I can see the status bar

Chapter 288 The Cause of Hemolysis

Blood disorders can cause severe vomiting and low back pain.When intravascular hemolysis occurs, free hemoglobin leads to depletion of nitric oxide, which induces smooth muscle spasm, which manifests as gastrointestinal symptoms, vomiting, and esophageal spasm that can lead to dysphagia.The blood vessels of the bone marrow may also spasm due to this reason, which may cause low back pain in patients.Severe spasms may lead to a "forced position" in the patient.Both are driven by pain to maintain a certain posture and cannot be relieved.

"Blood transfusion masked the symptoms of anemia caused by hemolysis. Nine days later, the transfused blood cells died, and nitric oxide depletion occurred again, and convulsions were induced." Yuan Ping'an was very confident in his judgment, and Sun Lien also agreed Yuan Ping'an's opinion—doesn't this coincide with "acute hemolysis, hemolytic anemia" in the status bar?
"Add a coagulation function test. If the coagulation time becomes shorter, then transfuse two units of suspended red blood cells first." Sun Lien asked Liu Pingchuan for instructions, "I think what Dr. Yuan said makes sense."

Erythrocytes contain esterase, which acts as a coagulant in the coagulation pathway.If the patient is hemolyzed, the clotting time must also change.At this time, doctors have to weigh and consider whether to supplement suspended red blood cells first to correct anemia, or to inject anticoagulants to prevent thrombosis.

Starting from Yuan Ping'an's diagnosis, of course the suspended red blood cells should be supplemented first - after the red blood cells increase, the nitric oxide in the body can be quickly replenished.This is also a very effective measure to relieve Zhanhao's smooth muscle spasm.

"The doctors in the Second Hospital are not fools." Liu Pingchuan shook his head lightly, "Xiao Yuan's idea is very good, but it's too easy to confirm this kind of problem. If the Second Hospital hasn't figured out what he got by now disease, then it shouldn’t be so direct.”

Although the Second Central Hospital is not as good as the First Central Hospital and the Affiliated Hospital of Ningyuan Medical College in terms of strength and reputation, it is still an excellent hospital ranked among the top ten in the province in terms of comprehensive capabilities.The reputation and strength of the hospital are not the result of repeated bombardment by advertisements.This is the affirmation that all doctors, nurses, auxiliary departments, and other staff have worked hard together for more than ten years in a hospital from top to bottom.It is the commendation and trophies obtained by doctors fighting against diseases.

Although the doctors of the Fourth Central Hospital usually look down on the Second Hospital, especially the way they cry and rob food.But to be honest, these colleagues do have two talents.

What's more, the Fourth Central Hospital has been thinking about rubbing the second hospital on the ground. If the level of the second hospital is in a mess, wouldn't it be blackmailing itself from another angle?
Liu Pingchuan's attitude is relatively more peaceful, anyway, doctors from the same association, everyone is like that.Therefore, Vice President Liu directly pointed out the logic problem in Yuan Ping'an's diagnosis - if it were really that simple, how could the Second Hospital fail to diagnose it?
Sun Lien's opinion is different, Zhan Hao must have hemolytic anemia.The status bar has already told him this directly.But the question is, what is the cause of the hemolysis.After all, hemolytic anemia, like central nervous system demyelination, is just a description of symptoms.To cure Zhan Hao, the key is still to find the cause.

"New inspection results." Xiao Guo became the busiest errand runner in the entire emergency room. He ran all the way back to the conference room with the results he had just printed out, and handed the inspection report to Sun Lien.

"ALT (alanine aminotransferase) 196U/L, TB (total bilirubin) 64μmol/L." Sun Lien quickly saw two abnormal values, "There is no problem with the diagnosis of acute liver injury."

"Another hospital used GSH (reduced glutathione) in the treatment, which is also a symptomatic treatment." Dr. Pascal rubbed his chin.He narrowed his eyes and said, "There's nothing wrong with their treatment."

Liu Pingchuan thought for a while, "Then we will continue the treatment." He leaned back and pondered, "If everything in the Second Hospital is done correctly, why did the patient suddenly get sick after being transferred to us?"

"The most reasonable explanation is that something in the Second Hospital is wrong, or they haven't done enough." Yuan Pingan seems to have no problem with being picked on for his diagnosis.However, he still looked down on the Second Hospital, "If they do everything well, then this patient must not stop at our Fourth Hospital, right?"

"I'll go to the laboratory to check the situation." Sun Li'en pondered for a while, and felt that the significance of being here didn't seem to be very great.The content discussed by this group of academic masters has almost exceeded his comprehension.The blood test has not yet come out due to the need to make up a blood smear. He plans to go to the laboratory to see if he can get the first-hand data. By the way, he will pass by Zhan Hao's bed to see if there is anything on the status bar above his head. new change.

However, the fact is disappointing that the status bar does not update anything.But Sun Li'en heard a piece of bad news from Shi Yan.

"This sample has obvious hemolysis. Under the microscope, you can see a lot of reticulocytes and basophilic stippling red blood cells." Shi Yan scratched the back of his head with a pen, looking a little absent-minded, "I suggest making a mechanical Add to the brittleness experiment."

"How long will this take?" Sun Lien asked, "Do you think it's necessary?"

"According to the requirements, this experiment takes at least 48 hours. The appearance of reticulocytes and basophilic stippling red blood cells are signs of anemia. Increased reticulocytes mean that the patient may have proliferative anemia or hemolytic anemia. According to the samples, it should be hemolytic anemia, that’s right.” Shi Yan explained, “However, the possibility of basophilic stippling red blood cells is more likely, such as heavy metal poisoning, organic compound poisoning, hemolytic anemia, Pernicious anemia...Anyway, there are many reasons for this. If you want to find out the direction, you must first determine the cause of hemolysis."

