I can see the status bar

Chapter 299

The first possibility that Sun Lien can think of is the coordinate system.Three points seem to just constitute the XYZ three-axis coordinate system.And these coordinate systems may directly point to the areas and organizations involved in the state.But this conjecture was quickly refuted by himself—the first group of numbers for common iliac vein thrombosis was 78, while left lower extremity popliteal vein thrombosis was 73, and stroke was 05.If numbers were a coordinate system, it shouldn't appear that the coordinates of both the head and the legs are lower than the common iliac vein below the lower abdomen - this is illogical.

Could it be something else?Those who meet the three sets of numbers... Sun Lien sat on the stool and began to scratch his head. All of them had only numbers but no letters. This is not an ICD10/11 disease code.The most important thing is that Sun Lien does not think that these numbers may be some kind of password that needs to be interpreted additionally - the status prompted in the status bar is all clues that are directly related to the patient's current disease. Since they are clues, there is no point in adding a password system.

"The result you want." Sun Lien was scratching his head, but Shi Yan came out of the laboratory.Another inspection report was thrown at Sun Lien's face. "Coagulation is normal."

"Normal?" Sun Lien was dumbfounded when he heard the result, "How is it possible?"

"What's impossible?" Shi Yan was very confident in the results he urged, "This is the result of the experiment, and we are responsible for every sample!"

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"It turned out." Sun Li'en was staring at the blood clotting time, but he was in a daze, and the baked gluten in his pocket sang again.On the other end of the phone, Xu Yourong said calmly, "There are multiple blood clots."

"There's no blood clot, right..." Sun Li'en hadn't gotten over the normal blood clotting time test results, and Xu Yourong's tone was so calm that he completely misheard the content.

"There are multiple blood clots." Xu Yourong re-emphasized, "Is your ear okay?"

Sun Li'en suddenly regained his spirits, "Apart from deep vein thrombus, where else is there thrombus?"

"There is an ischemic lesion in the small intestine on CT, and there may be ischemic necrosis. But the specific situation may need to be opened to find out." Xu Yourong replied, "It seems that there is also an ischemic lesion in the brain, which is located in the thalamus. But the whole body Tongmai CAT did not find sclerotic plaque."

Without hardened plaque, it is not cerebral arterial embolism caused by arteriosclerosis.But the clotting time is normal, so it shouldn't be a thrombus—especially in the absence of pulmonary embolism, it is impossible for a thrombus to skip the lungs and enter Xia Hongyuan's brain directly.

"Understood." Sun Lien rubbed his face in pain, "Take the patient back to the emergency room first, and I'll call for a consultation."

A strong sense of powerlessness lingered in Sun Lien's heart.He originally thought that with the status bar, he would be able to move forward indomitable from now on, and all kinds of strange diseases could be easily caught.But now he realized that he was a little too wrong.Even though he had done so many tests, he still had no clue. He didn't even know what kind of disease Xia Hongyuan had - was it an autoimmune system disease, or was it caused by an infection?Sun Lien had no idea at all.

Having no idea means that when he calls experts from other departments for consultation, he needs to invite more doctors from more departments to try his luck.Instead of having a general suspicion interval as before, and then inviting experts from the corresponding department.

Doctors from the Department of Hematology, Interventional Surgery and General Surgery came to the emergency room.

"My suggestion is to continue to stay in the hospital for observation." The doctor of the Department of Hematology first expressed his opinion, "Coagulation dysfunction may fluctuate, and a test is normal, but the patient has obvious hypercoagulation, which is absolutely necessary to stay in the hospital observed."

"This case of stroke is not a large blood vessel embolism, and mechanical thrombectomy is basically impossible." The doctor in the interventional department looked at his own one-third of an acre of land, "You can consider doing intravenous thrombolysis, and the deep vein thrombosis can be mechanically removed From the results of CTA, the patient's deep vein thrombosis is not too large, and there is no free thrombus."

The attitude of the general surgeon is rather frustrating, "The patient's deep venous thrombosis is too close to the renal vein, so the operation of placing the filter is no problem, but the effect is not necessarily good, and it is difficult to guarantee that there will be no thrombus falling off during the operation. Since The interventional department suggested thrombolysis, so it is better to simply treat conservatively, with anticoagulation and thrombolysis as the main method.”

The doctors from the three departments all put forward their own opinions on the patient's condition, but there was nothing about the diagnosis that Sun Lien wanted to know the most - what disease did Xia Hongyuan suffer from?

"Let's prepare according to thrombolytic therapy. How soon will the interventional operating room be ready?" Facing the doctors in these three departments, Sun Lien decided to treat the symptoms first after a long consideration.At least Xia Hongyuan's cerebral infarction should be relieved first, and his deep vein thrombosis should be treated through mechanical thrombectomy.

"Take the green channel, and it will be ready within 10 minutes." Doctors in the interventional department attach great importance to Xia Hongyuan's condition, and they are indeed the best department to deal with deep vein thrombosis and cerebral infarction when the patient's blood coagulation function is normal. "I'll let the operating room prepare it now."

