I can see the status bar

Chapter 1033 D+4 day (8)

Acute intestinal injury is a "forgotten" corner of the Institute of Critical Care Medicine.The reason is that the results of intestinal damage do not seem to be as rapid as other organ failures.

Patients with liver and kidney failure can have very serious consequences in a short period of time - and eventually death.And the damage from gut damage doesn't show up so quickly.

AGI (acute intestinal injury) is usually triggered by gastrointestinal ischemia or ischemia-reperfusion.As a result of the injury, a large amount of intestinal mucosa is damaged, and the vital "first barrier" function of the intestine is broken.

In addition to the function of absorption and digestion, the most important function of the human gastrointestinal tract is the "gut shielding" function.As a mechanical barrier, biological barrier, chemical barrier and immune barrier, the role of the gastrointestinal tract on the human body is far more important than we imagined.

The gastrointestinal tract is the "bacteria pool" of the human body. Under this biological barrier composed of various flora, the intestinal tract has the functions of defending against pathogen invasion and synthesizing vitamins.Under the bactericidal and antibacterial effects of gastric acid, intestinal juice, bile, pancreatic juice and other digestive juices, the chemical barrier can prevent bacteria and endotoxins from colonizing and adsorbing in the intestinal tract.

In the face of the infection of the new coronavirus, the more important role of the intestine is the role of the immune barrier.The gut is an important component of the mucosa-associated lymphoid tissue, which mediates immune responses, organizes bacterial adhesion to, destroys, and neutralizes infectious toxins.

The lymphoid tissue that fights infection in the respiratory tract and plays a role also belongs to the mucosa-associated lymphoid tissue.In other words, damage to intestinal mucosa-associated lymphoid tissue will also affect the working conditions of respiratory mucosa-associated lymphoid tissue.

The main work of this organization is to settle in immune cells such as mature T cells and B lymphocytes, and is responsible for filtering lymph.The process of filtering lymph is a very important way for the human body to remove pathogens.

Specific to patients with pneumonia infected with the new coronavirus, this process is even more important-due to the impaired immune barrier function of the intestine, the human body begins to mistakenly believe that it has encountered a very serious infection injury.The systemic lymphatic system becomes overactive, and a large number of cytotoxic T cells (TC) residing in the lymph are fully activated.They travel among all the cells in the body, massacring those that appear to be infected in an attempt to control the rate of infection.

However, a large number of cytotoxic T cells will inhibit the proliferation and activity of CD4+ helper T cells.The damage and messy "battlefield" caused by cytotoxic T cells lacks phagocytes to clean up, and the MHC molecules carried by dead cells are still floating in the human body, which will further stimulate cytotoxic T cells and increase their numbers and active.

The final result is to fall into a vicious circle and trigger a cellular inflammatory storm.

Therefore, the intestinal protection of infected patients should be improved to the same level as the triple therapy of tocilizumab, gamma globulin and CRRT.It should even be more active to carry out related treatments - after all, feeding patients [-] tablets of intestinal microbial ecological preparations has almost no negative effects on people.And the possible benefits are enormous.

Then there's no reason not to give it a try, is there?Sun Lien led the team into the cabin enthusiastically, and then started today's work.

Hu Jia and Sun Lien stood together, and she began to take on the job of the head nurse—no way, although other nurses also have a lot of work experience, their working hours in the cabin are limited.If you engage in this kind of half-in and half-preparation mode, then you have to add another shift in the middle.

This is obviously not conducive to the entry of the next group of staff, and hinders the smooth takeover of the entire process by the medical staff.In order to straighten out this process, the best way is to let Hu Jia be the head nurse - she has enough level and experience.But more importantly, she can work all the working hours in the red zone continuously.

For a nurse, the most important thing is to understand the patient's condition in his hands.And Hu Jia happened to have such ability.What's more coincidental, as the head nurse, Hu Jia's waist is very stiff when speaking in front of director Sun Li'en.

·
·
·
The effects of acute injury of the gastrointestinal tract on the patient itself are bewildering.In conscious patients, symptoms of acute GI injury are predominantly abdominal pain, constipation, and bloating.And this symptom is consistent with constipation caused by lying in bed for a long time and insufficient intake of cellulose.It is extremely difficult to get clues from conscious patients that they have acute gastrointestinal injury.And the status columns of these patients are really too many and complicated. Sun Lien himself did not find any patients with AGI in the four days of work anyway.

But if you don't find it, it doesn't mean you can let it go.Therefore, Sun Li'en issued the first "universal prescription" after he visited all the patients in the first round.For the first time, he didn't care about thousands of people and thousands of strategies, but prescribed live Bacillus licheniformis capsules to all the patients who were still receiving treatment in the North Fifth District, and the dosage was directly increased from two capsules at a time to three times a day It has reached the level of ten pills at a time, three times a day.

After writing out the prescription, Sun Li'en dealt with the intake and output settings of several patients, and then found the elder brother Qian Guojian who didn't want to continue the treatment and didn't want to live.

Qian Guojian is still under the influence of diazepam.But under the action of a relatively small dose of drugs, he still maintains a relatively clear consciousness.And can answer Sun Lien's questions.

"Brother Qian, your fever has subsided today." Sun Lien stood beside Qian Guojian and said while carefully observing the status bar above his head. "How do you feel now?"

"I want to...sleep." Qian Guojian muttered, then he opened his eyes with some difficulty, looked at Sun Lien and asked, "You...are you the doctor I talked to yesterday?"

"Yes, it's me." Sun Li'en nodded with a smile, although under the cover of the mask and mask, it's hard to say how much this kind of smile can be conveyed. "I think you seem to be in pretty good shape today."

"It's still hard to breathe, and I'm so sleepy." Brother Qian said after trying to breathe a few times, "But it's really... a little more comfortable."

"Do you feel uncomfortable in your stomach?" Sun Li'en nodded, then tapped Qian Guojian's abdomen a few times with his hand, "Do you feel any pain in this part?"

"It doesn't hurt, but it's uncomfortable." Qian Guojian replied, "I can't say why it's uncomfortable, but it just feels wrong."

It was only now that the two had talked, and Sun Li'en had just finished reading Qian Guojian's status bar.In the end, there was indeed a symptom of "AGI Phase I (04.12.33)".

Sun Lien roughly checked Qian Guojian's abdomen by percussion, and then announced his discovery to Qian Guojian, "You have a lot of accumulated gas in your stomach, which hinders the peristalsis of your intestines, which is why your abdominal pain is caused. Discomfort."

"Accumulation... Qi?" Qian Guojian repeated the word with some difficulty, and then asked, "What is that?"

"In the most easy-to-understand terms, it's 'fart'." Sun Lien explained, "It's actually quite simple to solve this discomfort, just let it out."

"I...can't release it." Qian Guojian frowned and said, "Do you have any medicine...or other means to deal with it?"

Sun Li'en thought for a while, then sighed, "We do have means, but this... this means may not be very comfortable."

　Sorry for the late update...a few hours, I may have overestimated my ability to recover.

　　There will be an update at [-] o'clock tomorrow morning, even if I don't sleep tonight, I have to write it.

　　
　
(End of this chapter)