"I'm also worrying about this." Sun Li'en spread his hands helplessly, "This patient is Zhan Jun's brother. When I went to his shop yesterday, he was still asking me about my recovery..."

"Rehabilitation?" Shi Yan frowned, "Why is it related to rehabilitation again? Isn't this a hemolytic anemia?"

"There are also symptoms of central nervous system demyelination." Sun Li'en roughly talked about the situation with Shi Yan, "At first, the second hospital thought that the acute abdomen was caused by acute hepatitis, and they felt that the situation had been brought under control. I guess I might focus on weakening the muscles of the lower limbs in the future, right?"

Shi Yan shook his head and said, "Then when Zhan Jun sent his brother to our fourth courtyard, you put all your energy on hemolysis?"

Sun Li'en was about to refute, but suddenly felt something was wrong.This is a very subtle feeling, so subtle that he needs to think sideways without saying a word.

"It's not just hemolysis..." Shi Yan didn't see Sun Lien's expression and movements clearly through a layer of glass, and thought that this guy was criticized to the point where he had nothing to say, so he fell silent.Unexpectedly, I just said five words, but Sun Lien said in exchange, "Shut up!"

Shi Yan touched his nose and remained silent.He could see that Sun Li'en seemed to be thinking hard about something.When Sun Lien lived together in the dormitory before, if this happened to Sun Lien, it was because he was struggling with some difficult problems, and he might have grasped the clues to solve the problems.It's best not to bother him at this time.

"No... I still can't figure it out." After working hard for a while, Sun Lien shook his head and sat down.He seemed to have grasped an important point just now, but when he really wanted to go back and pull out this important point, he couldn't even think of what the important point was.Sun Li'en scratched his hair in frustration, and even wanted to blame Shi Yan for interjecting inappropriately.

Shi Yan came out from the inspection window, and brought out a round lift chair with wheels, "It's normal if you can't figure it out. You're just a little regular trainer, and you're not Conan's reincarnation. You can figure it out with a flash of inspiration." The details of everything." Although the words were mocking, the core content was to appease.

"Let's do the mechanical fragility experiment." Sun Lien shook his head and stood up, "Under the current situation, it would be good to have one more reminder."

"Actually, you should first think about what is the cause of this patient's hemolysis." Shi Yan stood up and walked back towards the door of the Laboratory Department. "There are usually only a few reasons for hemolysis, mechanical hemolysis, osmotic pressure Change hemolysis, microbial hemolysis, and toxic hemolysis.” He slowly wandered into the laboratory, “Only by finding out the cause of hemolysis can we diagnose what disease he has, right?”

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Twelve hours passed, and Zhan Jun was busy opening the store and taking care of his son, so he was not in the hospital.In addition to Dr. Pascal and Liu Pingchuan, the rest of the treatment group never left the hospital.Even lunch and dinner are settled by takeaway.

"Continuing on like this is not an option." Xu Yourong stood up and stretched, she looked at the diagnostic content that was drawn on the whiteboard and then crossed out, "I'll go out and get some fresh air."

Yuan Pingan took the opportunity to announce that he was going to the bathroom, while Zhou Ce was even more straightforward, "I'll go back and take a shower, and I'll come back after changing clothes."

The members of the treatment group left one after another, leaving only Sun Li'en stubbornly standing silently in front of the whiteboard.He also really wanted to just let it go and leave it alone for the time being, but as the "head" of the treatment group, everyone else could go first, but Sun Li'en himself absolutely couldn't.

If even he gave up, who would heal Zhan Hao?

Hu Jia approached quietly from behind and hugged Sun Li'en.She had been standing at the door of the small meeting room for almost half an hour.When Xu Yourong went out, she walked in quietly.

Sun Lien was taken aback by Sun Li'en who was hugged suddenly, and he was slightly relieved when he turned around and found that it was his girlfriend.He lifted his right hand up a little smoothly, stroked Hu Jia's head and rubbed it, "Why are you here?"

"Come and see my Director Sun." Hu Jia saw that there was no one else in the small meeting room, so he leaned forward and kissed him openly.Then he looked at the whiteboard curiously and asked, "Is this patient troublesome?"

"Yesterday you also heard what Zhan Jun said." Sun Li'en said with a wry smile, "It took nine days at the Second Hospital, but we didn't even know what disease he had. If we could figure it out right away, wouldn't that be abnormal? "

Hu Jia roughly glanced at the whiteboard, which listed several possible causes of hemolysis according to their guesses.Then basically every possible reason was crossed out by a horizontal line.

"Thanks for your hard work." Hu Jia rubbed Sun Li'en, and then asked, "Are you going to work overtime tonight?" After finishing speaking, she took out a small stewing pot from behind. "This is the preserved egg and lean pork porridge I made at noon. It's for you as a midnight snack."

"I'm just hungry." Sun Li'en replied very brazenly. In fact, he was thinking about the diagnosis, not to mention wanting to eat. Now he couldn't even tell whether he was hungry or not.

"Originally I had some meat marinated and wanted to bring it to you. But the coating on the inside of the insulated box I used to use fell off. I was worried that it might not be good if you ate it..." Hu Jia said a little embarrassed, she Originally, there were a lot of meat dishes such as pig's trotters, but they didn't bring them over.While explaining, Hu Jia secretly made up his mind that he must go to the supermarket to buy a new set of insulation boxes later.

Sun Li'en was taken aback for a moment, then again.The expression on his face ranged from a smile to a frown.

"What's wrong?" Hu Jia couldn't help but feel a little worried when he saw his boyfriend's face changed like a face change.Unexpectedly, Sun Li'en hugged Hu Jia, and laughed loudly while hugging him, "Honey, you are really a genius!"

(End of this chapter)