"I'm going to ask the family members for signatures." Yuan Ping'an took on the responsibility of a subordinate doctor very consciously, and even without Sun Lien's initiative, he took the treatment consent form to Xia Hongyuan's parents to sign.

The doctors from the Department of Hematology and General Surgery left immediately, and only Sun Li'en and Xu Yourong were left in the small conference room.Xu Yourong was sitting on the seat looking at the information, and suddenly asked Sun Li'en, "You still haven't figured out what disease he has?"

Sun Lien smiled wryly and nodded, "This is the most incomprehensible thing for me—what kind of magic did his thrombus cast to make it go from the deep vein, bypass the pulmonary circulation system, and go directly into his brain." Sun Lien really I don't understand, and he doesn't even intend to continue to dwell on how people with normal coagulation function get deep vein thrombosis.

"The thing I can't figure out is different from yours." Xu Yourong closed the laptop in front of him and frowned, "A physical education teacher who runs around every day doesn't look like DVT (Deep Vein Thrombosis) The high-risk group—he is not an otaku who sits in front of the computer and plays games all day long."

"The three major factors of DVT are slow blood flow, damage to the vein wall, and hypercoagulable state." Xu Yourong continued, "A national first-class athlete has very normal cardiopulmonary function. And the usual work requires frequent exercise, so it is unlikely to be Blood flow is slow. Vein wall damage has been ruled out by CTA, and hypercoagulable state is even less plausible—his clotting time is normal."

"If there are only three possible causes of this condition, and all three are ruled out, then either there is a cause of DVT that we have never identified, or some of these three states have occurred after causing the patient's DVT. Change." Sun Lien frowned, and continued following Xu Yourong's train of thought, "The probability of a new cause of the disease is too small to be considered for now. The damage to the vein wall will not heal itself so quickly, the slow blood flow and his daily life Work and life are not compatible, so he must have had a hypercoagulable state?"

Speaking of this, Sun Li'en suddenly had a flash of inspiration.If Xia Hongyuan had been in a hypercoagulable state for a long time, then it would be quite normal for him to have a thrombus in his brain. It is not only the deep veins of the lower extremities that can produce thrombus. It is also possible to form a blood clot directly in the blood!
Xia Hongyuan's cerebral thrombosis was not caused by deep vein thrombosis, but caused by systemic hypercoagulable state!
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Compared with traditional surgical operations, the operations performed by the interventional department are characterized by less trauma and faster speed.To be honest, before the interventional department was born, it was simply impossible to perform craniotomy to exclude thrombus and perform DVT treatment on the leg at the same time.The interventional department only needs to insert one implant sheath into the patient's left femoral vein and right femoral artery respectively, so that two operations can be performed at the same time, and the trauma left is only two slightly larger pinholes.It has to be said that the differences in the performance of scientific and technological progress in medicine are indeed very obvious.

An hour later, Xia Hongyuan's interventional treatment ended.The effect of thrombolysis in the brain was obvious, and both lower extremity venous thrombi were removed.But the follow-up work was not over yet, and the removed thrombus was sent directly to the pathology department for pathological testing.Sun Lien hopes that the pathology department can clarify the nature of the emboli, which will make subsequent diagnosis easier.

And Sun Lien found his strongest helper.

"Well... such a complex and changeable condition, such a troublesome situation, really feels like an autoimmune disease." Dr. Pascal made a not-so-funny joke. "CAT confirms that there is no thickening of the vessel wall?"

Sun Li'en nodded, "I used this result to rule out blood coagulation caused by vasculitis, but I really can't think of any other diseases that can cause such multiple thrombus under the condition of normal blood coagulation function."

"We haven't been able to confirm that this is a thrombus." Dr. Pascal corrected Sun Lien's statement, "Before the results of the pathology department's examination come out, we can only think that the possibility of a thrombus is the greatest."

After correcting Sun Lien's statement, Dr. Pascal frowned, "Do a check for autoimmune diseases, first look at his antibody status."

"I just asked the operating room to take a sample, a blood sample taken before thrombolytic therapy." Sun Lien replied, "Including the latest blood routine and coagulation status, the results should come out soon."

"I bet you." Dr. Pascal said with a smile, "This blood sample must be in a hypercoagulable state."

Sun Lien was taken aback when he heard the words, he couldn't figure out why Dr. Pascal was so confident.

"You forgot a very important reason that affects blood coagulation." Dr. Pascal smiled. He was actually a little disappointed. After all, in the previous cases, Sun Lien noticed this difference in time and made a correct diagnosis .But this time he didn't seem to realize the existence of this variable at all.

"Body temperature. Don't forget, when he was admitted to the hospital, his body temperature was only 33 degrees." Dr. Pascal shook his head, "The low temperature will reduce the number of platelets and reduce the coagulation function. You took samples to check the coagulation function shortly after he was admitted to the hospital." , the result is normal. In other words, when his body temperature is normal, he should be in a hypercoagulable state."

(End of this chapter)