I can see the status bar

Chapter 300 The Truth
Sun Lien felt a little ashamed.Body temperature is the basic value of the human body. Like heart rate, blood pressure and blood oxygen, it is the focus of doctors' first attention.However, due to the special way of maintaining body temperature of warm-blooded animals, the measured value often lags behind the actual situation of the body.During the "nonsense" several times before, Sun Lien did use body temperature as the reason to explain the patient's symptoms.The explanations that are always invincible in the past, but when they can really come in handy, I forgot.

It has to be said that Dr. Pascal's eyes are very sophisticated and vicious, and he can see the root cause of the difference between the test results and the facts at a glance.

"Your excellent diagnostic skills and your current professional position are actually a kind of deep misfortune." Dr. Pascal patted Sun Lien's shoulder sympathetically, "Other young doctors at your age are still Keep making mistakes and learning. Unlike them, it doesn’t matter if they make mistakes. After all, no hospital will let them be responsible for the life and death of patients. But you are different. You are now leading many famous people, including me. Doctor, you are responsible for complex cases that other senior doctors cannot handle, and if these patients cannot be handled by you, they can only be transferred to higher-level hospitals.”

Listening to Dr. Pascal's words, Sun Li'en suddenly felt that he was under a lot of pressure.

"So, you can't make mistakes." Dr. Pascal's eyes became sharper. "Other young doctors can make mistakes, other senior doctors can make mistakes, even I can make mistakes. But you can't. The patients who need to be taken over by our treatment team are patients who have no other access to care, and The situation is often very serious. If someone else makes a mistake, the patient can be handed over to you, but if you make a mistake, the price you pay may be the patient's life."

Sun Lien was silent for a long time, then raised his head and said, "I can't guarantee that I will never make mistakes, but I promise that I will do my best to avoid mistakes."

"In the future, you should not only pay attention to whether you will make mistakes, but also pay attention to the position of the viewing angle." Dr. Pascal nodded with satisfaction, and then continued, "You are not only a person fighting alone, you are also a member of the treatment group. Leader. Apart from doing it yourself, you should also rely on the professional ability of the team members."

Sun Lien nodded honestly, anyway, Old Pa is not so much his subordinate, but rather the supervisor Xu Yourong invited for him.Experienced, has a wealth of teaching experience, and most importantly - has a straight-talking personality.If you switch to another doctor, you may have a lot of concerns because of the relationship between the team leader, or because you are not familiar with the so-called "working atmosphere".

Although it is always uncomfortable to be clearly pointed out that mistakes are made, Sun Lien is also very clear that these are valuable experiences that cannot be bought.For Pascal, who would rather give up his life in the United States, but also to come to China to carry out research to treat diseases and save lives, Sun Lien could not feel any resentment, but admired this ginger-red haired semi-bald old man from the bottom of his heart.

"Then, knowing that his blood coagulation condition is abnormal, we can know that there are some serious problems with his body." Sun Lien reorganized his mood and started his own diagnosis. "First of all, it is certain that the thrombus has affected his brain and small intestine. And his deep veins of the lower extremities have also developed thrombus. Although we have removed a large thrombus through interventional therapy, if the blood coagulation problem is not solved, he will die. Still continue to be at risk of embolism."

"Two organs are involved at the same time, but the most vulnerable lungs and heart have not been affected." Dr. Pascale nodded, "It should be said that he is still very lucky."

"Then the next question is how poor the coagulation function is and why coagulation disorder occurs." Sun Lien frowned and thought for a moment, then suddenly picked up the phone, "Dr. Yuan, give Xia Hongyuan a routine urine test. Find out about his kidneys."

"The investigation has been completed." Yuan Ping'an's voice on the other end of the phone sounded very serious, "The situation is not very good, he has a cast urine."

Casts are cylindrical protein aggregates formed by the condensation of proteins, cells, and cell debris in renal tubules and collecting ducts.The cast is an important component in the urine sediment, and its appearance means that the patient has suffered renal parenchymal damage, which means that the patient's glomeruli or renal tubules have been damaged.

