low voice, "Could it be a tumor? Paraneoplastic syndrome may also cause this symptom." He himself did not have much confidence in this inference.
"There is too little information now, so it's meaningless to just discuss it here." Sun Lien made a decision, "Do a lung and kidney biopsy on the patient."
(End of this chapter)
It was completely dawn, and there were many people in white coats or hospital gowns waiting in line at the entrance of the hospital cafeteria.On the other side of the cafeteria, more than a dozen tightly wrapped incubators were slowly entering the inpatient building under the push of the cafeteria staff.These are breakfasts delivered to patients who ordered meals.
As for doctors...they don't get such good treatment.Either come in line to eat, or order takeaway or go out to eat.Hospital canteens are also very helpless, their supply capacity is not enough to cover all hospital staff and inpatients.Today's stove equipment has reached its limit.Unless the canteen is completely covered, it is absolutely impossible to meet the needs of everyone who needs to eat.
Xu Yourong and Zhou Ce were eating in the cafeteria. They looked around, but they didn't see Sun Lien.
"Dr. Sun has already gone back, right?" Zhou Ce joked to Xu Yourong, "Supposedly he should have left work long ago, but you stopped him with a click, be careful that the leader will give you small shoes to wear in the future."
Xu Yourong wiped the traces of soy sauce from the corner of his mouth, and calmly replied, "If he can learn to wear small shoes for people, then I don't have to worry about this treatment group being dismantled."
Zhou Ce heard that Xu Yourong's words meant something else, and couldn't help asking in a low voice, "What's the news?"
"It's nothing special." Xu Yourong continued to eat rice rolls with his head down. The Guangdong rice rolls that the chef in Hunan learned from the boss in Jiangxi tasted unexpectedly delicious. "Anyway, my boss is supporting me now, so the sky won't fall."
·
·
·
"With such a tossing method, you will collapse sooner or later." Zhou Jun looked at Sun Lien in front of him, furious.
After pondering for several hours in the small conference room, Sun Lien finally raised his hand and surrendered.He is just a trained doctor, not a professor who specializes in nephrology.No matter how he tried, he couldn't connect the staphylococcal pneumonia with the rapid exacerbation of chronic glomerulonephritis.
But the biggest advantage of being a front-line doctor is that you have a backer to rely on.If you don't understand the question, you can ask your brother!
Then Sun Lien was scolded by Zhou Jun.
"Streptococcus infects both lungs, causing acute glomerulonephritis. What's wrong with this diagnosis?" Zhou Jun knocked on the table at Sun Lien, "This is not tuberculosis, and it can also explain the patient's symptoms. Isn't it a good diagnosis?"
"However, the performance of imaging studies is wrong." Sun Lien took out the CT examination report he just got with a bitter face. "The patient's lungs showed ground-glass shadows, which did not meet the typical symptoms of pneumococcal pneumonia."
Zhou Jun took the CT report in Sun Lien's hand suspiciously, frowned and looked at it for a while, and said in a deep thought, "Is it the result of inflammatory changes or alveolar hemorrhage? Considering his coughing up blood, it is diffuse alveolar Bleeding (DAH)."
"Then I couldn't figure it out." Sun Lien said with a bitter face, "Streptococcal pneumonia cannot cause diffuse alveolar hemorrhage. The patient's five items of infectious diseases were all negative, and Pneumocystis carinii pneumonia can be ruled out. Recently He has not been exposed to chemicals or toxic substances for a month. The tumor markers are all good, and the blood coagulation function is also normal..." Sun Lien sighed, "I really can't figure out what's wrong with him."
Zhou Jun glared at Sun Lien, "You know he's not tuberculosis?" He seemed a little dissatisfied with Sun Lien's attitude in his words, "You, Sun Lien, can't just pour cold water on someone, but you have to find a way to figure out what's wrong with this person. What's the use of complaining? Complaining can let you know what disease he has, or can he simply cure him?"
Sun Li'en nodded bitterly to show that he had heard Zhou Jun's criticism.He sighed, as if resigned to his fate, he picked up the checklist again and read it again.
"Brother Sun, the morning routine blood test is out." While Sun Lien was struggling with the checklist, the nurse Xiao Guo knocked on the door, holding a piece of paper in his hand, and shook it at Sun Lien. "It's the test result of your patient."
Sun Lien took the checklist and thanked Xiao Guo.Then he looked down at the report.
"HB (hemoglobin) is only 80g/L?" Sun Lien frowned looking at the freshly released report.Holding the report with one hand, he began to rummage through the case records with the other.After flipping through the sorted examination reports all over the table, he found the first blood routine examination report when the patient was admitted to the hospital about six hours ago.
Hemoglobin content, 88g/L.Within eight hours, the amount of hemoglobin in the patient's body decreased by 8g/L.
"The patient coughed up blood twice after being admitted, about 150 milliliters." Zhou Jun also came over, looked at the freshly released data, and said thoughtfully, "It counted that he coughed up 200 milliliters of blood today, and it was all Suspended red blood cells are only 1U, and it would be great to reduce 5g. The ratio of hemoglobin reduction is too large.”
Generally speaking, in the blood of normal adult males, the normal reference value of hemoglobin should be around 120-160g/L.And once it drops below 120g/L, it can be considered anemia.When the hemoglobin concentration drops to 90g/L, the patient will experience hypoxia such as asthma and fatigue.When the hemoglobin concentration drops to 60-40g/L, the patient will suffer from acidosis due to insufficient circulation.Once it is lower than 40g/L, it is basically equivalent to declaring the death of the patient.
According to Wang Lin's current hemoglobin drop rate, within a day, his hemoglobin concentration will drop to the critical value of acidosis.After about 38 hours, his hemoglobin concentration will drop to the death line.
"Supplement two units of suspended red blood cells." Sun Li'en responded immediately, Wang Lin's hemoglobin content could not be lowered any further, and must be kept at a minimum level of 70g/L.He called Xiao Guo in again, and arranged, "Increase the oxygen concentration to 98%."
"We must find out the cause as soon as possible." Zhou Jun patted Sun Lien on the shoulder, "Communicate with your team members more. Brainstorming will help you find out the real cause."
·
·
·
"The concentration of hemoglobin drops rapidly. This is not a symptom of streptococcal infection." Returning from the cafeteria to the conference room, Zhou Ce rejected his diagnosis in frustration.He was quite confident in his diagnosis of streptococcus, but he was slapped in the face twice by video and blood routine just after he went to eat.
"Could it be an autoimmune disease? I think it might be SLE (systemic lupus erythematosus)." Dr. Pascale said after pondering for a moment, "SLE first acts on the kidneys, causing chronic glomerulonephritis, and then turns to attack Inflamed his lungs, causing a cough and coughing up blood."
"The patient's WBC (white blood cell) count increased, indicating an infection." Xu Yourong shook his head, "It must be a symptom caused by some kind of infection. This is not SLE."
Yuan Pingan raised his head and asked in a low voice, "Could it be a tumor? Paraneoplastic syndrome may also cause this symptom." He himself did not have much confidence in this inference.
"There is too little information now, so it's meaningless to just discuss it here." Sun Lien made a decision, "Do a lung and kidney biopsy on the patient."
(End of this chapter)
Tip: You can use left, right, A and D keyboard keys to browse between chapters.