"When did you take the sample?" Sun Lien immediately stood up from his seat and walked quickly towards the emergency room.Renal parenchymal damage had not previously appeared in the patient's status column.This is a new symptom.

"I took the sample when Lao Pa entered the emergency room." Yuan Ping'an replied, "Probably less than 5 minutes?"

Sun Lien bypassed the busy medical staff in the emergency room, and rushed to Xia Hongyuan's side quickly.

"Xia Hongyuan, male, 26 years old, left pre-tibial blood blister (74.26.28), ischemic necrosis of small intestine (53.58.41), ischemic acute kidney injury (00.14.36)." Xia Hongyuan's status bar changed drastically, Most notable, however, were the emerging indications of kidney injury, and the two sets of numbers that changed.

After Sun Lien was stunned for a while, he saw Yuan Pingan who hurried back to the emergency room.

"It's not the coordinates..." Although Sun Lien saw Yuan Ping'an, his attention was on the change he had just discovered. "Those numbers are not coordinates, but time!"

Yuan Pingan looked at Sun Lien with blank eyes, and patted his arm worriedly, "Doctor Sun, you..." He was about to ask if Sun Lien was uncomfortable, but this action suddenly made Sun Lien turn his back Come on.

"Follow me!" Sun Li'en was as energetic as an electric doll that had suddenly been replaced with a fully charged battery, and led Yuan Ping'an into the small meeting room swiftly.He didn't even have time to say anything to Dr. Pascal, but rushed to the whiteboard in the small conference room and started recording the symptoms.

First, there was left common iliac vein thrombosis, followed by popliteal vein thrombosis, and soon, blood blisters appeared, followed by ischemic necrosis of the small intestine.Until the occurrence of stroke, and now acute kidney injury.A schedule appears on the whiteboard.

"His left common iliac vein had a thrombus first, and this thrombus slowed down the blood return of the entire left lower extremity, and a popliteal vein thrombus occurred." Sun Lien talked about his discovery to the doctors present, "We already know that, The blood blisters appeared at least three days ago. That is to say, the thrombosis in the veins of the lower extremities must have occurred three days ago-the venous return disorder of the lower extremities is the cause of the blood blisters."

Sun Li'en's explanation was very convincing, Dr. Pascal and Yuan Ping'an both nodded.

"And even without a CT scan, I can be sure that the length of ischemic necrosis of the patient's small intestine is not too large. After all, more than two days after the onset of abdominal symptoms, he can still go to work." Sun Lien continued, "From this It can also be proved in reverse that the cause of ischemic necrosis of the small intestine is not the insufficient blood supply of the small intestinal artery, or the blockage of the channel connecting the small intestinal vein to the hepatic portal vein, it must be capillary blockage."

"Until the patient developed symptoms of stroke. We have already resolved this through interventional surgery." Sun Lien drew two large circles on the whiteboard, circling the two symptoms of ischemic necrosis of the small intestine and stroke.Then I drew a triangle after two deep vein thrombosis with a pen.

"I don't know if you have noticed that the abnormal coagulation of the patient before admission includes both large blood vessels and small blood vessels?" Sun Lien said his findings. "And just now, we confirmed that the patient had casturia, that is to say, even after two deep vein thrombosis were removed through surgery and anticoagulant treatment was also performed, the patient's kidneys were still acutely injured."

Yuan Ping'an's eyes lit up, "You mean to say that kidney damage is also ischemic?"

"If yes." Sun Li'en did not answer the question directly, but continued following Yuan Pingan's hypothesis, "That is the third case of abnormal coagulation of small blood vessels within two days, and the third organ was involved."

Dr. Pascale stood up with a stern face, "This is CAPS, Catastrophic antiphospholipid-antibody syndrome. (Catastrophic Antiphospholipid Syndrome)"

(End of this chapter)